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Uterine leiomyoma or Fibroid

Uterine leiomyoma or Fibroid

Definition: Most common benign neoplasm of female genital tract composed of smooth muscle and connective tissue that is hormonally responsive (Growth ↑ in pregnancy and ↓ after menopause).
Gross pathology:

Discrete, round, firm, irregularly lobulated and often multiple.
Enlarged uterus
Smooth and white cut surface with whorled appearance
False capsule: pinkish color
Center of tumor is least vascular and likely to degenerate

Risk factors:

Nulliparity
Obesity
Hyperestrogenic state
Black race

Types:

Types
Features

Intramural
Within uterine …

Maternal Rhesus Isoimmunization

Maternal Rhesus Isoimmunization

Alloimmunization (Isoimmunisation) is defined as the antibody response to foreign antigen derived from different individual of the same species. Rh alloimmunization refers to the development antibodies to Rh D antigen. Antibodies may be produced to Rh antigens C,c,D,E, or e but only D is strongly immunogenic.
PATHOPHYSIOLOGY

1st Rh+ve pregnancy: Rh negative mother bearing Rh positive fetus
Feto-maternal bleed: Abortion, Amniocentesis, Antepartum hemorrhage, …

Acute Pelvic Inflammatory Disease (PID)

Acute Pelvic Inflammatory Disease (PID)

Definition: It is the polymicrobial infection and inflammation of the upper genital tract typically involving the fallopian tubes, ovaries and surrounding structures (endometritis, salpingitis, pelvic peritonitis, tubo-ovarian abscess).
Causative organisms:
Primary organisms: Ascending spread of micro-organisms from cervico-vaginal canal

Neisseria gonorrhoeae (1/3rd cases)
Chlamydia trachomats (1/3rd cases)
Mycoplasma hominis (1/10th cases)

Secondary organisms:

Endogenous aerobes: Non-hemolytic streptococcus, E.coli, Group B streptococcus, Staphylococcus
Endogenous anaerobes: Bacteroides, Peptostreptococcus, Peptococcus

Risk Factors:

Young, …

A Short Review of Spontaneous Abortion or Miscarriage

A Short Review of Spontaneous Abortion or Miscarriage

Abortion is defined as the termination of pregnancy, either spontaneously or intentionally:
1. Prior to age of viability (28 weeks) OR
2. < 500 gm birth weight
Common Causes of Spontaneous Abortion (Miscarriage):
A) 1st trimester (GEI)

Genetic factors: Autosomal trisomy, Polyploidy, Monosomy X, Mosaic, Double trisomy
Endocrine disorders: Luteal phase defect (LPD), Thyroid abnormalities, DM
Immunological: Autoimmune (ANAs, Anti-DNA antibodies, Anti-phospholipid antibodies), Alloimmune, Antifetal antibodies (Rh isoimmunization)
Infection …

A Review of Ectopic Pregnancy

A Review of Ectopic Pregnancy

Definition: Implantation and development of fertilized ovum outside the normal endometrial cavity
Sites of Implantation:
1. Extrauterine (98.5%):

Tubal (97%): Ampulla, Isthmus, Indundibulum, Interstitium
Ovarian (0.5%)
Abdominal (1%): Secondary > Primary

2. Uterine (1.5%):

Cervical (<1%)
Angular
Cornual (In bicornuate uterus)
Cesarean section scar

Heterotopic pregnancy: combination of intrauterine and ectopic pregnancy.
Risk Factors:

History of PID (Pelvic Inflammatory Disease)
Tubal/Pelvic surgery
Contraception failure
Previous ectopic pregnancy
History of infertility
IUD (Intrauterine Contraceptive Device)
Previous induced abortion
Tubal endometriosis

The fertilized …

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