Article

Recurrent massive hemoperitoneum due to ovulation as a clinical sign in congenital afibrinogenemia

Department of Obstetrics and Gynecology, Ankara University Medical Faculty, Ankara, Turkey.
Acta Obstetricia Et Gynecologica Scandinavica (Impact Factor: 1.99). 02/2011; 90(2):192-4. DOI: 10.1111/j.1600-0412.2010.01034.x
Source: PubMed

ABSTRACT Massive hemoperitoneum due to ovulation is a rare but serious and life-threatening complication for women with coagulation disorders, and may lead to surgical interventions and even oophorectomy. Congenital afibrinogenemia is an uncommon coagulation disorder usually discovered during childhood. Intraabdominal bleeding due to ovulation is very rare in these patients and only a few cases of corpus luteum rupture and hemoperitoneum in afibrinogenemic patients have been described. In all women, the diagnosis was known since childhood. We report on a 24-year-old woman with congenital afibrinogenemia with recurrent massive intraabdominal bleeding due to ovulation as the presenting clinical sign. Exploratory laparotomy and excision of the ruptured follicle was performed at the first bleeding episode; the second episode was managed with fresh frozen plasma and blood transfusions. Conservative management is crucial for these patients. If surgery cannot be avoided, a conservative surgical approach should be chosen to preserve ovarian function.

Download full-text

Full-text

Available from: Emre Pabuccu, Aug 26, 2014
1 Follower
 · 
111 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We have invented a method of hysterectomy prevention called the uterine hollow obliteration (HYUNHO) method to preserve the uterus and fertility after treating placenta previa or accreta. Eighty patients underwent cesarean section because of placenta previa between January 2003 and December 2009. All patients eligible for the study were evaluated by followup and a telephone questionnaire about fertility, menstruation recovery, and complications. The success rate on preserving the uterus with the HYUNHO method was 96.2%. Three cases required additional procedures, including a cesarean hysterectomy or uterine artery embolization (UAE), two cases underwent a cesarean hysterectomy after delivery, and one case underwent UAE. The HYUNHO method is a safe, easy method for placenta previa, although it should be evaluated in a randomized controlled trial.
    Clinical and experimental obstetrics & gynecology 01/2012; 39(4):462-5. · 0.36 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Endometrial osseous metaplasia is a rare clinical entity. It causes infertility and occurs in more than 80% of cases after an abortion. Various theories have been proposed and the most accepted theory is metaplasia of the stromal cells into osteoblastic cells that produce bone. This disease may be misdiagnosed. However once diagnosed, the complete removal of bone spicules by hysteroscopy allows, in most cases, fertility to be restored. We present the case of a 36-year-old patient nulliparous with a history of abortion for eight years who consulted May 5, 2008 to become pregnant. Detailed examination showed chronic endometritis with bone metaplasia as a possible cause of her infertility. Seven months after complete removal of bone fragments by hysteroscopy, the patient had a spontaneous pregnancy with normal development. She gave birth to a male infant weighing 3,000 g with an Apgar score of 9 at 1 and 5 min. Delivery and postpartum were normal.
    Clinical and experimental obstetrics & gynecology 01/2012; 39(4):559-61. · 0.36 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Leimyomatosis peritonealis disseminata (LPD) is a benign tumor of smooth muscle tissue. It is rare and is characterized by the development of multiple peritoneal nodules mimicking peritoneal carcinomatosis. We report a case of LPD diagnosed in a 35-year-old patient, G4/P1, without any major gynecological history. The patient underwent an elective cesarean section at 42 weeks, during which numerous peritoneal nodules ranging in size from 0.1 to 0.5 cm were found. Microscopic examination showed a proliferation of smooth-muscle cells without mitosis or atypia or necrosis.
    Clinical and experimental obstetrics & gynecology 01/2012; 39(4):541-3. · 0.36 Impact Factor