Pages 46-50

Abstract

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Keywords

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Servikal Kanalı Kapatan Myoma Uterili bir Missed Abortus Olgusunda Histerotomi ile Gebelik Tahliyesi ve Eş Zamanlı Myomektomi

Abstract

Uterus myomları 30 yaşın üzerindeki kadınların %20-50’sinde görülebilen benign tümörlerdir. Tüm gebeliklerin yaklaşık % 1.4-8.6’sında uterin myomlar görülür. Çoğunlukla uterus fundus ya da gövdesinde yerleşen myomların yaklaşık % 3’ü servikstedir. Submüköz ve subendometriyal myomlar nadiren endometriyumu aşarak endometrial kanal içine bir pedikülle birlikte uzayabilirler. Bu duruma gebelik de eşlik ediyorsa hastaların normal spontan vajinal yol ile doğurmaları zor veya imkânsız hale gelebilmekte ve birçok komplikasyonu beraberinde getirebilmektedir. Bu yazıda ultrasonografik olarak servikal kanalı kapatan myoma uterili bir missed abortus olgusunda histerotomi ile gebeliğin sonlandırılması ve eş zamanlı myomektomi işlemi sunulacaktır

Keywords

• Missed abortus, myoma uteri, myomektomi

References

1. Li TC, Mortimer R, Cooke ID. Myomectomy: a retrospective study to examine reproductive performance before and after surgery. Hum Reprod 1999;14(7):1735-40.
2. Phelan JP. Myomas and pregnancy. Obstet Gynecol Clin North Am 1995;22(4):801-5.
3. Burton CA, Grimes DA, March CM. Surgical management of leiomyomata during pregnancy. Obstet Gynecol 1989;74(5):707-9.
4. Kutteh WH. Antiphospholipid antibody associated recurrent pregnancy loss: treatment with heparin and low-dose aspirin is superior to low-dose aspirin alone. Am J Obstet Gynecol 1996;174(5):1584-88.
5. Cicero S, Spencer K, Avigido K, Faiola S, Nicoloides KH. Maternal serum biochemistry at 11-13(+6) weeks in relation to the presence or absence of the nasal bone on ultrasonography in chromosomally abnormal fetuseus: An update analysis of integrated ultrasound and biochemical sreening. Prenat Diagn 2005;25(11):977–83.
6. Robinson WP, Bernasconi F, Dutly F, Lefort G, Romain DR, Binekert A, et al. Molecular studies of translocation and trisomy involving chromosome 13. Am J Med Gen 1996;61(2):158-63.
7. Boivin JF. Risk of spontaneous abortion in women occupationing exposed to anesthetic gases; A meta –analyses. Occup Eviron Med 1997;54(8):541-8.
8. Klebanoff MA, Levine RJ, DerSimonian R, Clemens JD, Wilkins DG. Maternal serum paraxantine, a caffeine metabolite, and the risk of spontaneous abortion. N Engl J Med 1999;341(22):1639-44. .

9. Schorge JO. First –trimester abortion. In: Schorge JO, Schaffer JI, Halvorson LM, Hoffman BL, Bradshaw KD, Cunningham FG (Eds). Williams Gynaecology. New York: McGraw-Hill; 2008.
10. Devi Wold AS, Pham N, Arici A. Anatomic factors in recurrent pregnancy loss. Semin Reprod Med 2006;24(1):25-32.
11. Buttram VC, Gibbons WE. Mullerian anomalies: a proposed classifıcation (an analysis of 144 cases) Fertil Steril 1979;32(1):40-6.
12. Bunram VC Jr., Reiter RC. Uterin leiomyomata: etiology, symptomatology and management: Fertil Steril 1981;36(4):433-55.
13. Propst AM, Hill JA 3rd. Anatomic factors associated with recurrent pregnancy loss. Semin Reprod Med 2000;18(4):341-50.
14. Ventolini G, Zhang M, Gruber J. Hysteroscopy in the evaluation of patients with recurrent pregnancy loss. Surg Endosc 2004;18(12):1782-84.
15. Dendrinos S, Grigoriou O, Sakkas EG, Makrakis E, Creatsas G. Hysteroscopy in the evaluation of habituel abortions. Eur J Contracept Reprod Health Care 2008;13(2):198-200.
16. Cogendez E, Dolgun ZN, Sanverdi I, Turgut A, Eren S. Post-abortion hysteroscopy: a method for early diagnosis of congenital and acquired intrauterine causes of abortions. Eur J Obstet Gynecol Reprod Biol 2011;156(1):101-4.
17. Egarter C, Lederhilger J, Kurz C, Karas H, Reisenberger K. Gemoprost for first trimester missed abortion. Arch Gynecol Obstet 1995;256(1):29-32.
18. Gronlund A, Gronlund L, Clevin L, Andersen B, Palmgren N and Lidegaard O. Management of missed abortion: comparison of medical treatment with either mifepristone + misoprostol or misoprostol alone with surgical evacuation. A multi-center trial. Acta Obstet Gynecol Scand 2002;81(11):1060–65.