Difficulties and Errors of Differential Diagnostics Androgen-Secreting Tumors of the Addrum and Ovary on The Example of Clinical Case. Results of Treatment

Gynecology and Womens Health

The goal is to analyze the possibilities of differential diagnostics of androsteroma and virializing ovarian tumors and to analyze the case of erroneous adrenalectomy. A patient of 57 years with ovarian virilization was removed the adrenal gland. Hypotestosteronemia persisted. It was proposed to remove the second adrenal gland, the patient refused only after 5 years.

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Case Based Discussion of Surgical Approach to Deep Infiltrating Endometriosis

Gynecology and Womens Health

Endometriosis presents a diagnostic challenge as clinical symptoms do not correlate well with the extent of disease [1]. Cramer, et al. [2] found that menstrual cycle length shorter than 27 days, menses longer than 7 days and severe cramping dysmenorrhea were predictive of endometriosis with relative risks of 2.1 (95%CI 1.5-2.9), 2.4 (95%CI 1.4-4.0) and 6.7(95%CI 4.4-10.2) respectively. The study compared 268 women with infertility and laparoscopically confirmed endometriosis with 3794 women admitted for delivery (controls) using a retrospective questionnaire. The study was limited by recall bias and the criteria for laparoscopic diagnosis were not clearly defined. No significant correlation was found with chronic pelvic pain. The issue has been studied prospectively [3,4] in 134 women scheduled for laparoscopy for chronic pelvic pain (CPP). Dyschezia, dyspareunia, and non-menstrual pain were all identified as predictors of deep infiltrating endometriosis (DIE) with odds ratios of 3.9 (95%CI 1.7-8.9), 4.6 (95%CI 1.5-14.2) and 2.5 (95%CI 1.1-5.6) respectively. Mrs. SF presented with all of these symptoms to a greater or lesser extent. One criticism of Chapron’s study is that the diagnosis was made on laparoscopic appearance without histological confirmation. Visualization alone has been shown to have a positive predictive value (PPV) for endometriosis of 45% and up to 36% of lesions were down staged on histology [5].

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Maternal and Perinatal Outcome Among Pregnant Women with Thrombocytopenia Attending Ibrahim Malik Teaching Hospital- Sudan

Gynecology and Womens Health

Thrombocytopenia is encountered in 7-8% of all pregnancies. Thrombocytopenia is second to anemia as the most common hematological abnormality during pregnancy [1- 2]. Thrombocytopenia is defined as a platelet count below 150 x109/L, caused by accelerated platelet destruction or decreased production. It is classified as mild with a platelet count of 100–150x 109/L, moderate at 50–100 x109/L, and severe with less than 50x 109/L [3-4]. In normal pregnancies 7.6% of women present with mild thrombocytopenia and 65% of them will not be associated with any pathology [5]. The most causes of thrombocytopenia during pregnancy were gestational thrombocytopenia about 8% of all pregnancies and accounts for more than 75% of cases of thrombocytopenia in pregnancy [3-5]. Platelet counts normalize within 2-12 weeks following delivery. All women with gestational thrombocytopenia had normal platelet counts by the seventh postpartum day [5]. No pathological abnormality for the mother or fetus was noted in gestational thrombocytopenia. Preeclampsia and HELLP syndrome are the second most frequent cause of thrombocytopenia in late second and third trimester, accounting for 21% of cases of thrombocytopenia at the time of delivery.

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The Mechanism of Single Progesterone as Add-Back Therapy to GnRH-a Administration

Gynecology and Womens Health

Endometriosis (EMS) is a common estrogen-dependent gynecological disorder, which affects quality of life and fertility of productive-aged women [1]. Current treatment of EMS is mainly based on surgery and post-operative maintenance treatment of ovarian suppressive agents. A major challenge for women with EMS is the post-operative recurrence [2-3]. Some medical treatments have been suggested for EMS, such as oral contraceptive pills, and gonadotropin-releasing hormone agonists (GnRH-a). GnRH-a is an important treatment modality for EMS, significantly reducing EMSrelated symptoms [4-6].

However, the employment of GnRH-a could reduce the estrogen level, leading to severe peri-menopausal symptoms such as hot flash, colpoxerosis, sexual hypoactivity, and bone loss, which hinders its long-term and extensive application [7]. The perimenopausal symptoms could be solved by the hormone based “addback therapy” [8-10]. As for add-back therapy, three regimens were recommended by Obstetrics and Gynecology Branch of Chinese Medical Association [11].

Hormone Replacement Therapy – Computer Assisted Individualized Approach

Gynecology  and Womens Health

The onset of menopause occurs at around the age of 50.1 Some health issues, including but not limited to cardiovascular disease, metabolic syndromes, osteoporosis, cancer, and cognitive decline, are more prevalent in women in the years that follow. The onset of menopause is an ideal time to institute preventative strategies that increase the quality and length of women’s lives.


The use of hormone-replacement therapy (HRT) has undergone many changes since it was first introduced into clinical practice in the 1940s. At present, the pendulum seems to be swinging back to more acceptance of its use, following a marked reduction in prescriptions after the results of the Women’s Health Initiative (WHI) study were published in the early 2000s. HRT was shown to significantly decrease the incidence of menopausal symptoms, risk of osteoporotic fractures, and improve the overall quality of life. In younger, healthy women (aged 50-60 years), the risk-benefit balance is clearly in favor of using HRT. HRT is not risk-free. An increased risk of stroke with HRT has been reported in several studies.

Assisted Reproductive Technology: Where did the Journey Begin, and where are we Today – A 40-year History

Gynecology and Womens Health

Over the last four decades, significant developments have occurred within the field of assisted reproduction, initially sparked by the birth of Louise Brown in 1978, who will be forever be known as the first human baby born through in-vitro fertilization (IVF) treatment in the world. The first IVF cycle was based on a nonstimulated ovulatory cycle, in which the oocyte retrieval procedure was performed laparoscopically. IVF, however, was already being performed experimentally in animals, namely rabbits, as early as the 1980’s, with the first IVF human pregnancy reported as early as 1973, but unfortunately resulting in a first trimester loss.

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