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Re: uterine adhesions to post per. wallFrom: Farouk Fikry (farouk2@menanet.net)Wed Mar 23 14:28:15 2005
Dear Dr. Khaled, This is a rare case. Endometriosis was expected to improve with the occurrence of pregnancy. I think what you can do now is to wait till 16 weeks pregnancy, do laparotomy try to correct the impacted uterus if need remove any adhesions or cysts. good luck Dr. Farouk Fikry
> ----- Original Message ----- Hi all I have a case that I've known for some time, She is a case of diagnosed endometriosis. I did her adhesiolisis on 1993 and then she got pregnant, then she had a big endometriotic cyst and I removed it and then she got pregnant again. In the last six years, she got 2 endometriotic cysts that were very big and causing agonizing pains and had to be surgically removed in 2 occasions. Last 1 year ago and then she got pregnant spontaneously but missed abortion at 14 weeks and had to evacuate by extramniotic PG. Now she is in a new pregnancy 12 weeks but she is in a continuous pain for the last 4 weeks, yesterday I did her ultrasound to find the uterus acutely RVF with the cervix extremely anterior, by manual examination the uterus couldn't be erected, so I suppose the fundus is adherent to the post peritoneum, Now what can I do?... I thought of waiting till 16 wks gestation and attempt laparotomy removal of the adhesions if the spontaneous anteversion doesn't take place (with the possibility of subsequent bleeding and possible hysterectomy) or evacuation of the pregnancy now (which I don't like)...what can I do Khaled Homouda, M.D. Consultant Obstet Gynecologist Ass. Preofessor of ObGyn, Ain shams university, Kuwait
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