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
--Boundary_(ID_svF1oc43+FcVk6n5uzf3HQ)
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<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Hi all<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>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<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Khaled Homouda, M.D.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Consultant Obstet Gynecologist<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Ass. Preofessor of ObGyn, Ain shams university, <o:p></o:p></span></font></p>
<p class=MsoNormal><st1:country-region w:st="on"><st1:place w:st="on"><font
size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>Kuwait</span></font></st1:place></st1:country-region><font
size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'><o:p></o:p></span></font></p>
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