Adneksiyal kitlelere yaklaşım dr aydın köşüşAydın Köşüş
Adneksiyal kitlelerde izlenecek yöntem nasıl olmalıdır? Laparoskopinin yönetimde yeri nedir? Her adneksiyal kitleye cerrahi gerekir mi? Çocuklardaki adneksiyal kitlelerde yönetim nasıl olmalıdır?
Adneksiyal kitlelere yaklaşım dr aydın köşüşAydın Köşüş
Adneksiyal kitlelerde izlenecek yöntem nasıl olmalıdır? Laparoskopinin yönetimde yeri nedir? Her adneksiyal kitleye cerrahi gerekir mi? Çocuklardaki adneksiyal kitlelerde yönetim nasıl olmalıdır?
KANAMA VE DİSSEMİNE İNTRAVASKÜLER KOAGÜLASYONsercankuarktek
Dissemine intravasküler koagülasyon (DİK) lokal veya sistemik hücre hasarına cevaben normal hemostatik kontrolün kaybolmasıyla karakterize bir klinik tablodur.
This document provides guidelines for the prevention and management of preterm labour. It includes:
1. Definitions of key terms like suspected preterm labour, diagnosed preterm labour, and rescue cervical cerclage.
2. Recommendations for prevention of preterm labour, including prophylactic progesterone, cervical cerclage, and indications for rescue cerclage.
3. Guidance on diagnosis of preterm labour through clinical assessment, transvaginal ultrasound to measure cervical length, and fetal fibronectin testing.
4. Treatment options including tocolysis with calcium blockers, corticosteroids, magnesium sulfate, fetal monitoring, and discussions on mode of birth. The guidelines provide
- Recurrent pregnancy loss is defined as 3 or more consecutive miscarriages before 20 weeks.
- Genetic causes like chromosomal abnormalities are a major cause and account for around 70% of early miscarriages. Karyotyping of pregnancy tissue can identify chromosomal abnormalities.
- Advanced parental age increases the risk of genetic defects leading to miscarriage due to declining egg/sperm quality. Parental karyotyping may identify balanced translocations in 3-5% of couples.
- A thorough evaluation including genetic, endocrine, anatomical, immunological, and infectious factors can identify a cause in 60% of recurrent pregnancy loss cases.
Gestasyonel trafoblastik hastalıklarda (GTD) yönetim nasıl olmalıdır? Komplet ve parsiyel molde yönetim. Gestasyonel trofoblastik neoplazilerde yönetim. GTD tedavite kemoterapi. GTD de tedavi sonrası takip nasıl olmalıdır? GTD de cerrahinin yeri var mıdır? Neoplaziye dönüşüm kriterleri nelerdir? İnvaziv mol ve koryokarsinom takibinde önemli noktalar nelerdir?
Pelvic organ prolapse occurs when one or more pelvic organs, such as the bladder, uterus, or rectum, descend from their normal positions due to weakness or damage in the muscles and tissues that support these organs. The document discusses the anatomy of pelvic floor support, factors that can contribute to prolapse, and how different types of prolapse such as cystocele, rectocele, and enterocele are evaluated and treated. Conservative treatments focus on lifestyle changes while surgical repairs aim to reconstruct the weakened pelvic floor tissues and fascia.
This document discusses the evaluation and management of genital prolapse. It begins by describing normal uterine and vaginal support structures. It then discusses the pathophysiology of pelvic organ prolapse, including neuromuscular dysfunction and weakness of supporting ligaments. Evaluation involves history, physical exam including staging systems, and sometimes additional tests. Treatment options include conservative approaches like pessaries or intravaginal devices, as well as surgical options.
Complications of mesh and should we use it ? - www.jinekoklojivegebelik.comjinekolojivegebelik.com
The document discusses the use of mesh in pelvic organ prolapse (POP) surgery, comparing synthetic and biological meshes. It summarizes various studies that have found complication rates ranging from 0-39% for synthetic meshes and 0-64% for biological meshes. While mesh may be preferable for recurrent or complex cases, there is no strong evidence currently to support its routine use in POP surgery. Further research through RCTs and pooled audits is still needed.
The document discusses several potential postpartum complications including postpartum hemorrhage, infection, urinary incontinence, prolapse, and mental health issues. Postpartum hemorrhage is the leading cause of maternal mortality and can be life-threatening, with causes such as uterine atony, lacerations, and retained placenta. Other complications include infection, urinary incontinence, structural issues like prolapse, and mental health issues such as postpartum depression. Prevention, early assessment, and treatment are emphasized to manage complications.
This document provides an overview of abdominal anatomy terminology and structures. It discusses the internal coverings of the abdomen including the peritoneum and mesenteries. It then covers the blood supply and innervation of the foregut, midgut, and hindgut. Finally, it discusses some common congenital abnormalities that can occur in embryonic development of the gastrointestinal tract.
Gebelik Kolestazı -Cholestasis of Pregnancy - www.jinekolojivegebelik.comjinekolojivegebelik.com
1. Intrahepatic cholestasis of pregnancy is characterized by pruritus and jaundice in the last trimester of pregnancy, and can recur in subsequent pregnancies.
2. Laboratory findings include elevated serum bile acids and liver enzymes. The condition can cause complications like preterm birth and fetal distress.
3. Treatment focuses on relieving pruritus through medications like cholestyramine, antihistamines, phenobarbital, and ursodeoxycholic acid. Delivery may be indicated if symptoms are severe or fetal well-being is compromised.
PCOS is a common hormonal disorder characterized by oligomenorrhea and hyperandrogenism. It can cause long term health risks like diabetes, cardiovascular disease, and endometrial cancer. Management involves lifestyle changes like weight loss through diet and exercise to improve symptoms. Medications may be used to treat irregular periods, hirsutism, and help with ovulation induction and fertility. Screening for metabolic complications is recommended due to increased risk.
PCOS was first described in 1935 and affects 5-10% of women of reproductive age, making it the most common endocrine disorder. It is characterized by hyperandrogenism, chronic anovulation, and polycystic ovaries. Patients often see multiple medical practitioners before receiving a correct diagnosis of PCOS due to its variable signs and symptoms. Women with PCOS are also at higher risk of developing diabetes, cardiovascular disease, and other metabolic complications. Lifestyle interventions including diet and exercise can help manage symptoms and reduce health risks associated with PCOS.
Case 1 involves a 17-year-old female with primary amenorrhea who has normal development and health history. Her physical exam and labs are normal except she is underweight. She likely has hypothalamic amenorrhea due to inadequate calorie and fat intake and should be evaluated for an eating disorder.
Case 2 is a 24-year-old woman with secondary amenorrhea and irregular periods. She is overweight with signs of PCOS like acne and hirsutism. Her labs show elevated testosterone and cystic ovaries on ultrasound consistent with a diagnosis of PCOS.
Case 3 is a 29-year-old with secondary amenorrhea and a history of spontaneous abortion and D&
1. The document discusses various causes of amenorrhea including hypothalamic, pituitary, ovarian, and outflow tract issues.
2. Evaluation involves assessing secondary sex characteristics, symptoms, family history, and targeted medical tests.
3. Treatment focuses on identifying and managing underlying disorders, hormone replacement, and addressing risks like osteoporosis or infertility.
This document provides an overview of polycystic ovarian syndrome (PCOS), including its pathogenesis, diagnosis, and management. PCOS is characterized by hyperandrogenism, oligoovulation or anovulation, and polycystic ovaries. It affects 4-12% of women and is associated with insulin resistance and related metabolic complications. Diagnosis requires two of the three above criteria in the absence of other disorders. Management involves lifestyle changes, medications to regulate cycles and reduce hair growth, and long-term strategies to address insulin resistance and related risks like cardiovascular disease.
This document discusses different types of amenorrhea (primary and secondary) and provides information on their causes and evaluations. Primary amenorrhea is defined as the absence of menstruation by age 16 with normal development or by age 14 without development. Secondary amenorrhea is the absence of menses for 6 months in a previously menstruating female. Causes of primary amenorrhea include hypogonadism, gonadal dysgenesis, and hypogonadotropic hypogonadism. Causes of secondary amenorrhea include pregnancy, CNS disorders, pituitary disorders, ovarian disorders, uterine abnormalities, and systemic disorders/medications. Evaluations for amenorrhea involve pregnancy testing, physical exams, and laboratory tests
This document provides definitions and discusses the evaluation and treatment of amenorrhea and polycystic ovarian syndrome (PCOS). It defines types of amenorrhea and normal menstrual cycles. Evaluation includes pregnancy tests, hormone levels, and progestational challenges. Treatment depends on the underlying cause and may include birth control pills, progesterone, clomiphene, or metformin. PCOS is characterized by irregular periods and elevated androgens. Treatment focuses on weight loss, birth control pills, and improving insulin resistance.
The document discusses Polycystic Ovary Syndrome (PCOS), the most common endocrinopathy among women of reproductive age. PCOS is diagnosed based on two of three criteria: irregular periods, signs of high androgen levels, and enlarged ovaries with cysts. Women with PCOS have increased risks of infertility, metabolic and cardiovascular issues. Key aspects of PCOS include irregular periods due to hormonal imbalances, high androgen levels, insulin resistance, and enlarged ovaries. Treatment focuses on lifestyle changes, medication to manage symptoms and address insulin resistance, and fertility support.
This document discusses causes and evaluation of amenorrhea, or absent menstruation. It outlines categories of amenorrhea based on presence or absence of breast development and uterus. Initial tests include a progesterone challenge, thyroid and prolactin levels. Specific disorders mentioned include Turner syndrome, premature ovarian failure, and hypothalamic or pituitary issues. Evaluation involves assessing the hypothalamus, pituitary, ovaries, and outflow tract to determine the underlying cause.
72. aPTT 60-80 saniye 2 X 15000 – 30000 IU SC/24 saat Anti-Xa aktivitesi o,5-1,0 IU/mL Deltaparin 100 IU/kg/12 saat Enoxaparin 1mg/kg/12 saat Terapötik doz aPTT 35-40 saniye 2 X 7500 IU SC/24 saat Anti-Xa aktivitesi 0,2-0,4 IU/mL Deltaparin 5000 IU SC/24 saat Enoxaparin 40 mg SC/24 saat Fraxiparin 4000 IU SC/24 saat profilaktik doz UFH takibi UFH dozu LMWH takibi LMVH Dozu