Ovarian cysts are sacs filled with liquid or semi-liquid material that arise in the ovaries. The majority are benign and not cancerous. There are several types of ovarian cysts including functional cysts (follicular, corpus luteum, and theca lutein cysts), endometriomas, and polycystic ovarian syndrome. Ovarian cysts may cause lower abdominal pain but many are asymptomatic. Ultrasound is used to examine cyst features and size while blood tests and further imaging can help determine if a cyst is benign or potentially cancerous. Most small, simple cysts can be monitored but larger or complex cysts may require surgical removal. The prognosis for benign ovarian cysts is
what is endometriosis? Theories in endometriosis, sites of endometriosis. types and clinical presentation. signs and symptoms.
Investigations :TVS, CA125
laparoscopic findings
chocolate cyst and extrapelvic endometriosis.
Classification of endometiosis
Diffential diagnosis
Management :of asymptomatic and symptomatic cases
drugs and minimally invasive surgery
surgey and preventive measures in endometiosis.
what is endometriosis? Theories in endometriosis, sites of endometriosis. types and clinical presentation. signs and symptoms.
Investigations :TVS, CA125
laparoscopic findings
chocolate cyst and extrapelvic endometriosis.
Classification of endometiosis
Diffential diagnosis
Management :of asymptomatic and symptomatic cases
drugs and minimally invasive surgery
surgey and preventive measures in endometiosis.
India is the highest TB burden country accounting for more than one-fourth of the global incidence .Genital TB is found in 5-10% of women with infertility problems, with low rates in Australia (1%) and high rates of up to 19% in India (ICMR,2011)
India is the highest TB burden country accounting for more than one-fourth of the global incidence .Genital TB is found in 5-10% of women with infertility problems, with low rates in Australia (1%) and high rates of up to 19% in India (ICMR,2011)
Polycystic ovary syndrome (PCOS) is of clinical and public health importance as it is very common in today’s era affecting women of reproductive age group. It has significant and diverse clinical implications including reproductive (infertility, hyperandrogenism, hirsutism), metabolic (insulin resistance, impaired glucose tolerance, type 2 diabetes mellitus, adverse cardiovascular risk profiles) and psychological features (increased anxiety, depression and worsened quality of life).
Another commonest ovarian disorder is ovarian cyst. The treatment of an ovarian cyst relies on its nature, and accurate preoperative discrimination of benign and malignant cysts is therefore of crucial importance.
In a regular Homoeopathic OPD the physician today encounter these two cases frequently. Most of the patients visiting with these disorders opt for Homoeopathy as an alternative treatment option to revert surgical procedures, or after failed hormonal therapies.
Homoeopathic management should focus on education, addressing psychological factors and strongly emphasizing healthy lifestyle with targeted medical therapy as required.
The present article discusses on various aspects of these ovarian disorders. Cases of Ovarian disorders which were successfully treated with homoeopathic medicines by the author are reported here.
Dr. Smita Brahmachari
M.O., Dept. of AYUSH, Govt. of NCT Delhi.
Cervical incompetence is the inability for the cervix to retain an intra-uterine pregnancy till term as a result of structural and functional defects of the cervix
Slides for 3rd and 4th year medical students in Obstetrics and Gynecology- to not overlook the possibility as a diagnosis- still present. Slides highlighting diagnostic and management challenges
Many complications can occur during pregnancy and affect health of mother and fetus as well as outcomes. Hemorrhage is the first ten causes of maternal mortality and morbidity, affect about 32% of all maternal deaths. Abortion represents 4.5% of all maternal death. Many women do not understand the bleeding is abnormal and dangerous signs and they come late to health care facilities.
Pregnancies can be designated as high risk for any of several undesirable outcomes. In the past, risk factors were evaluated only from a medical standpoint. Therefore only adverse medical, obstetric,or physiologic conditions were considered to place the woman at risk. Today a more comprehensive approach to high-risk pregnancy is used, and the factors associated with high risk childbearing are grouped into broad categories based on threats to health and pregnancy outcome.
SCREENING
Screening is a process of identifying apparently healthy people who may be at increased risk of a disease or condition. They can then be offered information, further tests and appropriate treatment to reduce their risk and/or any complications arising from the disease or condition.
ASSESSMENT
Assessment is a process for defining the nature of that problem, determining a diagnosis, and developing specific treatment recommendations.
FETAL ULTRASOUND OR ULTRASONIC TESTING
Fetal ultrasound is a test done during pregnancy that uses reflected sound waves to produce a picture of a fetus camera.gif, the organ that nourishes the fetus (placenta), and the liquid that surrounds the fetus (amniotic fluid). The picture is displayed on a TV screen and may be in black and white or in color. The pictures are also called a sonogram, echogram, or scan, and they may be saved as part of your baby's record.
Approach to a Child with an Abdominal Mass and tumours.pptxJwan AlSofi
Clinically oriented approach to a child with abdominal mass.
Discussion about Neuroblastoma
Discussion about Wilms tumor
Discussion about Hepatic tumors
Case discussions
Ovulation was initially monitored by conventional methods like BBT, mid luteal serum progesterone and urinary LH.
Nowadays, USG is used for follicular monitoring for both natural and stimulated cycles.
2. Introduction
• Ovarian enlargements can be cystic or
solid but in most cases ovarian
enlargement are cystic.
Non-neoplastic
Neoplastic (Ovarian Tumors)
3. Non-neoplastic cysts of the ovary
• An ovarian cyst is a sac filled with liquid or semi-liquid
material arising in an ovary.
• The number of diagnoses of ovarian cysts has increased with
the widespread implementation of regular physical
examinations and ultrasound technology.
• The finding of an ovarian cyst causes considerable anxiety for
women because of the fear of malignancy, but the vast
majority of ovarian cysts are benign.
6. FUNCTIONAL CYSTS
Ovarian cysts arising in the normal process of ovulation
• They may be follicular ,theca-lutein or corpus luteum
cysts.
• These cysts can be stimulated by gonadotropins,
including follicle-stimulating hormone (FSH) and
human chorionic gonadotropin (hCG).
7. • Multiple functional cysts can occur as a result of
excessive gonadotropin stimulation or sensitivity
• This stimulation may occurs in cases of
GTDs (hydatiform mole and choriocarcinoma)
multiple pregnancy.
In patients being treated for infertility, ovulation induction
with gonadotropins (FSH and luteinizing hormone [LH]), and
clomiphene citrate, may lead to ovarian hyperstimulation
syndrome, especially if accompanied by hCG administration
8. ENDOMETRIOMATOUS CYSTS OF THE OVARY
• Cysts filled with blood arising from the
ectopic endometrium.
• They usually enlarge pre and during menses
and slightly shrink there after.
The ovary is the commonest site of pelvic
endometriosis.
11. Risk factors of ovarian cysts
1. Hypothyroidism
2. Infertility or women who are on treatment for infertility
3. Those taking tamoxifen, a drug to combat breast cancer
4. Irregular periods
5. Early periods (before 11 years)
6. Previous history of ovarian cysts.
7. A drug called clomiphene may lead to formation of corpus luteum
cyst.
12. Rotterdam criteria for diagnosis of PCOS
1. Menstrual irregularities. Most patients with PCOS
have menstrual irregularities that begin during
adolescence.
–Oligomenorrhea: less than nine menses per year
–Amenorrhea: no menses for 6 months or three or more
skipped cycles
Difficulty in conceiving is present in many women with
PCOS
13. 2. Hyperandrogenism. Patients may either show
signs of clinical hyperandrogenism or have
biochemical hyperandrogenism:
–Clinical hyperandrogenism: e.g hirsutism, acne, or
male pattern hair loss.
–Biochemical hyperandrogenism: Up to 90% of
women with PCOS have elevated serum androgen
concentration. However, the androgen levels may
be normal.
14. 3. Polycystic ovaries. A diagnosis of polycystic-
appearing ovaries can be made using pelvic
ultrasound.
–PCOS by ultrasound criteria is defined as 12 or more
antral follicles between 2 and 9 mm in size and
peripheral in location in at least one ovary
–Transvaginal ultrasound is more sensitive, but may
not be appropriate to perform in a young female.
15. History: Clinical presentation of ovarian
cysts
• The majority of ovarian cysts are asymptomatic.
• Pain or discomfort may occur in the lower abdomen.
Torsion (twisting) or rupture may lead to more severe pain.
• Patients may experience discomfort with intercourse,
particularly deep penetration.
• Having bowel movements may be difficult, or pressure may
develop, leading to a desire to defecate.
16. • Micturition may occur frequently and is due to pressure on
the bladder.
• Patients may experience abdominal fullness and bloating.
• Endometriomas are associated with endometriosis, which
causes a classic triad of painful and heavy periods and
dyspareunia.
• Patients with polycystic ovary syndrome presents
hirsutism, infertility, oligomenorrhea, obesity, and acne.
Note that infertility is not a rule.
17. Physical findings
• A large cyst may be palpable during the
abdominal examination
• Sometimes, discerning the cystic nature of an
ovarian cyst may be possible, and it may be
tender to palpation.
• If a cyst is huge ,The cervix and uterus may be
pushed to one side.
18. Laboratory Studies:
• No laboratory tests are diagnostic for ovarian cysts except for
PCOS for which hormone assays are done:
FSH
LH
Testosterone
Oestradiol
20. Medical Care:
•Many patients with simple
ovarian cysts based on
ultrasonography findings do not
require treatment.
21. Surgical Care:
• Persistent simple ovarian cysts larger
than 5-10 cm and complex ovarian cysts
should be removed surgically.
Laparotomy
Laparascopically
22. The following diagnostic tests may also be
ordered:
• Ultrasound scan - this will be carried out to help the doctor
make a diagnosis. A wand-like scanner probe (transducer) is
placed on the abdomen, over where the ovaries are.
• Sometimes the probe may be placed inside the vagina. In both
cases, the doctor is observing the ovaries on a video screen.
This test can help the doctor determine whether there is a
cyst, and whether it is solid, filled with fluid (or both).
23. • Blood test - if there is a tumor present blood levels of
CA125 (a protein) will be elevated.
• High CA125 levels could also mean the patient has
ovarian cancer. If a woman develops an ovarian cyst
that is partially solid she may have ovarian cancer.
• High CA125 levels may also be present in other
conditions, including endometriosis, uterine fibroids or
pelvic inflammatory disease.
24. • Laparoscopy - a thin, lighted instrument
(laparoscope) is inserted into the patient's
abdomen through a small incision (skin
cut). If the doctor spots an ovarian cyst
he/she may also remove it there and
then.
25. •Pregnancy test - a positive
result may suggest the
patient has a corpus luteum
cyst