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Pregnancy complicated by spontaneous rupture of uterus and endometrioses and ovarian endometrioma
92
53.year-old woman with regular menses and with low level of aromatase expression the estimation of FSH (5 mlU/ml) and estradiol(120 pgiml) excluded the menopause. The aromatase expression in endometriotic implants located in the scar after episiotomy was 6.6 pg RN/Jug DNA in one patient and it was not detected in the other one. Low serum estradiol was observed in the second case. Conclusion: The aromatase gene is expressed in endometriotic implant but its expression is much lower comparing to proliferative and secretive endometrium.
P3.05.10 KI-67 EXPRESSION IN THE ENDOMETRIUM OF HEALTHY WOMEN AND PATIENTS WlTH PERITONEAL ENDOMETRIOSIS V.A.Bourlev., S.V.Pavlovitch, N.I.Volkov, D.A.Stygar, Research Centre for Obstetrics, Gynecology and Perinatology, Moscow, Russia Objectives: The aim of the study was to investigate the expression of the proliferative marker Ki-67 in the endometrium of healthy women and patients with peritoneal endometriosis in the different stages of the menstrual cycle. Study Methods: Expression of the proliferative marker Ki-67 was evaluated in the stroma and glandular epithelium of endometrium from 6 healthy women and 25 patient with laparoscopically confirmed peritoneal endometriosis. Serial 5.0 pkm sections of endometrium had been performed and studied immunogistochemically using Ki-67 monoclonal antibodies (Immunotech, Marseille, France). The laboratory part of the investigation was carried out in the Department of Obstetrics and Gynecology of the Uppsala University, Sweden with scientific support of Prof. B.Lindblom. Results: The percentage of Ki-67 positive cells in the stroma of endometrium from healthy women elevated from proliferative to late secretory phase. Expression of the marker in the gladular epithelium was minimal in the secretory phase. In endometriotic patients Ki-67 expression’ changes in the glandular epithelium were similar. Stromal maximal expression of Ki-67 was in the early secretory phase, and was 2 times higher than in healthy patients. In the late secretory phase Ki-67 expression was significantly lower in endometriotic patients both in the stroma and in the glandular epithelium. Conclusions :Revealed changes in the proliferative activity in the endometrium of patients with peritoneal endometriosis indicate on their possible role in the pathogenesis of this pathologic condition.
P3.05.11 POSSIBLITIES OF INSTRUMENTAL METHODS IN THE DIAGNOSIS OF ADENOMYOSIS O.M. V.K Chaika, I.V. Vasilenko, Done&k State Regional Centre for Maternity and Childhood Protection, Donetsk, Ukraine. Objectives: The aim of the study was to investigate the possibilities of instrumental methods in diagnosis of adenomyosis on the basis of comparison of instrumental data of patients’ investigation and histological investigation results of corresponding operative materials. Study Methods: 107 women were operated on for adenomyosis. Berfore operation hysterography, transvaginal sonography, hysteroscopy and miometrium’s hysteroscopic needle biopsy were carried out by the whole patient. The sections of operative materials were studied through light microscope. Results: The informativity of hysterography has made 5.6%, sonography - 19.6%, hysteroscopy - 11.1% and miometrium’s hysteroscopic needle biopsy - 50.0%. That kind of informativity we explained with the following revealed histosructural features of adenomyosis: endometriotic lesions and glands in them with the sizes more than l-2 mm were met accordingly in 29.0% and 19.6% of cases; endometriotic glands of the round form were prevailed in endometriotci lesions; the communication of large tubular endometriotic glands gaps with uterus cavity was met in 5.6% of patients; “menstruate” endometriotic lesions were met in 11.1% of supervisions; connective capsule around of endometriotic lesions was absent in the whole cases; the combination of adenomyosis with uterus myoma was met in 56.1% of cases. Conclusions: Low informativity of instrumental methods in the diagnosis of adenomyosis we connected with histostructural features of this pathology.
WEDNESDAY,
SEPTEMBER
6
P3.05.12 PREGNANCY COMPLICATED BY SPONTANEOUS RUPTURE OF UTERUS AND ENDOMETRIOSES AND OVARIAN ENDOMETRIOMA L.M. Loues, R.A.M. Sa, I.B. Costa Jr., P.C. Games, P.R. Marinho, M.N. Ritto, A.L.M. Dourado, Dept. Maternal Fetal Medicine, Laranjeiras Clinica Perinatal, Rio de Janeiro, Brazil. Case Report: A 31 year-old Brazilian woman, gravida 1, Para 0, was admitted to Laranjeiras Clinica Perinatal at 26 weeks gestation with the chief complaint of mid-abdominal pain and vaginal bleeding. She had been treated with fl-adrenergic for preventing preterm labor 45 days before admission. Physical examination revealed normal blood pressure and pulse. The fetal heart rate was 146 bpm and the size of the uterus was consistent with 26 weeks gestation. The significant laboratory findings included a hematocrit of 25% and hemoglobin of 8.2gidl. A real-time ultrasound scan showed fetal biometry consistent with 26 weeks gestation, oligohydramnios, and 05 myomas. Doppler of fetal circulation was normal. Nausea, vomiting, hypotension, abdominal pain and vaginal bleeding began 12 days before admission. The initial clinical impression was abruptio placentae. Exploratory laparotomy was performed and upon opening the abdomen a sanguineous fluid was encountered. The uterus was elevated and multiple myomas were seen. In the posterior wall (occupying the cul-de-sac) was a chocolate-colored tumor and a uterine disruption. Both ovaries were adherent to the uterus with a chocolatecolored fluid-filled cyst measuring 15cm (on the left) and 20cm (on the right). She delivered by Cesarean a 20458 infant. Apgar 6. Hysterectomy and bilateral anexectomy was done. Histopatologic Observations: Uterine fibroids, adenomyosis and bilateral ovarian endometrioma. Follow up: Both mother and infant did well one year later.
P3.05.13 PSYCHOLOGICAL PECULIARITIES IN PATIENTS WITH ENDOMETRIOSIS L. Radzetskava, A.Fomin, L.Suprun, Dept. OBIGYN, Vitebsk Medical University, Vitebsk, Belarus. Objectives: The aim of this study was to investigate the psychological peculiarities in patients with endometriosis. Study Methods: We used a modified Russian version of the Minnesota Multiphase Personality Inventory (MMPI) and Spilberger’s test. We examined 54 patients with endometriosis and 23 controls. Results: We stated that patients with endometriosis had an elevated MMPI profile. Scale 5(M-F) had the lowest value -56,91,5 T-scores. The scales I, 6(Pa), 4(Pd) and 7 (Pt) reached to 70 T-scores and even more (p
P3.05.14 THREE-STEP THERAPY IN ENDOMETRIOSIS WITH DECAPEPTYL-DEPOT A. Kereszttiri, .I. Dam, S. KoloszBr, Z. Borthaiser, A. PB., Albert SzentGyGrgyi Medical University, Dept. OBIGYN, Szeged, Hungary. Introduction: The aim of the authors study was evaluate the relative safety and efficacy of triptorelin (Decapeptyl-Depot, FERRING) as primary treatment for endometriosis and obtain data about the ovarian
53.year-old woman with regular menses and with low level of aromatase expression the estimation of FSH (5 mlU/ml) and estradiol(120 pgiml) excluded the menopause. The aromatase expression in endometriotic implants located in the scar after episiotomy was 6.6 pg RN/Jug DNA in one patient and it was not detected in the other one. Low serum estradiol was observed in the second case. Conclusion: The aromatase gene is expressed in endometriotic implant but its expression is much lower comparing to proliferative and secretive endometrium.
P3.05.10 KI-67 EXPRESSION IN THE ENDOMETRIUM OF HEALTHY WOMEN AND PATIENTS WlTH PERITONEAL ENDOMETRIOSIS V.A.Bourlev., S.V.Pavlovitch, N.I.Volkov, D.A.Stygar, Research Centre for Obstetrics, Gynecology and Perinatology, Moscow, Russia Objectives: The aim of the study was to investigate the expression of the proliferative marker Ki-67 in the endometrium of healthy women and patients with peritoneal endometriosis in the different stages of the menstrual cycle. Study Methods: Expression of the proliferative marker Ki-67 was evaluated in the stroma and glandular epithelium of endometrium from 6 healthy women and 25 patient with laparoscopically confirmed peritoneal endometriosis. Serial 5.0 pkm sections of endometrium had been performed and studied immunogistochemically using Ki-67 monoclonal antibodies (Immunotech, Marseille, France). The laboratory part of the investigation was carried out in the Department of Obstetrics and Gynecology of the Uppsala University, Sweden with scientific support of Prof. B.Lindblom. Results: The percentage of Ki-67 positive cells in the stroma of endometrium from healthy women elevated from proliferative to late secretory phase. Expression of the marker in the gladular epithelium was minimal in the secretory phase. In endometriotic patients Ki-67 expression’ changes in the glandular epithelium were similar. Stromal maximal expression of Ki-67 was in the early secretory phase, and was 2 times higher than in healthy patients. In the late secretory phase Ki-67 expression was significantly lower in endometriotic patients both in the stroma and in the glandular epithelium. Conclusions :Revealed changes in the proliferative activity in the endometrium of patients with peritoneal endometriosis indicate on their possible role in the pathogenesis of this pathologic condition.
P3.05.11 POSSIBLITIES OF INSTRUMENTAL METHODS IN THE DIAGNOSIS OF ADENOMYOSIS O.M. V.K Chaika, I.V. Vasilenko, Done&k State Regional Centre for Maternity and Childhood Protection, Donetsk, Ukraine. Objectives: The aim of the study was to investigate the possibilities of instrumental methods in diagnosis of adenomyosis on the basis of comparison of instrumental data of patients’ investigation and histological investigation results of corresponding operative materials. Study Methods: 107 women were operated on for adenomyosis. Berfore operation hysterography, transvaginal sonography, hysteroscopy and miometrium’s hysteroscopic needle biopsy were carried out by the whole patient. The sections of operative materials were studied through light microscope. Results: The informativity of hysterography has made 5.6%, sonography - 19.6%, hysteroscopy - 11.1% and miometrium’s hysteroscopic needle biopsy - 50.0%. That kind of informativity we explained with the following revealed histosructural features of adenomyosis: endometriotic lesions and glands in them with the sizes more than l-2 mm were met accordingly in 29.0% and 19.6% of cases; endometriotic glands of the round form were prevailed in endometriotci lesions; the communication of large tubular endometriotic glands gaps with uterus cavity was met in 5.6% of patients; “menstruate” endometriotic lesions were met in 11.1% of supervisions; connective capsule around of endometriotic lesions was absent in the whole cases; the combination of adenomyosis with uterus myoma was met in 56.1% of cases. Conclusions: Low informativity of instrumental methods in the diagnosis of adenomyosis we connected with histostructural features of this pathology.
WEDNESDAY,
SEPTEMBER
6
P3.05.12 PREGNANCY COMPLICATED BY SPONTANEOUS RUPTURE OF UTERUS AND ENDOMETRIOSES AND OVARIAN ENDOMETRIOMA L.M. Loues, R.A.M. Sa, I.B. Costa Jr., P.C. Games, P.R. Marinho, M.N. Ritto, A.L.M. Dourado, Dept. Maternal Fetal Medicine, Laranjeiras Clinica Perinatal, Rio de Janeiro, Brazil. Case Report: A 31 year-old Brazilian woman, gravida 1, Para 0, was admitted to Laranjeiras Clinica Perinatal at 26 weeks gestation with the chief complaint of mid-abdominal pain and vaginal bleeding. She had been treated with fl-adrenergic for preventing preterm labor 45 days before admission. Physical examination revealed normal blood pressure and pulse. The fetal heart rate was 146 bpm and the size of the uterus was consistent with 26 weeks gestation. The significant laboratory findings included a hematocrit of 25% and hemoglobin of 8.2gidl. A real-time ultrasound scan showed fetal biometry consistent with 26 weeks gestation, oligohydramnios, and 05 myomas. Doppler of fetal circulation was normal. Nausea, vomiting, hypotension, abdominal pain and vaginal bleeding began 12 days before admission. The initial clinical impression was abruptio placentae. Exploratory laparotomy was performed and upon opening the abdomen a sanguineous fluid was encountered. The uterus was elevated and multiple myomas were seen. In the posterior wall (occupying the cul-de-sac) was a chocolate-colored tumor and a uterine disruption. Both ovaries were adherent to the uterus with a chocolatecolored fluid-filled cyst measuring 15cm (on the left) and 20cm (on the right). She delivered by Cesarean a 20458 infant. Apgar 6. Hysterectomy and bilateral anexectomy was done. Histopatologic Observations: Uterine fibroids, adenomyosis and bilateral ovarian endometrioma. Follow up: Both mother and infant did well one year later.
P3.05.13 PSYCHOLOGICAL PECULIARITIES IN PATIENTS WITH ENDOMETRIOSIS L. Radzetskava, A.Fomin, L.Suprun, Dept. OBIGYN, Vitebsk Medical University, Vitebsk, Belarus. Objectives: The aim of this study was to investigate the psychological peculiarities in patients with endometriosis. Study Methods: We used a modified Russian version of the Minnesota Multiphase Personality Inventory (MMPI) and Spilberger’s test. We examined 54 patients with endometriosis and 23 controls. Results: We stated that patients with endometriosis had an elevated MMPI profile. Scale 5(M-F) had the lowest value -56,91,5 T-scores. The scales I, 6(Pa), 4(Pd) and 7 (Pt) reached to 70 T-scores and even more (p
P3.05.14 THREE-STEP THERAPY IN ENDOMETRIOSIS WITH DECAPEPTYL-DEPOT A. Kereszttiri, .I. Dam, S. KoloszBr, Z. Borthaiser, A. PB., Albert SzentGyGrgyi Medical University, Dept. OBIGYN, Szeged, Hungary. Introduction: The aim of the authors study was evaluate the relative safety and efficacy of triptorelin (Decapeptyl-Depot, FERRING) as primary treatment for endometriosis and obtain data about the ovarian