1.Looks can be deceiving: A case of placental mesenchymal dysplasia with concomitant cytomegalovirus infection.
Evangelista Mona Rae P. ; Cruz-Javier Gumersinda
Philippine Journal of Obstetrics and Gynecology 2014;38(4):23-30
Pregnancy with placental mesenchymal dysplasia (PMD), with concomitant cytomegalovirus (CMV) infection, and with coexistent normal viable fetus is very rare. An 18 year old, Gravida 2 Para 0 (0-0-1-0), was referred to our institution at 24 weeks age of gestation, with impression of molar pregnancy with a live twin fetus. Subsequent ultrasound revealed placentomegaly with placental features similar to hydatidiform mole. Her pregnancy was complicated with intrauterine growth restriction (IUGR) and oligohydramnios. TORCH panel at 25 weeks age of gestation revealed positive for CMV IgG. She had normal serum ?-HCG, with elevated maternal serum alpha feto protein (msAFP). A caesarean section was done at 37 weeks age of gestation for placenta previa marginalis in haemorrhage. She delivered a live baby girl, APGAR score of 9,9, maturity testing of 37 weeks, small for gestational age. The baby was also positive for CMV IgG. Gross examination of the placenta revealed tortuous vessels and multiple cystic spaces. Histopatho-logically, there were hydropic stem villi with no trophoblastic proliferation. Immunohistochemically, placental mesenchymal dysplasia was confirmed.
Human ; Female ; Adolescent ; Cytomegalovirus
2.Knowledge, attitude and practices of obstetricians and gynecologists on non- invasive prenatal testing with cell free fetal DNA in a private tertiary hospital
Kristel Danica P. Panes ; Gumersinda Cruz-Javier
Philippine Journal of Obstetrics and Gynecology 2020;44(1):26-32
There are a number of novel prenatal cytoogenetic analysis tests for obstetricians and gynecologists on detecting aneuploidies. In the recent years, screening of pregnant patients with non-invasive prenatal testing (NIPT) is one. As the spread of genomic medicine and preventive obstetrics continue, it is prudent for obstetricians and gynecologists to accept and optimize new screening modalities, whenever available.
Chromosomal abnormalities are common. Worldwide, one out of 150 live births may involve chromosomal abnormalities. The American College of Obstetrics and Gynecologists (ACOG) and American College of Medical Genetics recommend invasive and non ? invasive prenatal testing (NIPT)3. The invasive testing, however, carries risk for procedure ? related miscarriage. 4This favors NIPT which avoids the risk. The current state of NIPT in the Philippines, is it was only in January 2018, were a NIPT workshop was conducted by the Society of Maternal Fetal Medicine.6
First, due to the minimal studies on personalized and precision medicine on prenatal testing, hence the strong move to conduct this study. In an extensive literature search review in Herdin, a local database and archives of Philippine Obstetrics and Gynecology, none specified researches on non ? invasive prenatal testing.
Second, in our country alone, there is no provision for national prenatal tests. In our institution, it was already introduced but with no uptake yet. Because of this gap, scantiness and non - uptake on NIPT locally, hence the conduct of this study. The study aimed to investigate on the obstetricians and gynecologists (OB-GYNs) knowledge, attitude towards and practices (KAP) about NIPT. Majority of the OBGYNs were knowledgeable, had positive attitude and were practicing NIPT. Strikingly, a fourth of the respondents were not comfortable in explaining NIPT. The researcher recommends that there is a need to conduct this study on a larger scale cross - sectional survey and multiple studies due to the paucity of data.
Pregnancy
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Female
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Prenatal Diagnosis
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Genetic Testing
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Mass Screening
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DNA
3.Pelvic arteriovenous malformation involving the uterine and internal iliac vessels with concomitant true aneurysm of uterine artery diagnosed through color Doppler ultrasound
Ma Cresilda Paz B. Salamilao-Sabularce ; Gumersinda Cruz-Javier
Philippine Journal of Obstetrics and Gynecology 2023;47(5):278-282
Background:
Pelvic arteriovenous malformations (AVMs) are rare but carries life-threatening consequences.
Case Report:
A 47-year-old multipara who had previously undergone four cesarean sections
came for re-evaluation of a malignant ovarian new growth. She was asymptomatic. Repeat ultrasound
revealed normal ovaries, and a cystic structure at the left adnexa with abundant mixing of colors,
turbulent flow and pulsative waveforms on spectral Doppler. It arises from serpentine tubular structures
from the uterine isthmus. Uterine artery aneurysm was considered. Magnetic resonance angiography
confirmed the findings of aneurysm and pelvic arteriovenous malformation. The patient underwent a
hysterectomy with ligation and excision of aneurysm. Histopathologic findings showed pelvic AVM
and a true aneurysm of the uterine artery.
Conclusion
Ultrasound with color Doppler is a low-cost and readily available tool for gynecologists
for the diagnosis and management of pelvic AVM.
Ultrasonography, Doppler