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The aim of this study was to determine whether the timing of prophylactic antibiotics at cesarean delivery influences maternal and neonatal infectious morbidity. This was a prospective, randomized trial. Four hundred patients that underwent elective cesarean section between June and December 2007 formed the study population. Eleven patients were excluded from the study because they needed transfusion during the cesarean section. The population was divided into two groups: Group A, antibiotic prophylaxis was applied to 194 women before skin incision and Group B, antibiotic prophylaxis was applied to 195 women after umbilical cord clamping. The occurrence of endomyometritis/endometritis, wound infection, febrile morbidity, total infectious morbidity, and neonatal complications were compared. There were 389 patients enrolled. No demographic differences were observed between groups. No significant difference was found between the groups for total infectious morbidity [relative risk (RR) 1.39, 95% confidence interval (CI) 0.71–2.69] and endometritis (RR 1.40, 95% CI 0.43–4.51). There was no increase in neonatal sepsis (RR 1.47, 95% CI 0.61–3.53), sepsis workup (RR 1.35, 95% CI 0.75–2.42), need for neonatal intensive care (RR 1.77, 95% CI 0.51–6.16), and intensive care stay period (P = 0.16). Time of antibiotic prophylaxis application does not change maternal infectious morbidity in cesarean section deliveries. Preoperative prophylaxis application does not affect neonate morbidity rates as stated in literature.

We evaluated the long-term cure rates, surgical complications rates after treatment of urodynamically confirrmed primary genuine stress incontinence with tension-free vaginal tape (TVT). We performed a retrospective review of all patients undergoing the TVT procedure over a 5-year period to report intraoperative complication, postoperative complications and subjective cure rates. TVT was performed on 600 patients under general anesthesia. Among these patients, 563 were followed up for least 5 years; the remaining 47 patients could not be followed up. The mean follow-up interval was 63.1 ± 3.1 (range 60–70) months. The mean age of the women was 51.7 ± 11.6 years and mean body mass index 31.7 ± 3.0 kg/m2. Sixty-two percent (347) of women underwent the TVT procedure in conjunction with other vaginal surgery, and 38% (216) underwent TVT alone. The subjective analysis of the effect of surgery on the symptom of GSI was that, overall, 86.7% were completely cured, 6.0% were significantly improved and 7.3% found no change in the severity of her incontinence. No major nerve or vessel injury occurred, but 17 patients (3.0%) incurred bladder injury during the surgery. De novo voiding urgency occurred in 36 patients (6.4%). Thirty patients (5.3%) developed voiding problem, of which 19 patients had short-term voiding problem. The TVT procedure is a relatively safe and effective, minimally invasive surgical technique for the treatment of female urinary stress incontinence.

Porencephaly is defined as an area of focal encephalomalacia that communicates with the ventricular system, giving the appearance of a dilated ventricle. It is assumed that vascular occlusion or an infectious process cause gray and white matter necrosis leading to cyst formation in the cerebral parenchyma. Possible etiology of porencephaly includes intracerebral thrombosis, intracranial hemorrhage and fetal infection. We report the first antenatal diagnosis of porencephaly, which apparently resulted from maternal carbon monoxide poisoning.

We aimed to evaluate perinatal outcome of seven pregnancies with twin reserve arterial perfusion sequence.Study group included seven cases of acardiac twins. Out of seven acardiac twins, two cases were followed without interventions. We performed four alcohol ablation and one bipolar coagulation. For alcohol ablation, a 20-gauge needle guided with color Doppler USG was directed to abdominal insertion site of the single umbilical artery of the acardiac twin, and 1.0-2.0 mL of absolute alcohol was injected. For bipolar coagulation of the umbilical cord, we used 3.5 mm laparoscopic trocar and 3.0 mm bipolar forceps. The procedures were performed under the guidance of transabdominal ultrasonography.Gestational age of the cases at diagnosis and at delivery was 15-32 and 17-38 weeks, respectively. Two cases without intervention were lost at 17 and 32 weeks. The mean time of procedure for bipolar coagulation and alcohol ablation were 30 and 10 min, respectively. One of the four cases of alcohol ablation group was aborted although alcohol ablation was successful. Another one case was aborted after alcohol ablation due to lost of fetal cardiac activity of the pump fetus. In two other cases, umbilical cord ablation with alcohol was successful, and they delivered live birth at 36 and 38 weeks. In one case, we performed bipolar cord coagulation successfully, and the case delivered live birth at 39 weeks. The overall survival rate for intrauterine surgery was 60% (N 3/5).In twin reserve arterial perfusion sequence pregnancies with findings of poor prognosis, alcohol ablation or bipolar cord coagulation as fetal therapy under the guidance of ultrasonography can be done successfully, and should be offered as a choice to families upon discussion of intervention or follow-up with own complications.

Objective Hydrometrocolpos is a rare congenital disorder very rarely reported on prenatal sonography. In this study we report a persisten urogenital sinus with hydrometrocolpos and ascites at 24 weeks of gestation. Case Detailed ultrasonographic examination revealed female fetus with pelvic mass measured as 60 £ 70 £ 80 mm, anterior to sacral bone and inferior to bladder, and ascites, ureterocele, hydoureters, hydronephrosis but normal amniotic Xuid. Further examination showed that cervical canal and uterin cavity was in continuation with the pelvic mass and dilatation of uterine tubes implicated hydrometrocolpos. Physical examination of the neonate revealed a single anterior opening at perineum and a patent anus but no visible urethral oriWce. A voiding cystourethrogram demonstrated a urethrovaginal Wstula. The neonate underwent ureteroneoostomy and was discharged on day 10 for follow-up and Wnal repair. Conclusion Prenatal ultrasonographic diagnosis of hydrometrocolpos in our case prevented unnecessary interventions and allowed early neonatal treatment.

Extralobar pulmonary sequestrations (ELS) are masses of non-functioning lung tissue that are supplied by an anomalous systemic artery and do not have a bronchial connection to the native tracheobronchial tree. On prenatal ultrasonography, an ELS appears as a well-defined echodense, homogeneous mass. Detection by color flow Doppler ultrasonography of a systemic artery from the aorta to the fetal lung lesion is a pathognomonic feature of fetal ELS. In this case report, we describe the sonographic diagnosis of an ELS in a fetus at 22 weeks' gestation with a review of the available literature.

Intrauterine devices are a very effective form of contraception used worldwide for more than 2 centuries. One of the serious, but rare, complications of intrauterine contraception is perforation through the uterine wall into the pelvic or abdominal cavity. In this report we describe, persistent periumbilical discharge associated actinomycosis caused by migration of a copper intrauterine contraceptive device. To our knowledge, this is the first report of persistent periumbilical discharge caused by migration of a copper intrauterine contraceptive device. We recommend consideration of this minor possibility during evaluation of women with chronic abdominal discharge.

Retroperitoneal soft tissue sarcoma (RPS) is extremely rare in pregnancy, so there has been little experience in dialing with this condition. We report our experience of a pregnant patient with a retroperitoneal soft tissue sarcoma, which was treated by complete surgical resection at 17 weeks gestation. After regular follow-up, the patient admitted to our hospital in labor, in the 38th gestational week and vaginally delivered a male fetus weighing 3,200 g with Apgar score of 8 and 10 at 1 and 5 min respectively. Adjuvant radiotherapy and chemotherapy is controversial in RPS and due to postoperative continuation of pregnancy in our case, the adjuvant therapy was not practiced. The patient had an uneventful recovery, and no recurrence was detected for 20 months in the follow-up period.

Neuroendocrine carcinomas primitive neuroectodermal tumor (PNET) arise from Kulchitsky cells and are frequently seen in gastrointestinal tract and lungs. But they are unusual in gynecology practice. We presented a case of PNET arising in the uterine corpus of a 22-year-old woman. To our knowledge, this is the first description of small-cell carcinoma of the uterine corpus with a pseudocyst formation within the myometrium without endometrial invasion.

Imperforate hymen is one of the most simple and most common anomalies in the female genital organs, occurring in 0.1% of girls born at term. Some are recognized because of mucocolpos at birth, but the diagnosis is usually not detected before puberty. Rarely, obstetric sonography may prenatally detect imperforate hymen due to presentation of hydrocolpos or hydrometrocolpos in the fetus if fetal cervical and vaginal secretions accumulate in response to circulating maternal estrogens. Nonetheless, reports of prenatal ultrasound diagnosis of hydrometrocolpos are still very rare. In this article we report a prenatally diagnosed of imperforate hymen with hydrometrocolpos.