Background: Uterus didelphys is a Müllerian duct anomaly which is clinically significant because only 45% of UD patients achieve term delivery and have associated increased risk of spontaneous abortion, foetal gr...Background: Uterus didelphys is a Müllerian duct anomaly which is clinically significant because only 45% of UD patients achieve term delivery and have associated increased risk of spontaneous abortion, foetal growth retardation, mal presentation, and a significant caesarean section delivery rate. Case: A 26-year-old Gravida 2 Para 1 Abortion 1 woman with uterus didelphys and associated complete, non-communicating, longitudinal vaginal septum carries a pregnancy to term in her right uterus in rural Canada. She delivers her baby at 41 weeks gestational age via vacuum assisted spontaneous vaginal delivery. Conclusion: This case report supports more recent literature that uterus didelphys should not be considered as an absolute indication for caesarean delivery. A trial of labour is conceivable with obstetrician gynaecologist involvement in more rural centers with a care plan in place.展开更多
Background: Uterine Didelphys is a rare congenital condition and it can affect both mother and fetus. A 24 year-old patient presented to the emergency room with pelvic pain and a pelvic ultrasound confirmed the presen...Background: Uterine Didelphys is a rare congenital condition and it can affect both mother and fetus. A 24 year-old patient presented to the emergency room with pelvic pain and a pelvic ultrasound confirmed the presence of Uterine Didelphys. She subsequently became pregnant and was first seen at 21 weeks gestation. She was designated as a high-risk patient during the second trimester when she experienced irregular contractions. She was monitored weekly with Non-Stress Tests and eventually was delivered by Cesarean Section. Uterine Didelphys can be detected in-utero in affected individuals, and clinical findings vary among individuals. Some may be asymptomatic, whereas others will experience dyspareunia, and still others may present with concurrent renal agenesis. Serial sonograms are performed throughout their pregnancy to evaluate fetal growth and well-being, as well as cervical length. Unlike many uterine anomalies, Uterine Didelphys does not affect fertility but can affect labor, fetal growth, placentation, fetal viability and fetal outcome. Uterine Didelphys frequently results in recurrent miscarriages and may cause preterm labor and necessitate cesarean section. The presentation, associated symptoms, methods of detection and management options for Uterine Didelphys will be discussed.展开更多
Uterus didelphys occurs in~0.4%of females and is found in~11%-20%of all uterus defects.It is a risk factor for cervical insufficiency,consequently contributing to late miscarriage or preterm birth.Thus far,only two pr...Uterus didelphys occurs in~0.4%of females and is found in~11%-20%of all uterus defects.It is a risk factor for cervical insufficiency,consequently contributing to late miscarriage or preterm birth.Thus far,only two prior cases of uterus didelphys accompanied by cervical insufficiency treated through laparoscopic cervical cerclage have been reported;however,livebirth only occurred in one hemiuterus.Herein,we report a case of uterus didelphys in a patient diagnosed with cervical insufficiency.Following the placement of a modified laparoscopic cervical cerclage,the patient had two successful livebirths through both hemiuteruses,respectively,with longer gestation age(ie,>36 weeks).The aim of this case report was to provide useful information for clinical practitioners to make better decisions on the management of cervical insufficiency in patients with uterus didelphys,and identify obstetric complications that clinicians should pay attention to during pregnancy.展开更多
Rationale:Herlyn-Werner-Wunderlich syndrome,also known as obstructed hemi-vagina with ipsilateral renal agenesis(OHVIRA)syndrome,is a rare congenital anomaly of the Müllerian and Wolffian ducts.It is often asympt...Rationale:Herlyn-Werner-Wunderlich syndrome,also known as obstructed hemi-vagina with ipsilateral renal agenesis(OHVIRA)syndrome,is a rare congenital anomaly of the Müllerian and Wolffian ducts.It is often asymptomatic until puberty and is usually misdiagnosed as infertility.Patient concerns:A 39-year-old woman desirous of pregnancy was referred to our radiodiagnosis unit for imaging evaluation on account of secondary infertility.Diagnosis:Incidental discovery of uterine bicornis bicollis and blind-ending hemivagina was noted at hysterosalpingography.Interventions:This necessitated the search for other genitourinary tract anomalies,and ipsilateral renal agenesis was also discovered.Outcomes:A diagnosis of Herlyn-Werner-Wunderlich syndrome was made.Lessons:Magnetic resonance imaging(MRI)is considered the gold standard imaging modality for the assessment of uterine malformations.However,in resource-poor centers where MRI is unavailable,a heightened clinical suspicion with the combination of available imaging modalities is important and reliable in making an accurate diagnosis,hence,successful management.展开更多
Objective:To isolate and identify the exact species of the genus Mycobacterium from Didelphis(D.)virginiana,and the direct implications of this bacterium to public health and veterinary medicine.Methods:Thirty-one D.v...Objective:To isolate and identify the exact species of the genus Mycobacterium from Didelphis(D.)virginiana,and the direct implications of this bacterium to public health and veterinary medicine.Methods:Thirty-one D.virginiana were captured and necropsied in Hidalgo,Mexico.Tissue samples were collected to culture mycobacteria present and examine individual specimens’histopathology.Mycobacterium identification was obtained through the application of amplification and sequencing of 16S rDNA techniques.Results:Three strains were isolated and identified as Mycobacterium(M.)avium subsp.hominissuis by utilizing M.avium complexspecific primers.Granulomatous lesions were observed in the subpleural zone(granuloma gradeⅡ)and bronchial(granuloma gradeⅠ)of the lungs of D.virginiana with positive isolation.Conclusions:Three strains of M.avium subsp.hominissuis,from lung tissue samples of D.virginiana were identified.This subspecies of M.avium has important implications in public health and veterinary medicine.展开更多
文摘Background: Uterus didelphys is a Müllerian duct anomaly which is clinically significant because only 45% of UD patients achieve term delivery and have associated increased risk of spontaneous abortion, foetal growth retardation, mal presentation, and a significant caesarean section delivery rate. Case: A 26-year-old Gravida 2 Para 1 Abortion 1 woman with uterus didelphys and associated complete, non-communicating, longitudinal vaginal septum carries a pregnancy to term in her right uterus in rural Canada. She delivers her baby at 41 weeks gestational age via vacuum assisted spontaneous vaginal delivery. Conclusion: This case report supports more recent literature that uterus didelphys should not be considered as an absolute indication for caesarean delivery. A trial of labour is conceivable with obstetrician gynaecologist involvement in more rural centers with a care plan in place.
文摘Background: Uterine Didelphys is a rare congenital condition and it can affect both mother and fetus. A 24 year-old patient presented to the emergency room with pelvic pain and a pelvic ultrasound confirmed the presence of Uterine Didelphys. She subsequently became pregnant and was first seen at 21 weeks gestation. She was designated as a high-risk patient during the second trimester when she experienced irregular contractions. She was monitored weekly with Non-Stress Tests and eventually was delivered by Cesarean Section. Uterine Didelphys can be detected in-utero in affected individuals, and clinical findings vary among individuals. Some may be asymptomatic, whereas others will experience dyspareunia, and still others may present with concurrent renal agenesis. Serial sonograms are performed throughout their pregnancy to evaluate fetal growth and well-being, as well as cervical length. Unlike many uterine anomalies, Uterine Didelphys does not affect fertility but can affect labor, fetal growth, placentation, fetal viability and fetal outcome. Uterine Didelphys frequently results in recurrent miscarriages and may cause preterm labor and necessitate cesarean section. The presentation, associated symptoms, methods of detection and management options for Uterine Didelphys will be discussed.
文摘Uterus didelphys occurs in~0.4%of females and is found in~11%-20%of all uterus defects.It is a risk factor for cervical insufficiency,consequently contributing to late miscarriage or preterm birth.Thus far,only two prior cases of uterus didelphys accompanied by cervical insufficiency treated through laparoscopic cervical cerclage have been reported;however,livebirth only occurred in one hemiuterus.Herein,we report a case of uterus didelphys in a patient diagnosed with cervical insufficiency.Following the placement of a modified laparoscopic cervical cerclage,the patient had two successful livebirths through both hemiuteruses,respectively,with longer gestation age(ie,>36 weeks).The aim of this case report was to provide useful information for clinical practitioners to make better decisions on the management of cervical insufficiency in patients with uterus didelphys,and identify obstetric complications that clinicians should pay attention to during pregnancy.
文摘Rationale:Herlyn-Werner-Wunderlich syndrome,also known as obstructed hemi-vagina with ipsilateral renal agenesis(OHVIRA)syndrome,is a rare congenital anomaly of the Müllerian and Wolffian ducts.It is often asymptomatic until puberty and is usually misdiagnosed as infertility.Patient concerns:A 39-year-old woman desirous of pregnancy was referred to our radiodiagnosis unit for imaging evaluation on account of secondary infertility.Diagnosis:Incidental discovery of uterine bicornis bicollis and blind-ending hemivagina was noted at hysterosalpingography.Interventions:This necessitated the search for other genitourinary tract anomalies,and ipsilateral renal agenesis was also discovered.Outcomes:A diagnosis of Herlyn-Werner-Wunderlich syndrome was made.Lessons:Magnetic resonance imaging(MRI)is considered the gold standard imaging modality for the assessment of uterine malformations.However,in resource-poor centers where MRI is unavailable,a heightened clinical suspicion with the combination of available imaging modalities is important and reliable in making an accurate diagnosis,hence,successful management.
基金the financial assistance from the Secretary of Research of Universidad Autónoma del Estado de Hidalgo(UAEH)through the project“Epidemiological surveillance of the genus Mycobacterium in the species Didelphis virginiana(Tlacuache)of the valley of Tulancingo Hidalgo”with number UAEH/DI/ICAp/MVZ/6.
文摘Objective:To isolate and identify the exact species of the genus Mycobacterium from Didelphis(D.)virginiana,and the direct implications of this bacterium to public health and veterinary medicine.Methods:Thirty-one D.virginiana were captured and necropsied in Hidalgo,Mexico.Tissue samples were collected to culture mycobacteria present and examine individual specimens’histopathology.Mycobacterium identification was obtained through the application of amplification and sequencing of 16S rDNA techniques.Results:Three strains were isolated and identified as Mycobacterium(M.)avium subsp.hominissuis by utilizing M.avium complexspecific primers.Granulomatous lesions were observed in the subpleural zone(granuloma gradeⅡ)and bronchial(granuloma gradeⅠ)of the lungs of D.virginiana with positive isolation.Conclusions:Three strains of M.avium subsp.hominissuis,from lung tissue samples of D.virginiana were identified.This subspecies of M.avium has important implications in public health and veterinary medicine.
