Document Detail


Successful pregnancy after treatment of deep adenomyosis with cytoreductive surgery and subsequent gonadotropin-releasing hormone agonist: a case report.
MedLine Citation:
PMID:  9884446     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Adenomyosis is a common pathologic finding significantly related to the menstrual and reproductive characteristics of women. Although noted during younger reproductive years, it usually presents in women over 35 years of age. For those with a strong desire to preserve fertility, there is presently no uniform agreement on the most appropriate therapeutic methods to manage the condition. Herein, we present a case of long-term secondary infertility with successful pregnancy after treatment of deep adenomyosis with cytoreductive surgery and a subsequent six-month course of gonadotropin-releasing hormone agonist (GnRHa) therapy. For those who want to conceive, early combined GnRHa therapy immediately following cytoreductive surgery and a delay of four to six months before attempting to fall pregnant is advisable. This is because adenomyosis tends to recur rapidly and the myometrium can be significantly disrupted during surgery. The major obstetric complications, such as uterine atony, rupture or placenta accreta, do not increase with adenomyosis during pregnancy. Although two events of threatened abortion and one of preterm labor were encountered during the pregnancy course, a healthy 2,900-g female was delivered by low transverse cesarean section at term. A cesarean section was performed because of previous large cytoreductive surgery. In contrast to GnRHa therapy alone, we report an effective alternative to hysterectomy in order to maintain fertility and achieve successful pregnancy.
Authors:
W H Huang; T S Yang; C C Yuan
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Zhonghua yi xue za zhi = Chinese medical journal; Free China ed     Volume:  61     ISSN:  0578-1337     ISO Abbreviation:  Zhonghua Yi Xue Za Zhi (Taipei)     Publication Date:  1998 Dec 
Date Detail:
Created Date:  1999-01-21     Completed Date:  1999-01-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0005327     Medline TA:  Zhonghua Yi Xue Za Zhi (Taipei)     Country:  TAIWAN    
Other Details:
Languages:  eng     Pagination:  726-9     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Veterans General Hospital-Taipei, Taiwan, ROC.
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MeSH Terms
Descriptor/Qualifier:
Adult
Combined Modality Therapy
Endometriosis / therapy*
Female
Humans
Leuprolide / therapeutic use*
Pregnancy
Chemical
Reg. No./Substance:
53714-56-0/Leuprolide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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