The aim of this work is to suggest a new diagnostic approach to the "female varicocele syndrome" which utilizes transvaginal ultrasonography. The presence of circular or linear anechogenic structures with a diameter greater than 5 mm, which were found in transverse and oblique sections of the lateral fornices, was indicative of pelvic varices. The vascular nature of these structures was confirmed with the Valsalva's maneuver and in the upright position. The presence of "pelvic varices" was confirmed by retrograde phlebography of the left ovarian vein in 46% of the cases. In such cases the parity was greater than in subjects without "pelvic varices" (chi square = 12.75, p less than 0.001), and the principal symptoms were characterized by pelvic pains and menstrual cycle disorders.
Congenital granular epulis is a benign tumor that has rarely been diagnosed prenatally, although there have been numerous reports on its postnatal diagnosis. We report a case of large granular epulis diagnosed at 31 weeks' gestation in a woman whose previous anomaly scan had been normal. The lesion was 2.5 cm in diameter, pedunculated, and arose from the maxilla. It was completely surgically removed following preterm vaginal birth and histologically examined. The tumor did not prevent deglutition of the amniotic fluid and did not interfere with feeding or respiration, but prevented complete closure of the lips. We discuss the fetal management and the theories of histogenesis, and highlight the importance of early diagnosis and treatment.
A 49,XXXXX fetus was detected in amniotic fluid cell cultures from a 39-year-old mother. On ultrasonography, growth retardation and bilateral radioulnar synostosis were found. Additional clinical manifestations were mild facial anomalies and hypoplastic ovaries depleted of oocytes. Molecular analysis showed that this aneuploidy arose by successive maternal non-disjunction.
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