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Uterine Wall (uterine + wall)
Selected AbstractsReciprocal chemokine receptor and ligand expression in the human placenta: Implications for cytotrophoblast differentiationDEVELOPMENTAL DYNAMICS, Issue 4 2004Penelope M. Drake Abstract At the onset of pregnancy, the human placenta, which forms the interface between the embryo/fetus and the mother, must rapidly develop into a life-sustaining organ. The many unusual processes entailed in placental development include the poorly understood phenomenon of maternal tolerance of the hemiallogeneic cells of the conceptus, including, most remarkably, placental trophoblasts that invade the uterine wall. To investigate whether this fetal organ exerts control over the maternal immune system at the level of leukocyte trafficking, we examined placental expression of chemokines, well-known cytokine regulators of leukocyte movements. In situ hybridization revealed abundant expression of 13 chemokines in the stromal but not the trophoblast compartment of chorionic villi. Potential roles for these molecules include recruitment of the resident macrophage (Hofbauer cell) population to the villi. In parallel, cytotrophoblast production of a panel of nine chemokine receptors was assessed by using RNase protection assays. The numerous receptors detected suggested the novel possibility that the paracrine actions of chemokine ligands derived from either the villous stroma or the decidua could mediate general aspects of placental development, with specific contributions to cytotrophoblast differentiation along the pathway that leads to uterine invasion. Developmental Dynamics 229:877,885, 2004. © 2004 Wiley-Liss, Inc. [source] Color doppler imaging in the sonohysterographic diagnosis of residual trophoblastic tissueJOURNAL OF CLINICAL ULTRASOUND, Issue 4 2002Yaron Zalel MD Abstract Purpose The purpose of this study was to evaluate the role of color Doppler imaging during sonohysterography in the diagnosis of residual trophoblastic tissue. Methods This prospective cohort study involved 25 consecutive women with clinical and sonographic signs of an echogenic intrauterine mass who were referred to the sonography unit of our institution for evaluation. All women underwent saline infusion sonohysterography with color Doppler sonographic evaluation. An operative hysteroscopy with histologic examination was performed in 17 cases. Results Thirteen women (group A) had sonohysterographic features suggestive of residual tropho- blastic tissue (ie, an echogenic intrauterine lesion not detached from the uterine wall after introduction of saline). The initial diagnosis was confirmed by histologic analysis in all cases. Blood flow was detected within the intrauterine mass in 6 (46%) of these 13 women; the resistance indices were low in all 6 cases (mean ± standard error, 0.38 ± 0.01). Twelve women (group B) had sonohysterographic findings negative for retained tissue, and no blood flow was detected within any of the intrauterine masses in this group (p < 0.05). Conclusions Our results confirm the potential role of color Doppler sonography in the initial diagnosis of residual trophoblastic tissue. The detection of color Doppler signals, especially with low-resistance flow, within an intrauterine lesion should increase the confidence of the sonologist in the diagnosis of residual trophoblastic tissue. © 2002 Wiley Periodicals, Inc. J Clin Ultrasound 30: 222,225, 2002; Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/jcu.10059 [source] Uterus-like mass: MRI appearance of a very rare entityJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 1 2007Kirsten A. Menn BA Abstract We describe a 37-year-old patient who presented with right lower quadrant pain and intermenstrual bleeding. MRI demonstrated a 5 × 5 cm lobulated mass centered in the right uterine wall interpreted as suspicious for malignancy. A total hysterectomy was performed, and the gross and histologic features were consistent with the diagnosis of a uterus-like mass. Uterus-like mass is a benign entity that can be found in a variety of organs, and is characterized by endometrium surrounded by smooth muscle. It is an extremely rare lesion with only approximately 15 cases reported in the current literature. There is a lack of imaging literature on this entity, which is primarily described in the pathology literature. Its histogenesis is uncertain, but is theorized to be metaplastic change, congenital anomaly, and/or heterotopia. However, given the MRI appearance in this case, we feel that uterus-like mass could be prospectively diagnosed or listed in a differential diagnosis. J. Magn. Reson. Imaging 2007;26:162,164. © 2007 Wiley-Liss, Inc. [source] Uterine preservation in a woman with spontaneous uterine rupture secondary to placenta percreta on the posterior wall: A case reportJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 2 2009Le-Ming Wang Abstract Several cases in which uteruses have been preserved in women with placenta percreta have been reported. We herein report a 38-year-old woman with a history of previous cesarean section who was admitted with lower abdominal pain and vaginal bleeding at 31 weeks of gestation. An urgent exploratory laparotomy revealed active bleeding from the uterine rupture on the posterior uterine wall. A female infant weighing 1560 g, with Apgar scores of 1, 1, and 3 at 1, 5, and 10 min, respectively, was delivered, and the placenta was removed. We performed bilateral uterine vessel occlusion, followed by wedge resection of the ruptured uterine wall with the aid of an intrauterine muscle injection of 20 IU oxytocin, a local injection of diluted vasopressin (1:60) into the myometrium around and into the rupture site, and an intramuscular injection of 0.2 mg methylergonovine, primary repair of the defect, and an additional 24-h postoperative oxytocin infusion (30 IU in 5% dextrose 500 mL) to preserve the uterus successfully. Although the overall blood loss was 3700 mL, no disseminated intravascular coagulopathy occurred after the patient had received adequate blood transfusion. The postoperative pathological diagnosis was placenta percreta with uterine rupture. The patient and her baby were discharged uneventfully. In some cases of spontaneous uterine rupture secondary to placenta percreta, we can preserve the uterus by performing bilateral uterine vessel occlusion and wedge resection of the ruptured uterine wall. [source] Computer-assisted navigation applied to fetal cardiac interventionTHE INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Issue 3 2007Stephen P. Emery Abstract Background Prenatal cardiac interventions (PCI) for human fetal aortic valve (AoV) stenosis can reduce left ventricular hypoplasia and restore ventricular growth and function. However, ,freehand' needle delivery from the maternal skin through the uterine wall, fetal chest and ventricular apex to cross the fetal AoV remains technically challenging and time intensive, and is the rate-limiting step in the procedure. Methods We developed a computer-assisted navigation (CANav) system that tracks the position and orientation of a two-dimensional (2D) ultrasound image relative to the trajectory of an electromagnetic (EM) embedded needle and stylet. We tested the CANav system in vitro using a water bath phantom, then in vivo using adult rats and pregnant (fetal) sheep. Results The CANav system accurately tracked the delivered needle position in both in vitro phantom and adult rat model experiments. We performed 22 PCI attempts with or without CANav in a fetal sheep model. Maternal laparotomy was required to adjust the fetal position in 50% of the procedures. The time required to deliver the needle from the skin into the left ventricle (LV) using CANav was 2.9 ± 1.7 (range 2,7) min (n = 14) vs. 5.5 ± 4.3 (range 1,12) min (n = 8) without CANav (p < 0.05). The time needed to cross the aortic valve once the needle was within the LV was similar with and without CANav (p = 0.19). Conclusions CANav reduces the PCI time required to accurately deliver a needle to the fetal heart. Adaptations of this technical approach may be relevant to other congenital cardiac conditions and ultrasound-guided medical procedures. Copyright © 2007 John Wiley & Sons, Ltd. [source] REVIEW ARTICLE: The Contribution of Macrophages to Normal and Pathological PregnanciesAMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 6 2010Takeshi Nagamatsu Citation Nagamatsu T, Schust DJ. The contribution of macrophages to normal and pathological pregnancies. Am J Reprod Immunol 2010 Macrophages represent one of the major leukocyte subsets in the uterine decidua. Owing to their remarkable phenotypic plasticity, decidual macrophages can participate in diverse activities during pregnancy. At baseline, decidual macrophages are characterized by an immunosuppressive phenotype and M2 polarization, supporting feto-maternal immune tolerance. In early pregnancy, macrophage-derived pro-angiogenic factors prompt vascular remodeling within the uterine wall to ensure appropriate utero-placental circulation. Upon invasion by pathogens, pattern recognition receptors on decidual macrophages help to alter the characteristics of these malleable cells toward an M1, inflammatory phenotype. Similar inflammatory characteristics are seen in those macrophages that accumulate in the lower segment of the uterus to drive cervical ripening. Disturbances in the tight control that balances macrophage function during pregnancy can trigger the development of pregnancy complications. Here, we discuss the physiologic role of uterine macrophages at different stages of pregnancy and describe their relevance in selected pregnancy disorders. [source] Uterine torsion diagnosed in a mare at 515 days' gestationEQUINE VETERINARY EDUCATION, Issue 10 2010C. López Summary A pregnant mare with a history of prolonged gestation (,515 days) and suspected diagnosis of fetal mummification was examined. Rectal palpation revealed that the left broad ligament of the uterus was dorsal and medial to the right uterine ligament and it was not possible to observe the cervix during vaginal examination. Transabdominal ultrasound revealed fluid in the uterus, fetal membranes and the uterine walls defined and thickened. Free fluid was not seen in the peritoneal cavity. Laboratory tests (blood cell count and clinical chemistry) were normal. Based on clinical history, physical examination and ultrasound findings, a chronic uterine torsion with fetal death was diagnosed and the mare was subjected to exploratory celiotomy. The uterus was strongly adhered to the peritoneum of the ventral abdominal wall and there were multiple adhesions to the colon. Hysterotomy was performed to remove the fetus and to permit repositioning of the uterus. When the fetus was removed, a large devitalised grey tissue area of the right ventral uterine horn was observed. Multiple adhesions prevented a rescue hysterectomy and euthanasia of the patient was performed. During the necropsy, a 180° cranial cervix clockwise uterine torsion was observed. This rare case of uterine torsion appears to be the most chronic case reported in the equine literature. [source] Uterine compression sutures for post-partum bleeding with atony; modification of the B-Lynch sutureAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2009Jeevan Prasanga MARASINGHE We have described a modification of the B-Lynch uterine compression suture which is simple and effective. This technique apposes the anterior and posterior uterine walls, obliterating the cavity and thereby provides effective control of post-partum haemorrhage as a result of uterine atony. It comprises of vertical compression sutures and is distinct from B-Lynch and Haymen's suture by having an additional firm puncture just below the uterine fundus. This means that the suture is transfixed at the uterine fundus, thus eliminating the risk of the sutures sliding off at the uterine fundus. [source] | |||||||||||||||||||