Focal cervical and vaginal necrosis following uterine artery embolisation.
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Biomedical subjects
Publications and source records attributed to Amnon Amit.
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BACKGROUND: Uterine cervical arteriovenous malformation is a rare cause of vaginal bleeding. CASE: A 32-year-old multigravida presented with severe vaginal bleeding originating in the cervix, which resulted in a hypovolemic shock. Attempts to control the bleeding included hysterectomy, pelvic arterial embolization, and upper vaginectomy. Each proved unsuccessful. Histopathologic examination revealed an arteriovenous malformation. Despite local packing, suturing of the vault area, and brachytherapy to the vaginal vault, bleeding persisted. Treatment with GnRH agonist and tranexamic acid stopped the bleeding. CONCLUSION: Severe vaginal bleeding can be the result of cervical arteriovenous malformation, and GnRH agonist may be used for treatment.
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OBJECTIVE: The purpose of the study was to investigate anxiety and other factors that may predict pain magnitude following termination of pregnancy (TOP) during the first trimester. DESIGN: Prospective, nonrandomized study. SETTING: Department of Obstetrics and Gynecology, Rambam Medical Center in Haifa, Israel. PATIENTS: Forty consecutive women undergoing TOP. OUTCOME MEASURES: Women undergoing a TOP were asked to fill out the State-Trait Anxiety Inventory. Pain magnitude was measured by using a visual analog scale (VAS) at 15, 30, and 60 minutes following the procedure. Correlations between state anxiety, trait anxiety, age, parity, number of TOP, gestational age, and pain magnitude were measured. RESULTS: State anxiety was able to predict pain magnitude on VAS 15 minutes after TOP (P = 0.023), and trait anxiety was able to predict pain magnitude on VAS 30 minutes after TOP (P = 0.013). Other variables failed to show significant results. CONCLUSIONS: Preoperative assessment of anxiety levels may lead to appropriate treatment in order to alleviate discomfort and ensure pain control outcome.