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EARL Y PREGNANCY COMPLICATIONS

Ectopic pregnancy An ectopic pregnancy refers to a pregnancy that grows outside of the uterine cavity , most commonly within the fallopian tube. - To facilitate management of an ectopic pregnancy it is import - - ant to be able to describe the location of t...

FURTHER READING British Association for Sexual Health and HIV . UK national guideline for the management of pelvic inflammatory disease . Macclesfield, UK: BASHH, 2011. Available from https://www .bashh.org/ - documents/3572.pdf. European Society of Human Rep...

Introduction No content extracted automatically.

Learning objectives To understand: Pelvic anatomy • Early pregnancy complications (ectopic pregnancy) • Common causes of an acute abdomen and chronic • abdominal pain

Mesh In the UK, mesh-related surgery is considered to be a high-vigilance operation, whereby use of synthetic mesh to treat SUI or urogynaecological prolapse has been restricted nationally secondary to a number of safety concerns that have been raised: /uni25...

Morcellation This is the process whereby larger tissue is broken down into smaller pieces, facilitating their removal through smaller inci sions in the abdomen. In gynaecology , this is usually o ff ered in the context of a laparoscopic myomectomy to remove fib...

Ovarian cancer Ovarian cancer is the sixth most common malignancy in women, behind breast, lung, bowel, uterine cancer and malig nant melanoma. In the UK, over 7000 women are diagnosed with ovarian cancer each year. Over 90% of cancers arise from the surface ...

TUMOURS Benign ovarian tumours and cysts Overall, 90% of ovarian tumours are benign, with an increased risk of malignancy in older women: the malignant potential of an ovarian cyst in a premenopausal woman is 1:1000, increasing to 3:1000 at the age of 50 y...

UROGYNAECOLOGY Urinary incontinence Urinary incontinence is defined as the involuntary leakage of urine. It is said to a ff ect approximately 30% of women, with a higher prevalence seen in older age groups. It can have a significant impact on quality of life. ...

Uterine fibroids (leiomyoma) Fibroids are usually benign, well-circumscribed, smooth muscle tumours of the uterus. Less than 1% of fibroids undergo malignant transformation (leiomyosarcoma). They are more common in certain populations (African–Caribbean women)...

Uterovaginal prolapse Pelvic organ prolapse refers to the protrusion or displacement of the pelvic organs from their normal anatomical position into or through the vagina to varying degrees ( Figure 87.23 ). It is said to a ff ect up to 40% of women at some p...

Acute antibody-mediated rejection Acute antibody-mediated rejection (AMR) occurs in <5% of renal transplants but is more serious and more di ffi cult to treat than cell-mediated rejection. It is caused by HLA DSA, which are produced by a sensitising episode fro...

Acute cell-mediated rejection In the era of modern immunosuppressive drugs, the incidence of acute cell-mediated rejection (CMR) is only 10–20%. Acute CMR is largely mediated by direct antigen presentation. As donor APCs in the allograft have a lifespan of ...

Antigen presentation in transplantation There are two main types of antigen presentation to T lympho cytes ( Figure 88.7 ). Direct antigen presentation involves donor APCs showing intact and unprocessed donor HLA (class I or class II) molecules on their cell ...

Antiproliferative agents (azathioprine and mycophenolic acid) These drugs are antiproliferative agents. Their mechanism of action is to block purine nucleotide synthesis. This prevents replication of DNA and thus interferes with lymphocyte prolif eration. The ...

Calcineurin inhibitors (ciclosporin and tacrolimus) The calcineurin inhibitors (CNIs) are the mainstay of modern immunosuppressive regimens. CNIs prevent transcription of the IL-2 gene in T cells. As IL-2 is the main T-cell growth factor, inhibition of its p...

Corticosteroids These are potent anti-inflammatory agents that have wide-ranging e ff ects on the immune system. Prolonged exposure to steroids causes numerous potential side e ff ects, including: a Cushingoid appearance with a moon face, central obesity , abdomi...