Abdome Agudo em Ginecologia

Abdome Agudo em Ginecologia
J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Conceito Afecção não-traumática em vísceras ou estruturas contidas na cavidade pélvica, correspondendo ao aparelho genital feminino, que surge de modo súbito, que pela gravidade e repercussões, deve ser tratada em caráter de urgência.

URGÊNCIA MÉDICA Objetiva Intensidade da dor Presença de massa pélvica Estado hemodinâmico Sinais de irritação peritoneal Internação: clínico ou cirúrgico

URGÊNCIA MÉDICA ABORDAGEM Anamnese Exame físico completo Investigação mínima: hemograma, B-HCG, urina Rotina de abdome agudo Ultrassom/TC/RM Cirurgia (videolaparoscopia)

URGÊNCIA MÉDICA CONDUTA Quadro clínico-hemodinâmico Dúvida diagnóstica Maioria dos casos é cirúrgico A laparoscopia é ideal para diagnóstico e tratamento do abdome agudo ginecológico

Classificação Hemorrágico Inflamatório Vascular (oclusão) J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Abdome Agudo Hemorrágico Gravidez ectópica rota Ruptura de cistos Folicular Corpo lúteo Ruptura de tumores Endometrioma J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Abdome Agudo Inflamatório Salpingite Abscesso tubo-ovariano J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Abdome Agudo Vascular Torção anexial Torção de leiomioma subseroso pediculado Torção de cisto-crescimento exagerado do folículo Tumor de ovário (5 a 15 cm) J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

RX Convencional Pronto-Socorro Início de investigação do quadro de dor Presença de líquidos ou coleções Afastar outras causas de abdome agudo Obstrutivo Inflamatório Vascular Direcionamento J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Ultrassonografia Método obrigatório Via transabdominal: bexiga repleta Doenças não relacionadas ao aparelho ginecológico: apendicite, diverticulite, etc Melhor caracterização de lesões volumosas Aterações vesicais: espessamento, debris na urina Via endovaginal Detalhes ecotexturais do útero, ovários e anexos J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Ultrassonografia J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Ultrassonografia Apendicite J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

TC/ RM Quando US não for suficiente para o esclarecimento diagnóstico Afastar ou diagnosticar outras doenças não relacionadas ao sistema genital Apendicite Diverticulite D. de Chron J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

TC/ RM Apendicite retrocecal Doença de Crohn J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Hemorrágicas (rotura) Cisto funcional Endometrioma Pós cirurgia uterina Gravidez ectópica Inflamatória DIP Vasculares Torção ovariana Torção de miomas Degeneração de miomas J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Hemorrágicas = Cisto funcional (folicular) / Cisto de corpo lúteo Sangramento Rotura: aumento da vascularização ovariana nesta fase Espaço intraperitoneal Dor: simula abdome agudo inflamatório J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Hemorrágicas Abdome Agudo em Ginecologia Cisto funcional ou folicular J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source. Cisto de corpo lúteo

Hemorrágicas = Endometrioma Dor pélvica e infertilidade Ovário: 80% US: diferentes aspectos Cisto com paredes finas e ecos em suspensão “Massa sólida” ou “Cisto chocolate” Nódulos murais RM Dúvida diagnóstica Estadiamento da doença J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Hemorrágicas = Endometrioma J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Hemorrágicas = Rotura uterina EXTREMAMENTE GRAVE Pós operatório imediato Coleções peri-uterinas hematomas J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Hemorrágicas = Rotura uterina PÓS CONIZAÇÃO UTERINA J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Hemorrágicas = Gravidez Ectópica Incidência: 2% das gestações. gestação heterotópica: 0,3 a 1% em gestações decorrentes de reprodução assistida. Mortalidade materna: 10 vezes maior do que no parto vaginal; 50 vezes maior do que no abortamento induzido; J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source. A gravidez ectópica é a principal causa de morte materna no primeiro trimestre da gestação (10 a 15%).

Hemorrágicas = Gravidez Ectópica Implantação ovular fora da cavidade uterina. Ampular=81% Ístmica=12% intraligamentar intersticial ovariana infundibular J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source. intramural Fimbrial=5% abdominal cervical

Hemorrágicas = Gravidez Ectópica Fisiopatologia Bloqueio da passagem do ovo em direção à cavidade uterina Implantação na parede da trompa Enfraquecimento Ruptura Hemorragias

Hemorrágicas= Gravidez Ectópica = Fatores de Risco Alto Risco: doença inflamatória pélvica; cirurgias pélvicas - laqueadura e plastia tubárias; gravidez ectópica anterior; dispositivo intra-uterino; alterações anatômicas das trompas : divertículos, tumores e hipoplasia; endometriose. Risco moderado: técnica de fertilização assistida; múltiplos parceiros sexuais; infecção ginecológica antiga (tuberculose genital).

Hemorrágicas=Gravidez Ectópica=Diagnóstico clínico Sintomas e sinais % Dor pélvica/abdominal Sangramento Amenorréia Massa anexial Tay et al:Ectopic Pregnancy. BMJ, v.320, p , 2000.

Hemorrágicas= Gravidez Ectópica Diagnóstico laboratorial Avaliação quantitativa β-hCG + ultra-sonografia transvaginal (USTV) USTV= massa cística anexial; sensibilidade de 84,4%; especificidade de 98,9%. USTV = inconclusiva (18% dos casos); dosagem do β-hCG. USG transvaginal + dosagem de β-hCG é capaz de diagnosticar a gestação tubária com sensibilidade de 97% e especificidade de 95%.

Hemorrágicas = Gravidez Ectópica

Hemorrágicas (rotura) Cisto funcional Endometrioma Pós cirurgia uterina Gravidez ectópica Inflamatória = DIP Vasculares Torção ovariana Torção de miomas Degeneração de miomas J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Inflamatória = Doença Inflamatória Pélvica Mulheres com vida sexual ativa Importante: eleva risco de gravidez ectópica e infertilidade no futuro Ascensão de microorganismos do trato genital inferior – polimicrobiana (gonococo e clamídia) Espectro de comprometimento: endometrite, salpingite, abscesso tubo-ovariano, peritonite purulenta J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Inflamatória = Doença Inflamatória Pélvica US J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Hemorrágicas (rotura) Cisto funcional Endometrioma Pós cirurgia uterina Gravidez ectópica Inflamatória DIP Vasculares Torção ovariana Torção de miomas Degeneração de miomas J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Vasculares = Torção Ovariana Pouco frequente e raramente lembrado Rotação do ovário em torno do próprio eixo  sofrimento vascular  isquemia Dor aguda Aumento do volume ovariano Antecedentes: cirurgia pélvica (ligadura tubária), tumor ovariano (teratoma) Crianças: sem antecedentes, capacidade de movimentação do ovário J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Vasculares = Torção e Degeneração de Miomas Degeneração vermelha - Infarto hemorrágico Torção - Subserosos - Submucosos: sangramento levando a hematométrio US RM J Infect Dis Feb;135(2): Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women. Badri MS, Zawaneh S, Cruz AC, Mantilla G, Baer H, Spellacy WN, Ayoub EM. Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Vasculares = Torção e Degeneração de Miomas Radiol Bras vol.41 no.4 São Paulo July/Aug. 2008

Vasculares = Torção e Degeneração de Miomas

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