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Vaginal cesarean section for second-trimester therapeutic abortion.
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Vaginal cesarean section for second-trimester therapeutic abortion.

Author: S Karakida Affiliation: Department of Obstetrics and Gynecology, Kenwakai Otemachi Hospital, Fukuoka 803-0814, Japan.T Sasaki Affiliation: Department of Obstetrics and Gynecology, Kenwakai Otemachi Hospital, Fukuoka 803-0814, Japan.K Kai Affiliation: Department of Obstetrics and Gynecology, Kenwakai Otemachi Hospital, Fukuoka 803-0814, Japan; Department of Obstetrics and Gynecology, Oita University Faculty of Medicine, Oita 879-5593, Japan. Electronic address: kenta9sp@oita-u.ac.jp.K Harada Affiliation: Department of Neurosurgery, Kenwakai Otemachi Hospital, Fukuoka 803-0814, Japan.S Yoshimura Affiliation: Department of Anesthesiology, Kenwakai Otemachi Hospital, Fukuoka 803-0814, Japan.All authors
Edition/Format: Article Article : English
Publication:Taiwanese journal of obstetrics & gynecology, 2013 Dec; 52(4): 564-7
Summary:
OBJECTIVE: Pregnancy does not increase the risk of bleeding from a brain arteriovenous malformation (AVM), but once an AVM has bled during pregnancy, the rate of rebleeding during the same pregnancy is high. Therefore, termination of the pregnancy is an option for patients in whom the AVM is located in an eloquent area. We report a woman with an intracerebral hemorrhage from a brain AVM who underwent a  Read more...
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Details

Document Type: Article
All Authors / Contributors: S Karakida Affiliation: Department of Obstetrics and Gynecology, Kenwakai Otemachi Hospital, Fukuoka 803-0814, Japan.; T Sasaki Affiliation: Department of Obstetrics and Gynecology, Kenwakai Otemachi Hospital, Fukuoka 803-0814, Japan.; K Kai Affiliation: Department of Obstetrics and Gynecology, Kenwakai Otemachi Hospital, Fukuoka 803-0814, Japan; Department of Obstetrics and Gynecology, Oita University Faculty of Medicine, Oita 879-5593, Japan. Electronic address: kenta9sp@oita-u.ac.jp.; K Harada Affiliation: Department of Neurosurgery, Kenwakai Otemachi Hospital, Fukuoka 803-0814, Japan.; S Yoshimura Affiliation: Department of Anesthesiology, Kenwakai Otemachi Hospital, Fukuoka 803-0814, Japan.; M Kono Affiliation: Department of Obstetrics and Gynecology, Kenwakai Otemachi Hospital, Fukuoka 803-0814, Japan.; H Narahara Affiliation: Department of Obstetrics and Gynecology, Oita University Faculty of Medicine, Oita 879-5593, Japan.
ISSN:1028-4559
Language Note: English
Unique Identifier: 5534576191
Awards:

Abstract:

OBJECTIVE: Pregnancy does not increase the risk of bleeding from a brain arteriovenous malformation (AVM), but once an AVM has bled during pregnancy, the rate of rebleeding during the same pregnancy is high. Therefore, termination of the pregnancy is an option for patients in whom the AVM is located in an eloquent area. We report a woman with an intracerebral hemorrhage from a brain AVM who underwent a second-trimester therapeutic abortion by vaginal cesarean section. CASE REPORT: A 30-year-old multiparous woman visited our emergency department at 17 weeks of gestation complaining of a sudden-onset headache with vomiting. She had no history of headaches or seizures. Based on the clinical presentation, computed tomography and magnetic resonance imaging, we made a clinical diagnosis of Spetzler-Martin Grade III AVM. Before undergoing stereotactic radiosurgery as a primary treatment, we advised her to terminate her pregnancy and performed a vaginal cesarean section at 19 weeks of gestation. Two months later, the patient underwent gamma knife surgery for the underlying lesion, without complications. Follow-up angiography and magnetic resonance imaging showed that the AVM had disappeared completely. CONCLUSION: Although its indications are limited, vaginal cesarean section is a useful option for terminating a pregnancy that compensates for the disadvantages of dilatation and curettage and systemic abortifacients.

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Primary Entity

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