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A Case of Pyomyoma following Uterine Fibroid Embolization and a Review of the Literature

Obele, Chika C; Dunham, Samantha; Bennett, Genevieve; Pagan, Johanna; Sung, Lok Yun; Charles, Hearns W
Background. Since its introduction in 1996, uterine fibroid embolization (UFE) has become standard medical practice in the management of symptomatic uterine fibroids. An extremely rare complication, pyomyoma, has been reported only 5 times previously in the literature following UFE. Case. A 37-year-old woman underwent UFE for symptomatic leiomyomas of the uterus. Signs and symptoms of uterine infection ensued, beginning at 6 days following the procedure. Recurrent fevers and increasing leukocytosis despite the intravenous administration of appropriate antibiotics eventually necessitated surgical intervention on postprocedure day #18. Conclusion. An extremely rare complication of UFE is herein presented, pyomyoma, with a review of other reported cases. Commonalities are sought among these few reported cases with the hope of increasing diagnostic acumen in the detection of this disease.
PMID: 27066283
ISSN: 2090-6684
CID: 2078062

Outcomes of multiple gestations with advanced maternal age

Fox, Nathan S; Rebarber, Andrei; Dunham, Samantha M; Saltzman, Daniel H
OBJECTIVE: To investigate outcomes of twin gestations with advanced maternal age (AMA). STUDY DESIGN: Historical cohort of twin gestations cared for by a maternal-fetal medicine faculty practice. Outcomes of patients with AMA (70) and non-AMA (75) were compared. AMA was defined as age > or =35. Analysis including mode of delivery, gestational age at delivery and overall complications was performed. Significance was determined using the chi-square test or the Student's t-test. RESULTS: The Cesarean rate for AMA was significantly greater compared to non-AMA (80.0% vs. 54.7%; p = 0.001). The main reason for the increased rate was uterine dysfunction. The mean gestational age at delivery for AMA was significantly greater than for non-AMA (36.7 weeks vs. 35.4 weeks; p = 0.02). There were no differences in rates of other adverse outcomes including gestational hypertension, pre-eclampsia, gestational diabetes, suspected fetal growth restriction, preterm birth, low birth weight or low birth weight percentiles. This remained true when we compared the 32 women ages > or =40 years to 118 women ages <40 years. CONCLUSION: Among twin pregnancies, AMA women are not at an increased risk of adverse pregnancy outcomes, aside from an increased rate of cesarean delivery
PMID: 19488951
ISSN: 1476-4954
CID: 133736

Luteal serum estradiol levels during in vitro fertilization-embryo transfer (IVF-ET) cycles do not suggest a role for estradiol supplementation [Meeting Abstract]

Dunham, S; Krey, LC; Noyes, N
ISSN: 0015-0282
CID: 48956

Outcome of multiple gestations with advanced maternal age [Meeting Abstract]

Saltzman D; Dunham S; Lee MJ; Rebarber A; Roshanfekr D; Paidas M
ISSN: 0002-9378
CID: 73669