PubMed Health⌕ Search

Biomedical subjects

Y N Bakri

Publications and source records attributed to Y N Bakri.

At least 19 recordsLinked to original sources
PubMed2001

Tamponade-balloon for obstetrical bleeding.

OBJECTIVES: To study the effectiveness of a large volume, fluid-filled tamponade balloon in the management of post-partum hemorrhage originating from the implantation site of low-lying placenta/placenta previa. METHODS: A silicone, fluid-filled balloon was designed for tamponade function, with a filling capacity volume of 500 cc of sterile saline, and strength to withstand a maximum internal and external pressure of 300 mmHg. Five women with postpartum bleeding caused by low-lying placenta/placenta previa, and one woman with cervical ectopic pregnancy, underwent a tamponade balloon insertion as a conservative measure in the management of bleeding. RESULTS: The tamponade balloon was used in five women with post-partum bleeding caused by low-lying placenta/placenta previa, and in one woman with cervical pregnancy. The balloon was effective in controlling post-partum hemorrhage originating from the placental site of the lower uterine segment, and bleeding from the implantation site of cervical ectopic pregnancy. CONCLUSION: Hemostasis in cases of post-partum bleeding caused by low-lying placenta/placenta previa can be achieved by using a large volume, fluid-filled tamponade balloon.

Balloon Occlusion↗
PubMed2000

Malignant germ cell tumors of the ovary. Pregnancy considerations.

OBJECTIVE: To study the pregnancy association and malignant germ cell tumors of the ovary with regard to its effects on tumor prognosis. STUDY DESIGN: : Seventy-five patients with malignant germ cell tumors of the ovary treated at the King Faisal Specialist Hospital-Research Center (KFSH-RC) Riyadh, Kingdom of Saudi Arabia between January 1976 and December 1992, were reviewed. Data was retrieved from the medical records and the database of ovarian tumor pathology. Patients with tumor/pregnancy association were identified and correlation with obstetrical outcome and tumor prognosis analyzed. Patients who conceived after treatment were identified and their reproductive outcome described. RESULTS: Malignant germ cell tumor was associated with pregnancy in a group of ten patients. Possible tumor effects upon pregnancy in this group included operative delivery by caesarean section (n=3), mid-trimester termination (n=2), spontaneous abortion (n=1). Four patients had normal vaginal birth with no apparent tumor effects upon pregnancy. Pregnancy did not seem to influence the tumor prognosis of pure dysgerminoma (n=6), however, two patients with non-dysgerminomatous germ cell tumor (one endodermal sinus tumor and one immature teratoma) died of rapidly progressive disease during the second trimester. Two patients with advanced (stage IIIC) disease concurrent with pregnancy (one pure dysgerminoma and one mixed germ cell tumor), had normal fetal outcomes and achieved long-term survival. Amongst the 22 patients who planned to conceive after conservative surgery, with or without post-operative adjuvant chemotherapy, 12 conceived (12/22) and achieved a total of 20 pregnancies. Their outcomes included normal births (n=18) including one set of twins and hydatidiform moles (n=2). CONCLUSIONS: Our findings suggest that, (1) The association of pure dysgerminoma and pregnancy did not adversely affect the tumor prognosis or fetal outcome. However, the question remains as to whether pregnancy worsened the prognosis of non-dysgerminomatous germ cell tumors. (2) Recent platinum-based regimens of multiagent chemotherapy for germ cell tumors did not seem to affect fertility potential.

Adolescent↗
PubMed1998

Complete molar pregnancy. Clinical trends at King Fahad Hospital, Riyadh, Kingdom of Saudi Arabia.

OBJECTIVE: To describe the clinical trends of complete hydatidiform mole at the King Fahad Hospital (KFH), Riyadh, Saudi Arabia. METHODS: Medical record review of 71 patients admitted to KFH for the primary management of complete hydatidiform mole (CHM) during the period 1984-1995 was performed, and clinical trends were identified. RESULTS: During the study period, 48,000 live births occurred, and a total of 71 patients were admitted for management of CHM; the incidence of CHM was 1:676 live births. The mean gestational age at molar evacuation was 13.3 weeks, and 54.4% of patients were diagnosed in the first trimester. At the time of presentation, excessive uterine size, anemia, hyperemesis and preeclampsia were present in 20 (28%), 11 (15.5%), 9 (12.6%) and 1 (1.4%) patient, respectively. Persistent gestational trophoblastic tumor developed in 32 (45.1%) patients. CONCLUSION: A higher proportion of our CHM patients developed persistent gestational trophoblastic tumors when compared with those in North American studies. CHM was diagnosed earlier in pregnancy in Saudi Arabia at our hospital during the past decade, and the patients frequently did not present with the classic signs and symptoms of complete mole.

Adolescent↗
PubMed1995

Augmentation cystoplasty after cesarean hysterectomy for placenta previa-percreta.

We report a case of a 38-year old woman with placenta previa-percreta and urinary bladder invasion. Resection of the bladder wall during cesarean hysterectomy was complicated by a postoperative vesico-vaginal fistula and small-capacity bladder. A reconstructive augmentation cystoplasty utilizing the ileum was successful in improving the bladder capacity. To our knowledge, this is the first report of a placenta previa-percreta with bladder wall invasion which required reconstructive augmentation cystoplasty after cesarean hysterectomy. The obstetrician-gynecologist should be aware of reports of complications related to augmentation procedures, including late malignancy which may develop in the bowel segment used for cystoplasty.

Adult↗
PubMed1994

Massive theca-lutein cysts, virilization, and hypothyroidism associated with normal pregnancy.

A 28-year old primigravida with massive bilateral theca-lutein cysts associated with a non-molar pregnancy is reported. The pregnancy resulted in a spontaneous premature vaginal birth of a 27-week gestation female infant, with no placental pathology or congenital anomalies. During the same pregnancy and post partum period the patient manifested an associated synchronous endocrinopathy of severe hypothyroidism and virilization. The cysts, except for one 2.5 cm in size still present, completely resolved with non-surgical approach during the 10 months period following delivery.

Adult↗
PubMed1994

Ureteral injury secondary to laparoscopic CO2 laser.

A case of a 32-year-old nulligravida who underwent a carbon dioxide laser-laparoscopy for endometriosis is reported. Ureteral injury was complicated by a postoperative 'urinoma'. Injury occurred despite utilizing the hydrodissection technique destined to create a bed of water beneath the peritoneum to prevent laser beam penetration to adjacent normal tissue. This case illustrates that the hydrodissection technique may be less effective in the presence of severe endometriotic adhesions and fibrosis.

Adult↗
PubMed1994

Pulmonary metastases of gestational trophoblastic tumor. Risk factors for early respiratory failure.

Between January 1980 and December 1990, 75 (57.3%) of 131 patients with metastatic gestational trophoblastic tumor had pulmonary metastases detected on plain chest roentgenography at the King Faisal Specialist Hospital and Research Centre. Pulmonary involvement was commonly extensive, with 32 (42.7%) patients having > 10 pulmonary metastases and 45 (60%) patients having a pulmonary lesion > 5 cm in diameter. Greater than 50% lung opacification, mediastinal involvement and pleural effusion were present in 25 (33.3%), 25 (33.3%) and 36 (48%) patients, respectively. Eight (10.7%) patients developed early respiratory failure requiring mechanical ventilation within one month of presentation. The development of early respiratory failure was significantly associated with the presence of dyspnea, anemia, clinical pulmonary hypertension, cyanosis, > 50% lung opacification, mediastinal involvement and bilateral pleural effusion. Because all patients requiring mechanical ventilation died, the use of extracorporeal perfusion should be considered in patients with early respiratory failure.

Adult↗
PubMed1993

Liver metastases of gestational trophoblastic tumor.

A retrospective study was conducted to determine if a chemotherapy regimen incorporating cis-platinum, etoposide, and actinomycin D (PEA) was associated with an outcome different from that of the standard triple regimen of methotrexate, actinomycin D, and chlorambucil (MAC) in patients with gestational trophoblastic tumor and liver metastases. Subjects were treated at the King Faisal Specialist Hospital Gestational Trophoblastic Center (KFSH-GTC) between January 1980 and December 1990. Of 19 patients with gestational trophoblastic tumor and liver metastases, 6 received MAC chemotherapy, and 8 received PEA. Five patients were terminally ill and received palliative treatment only. Treatment outcome was measured by beta-subunit human chorionic gonadotropin assay (beta-HCG) and by imaging studies which included ultrasound, computerized axial tomography, and/or magnetic resonance imaging. Durable remission was obtained in 5 of 8 (62.5%) PEA-treated patients and none of 6 MAC-treated patients. There was no difference in risk status or World Health Organization (WHO) prognostic score between the two groups. We conclude that PEA is a relatively effective chemotherapy regimen in the treatment of gestational trophoblastic tumor with liver metastases, and it may be worthy of consideration for prospective clinical trials.

Adult↗
PubMed1993

Placenta previa-percreta: magnetic resonance imaging findings and methotrexate therapy after hysterectomy.

A case is reported of a 42-year-old woman with placenta previa-percreta and multiple previous cesarean sections. Preoperative magnetic resonance imaging findings are described. Management included a cesarean supracervical hysterectomy, bilateral hypogastric arterial ligation, and intraoperative methotrexate administration. The placental portion that invaded the urinary bladder wall was left in place, without attempt to remove it surgically.

Adult↗
PubMed1993

Placenta percreta with bladder invasion: report of three cases.

Three cases are reported of placenta percreta with urinary bladder wall invasion. All three patients had complete placenta previa and each had five previous cesarean sections. Placental invasion caused a giant vesicouterine fistula in the first case. The second patient had a cesarean hysterectomy and the placental portion that penetrated the bladder wall was left to absorb spontaneously. The third patient underwent a cesarean supracervical hysterectomy during which the bladder invasion was left undisturbed. She received intraoperative methotrexate, and pelvic packing and bilateral hypogastric ligation were helpful in hemorrhage control.

Adult↗
PubMed1993

Gonadal dysgerminoma-seminoma associated with severe hypercalcemia.

A case is reported, of a 25-year-old phenotypic female, karyotypic male patient with metastatic gonadal dysgerminoma-seminoma and severe hypercalcemic paraneoplastic syndrome. Patient manifested normal female external genitalia, vagina, uterus, and fallopian tubes but with 46 XY karyotype. Adnexal gonads were calcified. External beam radiation therapy resolved the hypercalcemic state. Exploratory laparotomy after irradiation revealed gonadoblastoma originating from dysgenetic gonads.

Adult↗
PubMed1992

Pregnancy complicated by malaria, precipitate labor and uterine rupture.

A case of Plasmodium falciparum malaria is reported in a 25-year-old pregnant woman with a history of three previous cesarean sections. She developed premature precipitate labor which was complicated by stillbirth, uterine rupture, bladder and vaginal tears necessitating hysterectomy.

Adult↗