Biomedical subjects

Yasmin Jayasinghe

Publications and source records attributed to Yasmin Jayasinghe.

3 recordsLinked to original sources

PubMed2005

The presentation and early diagnosis of the rudimentary uterine horn.

OBJECTIVE: The key to successful management of the rudimentary uterine horn is early detection. This review of the literature seeks to illustrate important aspects of diagnosis and management of this anomaly. DATA SOURCES: An English language MEDLINE search from 1966 to 2003 was performed, using the search terms "rudimentary uterine horn," "accessory horn," "uterus bicornis unicollis," "hematometra," "unicornuate or bicornuate uterus," and "mullerian anomaly." References from previously published sources were also obtained. METHODS OF STUDY SELECTION: One hundred thirty letters, case reports, case series, and review articles featuring rudimentary uterine horn were found. Reports before 1966 were excluded because outcomes before the advent of modern diagnostic techniques were not relevant to this study. TABULATION, INTEGRATION, AND RESULTS: Three hundred sixty-six rudimentary horn presentations (210 gynecologic and 156 obstetric) were found. Noncommunicating horns accounted for 92% of cases (95% confidence interval [CI] 88-95%, P < .001), and renal anomaly was found in 36% (95% CI 29-44%). Contrary to the American Fertility Society classification of uterine anomalies, rudimentary horns may occur without a corresponding unicornuate uterus. The mean age of presentation was similar for gynecologic and obstetric presentations (23 and 26 years, 95% CIs 21.2-24.6 and 124.9-27.3 years, respectively). Presentation in the third decade of life or later occurred in 78% of patients (95% CI 70-84%, P < .001). Sensitivity of ultrasound examination for diagnosis was 26% (95% CI 18-36%). Diagnosis before clinical symptoms occurred in 14% (95% CI 7-23%). CONCLUSION: Many functional noncommunicating horns present during or after the third decade of life with acute obstetric uterine rupture. Surgical removal before pregnancy is recommended. Rates of prerupture diagnosis remain disappointingly low.

Adolescent↗

PubMed2005

Bleeding disorders in teenagers presenting with menorrhagia.

OBJECTIVE: To assess the prevalence of bleeding disorders and establish the clinical variables that are predictive of a bleeding disorder in adolescent women. DESIGN: A retrospective audit of all patients who had coagulation tests following presentation with menorrhagia. SETTING: Inpatient and outpatients of a tertiary adolescent gynaecology service. PATIENTS: Subjects aged 9-19 years with menorrhagia who had coagulation tests performed, and who did not have a known bleeding disorder prior to presentation were included. OUTCOME MEASURES: A bleeding screen was performed to assess prevalence of bleeding disorders in the population. Variables that were investigated as predictive of a bleeding disorder included clinical history, family history, and haematological indices of blood loss. RESULTS: The prevalence of an inherited bleeding disorder was 10.4%. The only statistically significant predictor was a family history of bruising and bleeding. Menstrual history was not predictive. CONCLUSION: Severity of menstrual loss was not predictive of a bleeding disorder, as a significant cause of teenage metrostaxis is due to anovulatory dysfunctional uterine bleeding. The authors recommend that a careful personal and family history of bruising and bleeding be taken in all teenagers who present de novo with menorrhagia. Routine screening in a primary care setting is impractical, but should be mandatory in all patients with a positive family history.

Adolescent↗

PubMed2004

Gonadal dysgenesis with a difference.

We report here an exceptional clinical finding of a 46,XY phenotypic female with complete gonadal dysgenesis, but who was found unexpectedly to have absence of the uterus and posterior vagina. Extensive review of current and past literature failed to confirm other reports of this variant form of complete gonadal dysgenesis.

Amenorrhea↗