Q & A

Q: Commentary case
A: A 20 year old girl presented with lower abdominal pain for few days. She had regular cycles. Ten months ago she underwent a laparotomy for ovarian cystectomy. The histopathological examination reported mucinous cyst adenoma. However, the treating doctor prescribed Gn RH-a monthly injection for six months, after which time he prescribed her combined pills for few months! Abdominal examination revealed a non-tender slightly mobile pelviabdominal mass of about 14 gestational weeks' size mainly in the left side. Ultrasound scanning detected a normal sized uterus with empty linear cavity and no focal lesion. There was a large thick walled, lobulated cyst full of echogenic fluid, most probably blood. The girl firmly told that she has a pelvic kidney, but this could not be confirmed by ultrasound. She was prepared for exploratory laparotomy. The latter revealed that the left adnexa had been removed in the previous surgery, leaving only the proximal part of the left tube. The right tube and ovary were completely normal. What other operative findings do you expect (approach to diagnosis)? What operative management? What postoperative management?

Q: Goals for Healthy Eating When Pregnant?
A: 1. Eat a variety of foods to get all the nutrients you need. Recommended daily servings include 6-11 servings of breads and grains, two to four servings of fruit, four or more servings of vegetables, four servings of dairy products, and three servings of protein sources (meat, poultry, fish, eggs or nuts). Use fats and sweets sparingly. 2. Choose foods high in fiber that are enriched such as whole-grain breads, cereals, pasta, rice, fruits, and vegetables. 3. Make sure you are getting enough vitamins and minerals in your daily diet while pregnant. You should take a prenatal vitamin supplement to make sure you are consistently getting enough vitamins and minerals every day. Your doctor can recommend an over-the-counter brand or prescribe a prenatal vitamin for you. 4. Eat and drink at least four servings of dairy products and calcium-rich foods a day to help ensure that you are getting 1000-1300 mg of calcium in your daily diet during pregnancy. 5. Eat at least three servings of iron-rich foods per day to ensure you are getting 27 mg of iron daily. 6. Choose at least one good source of vitamin C every day, such as oranges, grapefruits, strawberries, honeydew, papaya, broccoli, cauliflower, Brussel sprouts, green peppers, tomatoes, and mustard greens. Pregnant women need 70 mg of vitamin C a day. 7. Choose at least one good source of folic acid every day, like dark green leafy vegetables, veal, and legumes (lima beans, black beans, black-eyed peas and chickpeas). Every pregnant woman needs at least 0.4 mg of folic acid per day to help prevent neural tube defects such as spina bifida. 8. Choose at least one source of vitamin A every other day. Sources of vitamin A include carrots, pumpkins, sweet potatoes, spinach, water squash, turnip greens, beet greens, apricots, and cantaloupe.

Q: How much exercise while pregnant?
A: Maintaining a regular exercise routine throughout your pregnancy can help you stay healthy and feel your best. Regular exercise during pregnancy can improve your posture and decrease some common discomforts such as backaches and fatigue. There is evidence that physical activity may prevent gestational diabetes (diabetes that develops during pregnancy), relieve stress, and build more stamina needed for labor and delivery. If you were physically active before your pregnancy, you should be able to continue your activity in moderation. Don't try to exercise at your former level; instead, do what's most comfortable for you now. Low impact aerobics are encouraged versus high impact.