scholarly journals Ovarian Torsion in the Third Trimester of Pregnancy Leading to Iatrogenic Preterm Delivery

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Evangelia Vlachodimitropoulou Koumoutsea ◽  
Manish Gupta ◽  
Antony Hollingworth ◽  
Anwen Gorry
Keyword(s):  
Caesarean Section ◽  
Lower Abdominal Pain ◽  
Fetal Outcome ◽  
Ovarian Torsion ◽  
Third Trimester ◽  
Preterm Baby ◽  
Presumptive Diagnosis ◽  
Midline Laparotomy ◽  
The Third ◽  
The Right

Ovarian torsion in the third trimester of pregnancy leading to a midline laparotomy and caesarean section for the delivery of a preterm baby is an uncommon event. As the woman is likely to present with nonspecific symptoms of lower abdominal pain, nausea, and vomiting, ovarian torsion can often be misdiagnosed as appendicitis or preterm labour. Treatment and the opportunity to preserve the tube and ovary may consequently be delayed. We report the case of a multiparous woman who had undergone two previous caesarean sections at term, presenting at 35 weeks of gestation with a presumptive diagnosis of acute appendicitis. Ultrasonography described a cystic lesion 6 × 3 cm in the right adnexa, potentially a degenerating fibroid or a torted right ovary. MRI of the pelvis was unable to provide further clarity. The patient was managed by midline laparotomy and simultaneous detorsion of the ovarian pedicle and ovarian cystectomy together with caesarean section of a preterm infant. This report describes that prompt recognition and ensuring intraoperative access can achieve a successful maternal and fetal outcome in this rare and difficult scenario. Furthermore, we would like to emphasise that the risk for a pregnant woman and her newborn could be reduced by earlier diagnosis and management of ovarian masses (Krishnan et al., 2011).

Giant fibroepithelial vulvar polyp in a pregnant woman

2021 ◽  
Vol 14 (1) ◽  
pp. e236106
Author(s):  
Carolina Smet ◽  
Tatiana Gigante Gomes ◽  
Lurdes Silva ◽  
Júlio Matias
Keyword(s):  
Pregnant Woman ◽  
Elective Caesarean Section ◽  
Reproductive Age ◽  
Benign Lesions ◽  
Third Trimester ◽  
Women Of Reproductive Age ◽  
Spontaneous Bleeding ◽  
The Third ◽  
Fibroepithelial Polyps ◽  
The Right

Fibroepithelial polyps are benign lesions that may appear in the vulvovaginal region. They usually occur in women of reproductive age and tend to grow up to 5 cm, but there are some rare cases in which they grow up to 20 cm. We report a case of a 22-year-old woman in the third trimester of her first pregnancy with spontaneous bleeding from a pedunculated mass measuring 15 cm in the widest diameter on the right side of the vulva. Features of this case are discussed as well as its implications, especially regarding the decision of labour. Due to the big size of the mass and its propensity to bleed, we decided to perform an elective caesarean section as well as its excision.

scholarly journals Interstitial Pregnancy in the Third Trimester with Severe Preeclampsia: A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Shiho Nagayama ◽  
Hironori Takahashi ◽  
Shohei Tozawa ◽  
Risa Narumi ◽  
Rie Usui ◽  
...  
Keyword(s):  
Placenta Accreta ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Severe Preeclampsia ◽  
Third Trimester ◽  
Interstitial Pregnancy ◽  
The Third ◽  
Emergency Cesarean ◽  
Placenta Accreta Spectrum ◽  
The Right

An interstitial pregnancy that continues beyond the second trimester is a rare phenomenon. We report a patient with an interstitial pregnancy undiagnosed until the third trimester. A multiparous woman was referred to us because of preeclampsia at 26 weeks of gestation. The placental position was the right fundus, and color Doppler ultrasound revealed myometrial thinning and subplacental hypervascularity, leading to a suspicion of placenta accreta spectrum (PAS). Emergency cesarean section was performed at 281/7 weeks of gestation due to severe preeclampsia. The right tubal horn to the isthmus of the fallopian tube bulged with placental adhesion and a part of the tube had ruptured, with the omentum adhering to the ruptured part. Interstitial and tubal isthmic pregnancy with uterine rupture was diagnosed.

scholarly journals Uterine torsion of 90 degrees: case report

2020 ◽  
Vol 9 (4) ◽  
pp. 1743
Author(s):  
S. Tanouti ◽  
M. Chakri ◽  
H. Taheri ◽  
H. Saadi ◽  
A. Mimouni
Keyword(s):  
Case Report ◽  
Caesarean Section ◽  
Emergency Caesarean Section ◽  
Third Trimester ◽  
Singleton Pregnancy ◽  
The Third ◽  
Emergency Caesarean ◽  
Uterine Torsion ◽  
Vaginal Deliveries ◽  
Obstetrical Unit

Uterine torsion is defined as a rotation of uterus more than 45 degrees along its long axis. However, a pathologic rotation of the uterus beyond 45 degrees-torsion of the entire uterus-is rarely seen in obstetrical practice, authors report a case of torsion of the uterus by 90 degrees. The patient, a 30-year-old gravida 3 para 2 at 37 weeks’ gestation with a singleton pregnancy, her prior obstetrical history included two uncomplicated term vaginal deliveries, and the current pregnancy had been uncomplicated until the date of presentation was admitted to the obstetrical unit  with  labour at 37 weeks 5 days ,on obstetric examination the patient was in labour with transversal presentation of the fetus so an emergency caesarean section (CS) was carried out for. At the time of CS, the diagnosis of uterine torsion of 90 degrees was made. After the delivery of the baby, uterus returned to anatomical position and the torsion corrected spontaneously. The patient recovered and was discharged home with her baby on the third postoperative day. Uterine torsion is an infrequently reported and potentially dangerous complication of pregnancy that occurs mainly in the third trimester.

scholarly journals An elective combined caesarean section and small bowel GIST resection during the third trimester of pregnancy: Report of a case

2013 ◽  
Vol 4 (1) ◽  
pp. 121-124 ◽  
Author(s):  
N. Haloob ◽  
A.A.P. Slesser ◽  
A.R. Haloob ◽  
F. Khan ◽  
G. Bostanci ◽  
...  
Keyword(s):  
Small Bowel ◽  
Caesarean Section ◽  
Third Trimester ◽  
The Third

scholarly journals Computed Tomography Appearance of the “Whirlpool Sign” in Ovarian Torsion

2021 ◽  
Vol 5 (4) ◽  
pp. 468-469
Author(s):  
Joshua Livingston ◽  
Savannah Gonzales ◽  
Mark Langdorf
Keyword(s):  
Computed Tomography ◽  
Lower Abdominal Pain ◽  
Cystic Mass ◽  
Ovarian Torsion ◽  
Venous Flow ◽  
Contrast Enhanced ◽  
Whirlpool Sign ◽  
Ovarian Pathology ◽  
The Right ◽  
Enhanced Computed Tomography

Case Presentation: A 28-year-old female presented to the emergency department complaining of right lower abdominal pain. A contrast-enhanced computed tomography (CT) was done, which showed a 15-centimeter right adnexal cyst with adjacent “whirlpool sign” concerning for right ovarian torsion. Transvaginal pelvic ultrasound (US) revealed a hemorrhagic cyst in the right adnexa, with duplex Doppler identifying arterial and venous flow in both ovaries. Laparoscopic surgery confirmed right ovarian torsion with an attached cystic mass, and a right salpingo-oophorectomy was performed given the mass was suspicious for malignancy. Discussion: Ultrasound is the test of choice for diagnosis of torsion due to its ability to evaluate anatomy and perfusion. When ovarian pathology is on the patient’s right, appendicitis is high in the differential diagnosis, and CT may be obtained first. Here we describe a case where CT first accurately diagnosed ovarian torsion by demonstrating the whirlpool sign, despite an US that showed arterial flow to the ovary. Future studies should determine whether CT alone is sufficient to diagnose or exclude ovarian torsion.

scholarly journals Perinatal Outcome of Deliveries after One Previous Caesarean Section

2015 ◽  
Vol 3 (1) ◽  
pp. 19
Author(s):  
Narinder Kaur ◽  
Sushila Jain
Keyword(s):  
Caesarean Section ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Previous Caesarean Section ◽  
Lower Segment Caesarean Section ◽  
History Of ◽  
Live Fetus ◽  
The Right ◽  
A Prospective Study

Introduction: Contrary to the WHO recommended caesarean section (CS) rate of 15%, there is an alarming trend of increasing caesarean section rates. An important reason for this is repeat caesarean section (RCS). Vaginal birth after caesarean (VBAC) is one of the methods of reducing CS rates in women with history of previous CS. This study was done with the aim to see the maternal and fetal outcome among parturient with history of single previous caesarean section and to determine the rate of VBAC at Lumbini Medical College, Nepal. Methods: This is a prospective study done for a period of ten months. Seventy parturient fulfilling inclusion criteria of term pregnancy with single live fetus and history of one Lower Segment Caesarean Section (LSCS) were enrolled in the study. Patients meeting the criteria for VBAC were given trial of labour and others were taken for elective repeat CS. This cohort was analyzed further, with respect to age, parity, period of gestation, mode of delivery, indication for CS, maternal and fetal complications and outcomes. Results: VBAC was successful in 27.14% of patients (n=19) while the rest 51 (72.85%) underwent RCS . Indications for RCS was mainly scar tenderness 7 (13.7%), fetal distress 6 (11.7%), non progress of labour 6 (11.7%), meconium stained liquor 6 (11.7%) and post-dated pregnancy 6 (11.7%). Maternal morbidity was comparable in women undergoing RCS or VBAC. There was one still birth and one early neonatal death in each group due to complications of meconium aspiration. Conclusion: Patients with previous CS are at high risk of RCS. If trial of labor is allowed under careful patient selection and supervision, the rate of vaginal delivery after caesarean section can be increased safely. As there is no added perinatal morbidity and mortality in cases of VBAC as compared to RCS, VBAC shows the right way forward to decrease the rate of caesarean section.

scholarly journals Current Management and Outcome of Pregnancies in Women With Adrenal Insufficiency: Experience from a Multicenter Survey

2020 ◽  
Vol 105 (8) ◽  
pp. e2853-e2863 ◽  
Author(s):  
Christina Bothou ◽  
Gurpreet Anand ◽  
Dingfeng Li ◽  
Tina Kienitz ◽  
Khyatisha Seejore ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Mode Of Delivery ◽  
First Trimester ◽  
Fetal Outcome ◽  
Adrenal Crisis ◽  
Third Trimester ◽  
Maternal Complications ◽  
The Third ◽  
Addison Disease ◽  
Multicenter Survey

Abstract Context Appropriate management of adrenal insufficiency (AI) in pregnancy can be challenging due to the rarity of the disease and lack of evidence-based recommendations to guide glucocorticoid and mineralocorticoid dosage adjustment. Objective Multicenter survey on current clinical approaches in managing AI during pregnancy. Design Retrospective anonymized data collection from 19 international centers from 2013 to 2019. Setting and Patients 128 pregnancies in 113 women with different causes of AI: Addison disease (44%), secondary AI (25%), congenital adrenal hyperplasia (25%), and acquired AI due to bilateral adrenalectomy (6%). Results Hydrocortisone (HC) was the most commonly used glucocorticoid in 83% (97/117) of pregnancies. Glucocorticoid dosage was increased at any time during pregnancy in 73/128 (57%) of cases. In these cases, the difference in the daily dose of HC equivalent between baseline and the third trimester was 8.6 ± 5.4 (range 1-30) mg. Fludrocortisone dosage was increased in fewer cases (7/54 during the first trimester, 9/64 during the second trimester, and 9/62 cases during the third trimester). Overall, an adrenal crisis was reported in 9/128 (7%) pregnancies. Cesarean section was the most frequent mode of delivery at 58% (69/118). Fetal complications were reported in 3/120 (3%) and minor maternal complications in 15/120 (13%) pregnancies without fatal outcomes. Conclusions This survey confirms good maternal and fetal outcome in women with AI managed in specialized endocrine centers. An emphasis on careful endocrine follow-up and repeated patient education is likely to have reduced the risk of adrenal crisis and resulted in positive outcomes.

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