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.

Surgical Interventions for Interstitial Pregnancy in the Third Trimester with Placenta Accreta

2018 ◽  
Author(s):  
Li Yang ◽  
Zhongjie Yang ◽  
Yuhuan Qiao ◽  
Qi Guo ◽  
Xiaomei Li ◽  
...  
Keyword(s):  
Placenta Accreta ◽  
Third Trimester ◽  
Interstitial Pregnancy ◽  
Surgical Interventions ◽  
The Third

Prevalence of Sonographic Markers of Placenta Accreta Spectrum in Low-Risk Pregnancies

2018 ◽  
Vol 36 (08) ◽  
pp. 733-780 ◽  
Author(s):  
Jennifer Philips ◽  
Margot Gurganus ◽  
Sarah DeShields ◽  
Tina Cunningham ◽  
Elena Sinkovskaya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Placenta Accreta ◽  
Bladder Wall ◽  
Low Risk ◽  
Second Trimester ◽  
Clear Zone ◽  
Third Trimester ◽  
The Third ◽  
Cesarean Deliveries ◽  
Placenta Accreta Spectrum

Objective This study was aimed to evaluate the prevalence of sonographic markers for placenta accreta spectrum (PAS) in pregnancies at low-risk for PAS. Study Design Pregnant women at low-risk for PAS presenting for routine second trimester ultrasound who enrolled in the study were evaluated prospectively for sonographic markers of PAS during two ultrasounds at 18 to 24 and 28 to 34 weeks. Frequencies of PAS markers were compared between the second and third trimester and between those with and without prior cesarean deliveries (CD). Results Overall, 174 women were included. Several markers were seen frequently in the second trimester: vascular cervical invasion (57%), lacunae (46%), subplacental hypervascularity (37%), and irregularity of the posterior bladder wall (37%). Other markers were seen infrequently or not at all: loss of the retroplacental clear zone, uterovesical interface < 1 mm, bridging vessels, placental bulge or focal exophytic mass. Frequencies of markers did not differ between women with and without prior CD. Lacunae were larger and more numerous in the third trimester. Two or more PAS markers were observed in 98% of second trimester ultrasounds. Conclusion Several PAS sonographic markers occur commonly in low-risk pregnancies. In the absence of risk factors, the independent predictive value of these markers is questionable.

scholarly journals Placenta Accreta Spectrum Disorders and Cesarean Scar Pregnancy Screening: Are we Asking the Right Questions?

2021 ◽  
Vol 43 (05) ◽  
pp. 347-350
Author(s):  
Conrado Milani Coutinho ◽  
Laure Noel ◽  
Veronica Giorgione ◽  
Lígia Conceição Assef Marçal ◽  
Amar Bhide ◽  
...  
Keyword(s):  
Placenta Accreta ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Placenta Accreta Spectrum ◽  
Spectrum Disorders ◽  
The Right

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.

Clinical-sonographical and dopplerometric criteria of determining the obstetrician's tactics in cases of the umbilical cord entanglement of the fetal body

2021 ◽  
Vol 50 (2) ◽  
pp. 66-71
Author(s):  
U. R. Khamadyanov ◽  
V. I. Ivakhah
Keyword(s):  
Umbilical Cord ◽  
Color Doppler ◽  
The Body ◽  
Complex Method ◽  
Third Trimester ◽  
The Third ◽  
Trimester Pregnancy ◽  
Pregnancy And Delivery ◽  
Umbilical Cord Entanglement

The complex method of antenatal diagnostics of the cord entanglement round the body of the fetus is elaborated. It includes echography, color Doppler mapping, dopplerometry and actocardiography. On the basis of the data received the system of prognosing and estimating the severity of feta l hypoxia in the end of the third trimester pregnancy is suggested, that allows to choose the correct tactics of pregnancy and delivery management in different rates ofcord entanglement. The use o f this method made it possible to rise the effectiveness of antenatal diagnostics of this gestational complication from 23,5% to 79,4%, to decrease the frequency of postnatal asphyxia to 46,1% and, therefore, to avoid intra- and postnatal loss.

Ultrasound and magnetic resonance imaging in the diagnosis of clinically significant placenta accreta spectrum disorders

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Cecilia Cavalli ◽  
Claudia Maggi ◽  
Sebastiana Gambarini ◽  
Anna Fichera ◽  
Amerigo Santoro ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Color Doppler ◽  
Histopathological Diagnosis ◽  
Resonance Imaging ◽  
Placenta Accreta Spectrum ◽  
Clinically Significant ◽  
Placental Lacunae

Abstract Objectives We aimed to assess the performance of ultrasound (US) and magnetic resonance imaging (MRI) signs for antenatal detection of placenta accreta spectrum (PAS) disorders in women with placenta previa (placental edge ≤2 cm from the internal uterine orifice, ≥260/7 weeks’ gestation) with and without a history of previous Caesarean section. Methods Single center prospective observational study. US suspicion of PAS was raised in the presence of obliteration of the hypoechoic space between uterus and placenta, interruption of the hyperechoic uterine-bladder interface and/or turbulent placental lacunae on color Doppler. All MRI studies were blindly evaluated by a single operator. PAS was defined as clinically significant when histopathological diagnosis was associated with at least one of: intrauterine balloon placement, compressive uterine sutures, peripartum hysterectomy, uterine or hypogastric artery ligature, uterine artery embolization. Results A total of 39 women were included: 7/39 had clinically significant PAS. There were 6/18 cases of PAS with anterior placenta: hypoechoic space interruption and placental lacunae were the most sensitive sonographic signs (83%), while abnormal hyperechoic interface was the most specific (83%). On MRI, focal myometrial interruption and T2 intraplacental dark bands showed the best sensitivity (83%), bladder tenting had the best specificity (100%). 1/21 women with posterior placenta had PAS. There was substantial agreement between US and MRI in patients with anterior placenta (κ=0.78). Conclusions US and MRI agreement in antenatal diagnosis of clinically significant PAS was maximal in high-risk women. Placental lacunae on ultrasound scan and T2 intraplacental hypointense bands on MRI should trigger the suspicion of PAS.

Uterine Artery Doppler in the Third Trimester of Pregnancy and Postnatal Outcome of Patients with Severe Preeclampsia

2009 ◽  
Vol 29 (2) ◽  
pp. 135-147 ◽  
Author(s):  
Brena Carvalho Pinto de Melo ◽  
Melania Maria Ramos de Amorim ◽  
Leila Katz ◽  
Isabela Coutinho ◽  
Giselly Veríssimo
Keyword(s):  
Uterine Artery ◽  
Severe Preeclampsia ◽  
Third Trimester ◽  
Uterine Artery Doppler ◽  
The Third ◽  
Postnatal Outcome

scholarly journals A rare case of placenta percreta causing uterine rupture and massive haemoperitoneum in 2nd trimester: an obvious near miss

2021 ◽  
Vol 10 (6) ◽  
pp. 2495
Author(s):  
Chirayu Parmar ◽  
Mittal Parmar ◽  
Gayatri Desai
Keyword(s):  
Uterine Rupture ◽  
Placenta Accreta ◽  
Hypovolemic Shock ◽  
Placenta Percreta ◽  
Near Miss ◽  
Second Trimester ◽  
Rare Occurrence ◽  
Third Trimester ◽  
Placenta Accreta Spectrum ◽  
Ruptured Uterus

Placenta accreta spectrum is very rarely encountered with ruptured uterus and is commonly seen in third trimester of pregnancy. Hereby, a case of placenta percreta with uterine rupture in second trimester of pregnancy is presented. 40 year old women with previous 2 LSCS presented in emergency department with ninteen weeks pregnancy and massive haemoperitoneum. Emergency laprotomy revealed uterine rupture alnong with placenta percreta for which obstetric hysterectomy was done. Although, a rare occurrence, obstetricians should consider patients placenta accreta spectrum in patients with previous surgeries presenting with haemoperitoneum and signs of hypovolemic shock in second trimester of pregnancy, considering the possibility of rupture at the site of placenta adherance.

scholarly journals Effect of Magnesium Sulfate on Doppler Parameters of Fetal Umbilical and Middle Cerebral Arteries in Women with Severe Preeclampsia

2012 ◽  
Vol 2 ◽  
pp. 85 ◽  
Author(s):  
Nazanin Farshchian ◽  
Negin Rezavand ◽  
Saeed Mohammadi
Keyword(s):  
Magnesium Sulfate ◽  
Doppler Ultrasound ◽  
Color Doppler ◽  
Cerebral Arteries ◽  
Color Doppler Ultrasound ◽  
Severe Preeclampsia ◽  
Resistivity Index ◽  
Middle Cerebral Arteries ◽  
Before And After ◽  
The Mean

Objective: To assess the effect of injecting magnesium sulfate on Doppler parameters of fetal umbilical and middle cerebral arteries (MCA) in women with severe preeclampsia. Materials and Methods: A total of 21 patients with severe preeclampsia admitted to Imam Reza Hospital, Kermanshah (Iran), were evaluated. Before and after administration of magnesium sulfate, Doppler ultrasound scan was carried out to measure fetal middle cerebral artery and umbilical artery blood flow. Paired t-test was used for statistical analysis. Results: After injection of magnesium sulfate, the mean resistivity index (RI)-umbilical, and pulsatility index (PI)-cerebral showed a statistically significant reduction (P < 0.001). The cerebroumbilical C/U ratio increased after the intervention (P < 0.001). The PI-umbilical (P = 0.1) and pre- and post-RI-cerebral (P = 0.96) did not have statistically significant changes. Conclusions: Infusion of magnesium sulfate significantly decreases the flow in the fetus RI-umbilical and PI-MCA, and it increases C/U ratio indices in color Doppler ultrasound.

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