scholarly journals Spontaneous intra-abdominal bleeding in twin pregnancy: Case report

2008 ◽  
Vol 136 (5-6) ◽  
pp. 299-301 ◽  
Author(s):  
Milica Berisavac ◽  
Radmila Sparic ◽  
Miroslava Pervulov ◽  
Ljubica Arsenijevic ◽  
Svetlana Spremovic-Radjenovic ◽  
...  
Keyword(s):  
Spontaneous Rupture ◽  
Twin Pregnancy ◽  
Clinical Symptoms ◽  
Unknown Origin ◽  
Uterine Wall ◽  
Emergency Laparotomy ◽  
Recurrent Bleeding ◽  
Third Trimester ◽  
Abdominal Bleeding ◽  
In Pregnancy

INTRODUCTION Spontaneous rupture of utero-ovarian vessels is a rare cause of haemoperitoneum in pregnancy, leading to significant maternal and foetal morbidity and mortality. Aetiopathogenesis of this condition is still unclear. Establishing clinical diagnosis of this condition is difficult, but very important. Clinical symptoms are nonspecific, and the diagnosis is usually made at laparotomy. CASE OUTLINE We report a case of spontaneous haematoperitoneum in the third trimester of twin pregnancy. Differential diagnosis included uterine rupture and placental abruption. Due to the deteriorated condition of the patient, it was decided to perform laparotomy which established the diagnosis of ruptured venous varices on the posterior uterine wall. Delivery was performed by caesarean section. The postoperative period was uneventful. CONCLUSION The clinical presentation of spontaneous rupture of utero-ovarian blood vessels is not specific and clinical examination and ultrasonographic scanning may be insufficient for diagnosis. Once the diagnosis of spontaneous haematoperitoneum in pregnancy is established, emergency laparotomy is indicated. Following caesarean delivery, it is necessary to establish surgical haemostasis. There are some authors who suggest leaving the pregnancy intact in cases when the fetus is not viable, although one must have in mind the possibility of recurrent bleeding. The safety of this procedure requires further investigation. It is necessary to have in mind the possibility of blood vessel rupture in all cases of abdominal pain and hypotension of unknown origin during pregnancy.

scholarly journals Spontaneous Rupture of Uterine Vein in Twin Pregnancy

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Emek Doger ◽  
Yigit Cakiroglu ◽  
Sule Yildirim Kopuk ◽  
Bertan Akar ◽  
Eray Caliskan ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Spontaneous Rupture ◽  
Laboratory Tests ◽  
Twin Pregnancy ◽  
Acute Abdominal Pain ◽  
Clinical Symptoms ◽  
Rare Complication ◽  
Hypovolemic Shock ◽  
Third Trimester ◽  
The Right

Objective. Aim of our study is to present a case of a twin pregnancy following invitro fertilization cycle complicated with hemoperitoneum at third trimester.Case. A 26-year-old nulliparous pregnant woman at 32 weeks of gestation with twin pregnancy following invitro fertilization cycle complained of abdominal pain. After 48 hours of admission, laparotomy was performed with indications of aggravated abdominal pain and decreased hemoglobin levels. Utero-ovarian vein branch rupture was detected on the right posterior side of uterus and bleeding was stopped by suturing the vein. Etiopathogenesis of the present case still remains unclear.Conclusion. Spontaneous rupture of the uterine vessels during pregnancy is a rare complication and may lead to maternal and fetal morbidity and mortality. Diagnosis and treatment are based on the clinical symptoms of acute abdominal pain and laboratory tests of hypovolemic shock signs.

scholarly journals Hemoperitoneu Espontâneo na Gravidez

2019 ◽  
Vol 32 (11) ◽  
pp. 730 ◽  
Author(s):  
Daniela Gonçalves ◽  
Marcília Teixeira ◽  
Rosa Rodrigues ◽  
Jorge Braga
Keyword(s):  
Pregnancy Outcomes ◽  
Clinical Symptoms ◽  
Uterine Wall ◽  
Fetal Bradycardia ◽  
Chronic Disorder ◽  
Spontaneous Hemoperitoneum ◽  
Positive Effect ◽  
Previous Medical History ◽  
In Pregnancy

Endometriosis is a benign, estrogen-dependent chronic disorder. Pregnancy is considered to have a positive effect on endometriosis due to blockage of ovulation; however, evidence is emerging on the role of endometriosis not only in infertility but also in poor pregnancy outcomes. We present the case of a pregnant woman admitted for sudden and severe abdominal pain at 34 weeks gestation. Her previous medical history included endometriosis suspected by clinical symptoms and ultrasound. During cesarean section, performed by sustained fetal bradycardia, a large volume hemoperitoneum and multiple hemorrhagic foci in the posterior uterine wall were detected. Although rare, spontaneous hemoperitoneum may occur in pregnancy, especially in women with endometriosis. Thus, a prompt suspicion and expedite intervention are needed to improve maternal and fetal outcomes.

scholarly journals Spontaneous Rupture of Pyometra Causing Peritonitis in Elderly Female Diagnosed on Dynamic Transvaginal Ultrasound

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Sharad M. Malvadkar ◽  
Madhuri S. Malvadkar ◽  
Shilpa V. Domkundwar ◽  
Shariq Mohd
Keyword(s):  
Spontaneous Rupture ◽  
Rare Complication ◽  
Transvaginal Ultrasound ◽  
Uterine Cavity ◽  
Uterine Wall ◽  
Transvaginal Sonography ◽  
Inflammatory Cell Infiltrate ◽  
Emergency Laparotomy ◽  
First Case ◽  
Enhanced Computed Tomography

Pyometra is collection of pus within the uterine cavity and is usually associated with underlying gynaecological malignancy or other benign causes. Spontaneous rupture of pyometra is a rare complication. We report a case of a 65-year-old female who presented with acute abdomen and was diagnosed with a ruptured uterus secondary to pyometra and consequent peritonitis on dynamic transvaginal sonography (TVS) which was later confirmed on contrast enhanced computed tomography (CECT). An emergency laparotomy was performed and about 800 cc of pus was drained from the peritoneal cavity. A rent was found in the anterior uterine wall and hence hysterectomy was performed. Histopathology revealed mixed inflammatory cell infiltrate with no evidence of malignancy. There are only 31 cases of ruptured pyometra reported till date, most of which were definitively diagnosed only on laparotomy. In only two of these cases the preoperative diagnosis was made on CECT. We report this case, as the correct and definitive diagnosis was made preoperatively on dynamic TVS. To our knowledge,this is the first case report revealing spontaneous ruptured pyometra being diagnosed preoperatively on dynamic TVS. This report is aimed at giving emphasis on the use of simple dynamic TVS for accurate diagnosis of rare spontaneous ruptured pyometra causing peritonitis.

scholarly journals Spontaneous Rupture of Uterine Veins In Pregnancy

2013 ◽  
Vol 25 (2) ◽  
pp. 85-86 ◽  
Author(s):  
KH Shahnewaj ◽  
Md Al Sayed ◽  
Kauser Jabin
Keyword(s):  
Abdominal Pain ◽  
Maternal Mortality ◽  
Blood Vessels ◽  
Spontaneous Rupture ◽  
Unknown Origin ◽  
High Rate ◽  
Foetal Loss ◽  
Uterine Vessel ◽  
In Pregnancy ◽  
Uterine Vessels

Spontaneous rupture of uterine vessels during pregnancy is a rare cause of shock that has a  high rate of maternal and foetal loss. Though the usual presentation is of maternal shock, it  is necessary to have in mind that possibility of blood vessels rupture may be in cases of  abdominal pain & hypotension of unknown origin during pregnancy. In such an event an exploratory laparatomy followed by caesarean with ligation of the uterine  vessel or its branch can help in preventing a maternal mortality. The advent of modern  resuscitative facilities, anaesthesia techniques have lowered mortality associated with this condition from 49% to 3.6%. DOI: http://dx.doi.org/10.3329/bjog.v25i2.13745 Bangladesh J Obstet Gynaecol, 2010; Vol. 25(2) : 85-86  

scholarly journals UTERINE RUPTURE DURING PREGNANCY – CASE REPORT

2021 ◽  
Vol 2 (2) ◽  
pp. 72-76
Author(s):  
Mihai Cristian Dumitrașcu ◽  
Răzvan Fodoroiu ◽  
George Cătălin Nenciu ◽  
Aida Petca ◽  
Răzvan Petca ◽  
...  
Keyword(s):  
Uterine Rupture ◽  
Signs And Symptoms ◽  
Caesarian Section ◽  
Uterine Wall ◽  
Emergency Laparotomy ◽  
Previous Caesarean Section ◽  
Third Trimester ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Uterine Scar

Uterine rupture is a life-threatening complication in pregnancy with no specific signs and symptoms, that requires fast diagnosis and surgical treatment. The main risk factors for uterine rupture are previous caesarean section deliveries and myomectomies, which can lead to improper uterine wall healing. We report a case of a 37-year-old secundigravida in 29 weeks of pregnancy, with prior caesarian delivery that was admitted in our ward for altered general status and abdominal pain. The patient underwent emergency laparotomy during which we found a massive 3500ml hemoperitoneum, 1000 g dead fetus and a rupture in the posterolateral uterine wall. The uterine scar from the previous caesarian section was intact. Uterine rupture is a complication with a growing incidence in past years that is very difficult to predict, which can occur at any time during pregnancy, especially during labour, but also in the second or early third trimester. Fast diagnosis and proper management is imperious because of the catastrophic outcomes uterine rupture is associated with.

scholarly journals Use of point-of-care ultrasound to diagnose spontaneous rupture of fibroid in pregnancy

POCUS Journal ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 16-21
Author(s):  
Stephen Lammers ◽  
Christopher Hong ◽  
Jared Tepper ◽  
Christy Moore ◽  
Cameron Baston ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Spontaneous Rupture ◽  
Acute Abdominal Pain ◽  
Point Of Care ◽  
Pregnant Patient ◽  
Point Of Care Ultrasound ◽  
Third Trimester ◽  
Current Case ◽  
The Third ◽  
In Pregnancy

Background: Complications of fibroids in pregnancy are well known, including postpartum hemorrhage, labor dystocia, and cesarean delivery. Outside of pregnancy and labor, the rare occurrence of spontaneous fibroid rupture has been documented. Case: The current case report involves a woman who presented with acute abdominal pain in the third trimester of pregnancy and was found to have spontaneous rupture of a fibroid before the onset of labor. Her initial presentation, diagnosis through use of point-of-care ultrasound, acute surgical management, and postoperative course are described. Conclusion: When assessing acute abdominal pain in a pregnant patient, fibroid rupture should be considered despite the absence of prior uterine surgery. Bedside point-of-care ultrasonography is a useful tool for assessment of abdominal pain in the third trimester of pregnancy.

scholarly journals Uterine torsion in pregnancy, expect the unexpected: case report

2020 ◽  
Vol 9 (8) ◽  
pp. 3473
Author(s):  
Huda Nabihah Mokhtar ◽  
Sumayyah Mohammed Faridz ◽  
Rohana Ismail ◽  
Nasuha Yaacob ◽  
Roziana Ramli
Keyword(s):  
Preoperative Diagnosis ◽  
Twin Pregnancy ◽  
Placental Abruption ◽  
Clinical Presentation ◽  
Rare Condition ◽  
Uterine Wall ◽  
Uterine Torsion ◽  
Active Labour ◽  
Life Threatening ◽  
In Pregnancy

Uterine torsion in pregnancy is a rare condition, but potentially life-threatening. The non-specific clinical features make preoperative diagnosis difficult and most cases are discovered during caesarean deliveries done for other obstetric indications. Authors present 2 cases of uterine torsion with different clinical presentation and outcome. Case 1 was a G3P2 at 36 weeks with twin pregnancy presented in active labour with a prolapsed cord. A 180 degrees uterine torsion was discovered only after delivery of the foetuses, resulting in inadvertent posterior uterine wall incision. Case 2 was a G6P5 at 35 weeks who presented with an acute abdomen and went into shock. At laparotomy, a 360 degrees uterine torsion was discovered complicated with placental abruption, causing a fresh stillborn baby. These cases highlight uterine torsion as a rare but important diagnosis in obstetrics, which could be associated with potentially devastating outcome. 

Parkinson’s puzzle

2012 ◽  
Vol 153 (52) ◽  
pp. 2060-2069 ◽  
Author(s):  
András Guseo
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Symptoms ◽  
Critical Factor ◽  
Unknown Origin ◽  
Symptomatic Improvement ◽  
Blue Green Algae ◽  
Clinical Observations ◽  
Degenerative Disorders ◽  
Local Cell

Parkinson’s disease is one of the most frequent progressive degenerative disorders with unknown origin of the nervous system. The commutation of the disease on Guam led to the discovery of a neurotoxin which was also found in other continents. This neurotoxin was identified in the common cyanobacteria (blue-green algae). Early clinical observations suggested some loose correlations with gastric and duodenal ulcer and Parkinson’s disease, while recent studies revealed a toxin, almost identical to that found in cyanobacteria in one strain of Helicobacter pylori, which proved to cause Parkinson like symptoms in animals. Therefore, it cannot be ruled out that there is a slowly progressive poisoning in Parkinson’s disease. The disease specific alpha-sinuclein inclusions can be found in nerve cells of the intestinal mucosa far before the appearance of clinical symptoms indicating that the disease may start in the intestines. These results are strengthened by the results of Borody’s fecal transplants, after which in Parkinson patients showed a symptomatic improvement. Based on these observations the Parkinson puzzle is getting complete. Although these observations are not evidence based, they may indicate a new way for basic clinical research, as well as a new way of thinking for clinicians. These new observations in psycho-neuro-immunology strengthen the fact that immunological factors may also play a critical factor facilitating local cell necrosis which may be influenced easily. Orv. Hetil., 2012, 153, 2060–2069.

scholarly journals Treatment and therapeutic strategies for pituitary apoplexy in pregnancy: a case series

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yuya Kato ◽  
Yoshikazu Ogawa ◽  
Teiji Tominaga
Keyword(s):  
Pituitary Apoplexy ◽  
Clinical Symptoms ◽  
Case Series ◽  
Optimal Timing ◽  
Presenting Symptoms ◽  
Pathological Evaluation ◽  
Mother And Child ◽  
Life Threatening ◽  
In Pregnancy

Abstract Background Pregnancy is a known risk factor for pituitary apoplexy, which is life threatening for both mother and child. However, very few clinical interventions have been proposed for managing pituitary apoplexy in pregnancy. Case presentation We describe the management of three cases of pituitary apoplexy during pregnancy and review available literature. Presenting symptoms in our case series were headache and/or visual disturbances, and the etiology in all cases was hemorrhage. Conservative therapy was followed until 34 weeks of gestation, after which babies were delivered by cesarean section with prophylactic bolus hydrocortisone supplementation. Tumor removal was only electively performed after delivery using the transsphenoidal approach. All three patients and their babies had a good clinical course, and postoperative pathological evaluation revealed that all tumors were functional and that they secreted prolactin. Conclusions Although the mechanism of pituitary apoplexy occurrence remains unknown, the most important treatment strategy for pituitary apoplexy in pregnancy remains adequate hydrocortisone supplementation and frequent hormonal investigation. Radiological follow-up should be performed only if clinical symptoms deteriorate, and optimal timing for surgical resection should be discussed by a multidisciplinary team that includes obstetricians and neonatologists.

scholarly journals Serum cystatin is not a marker of glomerular filtration rate in pregnancy

2009 ◽  
Vol 2 (3) ◽  
pp. 121-122 ◽  
Author(s):  
Kate Bramham ◽  
David Makanjuola ◽  
Wael Hussein ◽  
Debra Cafful ◽  
Hassan Shehata
Keyword(s):  
Glomerular Filtration Rate ◽  
Observational Study ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Prospective Observational Study ◽  
Second Trimester ◽  
Third Trimester ◽  
Serum Cystatin ◽  
In Pregnancy

The role of cystatin C (Cys-C) as a marker of glomerular filtration rate (GFR) in pregnancy is undetermined. Measurements of Cys-C and creatinine (Cr) were taken at 14–17+6, 18–23+6, 27–31+6 weeks' gestation, at delivery and 2–6 weeks postpartum in a prospective observational study of 27 women. There was no difference between Cys-C levels in early and late second trimester, but they were significantly higher in early third trimester ( P < 0.001) than second trimester, despite no concurrent increase in Cr. Cys-C was also significantly higher at delivery than at all other times in pregnancy ( P < 0.001) and fell to postpartum values higher than second trimester measurements ( P < 0.01), but lower than delivery ( P<0.001). In conclusion, changes in Cys-C may be influenced by pregnancy-related changes in glomerular filtration and therefore we would advise against their use as a marker of GFR in pregnancy.

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