Case Report Of Pregnancy Research Articles

Hemorrhagic Shock Revealing an Ectopic Pregnancy Associated with an Evolving Intrauterine Pregnancy Case Report

Hemorrhagic Shock Revealing an Ectopic Pregnancy Associated with an Evolving Intrauterine Pregnancy Case Report

Pregnancy and symptomatic Huntington's disease-A case report.

SynopsisSymptomatic Huntington's disease (HD) in pregnancy requires multidisciplinary care. We address the challenges derived from the cognitive and physical impairment and illuminate social and ethical concerns.

Challenging thyroid storm in pregnancy case report

Challenging thyroid storm in pregnancy case report

Life-Threatening Obstetrical Emergency: Spontaneous Uterine Rupture Associated with Placenta Percreta in the First Trimester of Pregnancy—Case Report and Literature Review

Background: The greatest risk for the occurrence of the placenta accreta spectrum (PAS) is represented by uterine scars, which most frequently result after cesarean sections. Uterine rupture is a rare condition and appears mainly in the third trimester of pregnancy. The association between these two conditions is extremely rare in the first trimester of pregnancy. Methods: We performed a systematic review of abnormal placental adhesions and spontaneous uterine ruptures in the first trimester of pregnancy. We also reported a case of spontaneous uterine rupture in a 12-week pregnancy that presented with massive hemoperitoneum and hemorrhagic shock. Results: A 33-year-old patient with two previous cesarean sections, at the twelfth week of pregnancy at the time to this visit to the emergency room, presented with syncope and intense pelvic–abdominal pain. A clinical examination and ultrasound scan established the diagnosis of hemoperitoneum and hemorrhagic shock. Surgical exploration was performed, uterine rupture was identified, and hemostasis hysterectomy was necessary. The histopathological results showed placenta percreta. There have been eight reported cases of spontaneous uterine rupture in the first trimester of pregnancy associated with PAS. In these cases, it was found that 62.5% of the patients had undergone at least one cesarean section in the past; in 75% of the cases, hysterectomy was performed; and, in 87.5% of the cases, the presence of placenta percreta was confirmed. Conclusions: A high rate of cesarean sections determines the increase in the incidence of placenta accreta spectrum disorders. The possible life-threatening complications caused by this pathology can be observed in early pregnancies.

Triple-Negative Breast Cancer: A Rare Tumor Type Presenting in Pregnancy-Case Report

Introduction: Breast Cancer diagnosis during pregnancy is a relatively rare event, affecting about 1 in 1,000 pregnancies and representing 0.1% or less of all cancers. However, when it occurs, it is found to be more aggressive with the worst prognosis during pregnancy. Most notable reasons include delayed diagnosis due to changes in breast parenchyma in pregnant and lactating women, and the higher incidence of the poor prognostic subtype (triple-negative) among premenopausal patients. Aim: We present a 28year old nullipara with triple-negative right breast cancer in the third trimester of pregnancy. Methodology: Description of a successfully managed breast cancer disease in pregnancy and the histological diagnosis.

A Case Report of Twin Pregnancy Combined with Gingival Tumor Rupture and Hemorrhage with Successful Rescue

A Case Report of Twin Pregnancy Combined with Gingival Tumor Rupture and Hemorrhage with Successful Rescue

Case report of ectopic pregnancy on transverse colon

Abdominal ectopic pregnancy is a rare form of ectopic pregnancy, and there are a few cases of colonic implantation reported in the literature. In this report, we describe a unique instance of transverse colonic large hematocele associated with degressive ectopic pregnancy. Patient concerns: A 30–year–old female patient suffered abdominal pain and digestive disorders and did not report any gynecological diseases. The only indicator to diagnose gestative condition was beta-HCG, which increased slightly from 415IU/L to 435IU/L after 2 weeks. Transvaginal ultrasonography shows no evidence of a gestational mass inside the uterus or in the cul-de-sac, which is a frequent site of ectopic pregnancy. But abdominal CT with contrast injection revealed a hyperdense mass measuring 50´53´101mm along the edge of the right colon. A diagnosis of abdominal pregnancy was suspected. Thus, the patient underwent explanatory laparoscopy to confirm the diagnosis and for the treatment. Pathological examination confirms the diagnosis of transverse colonic ectopic pregnancy. After a few days of uncomplicated recovery, the patient was cleared to return home. On the first day following surgery, the beta-HCG results decreased to 112IU/L, and additional testing produced negative results. Conclusion: Ectopic pregnancy may be implanted anywhere in the abdominal cavity even on the transverse colon. When diagnosing a female patient of reproductive age with an inexplicable rise or even low blood BetaHCG level, clinicians must consider the potential of abdominal ectopic pregnancy.

THU622 Spontaneous Pregnancy In Isolated 17,20-lyase Deficiency

Abstract Disclosure: J.M. Oliveira: None. P.M. Sobral: None. C.M. Genari: None. R.J. Auchus: None. C.E. Kater: None. F.C. Barbosa: None. Introduction: 17-Hidroxylase/17,20-lyase deficiency (17OHD) is Brazil's second most common form of congenital adrenal hyperplasia and results from pathogenic variants in the CYP17A1 gene. The typical manifestations of 17OHD are a female phenotype, sexual infantilism, arterial hypertension, and hypergonadotrophic hypogonadism. In contrast, isolated 17,20-lyase deficiency (ILD) is due to pathogenic variants of genes in the catalytic system of the 17,20-lyase, which include: CYP17A1, POR, or CYB5A. In 46XX ILD patients, primary amenorrhea, absence of pubarche, and irregular menses have been reported whereas in 46XY ILD patients, hypospadias, micropenis, and bifid scrotum have been described. Both ILD and 17OHD are associated with infertility. Assisted reproductive technology may rarely result in pregnancy. In this challenging scenario, we present the first known case of spontaneous pregnancy in a patient with ILD. Clinical case: A 16y female was referred to the Endocrinology Department due to the absence of pubarche. She developed thelarche at 9y and menarche at 11y, with oligomenorrhea (6-month-interval cycles) ever since. She had normal blood pressure, external vulvovaginal genitalia, and a complete absence of pubarche and axillary hair. ILD was suspected. Laboratory: undetectable levels of testosterone, androstenedione, and DHEAS. Estradiol: 25.9 (12.5-166.0)pg/mL, 17OHP: 290 (20-130)ng/dL, Progesterone: 111 (3.1-15.2)ng/dL, FSH: 4.2 (3.5-12.5)mUI/mL, LH: 9.5 (2.4-12.6)mUI/mL (all reference intervals are for follicular phase). Pre/post-ACTH stimulation test cortisol: 10/14.5 (7-25/≥18) mcg/dL, corticosterone: 2131/12342 (95-1500/-) ng/dL, 17OHP: 149/159 (up to 110/63.2-296.4) ng/dL, DOC: 10/34 (up to 25/-) ng/dL, respectively. Pelvic USG showed right and left ovaries of 11.0 and 14.9cm3, respectively. CYP17A1 sequencing identified the homozygous pathogenic variant R347H at exon 6, confirming ILD. The patient was oriented to use glucocorticoids during stressful situations and oral contraceptives continuously. She lost follow-up for one year and, at 19y, returned with 20 weeks of gestation. Prenatal was uneventful and cesarean delivery was performed at 41 weeks, giving birth to a healthy boy. Conclusions: There are very few case reports of pregnancy among 46XX patients with ILD. In all cases, fertility treatments were necessary. This is, to the best of our knowledge, the first spontaneous gestation in a patient with an established diagnosis. The Homozygous R347H variant, associated with excessive gonadotrophic stimulation, might be linked to the intermittent and residual enzymatic 17OHase (65%) and 17,20-lyase activity (<5%). The resulting estrogenic gonadal effect (even in the lower range) may have been sufficient for folliculogenesis, ovulation, and the development of an adequate uterine environment for fertilization and spontaneous gestation. Presentation: Thursday, June 15, 2023

A rare case report of ovarian ectopic pregnancy – Expect the unexpected sometimes

Ectopic pregnancy is implantation of an embryo at sites other than its normal location - the uterine cavity. The most common site for ectopic implantation is the fallopian tube, other rare sites being ovarian ectopic, cervical ectopic and caesarean scar ectopic. Ovarian ectopic pregnancy accounts to around 3% of all ectopics, incidence being 1 in 2000 to 1 in 60,000. In this rare form of ectopic the implantation and development of embryo occurs in the ovary and eventually ends with rupture before the end of first trimester causing catastrophic results due to hemorrhage and hemostatic imbalance and sometimes even death. This case report is of such a rare form of ectopic pregnancy reported at ISO-KGH, Department of Obstetrics and Gynaecology, Government Medical College, Omandurar Government Estate, Chennai.

Laparoscopic management of a second trimester ruptured spontaneous heterotopic tubal pregnancy mimicking ovarian tumour, a case report.

Laparoscopic surgery in the second trimester of pregnancy is a high risk and demanding operation. Especially when dealing with adnexal pathology, the surgeon should balance between the effort to establish adequate visualisation of the operating field with minimal uterine manipulation and use of energy application to avoid any potential adverse effects on the intrauterine pregnancy. The video shows laparoscopic surgery performed in the second trimester of pregnancy and highlights modifications to technique to ensure safety. Materials and Methods: We present a case report of spontaneous heterotopic tubal pregnancy that mimicked an ovarian tumour and was managed surgically with a laparoscopy in the second trimester. During surgery, a previously ruptured left tubal pregnancy (? ectopic) was the cause for a concealed hematoma in the pouch of Douglas, misdiagnosed as ovarian tumour. This is one of the few cases of heterotopic pregnancy treated by laparoscopy in the second trimester of pregnancy. The patient was discharged the day 2 post-operatively, the intrauterine pregnancy progressed, and the patient delivered with a planned caesarean section on the 38th week. Laparoscopic surgery, with adjustments, is a safe and effective method to manage adnexal pathology during a second trimester pregnancy.

A Case Report of Cesarean Scar Pregnancy in the Late First Trimester With an Alive Fetus

Background: Cesarean scar pregnancy is one of the rare and challenging forms of ectopic pregnancy in treatment. Surgical and medical treatment options are available. Nevertheless, no approach is superior. Case Presentation: The present case reports a 29 years-old lady, presented with 12 weeks and 6 days, cesarean scar pregnancy without any symptoms, with a live fetus that underwent curettage two times. Conclusion: We can use curettage frequently for CSP treatment without methotrexate and, without side effects of other treatments.

Prolactinoma and Pregnancy Case report

Pregnancy in a patient with a secreting or non-secreting pituitary adenoma is a rare possibility in clinical practice. Management involves of both the consequences of pregnancy on the natural history of pituitary adenoma and the risks to the mother and fetus. We report the case of a patient who was followed for a pituitary adenoma prolactin and admitted to maternity in a clinical syndrome of intracranial hypertension.

Caesarean Section Scar Ectopic Pregnancy: A Case Report

Background Cesarean section scar ectopic pregnancy is recognized rare pregnancy complication which occurring in the myometrium of a previous scar of cesarean delivery with estimated rate one in 2000 pregnancies. Various management modalities for CSEP depend on the case presentation ranges from expectant or conservative management, medically with methotrexate, or surgical excision by hysteroscopy or laparoscopy or laparotomy, vacuum aspiration can be used to remove the ectopic scar. Methods And Patient A case report of caesarean section scar ectopic pregnancy presented at obstetrics and gynecology department in Tripoli university hospital on 5th September 2022, which experience profuse vaginal bleeding, drowsy, pallor her hemoglobin concentration was 7.6 g/dl and Beta HCG at admission was 5664 mIU/ml with history of insufficient antenatal care compliance on current pregnancy that confused the diagnosis of CSSEP for incomplete abortion. The patient undergone individual management and follow up till became significantly heath condition improved either clinically or laboratory Comments The cesarean scar ectopic pregnancy is considered as a rare type of ectopic pregnancy with difficult diagnosis and individual management according to health situation at presentation. Therefore, early recognition and proper assessment of CSEP is critical to achieve adequate management and to reduce related maternal morbidity and mortality

Ethics and Legal Aspect of Termination of Pregnancy with Trisomy 13 (Patau Syndrome)

Trisomy 13 is a serious genetic anomaly in the fetus that is one of the causes of abortion as a result of the chromosomal aneuploidy. Trisomy 13 affects roughly 1 in 10,000 to 20,000 live births, and more than 95% of pregnancies end in prenatal death. Due to the higher prevalence of preeclampsia and the danger of maternal death associated with early birth, abnormalities in these infants also have an impact on the mother's health. According to Law No. 36 of 2009 concerning Health, women who eligble for abortions if there are medical reasons to do so. The problems in this paper are 1) What are the ethical problems found in pregnancies with a fetus diagnosed with a genetic disorder due to trisomy 13? 2) What is the procedure for implementing medical abortion provocation that fulfills ethical aspects and complies with applicable regulations. To answer these problems, a research using normative legal research, accompanied by reports of cases of abortion. This normative legal research focuses on ethical and legal aspects of the implementation of provocative medical abortion following statutory regulations. This normative legal research starts with articles and case reports of fetal pregnancies with genetic disorders from the Gatot Soebroto Army Hospital. The results of the study show that consent to termination of pregnancy with medical indications by the patient and approved by the husband/family. T

Retrospective analysis of a case report of a left ovarian ectopic pregnancy after the former tubal

Up to 2% of pregnancies may be extrauterine. Despite reproductive problems, they might increase the risk of serious complications. We present a case report of a 31-year-old woman with two extrauterine pregnancies - tubal and ovarian, which occurred at the same side with little time difference. In addition, we aimed to examine possible reasons underlying this rare pathology. Thus, surgically removed tissue specimens were morphologically assessed and further compared with specimens from healthy control patients. Telocytes were analysed in detail due to their pivotal role in the female reproductive system. Our study had observational character and obvious limitations typical for a clinical case. Yet, such a clinical case of two ectopic pregnancies has not been previously reported in the literature.

Case report and discussion of pregnancy in a woman with Labrune syndrome and neurofibromatosis type 1

Labrune syndrome is a rare neurological autosomal recessive condition characterised by leukoencephalopathy, cerebral calcification and parenchymal cysts. Pregnancy has not been previously reported in an individual with this condition. This case report details the pregnancy of a primiparous woman with Labrune syndrome and neurofibromatosis type 1 who experienced a seizure in the second trimester of pregnancy, but went on to deliver her baby at term with good outcome for mother and baby. The case highlights the importance of pre-pregnancy advice in women with genetic conditions, and a multidisciplinary approach to the care of women with rare and complicated medical conditions during pregnancy.

Spontaneous cerebrospinal fluid rhinorrhoea during pregnancy-case report and review of literature

Abstract Objectives Rhinoliquorrhea is a condition where cerebrospinal fluid (CSF) leaks due to a liquor fistula formation of traumatic or non-traumatic origin. It can be associated with increased intracranial pressure often due to idiopathic intracranial hypertension (IIH), typically found in young and obese female patients. Case presentation A 27-year-old woman, 2 gravida, 1 para, presented with clear rhinorrhoea. After a beta-trace-protein test the diagnosis of CSF leakage was determined. The woman had had a traumatic car accident in 2018 but had never developed clear rhinorrhoea, especially not in her first pregnancy after the accident. Due to stable condition of the mother further diagnostics were postponed until after the birth. An elective caesarean section was performed in 40 + 0 weeks of gestations. The structural bone defect in the posterior wall of the sphenoid sinus was surgically repaired by defect coverage postpartum. Conclusions Nasal CSF leakage in pregnancy has previously been described in four other case reports with mostly traumatic etiology. Additionally, IIH is an important diagnosis to keep in mind. So far there are no guidelines or evidence-based recommendations regarding to optimal fistula treatment of pregnant women available. For therapy a prophylactic antibiotic therapy, surgical reconstruction with sealing and a wait-and-see strategy should be considered and discussed.

Retrospective analysis of a case report of a left ovarian ectopic pregnancy after the former tubal.

Up to 2% of pregnancies may be extrauterine. Despite reproductive problems, they might increase the risk of serious complications. We present a case report of a 31-year-old woman with two extrauterine pregnancies - tubal and ovarian, which occurred at the same side with little time difference. In addition, we aimed to examine possible reasons underlying this rare pathology. Thus, surgically removed tissue specimens were morphologically assessed and further compared with specimens from healthy control patients. Telocytes were analysed in detail due to their pivotal role in the female reproductive system. Our study had observational character and obvious limitations typical for a clinical case. Yet, such a clinical case of two ectopic pregnancies has not been previously reported in the literature.

Victims of Sexual Abuse with Child Pregnancy Case Report

Victims of Sexual Abuse with Child Pregnancy Case Report

Pseudocyesis - where is my fetus? A case report of false pregnancy

A 32-year-old housewife, married, single child to her parents, studied till Bachelor in commerce, hailing from a nuclear family, with well-adjusted premorbid personality, with significant family history of loss of both parents in her early life and being raised by her maternal aunt, with history of multiple failed attempts to conceive naturally and a failed IVF, consulted us following the resolution of her false belief regarding her pregnancy, seeking medication and counselling.Patient had probable signs of pregnancy including enlarged abdomen, weight gain, morning sickness and apparent fetal movements for 12 months with GPE and systemic examinations revealing no absolute signs of pregnancy. And MSE revealing falsely harboured thoughts of having been pregnant during the last 12-13 months which resolved after crossing the expected gestation period. In this case, the patient had introjected the repeated failed attempts to conceive naturally and loss of loved object (namely, her birth father and mother) into her false belief. This patient is unique in having features of both delusion of pregnancy and pseudocyesis as she didn’t have some of the symptoms seen in typical pseudocyesis, like presence of regular menstrual cycles.