In this report, we present a case of a term abdominal pregnancy managed in St Padre Pio Hospital Douala (Cameroon). The 28-year-old G2P1001 woman whom we received to our facility at 15 weeks gestation with an intraute...In this report, we present a case of a term abdominal pregnancy managed in St Padre Pio Hospital Douala (Cameroon). The 28-year-old G2P1001 woman whom we received to our facility at 15 weeks gestation with an intrauterine pregnancy confirmed by ultrasonography. She returned at 21 weeks with a history of syncope and blood transfusion in another facility. An obstetrical ultrasonography done that day revealed a live fetus located at the upper right side within the peritoneal cavity. She continued with her routine Antenatal visits, and at each visit, an ultrasonography was done, revealing a slowly growing fetus. At 38 weeks, a laparotomy was carried out, and the live male baby weighing 2500 grammes was extracted. The placenta was implanted in the uterus;it was removed with minimal blood loss of approximately 400 mls. The mother was heamodynamically stable post-operatively. The newborn presented with mild cyanosis, an oxygen saturation of 80%, which resolved after 24 hours of oxygen administration. Both mother and baby were discharged from the hospital one week after laparotomy in a stable state. This case illustrates that intra-abdominal pregnancies, though rare and complex, can be managed to term and produce viable fetuses. Practitioners should, therefore, understand the challenges in its management.展开更多
Mullerian duct anomalies are the most common congenital anomalies of the reproductive system and septate uterus is the most frequently diagnosed Müllerian anomaly. The true incidence of Mullerian duct anomalies i...Mullerian duct anomalies are the most common congenital anomalies of the reproductive system and septate uterus is the most frequently diagnosed Müllerian anomaly. The true incidence of Mullerian duct anomalies is difficult to state because some cases may be asymptomatic and there are pitfalls associated with various diagnostic methods. This is a case report of a 17-year-old primigravida with septate uterus diagnosed at caesarean section performed at term for cephalo-pelvic disproportion. Baby was delivered with bilateral talipes equinovarus.展开更多
BACKGROUND Low-grade endometrial stromal sarcoma(LGESS)is a rare indolent tumor with a favorable prognosis.With the importance of improving quality of life recognized,fertility-sparing surgery may be an option for tho...BACKGROUND Low-grade endometrial stromal sarcoma(LGESS)is a rare indolent tumor with a favorable prognosis.With the importance of improving quality of life recognized,fertility-sparing surgery may be an option for those young women.However,most of the reports suggested that stage IA patients might be candidates for fertility-sparing surgery,and adjuvant hormonal treatment was considered a feasible adjuvant therapy for reducing the recurrence risk of patients with LGESS and hysterectomy was recommended after the completion of pregnancy and delivery.CASE SUMMARY A 28-year-old pregnant woman diagnosed with stage IB LGESS was treated by fertility-sparing surgery when term cesarean section delivery was performed.Without any adjuvant treatment,she had the other successful term pregnancy and cesarean section 45 mo after first fertility-sparing surgery.Moreover,only hysteroscopic resection was performed to retain fertility again even when the tumor recurred after 6 years.So far the patient’s fertility and disease-free status have remained for more than 8 years without any adjuvant therapy despite local resection of the sarcoma.And the two babies were in good health.CONCLUSION For young patients with stage I LGESS,it seems that repeated fertility-sparing surgeries could be performed even after two term deliveries and the tumor recurrence,and it might be attempted without adjuvant therapy but the counseling should be considered as mandatory.展开更多
Uterine rupture is defined as the occurrence of communication between the abdominal and uterine cavity and may be complete or incomplete depending on the degree of involvement of the different layers of the uterus and...Uterine rupture is defined as the occurrence of communication between the abdominal and uterine cavity and may be complete or incomplete depending on the degree of involvement of the different layers of the uterus and surrounding organs. It is a rare complication whose consequences often involve the maternal and fetal prognosis. The majority of uterine rupture occurs on the scarred uterus, its incidence in France is estimated according to the series between 1/1000 and 1/2000 births, it represents 30% of causes of maternal death in the developing countries. The authors report here a case of uterine rupture outside of labor at 33 weeks of age in 32 years old woman, gravida 9 para 8, with no history of uterine surgery discovered during obstetric ultrasound for abdominal pain. During the interrogation, she was alarge multipara and had a child of 15 months. The abdominal ultrasound showed a right lateral corporeal rupture with hemoperitoneum of medium sized and a dead fetus. The emergency laparotomy revealed a right lateral uterine wound approximately 15 cm long with intra-abdominal placenta and a haemoperitoneum of medium sized of about 600 cc and a bladder lesion. After opening the amniotic sac, there was extraction of a dead fetus. The uterine and bladder lesions were repaired followed by bilateral tubal ligation. The patient received 500 cc of whole blood during and 500 cc after the procedure. The postoperative follow-up was simple. This case contributes to the knowledge of this rare and atypical event, and emphasizes the importance of maintaining a suspicion.展开更多
Complications arising from neglected umbilical hernia are not uncommon in pregnancy, more especially in developing countries with characteristically poor health seeking behaviour and less encouraging attitude towards ...Complications arising from neglected umbilical hernia are not uncommon in pregnancy, more especially in developing countries with characteristically poor health seeking behaviour and less encouraging attitude towards surgical intervention for un-complicated medical conditions. The report is on a 34-year-old para 8 who presented with prolonged labour and an irreducible herniated gravid uterus complicating a neglected congenital umbilical hernia. The patient was resuscitated. She had spontaneous vaginal delivery while preparation was being made for an elective caesarean section.展开更多
Background: Fetal weight estimation by ultrasound is an important factor in obstetrics;it is directly related to the gestational age which helps to plan the mode of delivery and labor management. Objective: to compare...Background: Fetal weight estimation by ultrasound is an important factor in obstetrics;it is directly related to the gestational age which helps to plan the mode of delivery and labor management. Objective: to compare between fetal thigh circumference (TC) and abdominal subcutaneous tissue thickness (SCT) in estimating birthweight in term pregnant women. Patients and Methods: This prospective cohort study was conducted at outpatient clinic or emergency room, Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University Maternity Hospitals from March 2022 until May 2023. During this study, 100 term pregnant females with gestational age 37 - 40 weeks attended El Demerdash Maternity Hospital and scheduled for delivery either at outpatient clinic or emergency room were enrolled, after consenting each of them. Basic fetal biometry was performed by an expert and professional medical personnel to ensure the accuracy of examination results. Fetal abdominal subcutaneous thickness and fetal thigh circumference were measured for assessment of gestational age and correlated with actual fetal body weight. In the current study, three formulas;Hadlock, Vintzileos’ and SCT formula were correlated with actual fetal body weight after birth. Results: The present study revealed that TC formula is closer to the actual birth weight, followed by Hadlock formula, while the SCT formula is the furthest from it. Conclusion: To increase the accuracy of birth estimations, regular ultrasound examinations should include fetal thigh circumference measurement.展开更多
妊娠期高血压疾病(hypertensive disorders of pregnancy,HDP)是一类严重的产科常见并发症,包括妊娠期高血压(gestational hypertension,GH)和子痫前期-子痫(preeclampsia-eclampsia,PE-E)等。近年来,国内外大量研究提示,GH/PE不仅会增...妊娠期高血压疾病(hypertensive disorders of pregnancy,HDP)是一类严重的产科常见并发症,包括妊娠期高血压(gestational hypertension,GH)和子痫前期-子痫(preeclampsia-eclampsia,PE-E)等。近年来,国内外大量研究提示,GH/PE不仅会增加孕产妇及胎儿的不良结局发生风险,同时可能会对母亲及其子代的远期健康产生影响,本文将重点阐述GH/PE对母儿远期健康影响的相关研究进展,从远期慢性高血压、糖尿病及血脂异常、心血管疾病、动脉粥样硬化和心脏功能、肾脏疾病、神经系统疾病、远期死亡风险的角度阐述对母亲远期健康的影响,同时从子代远期心血管代谢风险、神经系统发育、过敏性疾病及死亡风险等角度阐述对子代远期健康的影响。展开更多
文摘In this report, we present a case of a term abdominal pregnancy managed in St Padre Pio Hospital Douala (Cameroon). The 28-year-old G2P1001 woman whom we received to our facility at 15 weeks gestation with an intrauterine pregnancy confirmed by ultrasonography. She returned at 21 weeks with a history of syncope and blood transfusion in another facility. An obstetrical ultrasonography done that day revealed a live fetus located at the upper right side within the peritoneal cavity. She continued with her routine Antenatal visits, and at each visit, an ultrasonography was done, revealing a slowly growing fetus. At 38 weeks, a laparotomy was carried out, and the live male baby weighing 2500 grammes was extracted. The placenta was implanted in the uterus;it was removed with minimal blood loss of approximately 400 mls. The mother was heamodynamically stable post-operatively. The newborn presented with mild cyanosis, an oxygen saturation of 80%, which resolved after 24 hours of oxygen administration. Both mother and baby were discharged from the hospital one week after laparotomy in a stable state. This case illustrates that intra-abdominal pregnancies, though rare and complex, can be managed to term and produce viable fetuses. Practitioners should, therefore, understand the challenges in its management.
文摘Mullerian duct anomalies are the most common congenital anomalies of the reproductive system and septate uterus is the most frequently diagnosed Müllerian anomaly. The true incidence of Mullerian duct anomalies is difficult to state because some cases may be asymptomatic and there are pitfalls associated with various diagnostic methods. This is a case report of a 17-year-old primigravida with septate uterus diagnosed at caesarean section performed at term for cephalo-pelvic disproportion. Baby was delivered with bilateral talipes equinovarus.
基金Supported by Open Foundation of Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China,No.2018KF003.
文摘BACKGROUND Low-grade endometrial stromal sarcoma(LGESS)is a rare indolent tumor with a favorable prognosis.With the importance of improving quality of life recognized,fertility-sparing surgery may be an option for those young women.However,most of the reports suggested that stage IA patients might be candidates for fertility-sparing surgery,and adjuvant hormonal treatment was considered a feasible adjuvant therapy for reducing the recurrence risk of patients with LGESS and hysterectomy was recommended after the completion of pregnancy and delivery.CASE SUMMARY A 28-year-old pregnant woman diagnosed with stage IB LGESS was treated by fertility-sparing surgery when term cesarean section delivery was performed.Without any adjuvant treatment,she had the other successful term pregnancy and cesarean section 45 mo after first fertility-sparing surgery.Moreover,only hysteroscopic resection was performed to retain fertility again even when the tumor recurred after 6 years.So far the patient’s fertility and disease-free status have remained for more than 8 years without any adjuvant therapy despite local resection of the sarcoma.And the two babies were in good health.CONCLUSION For young patients with stage I LGESS,it seems that repeated fertility-sparing surgeries could be performed even after two term deliveries and the tumor recurrence,and it might be attempted without adjuvant therapy but the counseling should be considered as mandatory.
文摘Uterine rupture is defined as the occurrence of communication between the abdominal and uterine cavity and may be complete or incomplete depending on the degree of involvement of the different layers of the uterus and surrounding organs. It is a rare complication whose consequences often involve the maternal and fetal prognosis. The majority of uterine rupture occurs on the scarred uterus, its incidence in France is estimated according to the series between 1/1000 and 1/2000 births, it represents 30% of causes of maternal death in the developing countries. The authors report here a case of uterine rupture outside of labor at 33 weeks of age in 32 years old woman, gravida 9 para 8, with no history of uterine surgery discovered during obstetric ultrasound for abdominal pain. During the interrogation, she was alarge multipara and had a child of 15 months. The abdominal ultrasound showed a right lateral corporeal rupture with hemoperitoneum of medium sized and a dead fetus. The emergency laparotomy revealed a right lateral uterine wound approximately 15 cm long with intra-abdominal placenta and a haemoperitoneum of medium sized of about 600 cc and a bladder lesion. After opening the amniotic sac, there was extraction of a dead fetus. The uterine and bladder lesions were repaired followed by bilateral tubal ligation. The patient received 500 cc of whole blood during and 500 cc after the procedure. The postoperative follow-up was simple. This case contributes to the knowledge of this rare and atypical event, and emphasizes the importance of maintaining a suspicion.
文摘Complications arising from neglected umbilical hernia are not uncommon in pregnancy, more especially in developing countries with characteristically poor health seeking behaviour and less encouraging attitude towards surgical intervention for un-complicated medical conditions. The report is on a 34-year-old para 8 who presented with prolonged labour and an irreducible herniated gravid uterus complicating a neglected congenital umbilical hernia. The patient was resuscitated. She had spontaneous vaginal delivery while preparation was being made for an elective caesarean section.
文摘Background: Fetal weight estimation by ultrasound is an important factor in obstetrics;it is directly related to the gestational age which helps to plan the mode of delivery and labor management. Objective: to compare between fetal thigh circumference (TC) and abdominal subcutaneous tissue thickness (SCT) in estimating birthweight in term pregnant women. Patients and Methods: This prospective cohort study was conducted at outpatient clinic or emergency room, Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University Maternity Hospitals from March 2022 until May 2023. During this study, 100 term pregnant females with gestational age 37 - 40 weeks attended El Demerdash Maternity Hospital and scheduled for delivery either at outpatient clinic or emergency room were enrolled, after consenting each of them. Basic fetal biometry was performed by an expert and professional medical personnel to ensure the accuracy of examination results. Fetal abdominal subcutaneous thickness and fetal thigh circumference were measured for assessment of gestational age and correlated with actual fetal body weight. In the current study, three formulas;Hadlock, Vintzileos’ and SCT formula were correlated with actual fetal body weight after birth. Results: The present study revealed that TC formula is closer to the actual birth weight, followed by Hadlock formula, while the SCT formula is the furthest from it. Conclusion: To increase the accuracy of birth estimations, regular ultrasound examinations should include fetal thigh circumference measurement.
文摘妊娠期高血压疾病(hypertensive disorders of pregnancy,HDP)是一类严重的产科常见并发症,包括妊娠期高血压(gestational hypertension,GH)和子痫前期-子痫(preeclampsia-eclampsia,PE-E)等。近年来,国内外大量研究提示,GH/PE不仅会增加孕产妇及胎儿的不良结局发生风险,同时可能会对母亲及其子代的远期健康产生影响,本文将重点阐述GH/PE对母儿远期健康影响的相关研究进展,从远期慢性高血压、糖尿病及血脂异常、心血管疾病、动脉粥样硬化和心脏功能、肾脏疾病、神经系统疾病、远期死亡风险的角度阐述对母亲远期健康的影响,同时从子代远期心血管代谢风险、神经系统发育、过敏性疾病及死亡风险等角度阐述对子代远期健康的影响。
