A pregnant patient with type II osteogenesis imperfecta pregnancy

Osteogenesis imperfecta(OI)is a primary bone fragility disorder with an estimated prevalence of 1/15,000 births and is a hereditary syndrome characterized by one or more of the following:fractures,blue sclerae,impaired hearing,defective dentition,and hyperlaxibility throughout life.[1,2]We report a pregnant woman with type II OI and review her prenatal counseling,diagnosis,and pregnancy management to assist obstetricians in understanding the disease and managing it in emergency situations.

Primary hyperparathyroidism-induced acute pancreatitis in pregnancy:A systematic review with a diagnostic-treatment algorithm

BACKGROUND Primary hyperparathyroidism(PHPT)-induced acute pancreatitis(AP)during pregnancy has rarely been described.Due to this rarity,there are no diagnostic or treatment algorithms for pregnant patients.AIM To determine appropriate diagnostic methods,therapeutic options,and factors related to maternal and fetal outcomes for PHPT-induced AP in pregnancy.METHODS A literature search of articles in English,Japanese,German,Spanish,and Italian was performed using PubMed(1946-2023),PubMed Central(1900-2023),and Google Scholar.The Preferred Reporting Items for Systematic reviews and Meta-Analyses(PRISMA)protocol was followed.The search terms included“pancreatite acuta,”“iperparatiroidismo primario,”“gravidanza,”“travaglio,”“puerperio,”“postpartum,”“akute pankreatitis,”“primärer hyperparathyreoidismus,”“Schwangerschaft,”“Wehen,”“Wochenbett,”“pancreatitis aguda,”“hiperparatiroidismo primario,”“embarazo,”“parto,”“puerperio,”“posparto,”“acute pancreatitis,”“primary hyperparathyroidism,”“pregnancy,”“labor,”“puerperium,”and“postpartum.”Additional studies were identified by reviewing the reference lists of retrieved studies.Demographic,imaging,surgical,obstetric,and outcome data were obtained.RESULTS Fifty-four cases were collected from the 51 studies.The median maternal age was 29 years.PHPT-induced AP starts at the 20th gestational week;higher gestational weeks were seen in mothers who died(mean gestational week 28).Median values of amylase(1399,Q1-Q3=519-2072),lipase(2072,Q1-Q3=893-2804),serum calcium(3.5,Q1-Q3=3.1-3.9),and parathormone(PTH)(384,Q1-Q3=123-910)were reported.In 46 cases,adenoma was the cause of PHPT,followed by 2 cases of carcinoma and 1 case of hyperplasia.In the remaining 5 cases,the diagnosis was not reported.Neck ultrasound was positive in 34 cases,whereas sestamibi was performed in 3 cases,and neck computed tomography or magnetic resonance imaging was performed in 9 cases(the enlarged parathyroid gland was not localized in 3 cases).Surgery was the preferred treatment during pregnancy in 33 cases(median week of gestation 25,Q1-Q3=20-30)and postpartum in 12 cases.The timing was not reported in the remaining 9 cases,or surgery was not performed.AP was managed surgically in 11 cases and conservatively in 43(79.6%)cases.Maternal and fetal mortality was 9.3%(5 cases).Surgery was more common in deceased mothers(60.0%vs 16.3%;P=0.052),and PTH values tended to be higher in this group(910 pg/mL vs 302 pg/mL;P=0.059).Maternal mortality was higher with higher serum lipase levels and earlier delivery week.Higher calcium(4.1 mmol/L vs 3.3 mmol/L;P=0.009)and PTH(1914 pg/mL vs 302 pg/mL;P=0.003)values increased fetal/child mortality,as well as abortions(40.0%vs 0.0%;P=0.007)and complex deliveries(60.0%vs 8.2%;P=0.01).CONCLUSION If serum calcium is not tested during admission,definitive diagnosis of PHPT-induced AP in pregnancy is delayed,while early diagnosis and immediate intervention lead to excellent maternal and fetal outcomes.

DIAGNOSIS AND TREATMENT OF CESAREAN SCAR PREGNANCY

Objective To investigate the early diagnosis and treatment of cesarean scar pregnancy （CSP）. Methods Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007, including age, interval from the last cesarean delivery to diagnosis, clinical presentation, location of the lesion, process of diagnosis and treatment, outcome, and follow-up, were retrospectively analyzed. Re, salts CSP constituted 1.05 % of all ectopic pregnancies, and the ratio of CSP to pregnancy was 1 ： 1 221. The mean age of the group was 31.4 years. Twenty-six women had only one prior cesarean delivery. The interval from the last cesarean delivery to diagnosis ranged from 4 months to 15 years. The most common presenting symptoms of CSP were amenorrhoea and vaginal bleeding. Seventeen cases were misdiagnosed as early intrauterine pregnancies and 2 were misdiagnosed as gestational trophoblastic tumor. The other 9 were diagnosed definitely before treatment. The diagnosis was made based on cesarean delivery history, gynecologic examination, ultrasound, and magnetic resonance imaging （MRI）. The treatment of CSP included systemic or local methotrexate administration, conservative surgery, and hysterectomy. The conservative treatment was successful in 24 cases. All of the 28 women were cured through individual therapies. Conclusions CSP is rare and usually misdiagnosed as other diseases. Ultrasound is valuable for diagnosing CSP, and MRI can be used as an adjunct to ultrasound scan. Early diagnosis offers the options of conservative treatment and greatly improves the outcome of patients. Individual therapy is strongly recommended.

Pregnancy on Bicornuate Unicollis Uterus: Diagnosis, Management and Prognosis in Underprivileged Areas: About a Case, Yaoundé-Cameroon

Background: A bicornuate uterus is a relatively common and often asymptomatic congenital uterine malformation. Objective: The aim of this work is to highlight the diagnostic difficulty in this case, as well as its therapeutic and prognostic aspects. We report here the case of a young girl carrying a pregnancy on an undiagnosed unicollis bicornuate uterus, which was initially diagnosed as an unruptured ectopic pregnancy. Conclusion: The bicornuate uterus still poses diagnostic difficulties, especially in disadvantaged populations due to the poor accessibility of diagnostic means.

Diagnosis and treatment discussion of congenital factor VII deficiency in pregnancy:A case report

BACKGROUND Congenital factor VII deficiency(FVIID)is a rare autosomal recessive genetic disorder.The clinical manifestations of this deficiency vary greatly.Predicting the risk of bleeding during and after childbirth of pregnant women with congenital FVIID is difficult.Recombinant factor VIIa is the most common replacement therapy for FVIID.However,no unified diagnosis and treatment plan for pregnant women with congenital FVIID has been established.CASE SUMMARY We report the clinical history of a pregnant woman who was considered to have congenital FVIID.Recombinant factor VIIa was prophylactically administered to the pregnant woman at the time of cervical fully opening.She successfully delivered a live infant without any complications,such as postpartum hemorrhage,neonatal abnormalities,and so on.CONCLUSION Prophylaxis of recombinant factor VIIa during delivery can effectively reduce the incidence of postpartum hemorrhage among pregnant women with congenital FVIID associated with a high risk of bleeding.

Early Pregnancy Diagnosis by Serum Acid Titration in Three Sheep Breeds

[ Objective] Earlier identification of pregnant and non-pregnant animals post mating can greatly improve reproductive efficiency and pregnancy rate and decrease the interval between services. The experiment was conducted to develop a rapid and simple early pregnancy diagnostic method in sheep. [Method] The eady pregnancy diagnosis was conducted with serum acid titration in 1 317 female sheep （Duolang sheep, Cele sheep and Karakul sheep） after 16 -30 d post artificial insemination. [Result] After the serum acid titration, 1 128 pregnant ewes and 189 non-pregnant ewes were detected in the three sheep breeds. Compared with the actual pregnancy detection, the coincidence rate of pregnancy was 89.88% （1 013/1 128） ; the coincidence rate of non-pregnancy was 96.83% （183/189） ; and the total coincidence rate was 90.81% （1 196/1 317）. Chi-square test analysis showed that no significant difference （P 〈 0.05） was found between the three sheep breeds or between any two breeds. [ Conclusion ] This serum acid titration is a simple, convenient and highly accurate method for early pregnancy diagnosis in sheep, which shows highly practical and popularizing value.

The Diagnosis and Treatment for a Special Type of Cesarean Scar Pregnancy

Caesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy, and its incidence has been increased due to the increased rate of Cesarean sections performed. A special type of CSP, concealed CSP, was found in the clinical work in our institution. A retrospective review was performed. From September 2011 to June 2014, 208 women were presented with cesarean scar pregnancy by use of transvaginal color Doppler sonography. The medical records were consulted to collect the demographics and pertinent information. Six of them were determined to be concealed CSP. Four women were diagnosed in the first-trimester pregnancy after termination of pregnancy. The initial ultrasound of the other two women displayed that the gestational sacs were located in the lower uterine cavity. Placenta accrete, increta and previa were diagnosed by the following ultrasounds. Concealed CSP is a very unusual form of CSP. Continued pregnancy may be sufficiently evaluated because of subsequently serious complications. Our results indicate that continued pregnancy increases the risk of laparotomy and hysterectomy. Medical abortion in the first-trimester pregnancy should be considered as the optimal choice for the women with prior cesarean sections who want to terminate the gestation.

Liver biopsy for visceral leishmaniasis diagnosis in pregnancy: report of 2 cases

Visceral leishmaniasis(VL) or kala-azar is a zoonosis caused by intracellular protozoa of the Leishmania genus and is transmitted to humans by the bite of phlebotomine sandflies. It particularly affects cells in the phagocytic mononuclear system, accompanied by disturbances of cellular and humoral immunity. VL is potentially fatal and is characterized by fever, hepatosplenomegaly, diarrhea, epistaxis, jaundice, anemia, leucopenia, thrombocytopenia, hypoalbuminemia and hyperglobulinemia. Diagnostic suspicion is based on epidemiological, clinical and laboratory data and isconfirmed by detecting the parasite in infected tissue. Splenic aspiration is the most sensitive method, followed by bone marrow aspiration(BMA) by sternal puncture, liver biopsy and lymph node aspiration; but, due to safety concerns, BMA is the most recommended method. VL is included as a target disease by players in drug research and development. Severe liver dysfunction associated with VL is uncommon. We report two VL cases in pregnant women from Bauru, Sao Paulo state, Brazil, considered an endemic area. The first of them developed hepatic failure due to fulminant hepatitis. In both cases, BMA was unable to find the protozoan; thus, liver biopsy was the only means of making the diagnosis.

Antenatal Diagnosis of Isolated Total Arhinia in the Second Trimester of Pregnancy

Congenital arhinia is a very rare condition especially when it is isolated. Most of arhinia are identified after birth and only five prenatal cases are described in the literature. Generally, arhinia is associated with other malformations mainly craniofacial anomalies. Genetics aberrations are uncommon. Our case was diagnosed in the second trimester of pregnancy and we found no associated anomaly except for a single umbilical artery. Autopsy confirmed the diagnosis and neuropathology analysis revealed the absence of olfactory bulbs and tracts.

Doctors’Dilemma in Auspicious Pulse Diagnosis Represented in Ming-Qing Fiction

Auspicious pulse diagnosis/pregnancy diagnosis in traditional Chinese medicine involves such issues as medical skills,narrative skills,family decency,and ethics.It is an excellent case for the exploration of ethical dilemmas in traditional Chinese medical practice.The early classical medical texts such as Su Wen(Basic Questions)and Ling Shu Jing(Spiritual Pivot Canon)provide a principle-based ethical guide for doctor-patient communication,while popular fiction such as Hong Lou Meng(A Dream of Red Mansions),Yu Mu Xing Xin Bian(Stories:Entertain to Enlighten),and Feng Yue Meng(Courtesans and Opium)in the Ming and Qing dynasties present literary examples for solving ethical dilemmas.This article will analyze these texts from three perspectives.First,the doctors in the text were subject to gender order and other delicate etiquette and customs,therefore were unable to make the diagnosis without embarrassing the patients and jeopardizing family decency.Second,the narrator tends to attribute pregnancy misdiagnosis to three reasons:incomplete patient information,doctors’poor narrative competence,and doctors’corrupted medical ethics.Finally,the Ming-Qing fiction proposes three methods to solve this moral dilemma:clear pulse reading,tactful speech,and taboo challenging.This discussion of moral dilemmas in pregnancy diagnosis in traditional Chinese medical practice can be used as a reference for the localization of narrative medicine.

Misdiagnosis and Delayed Diagnosis for Ectopic and Heterotopic Pregnancies after In Vitro Fertilization and Embryo Transfer

This study examined the misdiagnosis and delayed diagnosis factors for ectopic pregnancy（EP） and heterotopic pregnancy（HP） after in vitro fertilization and embryo transfer（IVF-ET） in an attempt to reduce the diagnostic error. Clinical data of patients who underwent IVF-ET treatment and had clinical pregnancy from 12463 cycles were retrospectively analyzed. Their findings of serum β-hCG test and transvaginal ultrasonography were also obtained during follow-up. These patients were divided into two groups according to the diagnosis accuracy of EP/HP： early diagnosis and misdiagnosis/delayed diagnosis. The results showed that the incidence of EP and HP was 3.8%（125/3286） and 0.8%（27/3286） respectively for IVF/ICSI-ET cycle, and 3.8%（55/1431） and 0.7%（10/1431） respectively for frozen-thawed embryo transfer（FET） cycle. Ruptured EP occurred in 28 patients due to initial misdiagnosis or delayed diagnosis. Related factors fell in 3 categories：（1） clinician factors： misunderstanding of patients＇ medical history, insufficient training in ultrasonography and unawareness of EP and HP;（2） patient factors： noncompliance with medical orders and lack of communication with clinicians;（3） complicated conditions of EP： atypical symptoms, delayed elevation of serum β-hCG level, early rupture of cornual EP, asymptomatic in early gestation and pregnancy of unknown location. All the factors were interwoven, contributing to the occurrence of EP and HP. It was concluded that complicated conditions are more likely to affect the diagnosis accuracy of EP/HP after IVF-ET. Transvaginal ultrasonography should be performed at 5 weeks of gestation. Intensive follow-up including repeated ultrasonography and serial serum β-hCG tests should be performed in patients with a suspicious diagnosis at admission.

Pregnancy and Congenital Uterine Anomalies: Case Series

Background: Congenital Uterine Anomalies are malformations of the Uterus which occur during embryonic life and result from the abnormal formation, fusion or resorption of the Mullerian ducts. Most of them are asymptomatic and diagnosis is done incidentally or during examinations performed for other purposes. We report three cases of women with pregnancies in malformed uteri. Aim: To depict the diagnostic challenges and therapeutic aspects of management of pregnancies in congenitally malformed Uteri. Case Presentation: The first case was a 22-year-old student who came to consult for a second opinion on the management of an ectopic pregnancy. A 2D Ultrasound done prior revealed an ectopic pregnancy but failed to specify its location in a rudimentary uterine horn. Management with a Multi-dose Methotrexate regimen was initiated but progress was not favorable. She came to us for a second opinion on management. Diagnostic laparoscopy was done and revealed an ectopic pregnancy in a rudimentary uterine horn. This was confirmed by histopathology. Management consisted of resection of the rudimentary horn and a right total salpingectomy. The second case was that of a woman who presented with spotting in early pregnancy. An Obstetric 2D ultrasound done revealed a bicornuate Uterus with a Gestational sac in one horn. She was placed on progesterone supplementation for 2 weeks, with regular antenatal contacts. She had an elective cesarean section at 39 weeks. Surgery revealed a complete Bicornuate Uterus. The post-operative period was uneventful with no complications. The third case was that of a woman with a past history of five successive spontaneous abortions, who presented with spotting at about 8 weeks of gestation. An Obstetric Ultrasound done revealed a Bicornuate Uterus and an embryo in one cornus. She was admitted, given her poor obstetric history, for about 14 days and placed on progesterone supplementation till 20 weeks of gestation. Antenatal contacts were regular and she had an emergency cesarean section at 36 weeks. There were no complications in the post operative period. Conclusion: The high degree of diagnostic accuracy makes 3D ultrasound the diagnostic modality of choice. Nevertheless, 2D and Hysterosalpingography can be used as well. Management of pregnancies in women with congenital Uterine anomalies varies per case as presenting symptoms and outcomes with pregnancies are not alike. When diagnosed out of pregnancy, and depending on the type of anomaly, surgical management may be recommended.

Maternal diaphragmatic hernia in pregnancy:A systematic review with a treatment algorithm

BACKGROUND Diaphragmatic hernia(DH)is extremely rarely described during pregnancy.Due to the rarity,there is no diagnostic or treatment algorithm for DH in pregnancy.AIM To summarize and define the most appropriate diagnostic methods and therapeutic options for DH in pregnancy based on scarce literature.METHODS Literature search of English-,German-,Spanish-,and Italian-language articles were performed using PubMed(1946–2021),PubMed Central(1900–2021),and Google Scholar.The PRISMA protocol was followed.The search terms included:Maternal diaphragmatic hernia,congenital hernia,pregnancy,cardiovascular collapse,mediastinal shift,abdominal pain in pregnancy,hyperemesis,diaphragmatic rupture during labor,puerperium,hernie diaphragmatique maternelle,hernia diafragmática congenital.Additional studies were identified by reviewing reference lists of retrieved studies.Demographic,imaging,surgical,and obstetric data were obtained.RESULTS One hundred and fifty-eight cases were collected.The average maternal age increased across observed periods.The proportion of congenital hernias increased,while the other types appeared stationary.Most DHs were left-sided(83.8%).The median number of herniated organs declined across observed periods.A working diagnosis was correct in 50%.DH type did not correlate to maternal or neonatal outcomes.Laparoscopic access increased while thoracotomy varied across periods.Presentation of less than 3 days carried a significant risk of strangulation in pregnancy.CONCLUSION The clinical presentation of DH is easily confused with common chest conditions,delaying the diagnosis,and increasing maternal and fetal mortality.Symptomatic DH should be included in the differential diagnosis of pregnant women with abdominal pain associated with dyspnea and chest pain,especially when followed by collapse.Early diagnosis and immediate intervention lead to excellent maternal and fetal outcomes.A proposed algorithm helps manage pregnant women with maternal DH.Strangulated DH requires an emergent operation,while delivery should be based on obstetric indications.

Review of a challenging clinical issue:Intrahepatic cholestasis of pregnancy

Intrahepatic cholestasis of pregnancy(ICP) is a reversible pregnancy-specific cholestatic condition characterized by pruritus, elevated liver enzymes, and increased serum bile acids. It commences usually in the late second or third trimester, and quickly resolves after delivery. The incidence is higher in South American and Scandinavian countries(9.2%-15.6% and 1.5%, respectively) than in Europe(0.1%-0.2%). The etiology is multifactorial where genetic, endocrine, and environmental factors interact. Maternal outcome is usually benign, whereas fetal complications such as preterm labor, meconium staining, fetal distress, and sudden intrauterine fetal demise not infrequently lead to considerable perinatal morbidity and mortality. Ursodeoxycholic acid is shown to be the most efficient therapeutic agent with proven safety and efficacy. Management of ICP consists of careful monitoring of maternal hepatic function tests and serum bile acid levels in addition to the assessment of fetal well-being and timely delivery after completion of fetal pulmonary maturity. This review focuses on the current concepts about ICP based on recent literature data and presents an update regarding the diagnosis and management of this challenging issue.

Stones in pregnancy and pediatrics

Urinary stone disease is a highly prevalent condition affecting approximately 10% of the population,and has increased in incidence significantly over the past 20 years.Along with this,the rate of stone disease among women and children is also on the rise.The management of stone disease in specific populations,such as in children and during pregnancy can present unique challenges to the urologist.In both populations,a multi-disciplinary approach is strongly recommended given the complexities of the patients.Prompt and accurate diagnosis requires a high degree of suspicion and judicious use of diagnostic imaging given the higher risks of radiation exposure.In general,management proceeds from conservative to more invasive approaches and must be individualized to the patient with careful consideration of the potential adverse effects.However,innovations in endourologic equipment and techniques have allowed for the wider application of surgical stone treatment in these patients,and significant advancement in the field.This review covers the history and current advances in the diagnosis and management of stone disease in pregnant and pediatric populations.It is paramount for the urologist to understand the complexities of properly managing stones in these patients in order to maximize treatment efficacy,while minimizing complications and morbidity.

New guidelines for the diagnosis and management of pulmonary embolism:Key changes

Pulmonary embolism(PE)is an important public health problem.In August2019,the European Society of Cardiology in collaboration with the European Respiratory Society released new guidelines for the diagnosis and management of PE.We discuss the basic changes between these recent guidelines and the previous guidelines that were published in 2014.Regarding diagnosis,the new guidelines propose the use of an age-adjusted cut-off level of D-dimers instead of a fixed cut-off value.A D-dimer test adapted to clinical possibility should also be considered instead of fixed cut-off level of D-dimer.Detailed recommendations for the diagnosis of PE during pregnancy are also provided.Regarding risk stratification,assessment of PE-related early mortality risk is recommended.Moreover,the importance of right ventricular dysfunction is emphasized in lowrisk patients.For further risk stratification of the severity of PE in patients without hemodynamic instability,use of validated scores that combine clinical,imaging and laboratory PE-related prognostic factors might also be considered.Regarding treatment,the possibility of early discharge is mentioned in patients without severe comorbidities,who are not of high risk for sudden death and in whom proper medical management at home and proper medical follow up can be ensured.The new guidelines also suggest that pro-brain natriuretic peptide levels,right ventricular function and the presence of thrombus in the right heart could be useful for guiding the decision of early discharge.Overall,these new guidelines introduce several key changes and knowledge and adherence to them will improve the outcome of patients with PE.

Acute pancreatitis in pregnancy—Up to date

Acute pancreatitis during pregnancy is a rare event with wide variation in the incidence, ranging from 1:1000 to 1:10000. Pancreatitis in pregnancy presents the same etiological causes as in general population. However, differences are observed in the underlying mechanisms and the prevalence of each cause in the pregnant population. Acute pancreatitis is a complicated in diagnosis and treatment disease with various complications and severe prognosis in general population as well as pregnant women. The severity of acute pancreatitis is probably the most important issue that must be elucidated as early as possible since pancreatitis is an evolving disease. Clinical characteristics of acute pancreatitis in pregnancy do not differ from the non-pregnancy state. The most important disease during the first trimester which should be differentiated from acute pancreatitis is hyperemesis gravidarum. Complications of acute pancreatitis affect differently the mother and the fetus during pregnancy. Management of acute pancreatitis in pregnancy is a controversial issue since the initial treatment is similar to the non-pregnant patient but the subsequent management might differ due to the risk of fetal disturbances or teratogenesis. The initial management of acute pancreatitis is restricted in aggressive intravenous hydration. The interventional treatment of acute pancreatitis in pregnancy can be divided into three subcategories;the operational intervention for the disease itself, the operational intervention for biliary tract cormobidities and the endoscopic intervention. In conclusion, the initial assessment of acute pancreatitis severity and the initial management of the patient are of great importance in order to support the function and avoid failure of main organs.

Ovarian pregnancy rupture following ovulation induction and intrauterine insemination:A case report

BACKGROUND Ovarian pregnancy after assisted reproductive technology treatment has rarely been reported;ovarian pregnancy following intrauterine insemination(IUI)is even rarer,and only nine cases have previously been reported.CASE SUMMARY We report a case of ovarian pregnancy rupture after ovulation induction and IUI.The patient presented with bilateral lower abdominal pain and was referred to the emergency department.Ultrasound examination revealed ovarian pregnancy and intraperitoneal bleeding.Laparoscopy revealed an ovarian pregnancy with hemoperitoneum,which was subsequently removed.Pelvic adhesions were detected intraoperatively,which were treated immediately.The patient spontaneously conceived an intrauterine pregnancy 3 mo later,which was ongoing at the time of writing this study.CONCLUSION Close attention should be paid to any history of pelvic inflammatory disease before commencing IUI treatment,and patients with such a history should be closely followed up after IUI.Early measurement of serumβ-human chorionic gonadotropin levels and ultrasonic examination are essential for timely diagnosis of ovarian pregnancy after ovulation induction and IUI to avoid more serious complications.

The Diagnostic Significance of Ultrasound and Ultrasound-guided Coarse Needle Biopsy in Breast Cancer in Pregnancy

Objective:To explore the significance of ultrasound and ultrasound-guided coarse needle biopsy in the clinical diagnosis of breast cancer patients in pregnancy.Methods:A total of 10 patients with breast cancer in pregnancy were selected to study from October 2018 to October 2019 in our hospital,who were given preoperative ultrasound results and ultrasound-guided coarse-needle biopsy histopathology,and the results were analyzed.Results:All the 10 patients showed thickening of the mammary gland body,appeared to pick up disorderly situation,most of the dilated catheter,including 8 patients with solid hypoechoic mass,irregular shape,and“crab foot”edge burr.The corresponding aspect ratio value was greater than 1.The other 2 patients presented with cystic mixed masses with poor boundary definition,irregular shape,and mostly accompanied by posterior echo enhancement.Conclusion:Simple ultrasound diagnosis for patients with breast cancer during pregnancy has some errors,and should be used in combination with ultrasound-guided coarse needle biopsy operation.This method has a high clinical diagnosis rate and significant clinical application value,so it is worth promoting.