Case Reports in Obstetrics and Gynecology最新文献

{"title":"Evisceration of Abdominal Contents Through a Posterior Vaginal Defect: A Case Report.","authors":"Emily Nguyen, Jennifer Ferraro, Valerie Galvan-Turner, Iheanacho Emeruwa","doi":"10.1155/crog/9915866","DOIUrl":"10.1155/crog/9915866","url":null,"abstract":"<p><p>Vaginal evisceration is a very rare complication after a hysterectomy, and it can have extremely dire health consequences. We present a case of a 65-year-old female with a past medical history significant for obesity, pelvic organ prolapse, and rheumatoid arthritis-treated with chronic oral steroids-who presented with transvaginal small bowel evisceration more than 20 years after a total vaginal hysterectomy. The patient underwent emergent exploratory laparotomy with reduction of the bowel and reclosure of her vaginal cuff. The patient's postoperative course was complicated by bowel ischemia and subsequent bowel resection. We report this case to bring awareness to risk factors associated with vaginal evisceration; early diagnosis of this dangerous hysterectomy sequelae is vital to prevent life-threatening bowel ischemia.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2025 ","pages":"9915866"},"PeriodicalIF":0.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to \"A Case of Undiagnosed Placenta Increta Originating From a Demised Twin in the Second Trimester\".","authors":"","doi":"10.1155/crog/9786893","DOIUrl":"https://doi.org/10.1155/crog/9786893","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1155/crog/1329744.].</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2025 ","pages":"9786893"},"PeriodicalIF":0.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrauterine, Vacuum-Induced, Hemorrhage-Control Device System Contributing to Blood Loss in Fulminant DIC.","authors":"Alina Zabolotico, Victoria Kucinski, Chad Strittmatter, Bruce Rodgers","doi":"10.1155/crog/3747372","DOIUrl":"10.1155/crog/3747372","url":null,"abstract":"<p><p><b>Background:</b> Postpartum hemorrhage (PPH) complicates 3%-5% of deliveries. Uterine atony is the most common cause of PPH, and there are several interventions that can be used to improve atony, including uterine massage, uterotonics, and intrauterine balloons. The intrauterine vacuum-induced hemorrhage-control device is a suction device that is placed in the lower uterine segment, which creates negative pressure on the myometrium to induce myometrial contraction. <b>Case:</b> The patient was a 37-year-old G3P1011 female with chronic hypertension who presented for induction of labor at term. Spontaneous rupture of membranes occurred several hours later with simultaneous placental abruption leading to DIC. Urgent cesarean section was performed for fetal distress remote from delivery. Massive transfusion protocol was initiated, and an intrauterine vacuum-induced hemorrhage-control device was placed intravaginally in an attempt to control blood loss. However, rather than acting as a tamponade, the device appeared to draw out a great blood loss with its suction. The patient underwent bilateral uterine artery embolization, and the device was replaced with an intrauterine balloon. Patient was transferred to the ICU, and blood products were transfused until the patient was stabilized. <b>Conclusion:</b> While a preliminary study appeared to show the safety and efficacy of the intrauterine vacuum-induced hemorrhage-control device, its use was limited to uterine hemorrhage secondary to uterine atony. It should be avoided in cases of hemorrhage where coagulopathy is suspected.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2025 ","pages":"3747372"},"PeriodicalIF":0.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ovarian Torsion in Normal Ovaries in Reproductive-Aged Women.","authors":"Bushra Zaman Bandhon, Vinita Rajadurai, Cherynne Johansson","doi":"10.1155/crog/6630642","DOIUrl":"10.1155/crog/6630642","url":null,"abstract":"<p><p>Ovarian torsion is a gynecological emergency caused by the rotation of an ovary on its supporting ligaments, which can obstruct blood flow and lead to ovarian necrosis if untreated. Typically, torsion is associated with ovaries enlarged by cysts or masses, which increase the likelihood of rotation around the supporting ligaments. Although torsion can also occur in normal ovaries, especially in premenarchal girls with elongated infundibulopelvic ligaments, literature on this occurrence in reproductive-aged women is limited. This report presents two cases of ovarian torsion in normal ovaries, highlighting diagnostic and management challenges. The first case involves a 19-year-old who presented with acute right iliac fossa pain. Ultrasound showed a normal ovary with intact blood flow. However, due to ongoing pain, she underwent laparoscopy, which confirmed a 1.5-twist torsion at the utero-ovarian ligament. Right ovarian detorsion was performed successfully, and her postoperative recovery was uneventful, with follow-up ultrasound showing no abnormalities. The second case describes a 40-year-old woman with a prior hysterectomy, presenting with left iliac fossa pain. Ultrasound showed an enlarged, heterogeneous left ovary (5 × 3.2 × 4.2 cm) with poor blood flow and complex free pelvic fluid, raising suspicion for torsion. Emergency laparoscopy confirmed a 2-twist torsion on the infundibulopelvic ligament. Despite attempts at detorsion, the ovary remained nonviable, leading to left oophorectomy. These cases emphasize that ultrasound and Doppler findings may not reliably detect torsion in normal ovaries. Laparoscopy remains the definitive method for diagnosis and intervention, providing timely treatment that is essential to preserve ovarian function. Clinicians should maintain a high suspicion for torsion in reproductive-aged women with acute abdominal pain, even if imaging is inconclusive, to prevent severe complications. These cases highlight the need for heightened awareness of ovarian torsion in normal ovaries to optimize surgical outcomes and fertility preservation.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2025 ","pages":"6630642"},"PeriodicalIF":0.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of a Pregnant Woman With Malaria, Stillbirth, and a 12 × 11-cm Amoebic Liver Abscess in a Burundian Hospital: A Case Report.","authors":"Maria Antonietta Castaldi, Salvatore Giovanni Castaldi","doi":"10.1155/crog/9403522","DOIUrl":"10.1155/crog/9403522","url":null,"abstract":"<p><p><b>Background:</b> Malaria and amoebic infections are considered risk factors for stillbirth and preterm labor, but their coexistence during pregnancy has not been previously reported. <b>Case:</b> We describe the first case of averted maternal mortality with fetal death in utero at 22 weeks' gestation, complicated by both <i>falciparum</i> malaria and hepatic amoebic abscess, in a rural hospital in Burundi. <b>Conclusion:</b> Amoebic liver abscesses are rarely described in pregnancy and, as far as we are aware, never in conjunction with severe malaria: two parasitic infections requiring completely different treatments. We successfully managed this difficult case in a rural context thanks to at least three main factors: staff skills, inventiveness, and advances in ultrasonographic technology.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2025 ","pages":"9403522"},"PeriodicalIF":0.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Labium Majus Ectopic Pregnancy: Diagnostic and Therapeutic Implications of a Rare Obstetric Phenomenon-A Case Report.","authors":"Katuma Ruvuna, Viateur Hategekimana, Jean Bizimana Kalibushi, Richard Kabuseba Kabuyanga, Théophile Barhwamire Kabesha, Zacharie Kibendelwa Tsongo, Simeon Sibomana, Vincent Kalumire Cubaka, Stephen Rulisa, Jean-Baptiste Sakatolo Zambèze Kakoma","doi":"10.1155/crog/6651439","DOIUrl":"10.1155/crog/6651439","url":null,"abstract":"<p><p>Ectopic pregnancy occurs when a fertilized ovum implants outside the uterine cavity, most commonly in the fallopian tube. While rare, ectopic pregnancies can also occur in atypical locations such as the ovary, cervix, abdominal cavity, or broad ligament, often posing significant diagnostic and therapeutic challenges. We report a highly unusual case of ectopic pregnancy implanted in the left labium majus, a site not previously documented in the literature. A 20-year-old woman presented with abdominal pain, vulvar swelling, and amenorrhea of approximately 4 months. Initial imaging and clinical evaluation did not reveal the ectopic implantation. Diagnosis was made intraoperatively during marsupialization of the vulvar swelling, which revealed a macerated fetus within the left labium majus. This case highlights the importance of maintaining a high index of suspicion for rare ectopic pregnancy sites in patients presenting with unexplained vulvar symptoms and a positive pregnancy test-particularly when imaging is inconclusive. It underscores the critical role of prompt surgical exploration in preventing life-threatening complications and contributes to expanding the clinical spectrum of ectopic pregnancy presentations.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2025 ","pages":"6651439"},"PeriodicalIF":0.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144990950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ruptured Splenic Ectopic Pregnancy: The Importance of Considering Nontubal Sites.","authors":"Yomna Fahmy, Claire Ross, Nora Kiss, Duaa Gumaa, Ee Xuan Ngeyu, Despina Mavridou, Rasana Bajracharya","doi":"10.1155/crog/8867392","DOIUrl":"10.1155/crog/8867392","url":null,"abstract":"<p><p><b>Objective:</b> Splenic ectopic pregnancy is an exceptionally rare and life-threatening form of abdominal ectopic pregnancy, often presenting significant diagnostic and management challenges. We report a case of ruptured splenic ectopic pregnancy initially suspected to be a tubal miscarriage. <b>Case Report:</b> A 36-year-old woman presented with mild left-sided pelvic pain, no vaginal bleeding and a positive pregnancy test. This was an unplanned pregnancy, and she was not sure of her LMP. This presentation in early pregnancy requires ruling out an ectopic pregnancy through clinical assessment and laboratory investigations. Clinical examination showed normal observations and generalized abdominal tenderness with no signs of peritonism. Initial investigations revealed a significantly elevated <i>β</i>-hCG of 24,076 IU/L, and transvaginal ultrasound showed an empty uterus. Given the findings, an ectopic pregnancy was suspected, and diagnostic laparoscopy was performed. During laparoscopy, no ectopic pregnancy was identified in the pelvis, both tubes looked normal, but a left fimbrial cyst was noted, and 300 mL of haemoperitoneum was observed, without active bleeding. A tubal miscarriage was presumed with the plan to follow up <i>β</i>-hCG to confirm resolution of the pregnancy. Postoperatively, the patient developed worsening pain and a significant haemoglobin drop to 97 g/L, inconsistent with the amount of intraoperative blood loss which raised the suspicion of extrapelvic ectopic pregnancy with active bleeding. A contrast-enhanced CT scan identified free blood surrounding the spleen and a 25-mm peripherally enhancing lesion with venous drainage into the splenic vein, consistent with a ruptured splenic ectopic pregnancy. An urgent multidisciplinary team discussion led to surgical management via midline laparotomy and splenectomy. The postoperative course was complicated by ileus, which resolved with conservative management. The patient's <i>β</i>-hCG levels progressively declined, confirming resolution. <b>Conclusion:</b> This case highlights the importance of considering splenic ectopic pregnancy when <i>β</i>-hCG is markedly elevated, and no pelvic ectopic pregnancy is identified. Prompt imaging and diagnosis are crucial to prevent morbidity associated with delayed management.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2025 ","pages":"8867392"},"PeriodicalIF":0.8,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12349982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enormous Myoma Pedunculated Through the Cervix: A Surgical Challenge.","authors":"F Futcher, P George, N Habib, P Von Theobald, A Birsan-Frances","doi":"10.1155/crog/8044836","DOIUrl":"10.1155/crog/8044836","url":null,"abstract":"<p><p>We report the case of a 57-year-old woman who presented to the gynecological emergency department with an enormous 18 cm submucosal leiomyoma pedunculated through the cervix. She was anemic due to bleeding over the past 2 months. The aim of this study was to highlight the challenges of managing such an unusual clinical scenario. We also describe the preoperative and intraoperative methods that can be used to minimize intraoperative blood loss and improve the safety and feasibility of this kind of surgical procedure. In our case, we decided to perform a vaginal myomectomy after a tourniquet on the pedicle to reduce bleeding.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2025 ","pages":"8044836"},"PeriodicalIF":0.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hysteroscopic Confirmation of a Uterine Arteriovenous Malformation as a Possible Cause of Recurrent Pregnancy Loss.","authors":"Lionel Reyftmann, Dharmesh Kothari, Mark Power","doi":"10.1155/crog/6655067","DOIUrl":"10.1155/crog/6655067","url":null,"abstract":"<p><p>This case report highlights the cornerstone role played by hysteroscopy to confirm a diagnosis of uterine arteriovenous malformations that was ambiguous with the imaging studies. A 30-year-old nulliparous woman who experienced three unexplained recurrent pregnancy losses was suspected of having a uterine arteriovenous malformation. The arteriovenous malformation was confirmed through hysteroscopy and managed with a multidisciplinary approach involving interventional radiology and reproductive specialists. The hysteroscopy was followed by uterine artery embolization, which resulted in the resolution of the arteriovenous malformation. A spontaneous pregnancy and live birth rapidly followed. Uterine arteriovenous malformations have been widely reported in gynecology as a consequence of the surgical treatment of a miscarriage or gestational trophoblastic disease. We suggest that they are also important to diagnose in patients presenting with recurrent pregnancy loss, where they represent a curable etiology.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2025 ","pages":"6655067"},"PeriodicalIF":0.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Ovarian Clear Cell Carcinoma: A Case of Successful Management With Targeted Therapies.","authors":"Sydney Pence, Kellie Rath, Aine Clements","doi":"10.1155/crog/1319978","DOIUrl":"10.1155/crog/1319978","url":null,"abstract":"<p><p><b>Background:</b> Advanced stages of ovarian clear cell carcinoma have poorer prognoses than many other ovarian cancers. When standard treatments are ineffective, alternative options are needed. <b>Case:</b> A 56-year-old woman was diagnosed with ovarian clear cell carcinoma and treated with surgical management as well as carboplatin and paclitaxel. At recurrence, her disease progressed despite multiple chemotherapy regimens. A durable response was achieved first with alpelisib, chosen based on genomic testing. When progression occurred on this agent, a partial disease response was achieved with the combination of nivolumab and ipilimumab. <b>Conclusion:</b> The use of targeted therapies as well as the combination of nivolumab and ipilimumab is a promising option in advanced and recurrent cases of ovarian clear cell carcinoma.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2025 ","pages":"1319978"},"PeriodicalIF":0.6,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}