Case Reports in Obstetrics and Gynecology最新文献

{"title":"Healthy Baby Delivery After 100 Days of Somatic Support in a Brain-Dead Pregnant Woman.","authors":"Luísa Cerqueira, José Manuel Pereira, Marina Moucho","doi":"10.1155/crog/2746188","DOIUrl":"https://doi.org/10.1155/crog/2746188","url":null,"abstract":"<p><p>After diagnosing brain death, with few exceptions, it is unethical to maintain organ support. This decision may be considered in case of pregnancy to guarantee foetal viability and improve the perinatal outcome. We describe a case of prolonged organ support after brain death in a pregnant woman, following cardiac arrest secondary to an acute asthma attack. A 26-year-old primigravida, 18 weeks pregnant, with a history of stable asthma, was admitted to an ICU after cardiac arrest secondary to an acute asthma attack. It was possible to maintain organ support for 100 days with the collaboration of a multidisciplinary medical team. A healthy child was born, and favourable outcomes were observed at the 3-year follow-up. Brain death during pregnancy is a rare event and is a unique ethical, financial, and technical challenge. No guidelines are available for the management of these patients. This case demonstrates that it is possible to prolong organ support in this situation and successfully deliver a healthy child.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2025 ","pages":"2746188"},"PeriodicalIF":0.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172615","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":"A Rare Case of Uterine-Origin Vulvar Leiomyoma Occurring in a Juvenile Girl: Case Report and Literature Review.","authors":"Emiko Hamada, Naomi Shiga, Mika Watanabe, Satoko Sato, Zen Watanabe, Masahito Tachibana, Masatoshi Saito","doi":"10.1155/crog/8874924","DOIUrl":"https://doi.org/10.1155/crog/8874924","url":null,"abstract":"<p><p>Leiomyoma arising from the vulva is very rare, and it is difficult to differentiate it from a Bartholin gland cyst and aggressive angiomyxomas. We report a case of vulvar leiomyoma in a juvenile girl. The patient, a 16-year-old female, had noted a tender subcutaneous nodule on the right vulva for 2 years. At first, a Bartholin gland cyst was suspected, and she was prescribed antibiotics. However, because of persistent symptoms, the patient was referred to our clinic for further examination. An MRI scan suspected a mesenchymal tumor, and surgical resection was performed. Tumor cells were diffusely positive for anti-smooth muscle antibodies, HHF35, and Desmin, and leiomyoma was suspected. Immunostaining tests were negative for estrogen receptor and positive for progesterone receptor. The patient exhibited an excellent postoperative course with no evidence of recurrence at the latest follow-up. Surgical resection is the only curative treatment, and long-term follow-up is recommended because of rare reports of recurrence.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2025 ","pages":"8874924"},"PeriodicalIF":0.6,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954704","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":"Formation of Blastocysts From Zona Pellucida-Free Oocytes: A Case Report on a Modified Technique in In Vitro Fertilization.","authors":"Minh Tam Le, Trung Van Nguyen, Hong Nhan Thi Dang, Quoc Huy Vu Nguyen","doi":"10.1155/crog/5247242","DOIUrl":"https://doi.org/10.1155/crog/5247242","url":null,"abstract":"<p><p><b>Objective:</b> Zona-free oocytes (ZFOs) were rarely present when performing the intracytoplasmic sperm injection (ICSI) technique. There have been some reports showing that embryos from these oocytes still result in pregnancy after treatment. These oocytes are often discarded due to quality concerns and difficulties in manipulating and cultivating. This case report shows how ZFOs are handled in in vitro fertilization (IVF). <b>Methods:</b> This case report concerns IVF with ICSI and blastocyst culture in an infertile woman with polycystic ovary syndrome. A modified ICSI procedure was proposed to fertilize the ZFO without any damage. The primary outcome measurements involve fertilization assessment and blastocyst development. <b>Results:</b> Among 23 retrieved oocytes, 5 of them were zone ZFOs. Three of the five were fertilized and then developed into good-quality blastocysts. <b>Conclusions:</b> By employing appropriate techniques for fertilization and embryo culture, ZFOs are capable of the development and production of good-quality blastocysts.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2025 ","pages":"5247242"},"PeriodicalIF":0.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960190","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":"Complex Presentation of Uterus Didelphys With Bilateral Leiomyomas: A Case Report.","authors":"Assaye Mezgebu Wube, Yusuf Mohammed Yusuf, Biniyam Afework Abate, Meksud Shemsu Hussen, Yabets Tesfaye Kebede, Bekri Delil Mohammed","doi":"10.1155/crog/6231298","DOIUrl":"10.1155/crog/6231298","url":null,"abstract":"<p><p>Müllerian duct anomalies and uterine leiomyomas represent distinctive facets of female reproductive health. While uterine leiomyomas are prevalent reproductive pathologies, the coexistence of Müllerian anomalies and leiomyomas is relatively uncommon. This case study examines the complex medical and surgical management of a woman who initially presented with chronic abdominal pain and swelling. Following evaluation, the patient received a diagnosis of an uncommon co-occurrence of congenital uterus didelphys and leiomyomas. Notably, during the surgical procedure, a rectovesical peritoneal band was identified. This case study seeks to broaden the scientific understanding of these subsets of women, offering insights into the complexities arising from a common diagnosis overlaying a rare condition.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2025 ","pages":"6231298"},"PeriodicalIF":0.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063849","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":"Fetal Tetra-Amelia Birth: A Case Report.","authors":"Eyob Asefa Belay, Anberbir Girma Asebot, Bezza Kedida Dabi","doi":"10.1155/crog/7801322","DOIUrl":"https://doi.org/10.1155/crog/7801322","url":null,"abstract":"<p><p>Fetal limb anomaly presentation varies greatly. It can present as amelia (complete absence of skeletal part of one or more limb), meromelia (partial absence of skeletal part of one or more limb), phocomelia (only rudimentary limb formed), and minor limb disorders like polydactyly. The complete absence of the four fetal limbs is extremely rare. Incidence of tetra-amelia is not well known, but it is mentioned to be 1-4 in 100,000 births in different literature. Etiopathogenesis of fetal tetra-amelia remains speculative. Tetra-amelia occurs either as tetra-amelia syndrome (when other organ systems are affected too) or isolated tetra-amelia. Tetra-amelia syndrome is more common than isolated tetra-amelia. It occurs secondary to genetic aberration or is sporadic. Genetic inheritance of tetra-amelia may present as autosomal dominance, autosomal recessive, or X-linked recessive. The protein coded on WTN 3 on chromosome 17q21 is important for fetal limb and other organ system formation. Mutation associated with the WTN 3 gene is a known cause for fetal limb malformation. Maternal diabetes, amniotic band syndrome, TORCH (toxoplasmosis, rubella cytomegalovirus, herpes simplex, and HIV) infection, alcohol consumption, and intrauterine exposure to some drugs like thalidomide, glucocorticoids, and sedatives are risk factors for limb malformation. Tetra-amelia can be diagnosed as early as the first trimester of pregnancy. Ultrasound imaging is a gold standard investigation to detect tetra-amelia. Tetra-amelia syndrome is associated with high mortality and morbidity than isolated tetra-amelia. In this case report, we present an extremely rare case, isolated tetra-amelia, born to G3P2 (Gravida 3, Para 2) mother at 36 weeks of gestation. It was diagnosed late in pregnancy at 34 weeks. The fetal organs (kidney, lung, abdominal wall, heart, vertebrae, and brain) were evaluated with ultrasound and were found healthy. She gave birth by cesarean section at 36 weeks of gestation for other obstetric indication. Isolated tetra-amelia is an extremely rare case. Early antenatal ultrasound fetal evaluation should be promoted. Early detection of tetra-amelia helps to provide parental counselling and option of management timely. Parental counselling should involve how to care for the neonate with tetra-amelia. Community awareness creation is important to decrease social stigma against babies with tetra-amelia. In such rare cases, it is important to alert public health researchers for possible further epidemiological study.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2024 ","pages":"7801322"},"PeriodicalIF":0.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945116","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":"A Case of Undiagnosed Placenta Increta Originating From a Demised Twin in the Second Trimester.","authors":"Anthony Grandelis, Jordan Emont, Brittany Arditi, Noelle Breslin, Tarah Pua","doi":"10.1155/crog/1329744","DOIUrl":"10.1155/crog/1329744","url":null,"abstract":"<p><p>Placenta accreta spectrum (PAS) presents a significant risk of maternal morbidity and mortality, in large part due to the potential for massive hemorrhage at time of delivery. Recently, multiple gestations have been shown to be an independent risk factor for PAS, especially in the setting of other major risk factors. Importantly, antenatal detection of PAS in twin pregnancies has been shown to be suboptimal when compared to singleton pregnancies. Here, we present a case of postpartum hemorrhage and unplanned cesarean hysterectomy due to an undiagnosed placenta increta, which originated from the placenta of a demised twin in the second trimester. This case underscores the importance of thorough prenatal monitoring and evaluation for PAS, especially in multifetal gestations with additional risk factors. It also highlights the need for heightened awareness among healthcare providers to mitigate risks associated with PAS in twin pregnancies. Early detection and multidisciplinary collaboration are crucial in optimizing outcomes for both mothers and infants in such complex obstetric scenarios.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2024 ","pages":"1329744"},"PeriodicalIF":0.6,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799554","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":"Large Endometrioma That Triggered a Hypertensive Emergency: A Case Report.","authors":"Varnita Vishwanath, Gregory Marchand, Ali Azadi","doi":"10.1155/2024/7869172","DOIUrl":"10.1155/2024/7869172","url":null,"abstract":"<p><p>Endometriosis is a common gynecological condition in women of reproductive age and has variable symptomology such as pelvic pain, menorrhagia, dysmenorrhea, dyspareunia, and infertility. Endometriomas are a form of endometriosis and are characterized by cystic masses most commonly found on the ovaries. This case discusses the management of a rare occurrence of a 25-cm endometrioma in a patient without a prior diagnosis of endometriosis, who presented to the emergency room in an acute hypertensive emergency. It is believed that the large cyst caused a mass effect against renal vasculature precipitating renovascular hypertension that required immediate intervention. This case was approached with minimally invasive surgical removal of the cyst and lysis of adhesions without postoperative complications.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2024 ","pages":"7869172"},"PeriodicalIF":0.6,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543896","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":"A Rare Case of Giant Cystic Adenomatoid Tumor of the Uterus With Literature Review.","authors":"Pranav S Renavikar, Lina Adwer, David G Wagner, Subodh M Lele","doi":"10.1155/2024/7791245","DOIUrl":"10.1155/2024/7791245","url":null,"abstract":"<p><p>Adenomatoid tumors are rare benign neoplasms arising from mesothelial cells, commonly found in the female genital system, particularly the uterus and fallopian tubes. The giant cystic variant of adenomatoid tumor is exceptionally rare and can cause massive growth mimicking malignant gynecological conditions. Histology and immunohistochemistry play a crucial role in confirming the diagnosis, with markers such as calretinin, D2-40, CK7, BAP1, ER, and WT1 proving useful. A 51-year-old female with a history of breast cancer presented with pelvic pressure and vague pain. Imaging revealed an enlarged uterus with multiple heterogeneously enhancing masses and a predominantly cystic mass arising from the fundus, all believed to be leiomyomas. Surgical exploration and subsequent pathologic examination identified the cystic tumor as cystic adenomatoid tumor coexisting with leiomyomas, adenomyosis, and abdominal endometriosis. Diagnosing cystic adenomatoid tumor presents challenges, especially in patients with complex gynecologic histories. Cystic adenomatoid tumors typically have a favorable prognosis following surgical intervention. This case demonstrates one of the few reports of a giant cystic adenomatoid tumor (11.5 cm) and highlights diagnostic mimics. As these tumors are typically small and often seen only microscopically, the large size can confuse the pathologist who may be unaware of this feature leading to a misdiagnosis.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2024 ","pages":"7791245"},"PeriodicalIF":0.6,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543895","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":"A Case of Carcinosarcoma of the Peritoneum With Serous Tubal Intraepithelial Carcinoma.","authors":"Akiko Kanemura, Tohru Morisada, Mai Momomura, Fumio Asano, Hiromi Shibuya, Hironori Matsumoto, Kiyotaka Nagahama, Junji Shibahara, Yoichi Kobayashi","doi":"10.1155/2024/1907965","DOIUrl":"https://doi.org/10.1155/2024/1907965","url":null,"abstract":"<p><p>In this case, a 66-year-old female patient presented with the chief complaint of abdominal distention. Computed tomography and magnetic resonance imaging revealed no enlarged ovaries or obvious primary lesions; however, massive ascites and peritoneal disseminated nodules were observed. Ascites cytology revealed adenocarcinoma and immunohistochemical findings suggested serous carcinoma. The patient then underwent tumor reduction surgery after preoperative chemotherapy for suspected Stage IIIC primary peritoneal carcinoma. Postoperative histopathology revealed carcinoma consisting mainly of high-grade serous carcinoma (HGSC) and sarcoma. In addition, serous intraepithelial carcinoma (STIC) of the fallopian tube was observed in the fimbriae of the left fallopian tube. Recently, it has been noted in the literature that most cases of peritoneal carcinoma are metastases or dissemination of carcinoma originating from the fimbriae of the fallopian tube. This is a rare case of peritoneal carcinosarcoma with STIC, and its report leads to a better understanding of the disease's features and possible therapeutic approaches.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2024 ","pages":"1907965"},"PeriodicalIF":0.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543894","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":"Recurrent Anti-NMDAR Encephalitis Necessitating Oophorectomy in an Adolescent Patient: A Case Report.","authors":"Shadowen Caroline, Agrawal Nidhi, Fugina Alexa, Messersmith Cole, Terasaki Laurne, Allen Hannah, Goldberg Aaron, Pflugner Lindsey","doi":"10.1155/2024/6150107","DOIUrl":"https://doi.org/10.1155/2024/6150107","url":null,"abstract":"<p><p><b>Background:</b> Anti-NMDA receptor (A-NMDAR) encephalitis is an autoimmune condition often associated with ovarian teratoma. Surgical removal of the teratoma is generally curative, and recurrence is uncommon. <b>Case:</b> A 14-year-old female presented with psychiatric symptoms and was ultimately diagnosed with A-NMDAR encephalitis during a prolonged hospitalization. She was found to have bilateral ovarian teratomas, underwent laparoscopic bilateral ovarian cystectomy, and returned to neurologic baseline within 2 months. One year later, the patient was re-presented with similar symptoms and was diagnosed with recurrent A-NMDAR encephalitis. Initial imaging was negative for ovarian teratomas. After another prolonged hospitalization, repeat imaging ultimately demonstrated a suspected left ovarian teratoma. A left salpingo-oophorectomy was performed, and the patient's condition again fully recovered. <b>Conclusion:</b> This case of A-NMDAR encephalitis presented with many atypical features including neuropsychiatric presenting symptoms, bilateral teratomas, and severe recurrence of disease. While imaging is the recommended modality for investigation of etiology, no teratoma was identified on the second presentation, leading to an ethical and clinical conundrum in this adolescent patient. More research is needed to investigate other diagnostic methods for A-NMDAR encephalitis without distinct teratoma on imaging in female patients.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2024 ","pages":"6150107"},"PeriodicalIF":0.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495742","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}