Case Reports in Obstetrics and Gynecology最新文献

{"title":"Vulvar Aggressive Angiomyxoma in a Postmenopausal Woman: Diagnostic Pitfalls and Surgical Implications-A Case Report.","authors":"Melkamu Siferih, Bekalu Molla, Yemisrach Alemneh, Shiferaw Desta","doi":"10.1155/crog/5616384","DOIUrl":"https://doi.org/10.1155/crog/5616384","url":null,"abstract":"<p><strong>Background: </strong>Vulvar aggressive angiomyxoma (VAAM) is a rare, benign mesenchymal tumor with a deceptively indolent histology but locally infiltrative growth and a high risk of recurrence, typically within 3 years and occasionally more than a decade after excision. Its occurrence in postmenopausal women is exceptionally rare, often leading to delayed diagnosis and posing unique surgical challenges.</p><p><strong>Case presentation: </strong>We report the case of a 45-year-old postmenopausal Ethiopian woman presenting with an 8 × 6-cm vulvar mass initially misdiagnosed as a lipoma based on clinical findings. Absence of preoperative imaging or tissue sampling contributed to underestimation of tumor extent. Intraoperatively, the lesion demonstrated nonencapsulated infiltrative extension into deep paravaginal tissues, prompting intraoperative multidisciplinary consultation and conversion to exploratory laparotomy to exclude retroperitoneal or intrabdominal involvement. Complete wide-margin excision was not feasible due to deep infiltration and proximity to critical neurovascular structures; therefore, maximal resection was performed. Histopathological examination confirmed aggressive angiomyxoma. At 12 months' follow-up, no clinical recurrence was detected; however, long-term surveillance is ongoing.</p><p><strong>Conclusion: </strong>VAAM is a rare yet clinically demanding tumor that poses significant diagnostic and surgical challenges, particularly in postmenopausal women and resource-limited settings. This case establishes the central role of preoperative imaging in precise tumor delineation, confirms the definitive diagnostic value of histopathological evaluation, affirms the importance of intraoperative adaptability, and supports the integration of structured, long-term surveillance to optimize early detection of recurrence.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"5616384"},"PeriodicalIF":0.8,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834086","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":"Unexpected Fetal Supraventricular Tachycardia Temporally Associated With Maternal Antihistamine Use: A Case Report.","authors":"Khadijeh Riazi Kermani, Shahrokh Rajaei, Razieh Moazami Goudarzi, Nazanin Abdi","doi":"10.1155/crog/6498180","DOIUrl":"https://doi.org/10.1155/crog/6498180","url":null,"abstract":"<p><p>Fetal supraventricular tachycardia (SVT) represents the most common cause of sustained fetal tachyarrhythmia and may result in significant hemodynamic compromise when persistent. Data regarding the cardiovascular effects of maternal antihistamine use during pregnancy remain limited. We report a near-term fetus with sustained SVT temporally associated with maternal ingestion of cetirizine and an antihistamine-decongestant combination for the treatment of allergic rhinitis. Owing to the persistence of the tachyarrhythmia during hospitalization, transplacental antiarrhythmic therapy with flecainide was initiated. After 48 h of treatment, successful rhythm control was achieved. Concurrent use of cetirizine and an antihistamine decongestant in a single dose during pregnancy resulted in sustained SVT in the fetus, necessitating treatment. Therefore, the use of cetirizine in the third trimester and antihistamine decongestants throughout pregnancy requires further investigation.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"6498180"},"PeriodicalIF":0.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834048","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":"The Outcome of a Pregnant Woman With Tethered Cord Syndrome Following Adult Repair of Open Apina Bifida: Case Report and Literature Review.","authors":"Jing Lyu, Huijing Zhang, Yuhua Zhao, Yunfeng Wang","doi":"10.1155/crog/6674683","DOIUrl":"https://doi.org/10.1155/crog/6674683","url":null,"abstract":"<p><strong>Background: </strong>Tethered cord syndrome (TCS) refers to the traction, compression, and low position of the spinal cord caused by various congenital or acquired factors. There are a few reports on pregnancy complicated by TCS.</p><p><strong>Case presentation: </strong>A 28-year-old Chinese pregnant nullipara woman was born with open spina bifida, who had persistently symptoms of lower extremity weakness, urinary incontinence and constipation. An elective cesarean section under general analgesia at 37 weeks of gestation after a multidisciplinary meeting and management. The pregnancy outcome was satisfactory.</p><p><strong>Conclusion: </strong>The prognosis of pregnancy complicated with TCS is good with the support of multidiscipline cooperation.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"6674683"},"PeriodicalIF":0.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834068","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":"Living Newborn Back-To-Back With a Complete Hydatidiform Mole: A Rare Twin Pregnancy Outcome.","authors":"Rime Abou Chakra, Wissam Arab, Nadine El Kassis, Malek Nassar, Karen El Ghoul, David Atallah","doi":"10.1155/crog/1897191","DOIUrl":"https://doi.org/10.1155/crog/1897191","url":null,"abstract":"<p><p>Twin pregnancy with complete hydatidiform mole (CHM) management is challenging and remains unguided up to this date. This report presents the case of a 20-year-old woman that was diagnosed with CHM coexisting with a healthy fetus at 18 week of gestation, following presentation with an episode of vaginal bleeding. After rigorous counseling about the significantly high risks of obstetrical complications and gestational trophoblastic neoplasia (GTN), the patient declined termination. Luckily, pregnancy was uncomplicated and successfully brought up to 34 weeks of gestation with serial follow-ups, leading to an uncomplicated delivery via cesarean section. This condition presents unique diagnostic and management challenges, as clinicians must balance the potential for fetal survival against significant maternal risks.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"1897191"},"PeriodicalIF":0.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811262","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":"Preserving Fertility in Young Women: Triple-Step Strategy for Managing Giant Endometriomas With Minimal AMH Decline-A Case Report.","authors":"Arry Soryadharma, Hanom Husni Syam, Mulyanusa Amarullah Ritonga","doi":"10.1155/crog/9079350","DOIUrl":"https://doi.org/10.1155/crog/9079350","url":null,"abstract":"<p><p>Endometriomas are a frequent cause of infertility in reproductive-aged women, often requiring surgery. However, cystectomy for large endometriomas may reduce ovarian reserve, as indicated by decreased anti-Müllerian hormone (AMH) levels. This case report presents a triple-step approach to managing a 20-year-old woman with bilateral endometriomas and infertility, focusing on preserving ovarian function. The patient, with primary infertility for 2 years and large bilateral endometriomas (10 cm on the right ovary and 5 cm on the left), underwent a staged treatment. Step 1 involved laparoscopic drainage of the cysts, followed by 3 months of GnRH agonist therapy to shrink the cysts and suppress endometriosis. Step 2 was a laparoscopic cystectomy performed carefully to minimize ovarian tissue loss. Step 3 included 3 more months of postoperative GnRH agonist therapy to suppress residual disease and aid ovarian recovery. Predrainage AMH was 3.27 ng/mL, decreased slightly to 3.17 ng/mL at 6 months after surgery, and was 2.54 ng/mL at 12 months of follow-up, indicating minimal ovarian reserve depletion. The patient resumed regular menstrual cycles 3 months postoperatively and conceived within 1 year, with no evidence of endometrioma recurrence observed. This case highlights the effectiveness of the triple-step approach in managing giant endometriomas while preserving fertility. Combining medical and surgical methods reduced AMH depletion and improved reproductive outcomes. This strategy may be a valuable option for young women with endometriomas, though further research is needed to confirm its long-term benefits.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"9079350"},"PeriodicalIF":0.8,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763547","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":"Exaggerated Placental Site Reaction: A Challenging Diagnosis.","authors":"Eleonora Nardi, Silvio Tartaglia, Davide Mulone, Ursula Catena, Antonio Lanzone, Vincenzo Arena","doi":"10.1155/crog/8854757","DOIUrl":"https://doi.org/10.1155/crog/8854757","url":null,"abstract":"<p><p>Gestational trophoblastic disease (GTD) includes both neoplastic and nonneoplastic disorders arising from placental trophoblastic tissue. Among tumor-like conditions, exaggerated placental site reaction (EPSR) is a rare benign condition characterized by the persistence of the normal implantation site reaction following pregnancy. Histologically, it is characterized by diffuse infiltration of intermediate trophoblastic cells into the endometrium and superficial myometrium without features of malignancy. We report a case of EPSR presenting with persistent vaginal bleeding and rising <i>β</i>-hCG levels after first-trimester surgical termination of pregnancy, initially raising suspicion of retained products of conception and abnormal uterine vascularity on imaging. This case highlights the diagnostic challenges of EPSR and the importance of integrating clinical, biochemical, radiological, and histopathological findings to avoid overtreatment.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"8854757"},"PeriodicalIF":0.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763470","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":"Delayed Vaginal Cuff Ectopic Pregnancy Following Hysterectomy: A Case Report.","authors":"Emmanuel Nshimiyumuremyi, Dawit Worku Kassa, Bagambe Patrick, Diomede Ntasumbumuyange, Fikremelekot Temesgen, Thomas Ugiruwatuma, Viateur Mutabazi, Theogene Bazimaziki, Emmanuel Itangishaka, Vedaste Musangamfura, Etienne Nsengimana, Oscar Umuhoza","doi":"10.1155/crog/5973350","DOIUrl":"https://doi.org/10.1155/crog/5973350","url":null,"abstract":"<p><strong>Background: </strong>Vaginal cuff ectopic pregnancy after hysterectomy is extremely rare and poses diagnostic challenges due to unusual anatomical implantation and low clinical suspicion. Delay in diagnosis may result in catastrophic hemorrhage.</p><p><strong>Case presentation: </strong>A 30-year-old G7P5014 (gravida 7 para 5 1 miscarriage and 4 living children, one stillbirth because of uterine rupture) woman presented 10 months after total abdominal hysterectomy and right oophorectomy with nausea and dizziness. Transvaginal ultrasound revealed a live 8-week embryo. She initially declined surgery. Two days later, she returned with abdominal pain, hypotension (BP 90/70 mmHg), and tachycardia (HR 130 bpm). Repeat ultrasound showed intra-abdominal free fluid. Emergency laparotomy revealed 2.5-L hemoperitoneum and a gestational sac implanted on the vaginal cuff. The sac was excised, hemostasis secured, and the patient recovered well after transfusion.</p><p><strong>Conclusion: </strong>Clinicians should maintain high suspicion for ectopic pregnancy in reproductive-aged women with preserved ovaries, even after hysterectomy. Early diagnosis and urgent surgical intervention are essential to prevent mortality.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"5973350"},"PeriodicalIF":0.8,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763508","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":"Locked Twins in a Primigravida: A Rare Obstetric Emergency Successfully Managed by Cesarean Section-A Case Report.","authors":"Getahun Wodalo, Amanuel Admasu Yayna, Amdetsiyon Yemane, Adane Ayza, Ashebir Tesfaye, Bereket Worana, Belachew Shote, Biranu Mamo, Elsabeth Samuel, Getu Kassaye, Wokil Wolde Dana","doi":"10.1155/crog/2974129","DOIUrl":"https://doi.org/10.1155/crog/2974129","url":null,"abstract":"<p><strong>Background and aims: </strong>Locked twins are a rare and life-threatening obstetric complication, occurring in approximately 1 in 1000 twin pregnancies, most commonly during labor when the first twin presents as breech and the second as cephalic. This condition poses significant risks to both the mother and fetuses if not promptly recognized and managed. We report a rare case of chin-to-neck locked twins and highlight the importance of early diagnosis and meticulous intraoperative management.</p><p><strong>Methods: </strong>A 20-year-old primigravida at 9 months of amenorrhea presented with pushing down pain for 12 h and ruptured membranes for 4 h. Clinical examination revealed a twin pregnancy with the first twin in breech presentation and a fetal heart rate of 98-100 beats per minute, while the second twin was in cephalic presentation with a fetal heart rate of 136-138 beats per minute. An emergency cesarean section was performed. Intraoperatively, a chin-to-neck interlocking of the twins was identified. Both twins were successfully delivered through the lower segment transverse uterine incision and careful intraoperative disimpaction without intraoperative complications.</p><p><strong>Results: </strong>The first twin was a male weighing 1600 g with Apgar scores of 5 and 7 at 1 and 5 min, respectively, and died 1 h postpartum due to respiratory failure related to prematurity and with a possible contribution from intrapartum hypoxia associated with interlocking of the twins. The second twin was a female weighing 1800 g with Apgar scores of 7 and 9, who required brief neonatal intensive care for respiratory distress syndrome and subsequently recovered well. The mother had an uneventful postoperative course.</p><p><strong>Conclusion: </strong>This case underscores the critical importance of early recognition of locked twins, timely surgical intervention, and careful intraoperative techniques to minimize maternal and fetal morbidity and mortality. Vigilant antenatal surveillance and preparedness in high-risk twin pregnancies are essential to prevent catastrophic outcomes associated with this rare obstetric emergency.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"2974129"},"PeriodicalIF":0.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763473","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":"Varicella-Zoster Virus Reactivation Presenting as Cranial Neuritis Without Rash in Late Pregnancy: A Case Report.","authors":"Renata Košir Pogačnik, Ana Kofol, Tatjana Mrvič, Maja Dolanc Merc","doi":"10.1155/crog/5236883","DOIUrl":"https://doi.org/10.1155/crog/5236883","url":null,"abstract":"<p><strong>Introduction: </strong>Neurological complications of reactivated varicella-zoster virus (VZV) are uncommon in immunocompetent individuals and are rarely reported during pregnancy. VZV reactivation may cause cranial neuritis, including Ramsay Hunt syndrome, or may present without cutaneous lesions as zoster sine herpete, complicating diagnosis.</p><p><strong>Case presentation: </strong>We report the case of a 26-year-old primigravida at 37 weeks of gestation who presented with paresthesia of the left side of the tongue, dizziness, and subsequent left-sided facial nerve palsy. Brain magnetic resonance imaging showed no abnormalities. Audiometry demonstrated mild high-frequency hearing loss on the left side. Cerebrospinal fluid analysis revealed lymphocytic pleocytosis, and polymerase chain reaction detected VZV DNA. The patient received intravenous acyclovir (10 mg/kg every 8 h for 10 days). No vesicular rash developed during the clinical course. The clinical presentation was consistent with VZV-associated cranial neuritis involving Cranial Nerves VII and VIII within the spectrum of zoster sine herpete. Intravenous acyclovir therapy was administered for 10 days, and corticosteroids were discontinued after virological confirmation. Delivery was performed by planned cesarean section due to breech presentation, and the newborn was healthy with no signs of neonatal varicella infection. At hospital discharge, the mother had persistent House-Brackmann grade V facial paralysis. One month after symptom onset, the facial paresis had completely resolved.</p><p><strong>Conclusion: </strong>VZV reactivation in pregnancy may present as isolated cranial neuritis without rash. Cerebrospinal fluid PCR is essential for diagnosis in atypical cases. Early antiviral treatment is associated with favorable maternal and fetal outcomes. Only a few cases of VZV meningitis or encephalitis in pregnant patients have been reported in the literature. Although immunodeficiencies are usually associated with these clinical manifestations, pregnancy is a condition in which various changes occur in the woman's immune system. This case highlights that VZV reactivation may present as cranial neuropathy without rash during pregnancy. Detection of VZV DNA in cerebrospinal fluid is essential for diagnosis in atypical presentations. Early recognition and antiviral therapy are important for maternal neurological outcomes and are safe for the fetus.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"5236883"},"PeriodicalIF":0.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763542","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":"Isolated Fallopian Tube Torsion Concomitant With an Adenomatoid Tumor Arising From the Fallopian Tube: A Case Report.","authors":"Fumitaka Mukouyama, Hiroshi Ishikawa, Aki Kinoshita, Mariko Inoue, Yoshinori Itsuka, Yohei Hosokawa, Kenichi Harigaya, Jun-Ichiro Ikeda, Kaori Koga","doi":"10.1155/crog/7233415","DOIUrl":"https://doi.org/10.1155/crog/7233415","url":null,"abstract":"<p><p>Isolated fallopian tube torsion (IFTT) is a rare condition in which the fallopian tube undergoes torsion without ovary involvement. The causes of IFTT vary widely, ranging from intrinsic abnormalities of the fallopian tube itself to extrinsic factors affecting the peritubal environment. Here, we report a case of IFTT concomitant with an adenomatoid tumor arising from the fallopian tube. A 49-year-old triparous patient presented with sudden-onset lower abdominal pain. Imaging findings revealed a 3-cm solid mass in the subserosal area of the left fallopian tube, and laparoscopy confirmed IFTT involving a dark red and solid mass. Histologically, an adenomatoid tumor was identified in the twisted fallopian tube. Adenomatoid tumors of the fallopian tube are typically small, asymptomatic, and identified incidentally during gynecologic surgeries or imaging; therefore, this tumor is an extremely rare cause of IFTT. Adenomatoid tumors in the fallopian tube, even those as small as 3 cm, can result in torsion.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"7233415"},"PeriodicalIF":0.8,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763464","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}