Case Reports in Obstetrics and Gynecology最新文献_第10页

Rotational Thromboelastometry-Guided Venoarterial Extracorporeal Membrane Oxygenation in the Treatment of Amniotic Fluid Embolism. 旋转血栓弹力仪引导静脉动脉体外膜肺氧合治疗羊水栓塞。

Case Reports in Obstetrics and Gynecology Pub Date : 2022-05-18 eCollection Date: 2022-01-01 DOI: 10.1155/2022/9658708

Jillian K Wothe, Elizabeth Elfstrand, Michael R Mooney, Donald D Wothe

{"title":"Rotational Thromboelastometry-Guided Venoarterial Extracorporeal Membrane Oxygenation in the Treatment of Amniotic Fluid Embolism.","authors":"Jillian K Wothe, Elizabeth Elfstrand, Michael R Mooney, Donald D Wothe","doi":"10.1155/2022/9658708","DOIUrl":"https://doi.org/10.1155/2022/9658708","url":null,"abstract":"<p><p>Amniotic fluid embolism (AFE) is a rare and often fatal complication of pregnancy that occurs during the puerperium. The low incidence of AFE has resulted in few large studies, which makes evidence-based management of AFE challenging. The use of extracorporeal membrane oxygenation (ECMO) has been reported but is limited by availability and challenges managing anticoagulation. In this report, we detail the case of a 29-year-old female who suffered from an AFE leading to cardiac arrest and disseminated intravascular coagulopathy. She was treated with protocolized A-OK (adenosine, ondansetron, and ketorolac), emergency c-section, cardiopulmonary resuscitation, massive blood transfusion, and rotational thromboelastometry-guided ECMO, allowing her to forgo initial anticoagulation. After a prolonged rehabilitation with initial poor neurological status, she made a complete recovery. In this report, we describe the protocols that contributed to her recovery and detail management of complicated AFE for other clinicians.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2022 ","pages":"9658708"},"PeriodicalIF":0.0,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9132692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71421013","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}

引用次数: 1

A Case of Preeclampsia with Uterine Necrosis after Uterine Artery Embolization for Postpartum Hemorrhage 子宫动脉栓塞治疗产后出血后子痫前期合并子宫坏死1例

Case Reports in Obstetrics and Gynecology Pub Date : 2022-05-17 DOI: 10.1155/2022/2859766

Midori Yoshikawa, T. Seyama, T. Iriyama, S. Sayama, T. Fujii, Masatake Toshimitsu, Moto Nakaya, R. Kurokawa, Eisuke Shibata, T. Watadani, K. Kumasawa, T. Nagamatsu, K. Koga, Y. Osuga

{"title":"A Case of Preeclampsia with Uterine Necrosis after Uterine Artery Embolization for Postpartum Hemorrhage","authors":"Midori Yoshikawa, T. Seyama, T. Iriyama, S. Sayama, T. Fujii, Masatake Toshimitsu, Moto Nakaya, R. Kurokawa, Eisuke Shibata, T. Watadani, K. Kumasawa, T. Nagamatsu, K. Koga, Y. Osuga","doi":"10.1155/2022/2859766","DOIUrl":"https://doi.org/10.1155/2022/2859766","url":null,"abstract":"Uterine necrosis is a rare complication in uterine artery embolization (UAE) for postpartum hemorrhage (PPH). Preeclampsia (PE) is a condition characterized with systemic endothelial damage and intravascular volume depletion. Whether a patient with PE is at high risk for uterine necrosis after UAE for PPH has been unknown. A 30-year-old primipara woman was diagnosed with PE based on hypertension and proteinuria during delivery. UAE was performed for PPH after forceps delivery. After UAE, the patient presented with pleural effusion and massive ascites as well as persistent fever unresponsive to antibiotics. Ultrasonography and contrast-enhanced magnetic resonance imaging (MRI) led to the diagnosis of uterine necrosis, for which we performed total laparoscopic hysterectomy. It should be kept in mind that patients with PE associated with massive ascites may be at high risk for uterine necrosis after UAE due to decreased uterine perfusion. Therefore, it is important to pay attention to persistent symptoms such as fever and abdominal pain after UAE to diagnose uterine necrosis.","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89210396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

More than an Incidentaloma: The Nonreportable NIPT 不只是偶发瘤:不可报告的NIPT

Case Reports in Obstetrics and Gynecology Pub Date : 2022-04-30 DOI: 10.1155/2022/2496057

Allison M Jay, Brian Mason, D. Lebovic, P. Chuba

引用次数: 0

Appearances Are Deceptive: Two Case Reports in Teenagers on the Conservative Laparoscopic Surgery for Adnexal Torsion with Apparent Infarction 外表具有欺骗性:两例青少年保守腹腔镜手术治疗伴有明显梗死的附件扭转

Case Reports in Obstetrics and Gynecology Pub Date : 2022-04-27 DOI: 10.1155/2022/1798599

A. Jayawardane, M. Patabendige, C. Gunathilaka

引用次数: 0

Atypical Eclampsia in a Pregnant Woman Infected by COVID-19 COVID-19感染孕妇的非典型子痫

Case Reports in Obstetrics and Gynecology Pub Date : 2022-04-27 DOI: 10.1155/2022/9952355

M. A. Odeh, Yousef S. Abuzneid, Omar Badareen, Khaled Masarweh

引用次数: 2

A Case of Markedly Elevated Isolated Alkaline Phosphatase in the Third Trimester of Pregnancy 妊娠晚期分离性碱性磷酸酶显著升高1例

Case Reports in Obstetrics and Gynecology Pub Date : 2022-04-27 DOI: 10.1155/2022/1611304

Courtney T Connolly, Olivia Grubman, Zainab Al-ibraheemi, Tatyana Kushner

{"title":"A Case of Markedly Elevated Isolated Alkaline Phosphatase in the Third Trimester of Pregnancy","authors":"Courtney T Connolly, Olivia Grubman, Zainab Al-ibraheemi, Tatyana Kushner","doi":"10.1155/2022/1611304","DOIUrl":"https://doi.org/10.1155/2022/1611304","url":null,"abstract":"Background Alkaline phosphatase (ALP) is an enzyme produced by the liver, small intestine, bone, and kidneys as well as the placenta during pregnancy. ALP levels may increase up to twice the normal limit during pregnancy secondary to placental release and fetal bone growth. Rare case reports of extremely elevated levels of ALP during pregnancy have demonstrated possible association with adverse pregnancy outcomes. Case The patient is a 36-year-old G2P1001 who was found to have extremely elevated ALP levels during pregnancy after presenting with bilateral lower leg swelling and rash after receiving the Pfizer COVID-19 vaccine. She subsequently developed intrahepatic cholestasis of pregnancy and preeclampsia. ALP peaked at 2,601 U/L immediately prior to delivery at 36 weeks 1 day. She was followed postpartum, and her ALP levels had nearly normalized by 15 weeks postpartum. Conclusion Our case demonstrates a rare report of an extremely elevated level of ALP in the setting of multiple adverse pregnancy outcomes, including preterm delivery, preeclampsia without severe features, and intrahepatic cholestasis of pregnancy.","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88062125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Challenging Obstetrical Management in Generalized Peritonitis during Pregnancy 妊娠期广泛性腹膜炎的产科管理挑战

Case Reports in Obstetrics and Gynecology Pub Date : 2022-04-21 DOI: 10.1155/2022/1249676

S. Oliveira, A. Sousa, N. N. Martins

{"title":"Challenging Obstetrical Management in Generalized Peritonitis during Pregnancy","authors":"S. Oliveira, A. Sousa, N. N. Martins","doi":"10.1155/2022/1249676","DOIUrl":"https://doi.org/10.1155/2022/1249676","url":null,"abstract":"Acute abdomen in pregnancy represents a diagnostic and therapeutic challenge, despite the current advances in modern medicine, since the typical symptoms and altered laboratory parameters mimic normal pregnancy. Acute appendicitis is the most common nonobstetric surgical emergency during pregnancy, with an incidence of 1 per 500-2000 pregnancies. Delayed diagnosis and reluctance to operate on a pregnant woman predispose to adverse maternal and fetal outcomes. The elective termination of pregnancy or interventions to prolong it in the presence of appendicitis is controversial. We present a case of a 38-year-old Caucasian woman, G2P0, admitted to the Obstetric Emergency Department at 13 4/7 weeks of gestation with a primary complaint of severe nausea and vomiting associated with progressive diffuse abdominal pain which had started 7 days before. After the difficulty of inherent differential diagnosis, she was diagnosed with generalized peritonitis due to acute perforated appendicitis. Prompt exploratory laparotomy with appendectomy and drainage of multiple abscesses were performed. Conservative obstetrical management was assumed, with subsequent periodic monitoring of the fetal focus. Due to abdominal compartment syndrome, the abdomen was left open for 4 days. After 7 days in the intensive care unit, recovery was favorable, pregnancy remained uneventful, and a healthy full-term baby was born 27 weeks later. This case represents a successful example of how the cooperation of the obstetrics and general surgery teams and the decision of conservative obstetrical management in the surgical environment contributed to optimizing maternal health, achieving the best obstetrical outcome.","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73134580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Perinatal Catatonia in a Patient with a Twin Pregnancy of Unknown Chorionicity and Gestational Age Presenting in Spontaneous Preterm Labor 围生期紧张症患者与双胞胎妊娠不明绒毛膜和胎龄表现为自然早产

Case Reports in Obstetrics and Gynecology Pub Date : 2022-04-12 DOI: 10.1155/2022/3143601

Ryan Farias, J. Hartnett

引用次数: 2

15-Year-Old Patient with an Unusual Alpha-Fetoprotein-Producing Sertoli-Leydig Cell Tumor of Ovary 15岁的卵巢罕见的产生甲胎蛋白的支持-间质细胞瘤患者

Case Reports in Obstetrics and Gynecology Pub Date : 2022-04-12 DOI: 10.1155/2022/4759826

Kaçar Serife, S. Karampelas, N. Hottat, C. Devalck, K. Vanden Houte

{"title":"15-Year-Old Patient with an Unusual Alpha-Fetoprotein-Producing Sertoli-Leydig Cell Tumor of Ovary","authors":"Kaçar Serife, S. Karampelas, N. Hottat, C. Devalck, K. Vanden Houte","doi":"10.1155/2022/4759826","DOIUrl":"https://doi.org/10.1155/2022/4759826","url":null,"abstract":"Ovarian Sertoli-Leydig cell tumors (SLCTs) are extremely rare ovarian sex-cord stromal tumors. Alpha-fetoprotein (AFP) production by SLCTs is a rare event generally linked to the presence of hepatocytes or intestinal mucinous epithelium as heterologous elements. We report here a case of a 15-year-old female complaining about abdominal pain, constipation, and spaniomenorrhea with high level of serum AFP leading to a clinical suspicion of malignant germ cell tumor. Final histopathological diagnosis was a moderately differentiated Sertoli-Leydig cell tumor of the ovary with alpha-fetoprotein-producing cells without hepatocytic or intestinal epithelium differentiation. NGS analysis showed mutation in DICER1 gene. SLCTs occur in patients at any age with a mean age of 25 years. The presence of alpha-fetoprotein-producing cells is an important tool in the differential diagnosis of germ cell tumors and challenging in this case of SLCT because of its rarity in this context. An adequate sampling and exhaustive immunohistochemical analyses are mandatory to make the correct differential diagnosis and confirm the presence of alpha-fetoprotein-producing cells and also define the differentiation because of therapeutic strategies between conservative surgery and/or chemotherapy.","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79491730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Gastrointestinal Stromal Tumor with Repeated Multiple Cerebral Infarction Mimicking Ovarian Cancer with Trousseau's Syndrome 胃肠道间质瘤伴重复多发性脑梗死，模拟卵巢癌伴特鲁索综合征

Case Reports in Obstetrics and Gynecology Pub Date : 2022-04-06 DOI: 10.1155/2022/5537990

Misa Kobayashi, Y. Otsuki, Hiroharu Kobayashi, Takashi Suzuki, S. Nakayama, H. Adachi

{"title":"Gastrointestinal Stromal Tumor with Repeated Multiple Cerebral Infarction Mimicking Ovarian Cancer with Trousseau's Syndrome","authors":"Misa Kobayashi, Y. Otsuki, Hiroharu Kobayashi, Takashi Suzuki, S. Nakayama, H. Adachi","doi":"10.1155/2022/5537990","DOIUrl":"https://doi.org/10.1155/2022/5537990","url":null,"abstract":"We report a case of gastrointestinal stromal tumor (GIST) with repeated multiple cerebral infarctions mimicking ovarian cancer. A 79-year-old postmenopausal woman had multiple cerebral infarctions with a giant pelvic tumor detected by computed tomography. Ovarian cancer with Trousseau's syndrome was suspected. Through laparoscopic biopsy on the tumor surface, she was diagnosed with left ovarian fibrosarcoma; although, the abdominal cavity could not be observed appropriately. Ovarian fibrosarcoma is an extremely rare tumor and still has no adequate treatment strategy. Complete resection was planned. The tumor was extremely fragile, and gelatinous that it easily bled. Meanwhile, the uterus and bilateral ovaries and fallopian tubes were all normal. The tumor invaded only the peritoneum near the left sacral uterine ligament and sigmoid colon, with no peritoneal dissemination. To completely remove the tumor, we performed total hysterectomy with bilateral salpingo-oophorectomy and omentectomy and sigmoidal and rectal resection with colostomy. Despite resuming her anticoagulant therapy on postoperative day 4, she had recurrent multiple strokes. On histopathological examination, tumor showed spindle cell proliferation with severe atypia, increased mitotic activity, and widespread necrosis. Immunohistochemical studies showed positive staining for c-kit, CD34, and DOG1. Thus, she was diagnosed with GIST. This case was rare and highly malignant, with a high risk of recurrence of GIST because of a giant ruptured tumor that had a mitotic activity of 36/10 high-power fields from the sigmoid colon. Multiple cerebral infarctions mimicking ovarian cancer recurred. Therefore, preoperative diagnosis of an atypical GIST was extremely difficult.","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87103320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1