{"title":"Long-Term Sequential Therapy for Pregnancy- and Lactation-Associated Osteoporosis With Multiple Vertebral Fractures: A Case Report of Over 5 Years.","authors":"Kaneyuki Tsuchimochi, Hiroe Tsuchimochi","doi":"10.1155/crog/5696865","DOIUrl":"10.1155/crog/5696865","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy- and lactation-associated osteoporosis (PLO) is a rare condition that may cause multiple vertebral fractures during late pregnancy or the postpartum period. Evidence regarding treatment strategies remains limited, particularly regarding long-term outcomes of sequential regimens combining anabolic and antiresorptive therapies.</p><p><strong>Case presentation: </strong>A 37-year-old woman developed low back pain 3 months postpartum and was diagnosed with PLO accompanied by multiple acute and chronic vertebral fractures. Breastfeeding was discontinued, and initial treatment with vitamin D analogs and bisphosphonate therapy was selected based on clinical and patient-specific considerations, including documented efficacy in PLO, the absence of reproductive safety concerns, and patient preferences. Despite early improvement, lumbar spine Z-score remained persistently low at -3.0, and therapy was sequentially transitioned to daily teriparatide for 2 years, romosozumab for 1 year, and denosumab for maintenance. Over 5 years and 7 months, lumbar spine and femoral neck bone mineral density increased by 53.4% and 26.1%, respectively. No new fractures occurred, and serial bone turnover markers demonstrated appropriate anabolic and antiresorptive responses at each phase of therapy.</p><p><strong>Conclusion: </strong>This case highlights a successful long-term sequential treatment strategy for PLO involving bisphosphonate, teriparatide, romosozumab, and denosumab in a patient without desire for further pregnancy, without reproductive safety constraints. The individualized sequential approach developed through patient education and shared decision-making may help achieve sustained improvements in bone mineral density and prevent refracture in patients at very high fracture risk, particularly when an anabolic-first strategy is not initially feasible.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"5696865"},"PeriodicalIF":0.8,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13261773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249239","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":"Not Just a Cold Sore: Postpartum Herpes Simplex Virus Endometritis.","authors":"Olivia Moore, Jesse Cottrell","doi":"10.1155/crog/7459192","DOIUrl":"10.1155/crog/7459192","url":null,"abstract":"<p><p>Endometritis is a well-described cause of postdelivery morbidity for both mother and neonate. Although the usual causative organisms are bacteria, in very rare cases it can be due to herpes simplex virus (HSV). In postpartum endometritis unresponsive to conventional treatment, prompt diagnosis and early antiviral therapy are required for clinical improvement in mothers and their neonates.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"7459192"},"PeriodicalIF":0.8,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13254999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249225","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 Leiomyoma-Associated Cutaneous Sinus Tract Secondary to an Infected Uterine Leiomyoma Without Prior Myomectomy.","authors":"Brahmana Askandar Tjokroprawiro, Khoirunnisa Novitasari, Renata Alya Ulhaq, Hanif Ardiansyah Sulistya, Teuku Mirza Iskandar","doi":"10.1155/crog/3211851","DOIUrl":"10.1155/crog/3211851","url":null,"abstract":"<p><strong>Background: </strong>Leiomyoma-associated cutaneous sinus tracts are exceptionally rare and typically associated with prior uterine surgeries, such as cesarean section or myomectomy. Fistula formation from an infected uterine leiomyoma involving the uterine parenchyma, without prior myomectomy, represents an uncommon clinical presentation.</p><p><strong>Case: </strong>A 22-year-old woman with a history of cesarean section 5 months prior presented with purulent discharge from an abdominal mass. Imaging revealed a large uterine mass containing gas, with a fistulous tract extending to the abdominal skin. Laparotomy confirmed a fistulous tract extending from the abdominal skin to an infected leiomyoma within the uterine fundal parenchyma, without demonstrable communication with the endometrial cavity. Surgical intervention consisted of fistula closure, myomectomy, and drainage. Histopathological examination confirmed the presence of a uterine leiomyoma with chronic suppurative inflammation, consistent with an infected myoma. The patient remained asymptomatic for 15 months following surgery.</p><p><strong>Conclusion: </strong>This case highlights a rare variant of leiomyoma-associated cutaneous sinus tract arising from an infected uterine leiomyoma involving the uterine parenchyma. Careful diagnostic evaluation and tailored surgical management resulted in complete recovery and a favorable long-term outcome.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"3211851"},"PeriodicalIF":0.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148223420","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}
Dominick J Rich, Meridith P Pollie, Julie P Barbera, Jordan S Stone, Adi Hirshberg
{"title":"Cyclic Fevers in Pregnancy: A Case of Parvovirus-Related Hemophagocytic Lymphohistiocytosis.","authors":"Dominick J Rich, Meridith P Pollie, Julie P Barbera, Jordan S Stone, Adi Hirshberg","doi":"10.1155/crog/7218689","DOIUrl":"10.1155/crog/7218689","url":null,"abstract":"<p><p>Parvovirus B19 typically causes mild symptoms in healthy adults, including fever, rash, and arthralgias. Certain immunocompromised adult populations, including those with immunodeficiencies or hematologic disease, are at risk of clinically significant complications, including transient aplastic crisis. Further, in pregnant patients, there is a risk of transplacental viral transmission, which may lead to severe fetal anemia, nonimmune hydrops fetalis, and intrauterine fetal demise. The clinical course of parvovirus B19 in pregnant patients with underlying hematologic disease has not been well reported. In this case report, we present a 27-year-old pregnant patient with sickle cell beta thalassemia who was infected with parvovirus B19 at 20 weeks of gestation. She experienced a prolonged hospitalization characterized by persistent maternal vaso-occlusive crisis with concomitant transient aplastic crisis. There was suspected vertical transmission of the virus, leading to concern for severe fetal anemia and termination of the pregnancy. The patient continued to have cyclic fevers, bicytopenia, and a constellation of laboratory findings leading to a diagnosis of postviral hemophagocytic lymphohistiocytosis (HLH). She was successfully treated with pulse dose corticosteroids and an Interleukin-1 receptor antagonist with subsequent improvement of her symptoms and laboratory markers. This report highlights the distinct diagnostic and management challenges of parvovirus B19 in pregnant patients with comorbid hematologic disease, including a rare but serious sequela of the infection, and the risk for severe maternal and fetal complications.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"7218689"},"PeriodicalIF":0.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148223390","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":"Broad Ligament Hernia Causing Small Bowel Obstruction: When Gynecologic Symptoms Conceal Surgical Emergencies-A Case Report.","authors":"Tiffany Chang, Bella Swan, Antoun Al Khabbaz","doi":"10.1155/crog/3055029","DOIUrl":"10.1155/crog/3055029","url":null,"abstract":"<p><p>Internal hernias are an uncommon cause of small bowel obstruction (SBO), accounting for approximately 1% of cases. Among these, broad ligament hernias represent a rare subtype, comprising approximately 4% of internal hernias. Despite their rarity, they carry a significant risk of bowel strangulation and ischemia, necessitating prompt recognition and surgical intervention. We report the case of a 35-year-old G5P3023 woman with no prior abdominal surgeries who presented with a 2-day history of sharp abdominal pain, nausea, and vomiting. Initial imaging findings were suggestive of a tubo-ovarian abscess (TOA); the patient was managed with broad-spectrum antibiotics and subsequently underwent an unsuccessful image-guided drainage attempt. Due to clinical deterioration, a diagnostic laparoscopy was performed, revealing a broad ligament hernia with incarcerated small bowel. The procedure was converted to an exploratory laparotomy, during which the ischemic ileum was resected and a primary was anastomosis performed. The broad ligament defect was subsequently repaired. This case highlights the diagnostic challenges associated with internal hernias, particularly when presentation mimics gynecologic pathology. Failure to include internal hernias in the differential diagnosis may delay appropriate intervention. Early recognition based on clinical and radiologic findings is critical to improving outcomes and preventing bowel compromise.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"3055029"},"PeriodicalIF":0.8,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13244381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210248","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":"DARIP Technique: A Novel Approach in the Surgical Management of Placenta Accreta Spectrum in the Second Trimester From Tu Du Hospital, Vietnam.","authors":"Ngoc Hai Tran, Phuc Nhon Nguyen, Van Hoang Bui","doi":"10.1155/crog/7907465","DOIUrl":"10.1155/crog/7907465","url":null,"abstract":"<p><strong>Background: </strong>Placenta accreta spectrum (PAS) is an increasingly common complication during pregnancy that has led to high maternal mortality and morbidity in the past decades. Treatment of PAS in the second-trimester pregnancy includes expectant management and surgical intervention. However, PAS surgery is related to complex obstetric management involving psychological issues and life-threatening hemorrhage. In low- and middle-income countries, cesarean delivery, along with uterine-sparing surgery in pregnancies complicated by PAS disorders, could be an optimal choice due to limited resources.</p><p><strong>Methods: </strong>Herein, we describe a novel procedure in managing PAS in the second trimester of gestation through a clinical case and presentation of a video.</p><p><strong>Case presentation and results: </strong>The 35-year-old pregnant woman at term of 21 weeks and 6 days was hospitalized due to important vaginal bleeding. An ultrasound scan revealed PAS type percreta. The patient was managed with the DARIP procedure. The surgical approach included five steps: (1) <i>D</i>issection of the uterovesical interface containing newly proliferative vessels, (2) <i>A</i>mniotic fluid reduction, (3) <i>R</i>ectangular-shaped hemostatic sutures, (4) <i>I</i>ncision of the uterine layer through the vascular-blocked region, and (5) <i>P</i>recise suturing of the placental bed. Regarding surgical outcomes, the estimated blood loss was 300 mL, and no surgical complication was noted. The patient was sent home on Day 7.</p><p><strong>Conclusions: </strong>The DARIP procedure is a promising method in managing PAS disorders in the second trimester. However, the DARIP technique requires further validation in larger studies. Moreover, this feasible procedure should be performed at an expert center to optimize the maternal outcomes.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"7907465"},"PeriodicalIF":0.8,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13244563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210230","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}
Sara N Peters, Emily J Bollinger, Stacey S Schmiedecke, Julie A Watters
{"title":"Favorable Pregnancy Outcome in a Dicavitary Twin Gestation: A Case Report and Literature Review.","authors":"Sara N Peters, Emily J Bollinger, Stacey S Schmiedecke, Julie A Watters","doi":"10.1155/crog/1477270","DOIUrl":"10.1155/crog/1477270","url":null,"abstract":"<p><p>Congenital Müllerian anomalies pose unique risks for complications in pregnancy, particularly in the setting of multifetal gestation. Uterine didelphys with dicavitary twin gestation remains a rare entity with fewer than 10 cases reported in the medical literature. Currently, there are no established guidelines for the management or delivery of dicavitary twin gestations. We report a case of naturally conceived dicavitary twins in the setting of uterine didelphys with two functional cervices and a prior vaginal septum excised in childhood. Delivery occurred in the 35th week of gestation via cesarean section with two low vertical hysterotomy incisions. Late-preterm delivery was recommended for maternal indications, specifically superimposed preeclampsia with severe features. Cesarean delivery was recommended due to malpresentation, with both fetuses in a double-footling breech position. The patient and twins were discharged home in good condition on Postpartum Day 3 (Day of Life 4). This case contributes to the literature on the management of a rare obstetric condition with favorable outcomes for the mother and infants, including a nuanced surgical technique.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"1477270"},"PeriodicalIF":0.8,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210250","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":"Unusual Case of Cervical Tissue Penetration by a Wool-Like Foreign Body Inserted for Male Child Conception.","authors":"Alireza Babajani, Sayna Abbaszadeh, Fatemeh Ayatollahi, Mahnaz Faramarzi Kheneshti","doi":"10.1155/crog/8965121","DOIUrl":"10.1155/crog/8965121","url":null,"abstract":"<p><p>Retention of a foreign body in the vagina can occur intentionally or unintentionally. This condition can lead to a variety of clinical symptoms. We present a case involving a 39-year-old multiparous woman with an obstetric history comprising four pregnancies, three term vaginal deliveries and one spontaneous miscarriage, who was hospitalized on January 17, 2024, for acute management of profuse vaginal discharge and pyrexia secondary to the intravaginal retention of a wool-like foreign body. Clinical examination revealed a woolen foreign body in the cervix, inserted 4 years earlier as a traditional method to influence fetal sex. Pelvic ultrasound showed a spongy mass (50 × 30 mm) in the vaginal canal. Vaginoscopy and hysteroscopy performed under general anesthesia facilitated the identification and extraction of a 50 × 50 mm malodorous, wool-like foreign body embedded 5 mm within the cervical stroma. Biopsies confirmed a foreign body reaction with acute and chronic inflammation, reactive epithelial changes, and keratin-like fibers infiltrating the cervical stroma. Intraoperative assessment revealed no extension to the uterine cavity or urinary bladder. The patient was administered a 72-h course of empirical antibiotic therapy, achieved complete clinical resolution, and was subsequently discharged with recommendations for ambulatory follow-up. The retention of a foreign body within the vaginal vault may engender a spectrum of clinical manifestations and sequelae, contingent upon the nature of the foreign material and the duration of its persistence. Prolonged indwelling of such objects can precipitate histopathologic alterations in contiguous tissues, potentially mandating surgical extirpation and serial surveillance evaluations.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"8965121"},"PeriodicalIF":0.8,"publicationDate":"2026-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210255","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":"Müllerian Duct Remnants on the Uterine Surface With Ovarian Serous Cystadenoma: A Case Report and Literature Review.","authors":"Wenxin Zhong, Xiuqing Lei, Shuangyang Qin, Yun Dai, Guangming Yang, Qi Bao","doi":"10.1155/crog/1233064","DOIUrl":"10.1155/crog/1233064","url":null,"abstract":"<p><p>This report describes a case of a patient diagnosed with a residual Müllerian duct mass on the uterine surface at our hospital. Through analysis of this case and a review of the literature, we are aimed at reducing the risk of misdiagnosis and optimising treatment protocols for uterine cystic masses.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"1233064"},"PeriodicalIF":0.8,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13238537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197523","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}
Lela Tandashvili, George Jinchveladze, Lela Iremadze, Sofio Skliarenko, Irina Gagua
{"title":"A Rare Case of Uterine Artery Pseudoaneurysm After Hysteroscopic Management of Trophoblastic Disease.","authors":"Lela Tandashvili, George Jinchveladze, Lela Iremadze, Sofio Skliarenko, Irina Gagua","doi":"10.1155/crog/6367800","DOIUrl":"10.1155/crog/6367800","url":null,"abstract":"<p><strong>Introduction: </strong>Uterine artery pseudoaneurysm (UAP) is a rare but potentially life-threatening condition, most commonly associated with childbirth and less frequently with intrauterine procedures such as dilatation and curettage or hysteroscopy. Its incidence is estimated at 3-6 per 1000 deliveries, whereas occurrence in the context of gestational trophoblastic disease (GTD) is extremely uncommon. UAP may remain asymptomatic before presenting as sudden vaginal hemorrhage days to weeks after uterine intervention. Prompt recognition and timely imaging are essential for effective management. Computed tomography (CT) angiography is considered the gold standard, whereas Doppler ultrasound and magnetic resonance imaging (MRI) are valuable alternatives. Uterine artery embolization is the preferred treatment due to its high success rate and fertility-preserving potential.</p><p><strong>Case presentation: </strong>We report an exceptionally rare case of UAP developing 5 weeks after hysteroscopic removal of retained products of conception in the context of GTD. Power Doppler ultrasonography demonstrated a hypervascular lesion with a characteristic swirling flow pattern, confirmed by contrast-enhanced CT. The patient underwent successful selective uterine artery embolization, resulting in complete symptom resolution. Over 5 years of follow-up, she remained recurrence-free, with regular menstruation and a subsequent full-term delivery, indicating preserved reproductive function.</p><p><strong>Discussion: </strong>This case highlights the importance of considering UAP in delayed posthysteroscopic hemorrhage, particularly in GTD. Multimodal imaging is essential for accurate diagnosis and differentiation from other vascular lesions. Selective uterine artery embolization is a safe, effective, and fertility-preserving treatment with favorable long-term outcomes, including successful pregnancy.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":"2026 ","pages":"6367800"},"PeriodicalIF":0.8,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197520","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}