Case Reports in Obstetrics and Gynecology最新文献

{"title":"A Case of a Patient with Adhesive Small Bowel Obstruction in Pregnancy after Extensive Myomectomy for Diffuse Uterine Leiomyomatosis.","authors":"Yuri Suminaga,&nbsp;Mana Taki,&nbsp;Haruko Okamoto,&nbsp;Yosuke Kawamura,&nbsp;Yusuke Sagae,&nbsp;Masumi Sunada,&nbsp;Yoshitsugu Chigusa,&nbsp;Akihito Horie,&nbsp;Masaki Mandai,&nbsp;Haruta Mogami","doi":"10.1155/2022/3601945","DOIUrl":"https://doi.org/10.1155/2022/3601945","url":null,"abstract":"<p><strong>Background: </strong>Diffuse uterine leiomyomatosis is a rare disease in which countless, poorly defined, and small nodules are present in most parts of the uterine myometrium. It frequently occurs in fertile women and causes infertility. A deep, median, longitudinal incision of the uterine corpus with the opening of the endometrial cavity, \"extensive myomectomy,\" is required to restore fertility. However, myomectomy may also be a risk factor for perinatal complications. We present a rare case of adhesive small bowel obstruction after extensive myomectomy for diffuse uterine leiomyomatosis.</p><p><strong>Case: </strong>A 37-year-old primigravida presented with sharp epigastric pain and vomiting at 21-week gestation. The patient had a history of extensive myomectomy for diffuse uterine leiomyomatosis. Abdominal radiography revealed moderate air fluid levels in the small intestine, and the patient was diagnosed with adhesive small bowel obstruction. The patient was also diagnosed with placenta previa. Bowel rest with intestinal tube was continued until delivery. Cesarean section was performed at 32-week gestation due to (i) prolonged fasting and total parenteral nutrition for conservative treatment and (ii) fear of sudden massive bleeding from placenta previa. Because the ileum was strongly adherent to the uterine scar from the previous myomectomy, adhesiolysis and enterectomy were performed. The placenta was uncomplicatedly delivered and the hemorrhage was well-controlled.</p><p><strong>Conclusions: </strong>Pregnancy with a history with extensive myomectomy for diffuse uterine leiomyomatosis should be carefully monitored because of the occasional occurrence of adhesive small intestine obstruction during pregnancy.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":" ","pages":"3601945"},"PeriodicalIF":0.0,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9529410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33506526","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":"Fibrodysplasia Ossificans Progressiva and Pregnancy: A Case Series and Review of the Literature.","authors":"Alexandra D Forrest,&nbsp;Danielle M Vuncannon,&nbsp;Jane E Ellis,&nbsp;Zvi Grunwald,&nbsp;Frederick S Kaplan","doi":"10.1155/2022/9857766","DOIUrl":"https://doi.org/10.1155/2022/9857766","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate maternal and fetal outcomes in pregnant patients with fibrodysplasia ossificans progressiva (FOP; OMIM#135100), an ultrarare genetic disorder characterized by progressive heterotopic ossification of soft tissues and cumulative disability.</p><p><strong>Methods: </strong>This is a retrospective case series of three patients with FOP who were admitted to Grady Memorial Hospital in Atlanta, Georgia, from to February 2011 to July 2021.</p><p><strong>Results: </strong>Three women delivered preterm infants at our institution. These cases posed unique anesthetic and obstetric technical challenges, particularly when securing the airway and performing cesarean delivery. Importantly, each patient received perioperative glucocorticoids for prevention of further heterotopic ossification.</p><p><strong>Conclusion: </strong>FOP is a unique clinical diagnosis encountered by obstetricians and requires multidisciplinary management for optimal outcomes.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":" ","pages":"9857766"},"PeriodicalIF":0.0,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9507790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33483477","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":"Early Fetal Growth Restriction of Both Twins in a Transgender Man.","authors":"Alicia Martínez-Varea,&nbsp;Clara Martínez-Sáez,&nbsp;María Patrocinio Tarrazó-Millet,&nbsp;Vicente Diago-Almela","doi":"10.1155/2022/2905539","DOIUrl":"https://doi.org/10.1155/2022/2905539","url":null,"abstract":"<p><p>Gender dysphoria affects 0.5% of people worldwide. Transgender men display a divergence between the female genetic sex and the gender male identity. To the best of our knowledge, we describe the first case report with regard to a transgender man with a dichorionic diamniotic twin pregnancy obtained by artificial insemination using donor sperm as a monoparental family, presenting early fetal growth restriction of both twins. The patient is a 35-year-old transgender man who had previously received gender-affirming hormone therapy based on testosterone for five years and had a prior bilateral mastectomy as gender-affirming surgery. Whether assisted reproductive techniques have any influence on obstetrical outcomes among these patients and whether prior long-term intake of gender-affirming hormone therapy has an impact on pregnancy and obstetrical outcomes remain to be elucidated.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":" ","pages":"2905539"},"PeriodicalIF":0.0,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9477589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40365927","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":"Use of Mirtazapine and Olanzapine in the Treatment of Refractory Hyperemesis Gravidarum: A Case Report and Systematic Review.","authors":"Marco Aurélio Knippel Galletta,&nbsp;Vera Lucia Carvalho Tess,&nbsp;Isabela Marangon Pasotti,&nbsp;Luiza Fior Pelegrini,&nbsp;Nicole Kemberly Ribeiro Rocha,&nbsp;Carolina Burgarelli Testa,&nbsp;Rossana Pulcineli Vieira Francisco","doi":"10.1155/2022/7324627","DOIUrl":"https://doi.org/10.1155/2022/7324627","url":null,"abstract":"<p><p>Hyperemesis gravidarum (HG) is a rare condition (1.1%) characterized by excessive vomiting, malnutrition, dehydration, and laboratorial alterations. Herein, we describe the even rarer and serious presentation of refractoriness to the usual treatment of antiemetics and parenteral nutrition, with improvement only after the use of olanzapine and mirtazapine. Two subsequent pregnancies of the same woman with HG are described, which were associated with severe weight loss, anemia, hyponatremia, hypokalemia, and mild dysfunction of liver enzymes. In the third pregnancy, the usual treatment for HG was not successful, requiring enteral nutrition and the introduction of olanzapine. In the fourth pregnancy, the patient refused to use enteral nutrition for refractory HG. Hence, the patient was started on mirtazapine at an initial dose of 15 mg/day, which was gradually increased to 30 mg/day. The patient responded well to the new regimen, as demonstrated by the decrease in symptoms, the gain of 10 kg in the pregnancy, and delivering a healthy newborn. A systematic review of literature showed 11 articles and 30 cases that successfully used mirtazapine in HG. Good clinical outcomes were seen with 4 days of the treatment and at an initial dose of 15 mg/day. However, most of these reports were from psychiatric profiles, with a predominance of depression and anxiety symptoms, and a poor description of the obstetric conditions and the disease progression itself. Pulmonary hypertension was described in one case and neonatal hyperexcitability in another. The case described in this paper reinforces the idea that mirtazapine and olanzapine can be considered in refractory HG, with good results. In the world literature, this is the second case of HG that has been successfully treated with olanzapine and the first in Latin America treated with mirtazapine.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":" ","pages":"7324627"},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9467790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40358837","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 Report of Severe Coagulopathy in Antenatal COVID-19.","authors":"Anna Sand,&nbsp;Roza Chaireti,&nbsp;Maria Sennström,&nbsp;Karin Pettersson,&nbsp;Maria Magnusson","doi":"10.1155/2022/7777445","DOIUrl":"https://doi.org/10.1155/2022/7777445","url":null,"abstract":"<p><p>Pregnancy is a naturally occurring hypercoagulable state, and COVID-19 can cause profound changes in the coagulation system associated with thromboinflammation. We report a case of a pregnant woman with moderate symptoms of COVID-19 and a severe coagulopathy with unexpected low levels of fibrinogen and factor VIII as well as atypical thrombelastometry results. She developed a severe placental dysfunction with intrauterine fetal distress and perinatal death. The case did not fulfil the criteria for preeclampsia or sepsis, and the adverse outcome was assessed as a direct effect of the COVID-19 infection with placental insufficiency, despite absence of serious maternal pulmonary symptoms. Atypical persistent coagulopathy may serve as an important marker of a serious obstetrical situation in COVID-19.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":" ","pages":"7777445"},"PeriodicalIF":0.0,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9440626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40349922","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":"Efficacy of Hydroxychloroquine for Improving Pregnancy Outcomes in a Female with Systemic Lupus Erythematosus and Antiphospholipid Syndrome.","authors":"Yumika Takaki,&nbsp;Atsushi Daimon,&nbsp;Misa Nunode,&nbsp;Tomohito Tanaka,&nbsp;Daisuke Fujita,&nbsp;Masahide Ohmichi","doi":"10.1155/2022/5612091","DOIUrl":"https://doi.org/10.1155/2022/5612091","url":null,"abstract":"<p><p>The use of heparin and low-dose aspirin is the current conventional treatment for pregnant females with antiphospholipid syndrome (APS). However, there is no additional treatment recommended for cases where the standard treatment cannot prevent obstetric complications such as fetal loss and placental insufficiency. Recently, the addition of a novel antimalarial, hydroxychloroquine (HCQ), to the conventional treatment has shown the potential to prevent obstetric complications. Herein, we report a case in which the addition of HCQ improved adverse pregnancy outcomes in a pregnant female with systemic lupus erythematosus and aspirin-heparin-resistant APS.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":" ","pages":"5612091"},"PeriodicalIF":0.0,"publicationDate":"2022-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9420616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40335086","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":"Oocyte Retrieval in Asymptomatic Patients Positive for SARS-CoV-2.","authors":"Allison Akers,&nbsp;Erika P New,&nbsp;Shayne Plosker,&nbsp;Celso P Silva,&nbsp;Rachel Sprague,&nbsp;Anthony N Imudia","doi":"10.1155/2022/3107747","DOIUrl":"https://doi.org/10.1155/2022/3107747","url":null,"abstract":"<p><strong>Objective: </strong>To report two cases of oocyte retrieval performed in asymptomatic SARS-CoV-2-positive patients.</p><p><strong>Design: </strong>Case report. <i>Setting</i>. Outpatient private practice infertility center. <i>Patients</i>. A 28-year-old woman at risk for OHSS who took her trigger injection prior to testing positive for SARS-CoV-2 and a 19-year-old oncofertility patient who tested positive prior to retrieval due to a family exposure. Both patients were asymptomatic. <i>Main Outcome Measures</i>. Cycle outcomes, patient safety, and staff safety.</p><p><strong>Results: </strong>Both patients underwent successful oocyte retrieval procedures without developing symptoms or complications from COVID-19. No staff members that cared for these patients developed symptoms of COVID-19.</p><p><strong>Conclusion: </strong>Worsening fertility outcomes and potential for psychological and financial burdens to the patient must be balanced with risk of perioperative complications in patients testing positive for SARS-CoV-2. As we continue to provide fertility care in a world with COVID-19, appropriate risk mitigation strategies should be implemented to minimize exposure to SARS-CoV-2.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":" ","pages":"3107747"},"PeriodicalIF":0.0,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9391171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40414158","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":"Case Report of a Triplet Pregnancy with Complete Hydatidiform Mole and Coexisting Twins.","authors":"Marjorie H Thompson,&nbsp;Nathaniel R Miller,&nbsp;Shelby L Haugan,&nbsp;Michael C Gordon","doi":"10.1155/2022/2865342","DOIUrl":"https://doi.org/10.1155/2022/2865342","url":null,"abstract":"<p><strong>Background: </strong>Triplet pregnancy with complete hydatidiform mole and coexisting twin fetuses is extremely rare with an unknown incidence.</p><p><strong>Case: </strong>Here, we present a case report of a pregnancy with twin fetuses and concurrent hydatidiform mole that resulted in the preterm delivery of one viable baby, the unfortunate intrauterine demise of the other twin, and successful treatment of gestational trophoblastic neoplasia in the postpartum period.</p><p><strong>Conclusion: </strong>This case highlights several important questions that arise for women who choose to carry a multiple gestation pregnancy with complete hydatidiform mole and describes complications that can occur. It is imperative to accurately assess risks and counsel individuals who elect to carry these pregnancies to provide the best possible outcomes.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":" ","pages":"2865342"},"PeriodicalIF":0.0,"publicationDate":"2022-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9371886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40697402","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":"Retroperitoneal Hydropic Leiomyoma Mimicking an Ovarian Cyst.","authors":"Pei-Hsuan Lai,&nbsp;Dah-Ching Ding","doi":"10.1155/2022/2012376","DOIUrl":"https://doi.org/10.1155/2022/2012376","url":null,"abstract":"<p><p>Leiomyoma is the most common benign neoplasm of the reproductive organs in women. Retroperitoneal hydropic leiomyoma is rare type of myoma. Herein, we present the case of a 46-year-old (gravida 0) woman with retroperitoneal hydropic leiomyoma that was preoperatively diagnosed as an ovarian cyst. Transvaginal sonography and abdominal computed tomography revealed a mass, measuring 8.1 × 3.8 cm, with solid and cystic components in the right pelvic cavity. The patient underwent laparoendoscopic single-site surgery for the tumor excision. During the surgery, a retroperitoneal cystic tumor was resected from the right retroperitoneal cavity. Histopathologic and microscopic examinations revealed a hydropic leiomyoma with infarction. This case is impressive because of the rare location and hydropic degeneration of the leiomyoma. Furthermore, it mimicked an ovarian cyst at its initial presentation making accurate diagnosis difficult. By warning of this case, surgeons can recognize the disease entities and provide the necessary treatment.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":" ","pages":"2012376"},"PeriodicalIF":0.0,"publicationDate":"2022-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9371877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40697401","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 Ruptured Decidualized Ovarian Endometrioma: Usefulness of Serial MRI for Determining Adequate Management.","authors":"Saki Yamamoto,&nbsp;Tomohiro Kikuchi,&nbsp;Hiroyuki Fujii,&nbsp;Yuko Otake,&nbsp;Mitsuru Matsuki,&nbsp;Risa Narumi,&nbsp;Masashi Endo,&nbsp;Hiroyuki Fujiwara,&nbsp;Harushi Mori","doi":"10.1155/2022/3234784","DOIUrl":"https://doi.org/10.1155/2022/3234784","url":null,"abstract":"<p><p>Decidualization can originate in ovarian endometrioma by elevated serum progesterone levels during pregnancy, which mimics malignancy on ultrasonography. Moreover, decidualized ovarian endometrioma may rupture and cause acute abdominal pain during pregnancy. Magnetic resonance imaging (MRI) is reportedly useful in differentiating decidualized ovarian endometriomas from malignancies. However, to our knowledge, serial MRI of decidualized ovarian endometrioma before and after rupture has not been reported. Herein, we report the case of a 39-year-old woman with a ruptured decidualized ovarian endometrioma in which serial MRI was useful for adequate management. She had a history of right ovarian endometrioma. Transvaginal ultrasonography at 20 weeks of gestation showed the known right ovarian endometrioma with mural nodules that were not evident before pregnancy. MRI for further evaluation showed ovarian endometrioma with mural nodules with signals similar to those of the placenta. Based on the MRI findings, we diagnosed a decidualized ovarian endometrioma. At 27 weeks of gestation, she complained of sudden abdominal pain, for which MRI was performed. MRI showed disappearance of the ovarian endometrioma and bloody ascites, based on which we diagnosed a ruptured ovarian endometrioma. The abdominal pain subsided immediately, and a conservative observational treatment approach was taken. At 37 weeks of gestation, right ovarian cystectomy was performed simultaneously with an elective cesarean section, which revealed a ruptured decidualized ovarian endometrioma. Our findings demonstrate that the accurate diagnosis of a ruptured decidualized ovarian endometrioma on serial MRI can contribute to its management.</p>","PeriodicalId":9610,"journal":{"name":"Case Reports in Obstetrics and Gynecology","volume":" ","pages":"3234784"},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9357808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40704173","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}