Case Reports in Women's Health最新文献_第10页

Hepatic encephalopathy precipitated by preeclampsia in the setting of cirrhosis: A case report 肝硬化患者先兆子痫引发的肝性脑病：病例报告

Case Reports in Women's Health Pub Date : 2024-03-01 DOI: 10.1016/j.crwh.2024.e00587

Mary E. Fang , Nicholas A. Peoples , Alison N. Goulding , Mary C. Tolcher

{"title":"Hepatic encephalopathy precipitated by preeclampsia in the setting of cirrhosis: A case report","authors":"Mary E. Fang , Nicholas A. Peoples , Alison N. Goulding , Mary C. Tolcher","doi":"10.1016/j.crwh.2024.e00587","DOIUrl":"10.1016/j.crwh.2024.e00587","url":null,"abstract":"<div><p>Preeclampsia and decompensated chronic liver disease are known triggers of acute hepatic dysfunction in pregnancy, rarely including hepatic encephalopathy. Differentiating the driver of acute hepatic dysfunction in patients with concomitant preeclampsia and preexisting liver disease presents a diagnostic challenge with important management implications.</p><p>A 42-year-old woman, gravida 3 para 0201, at 24 1/7 weeks of gestation presented with hepatic encephalopathy, transaminitis, and hyperbilirubinemia in the setting of cirrhosis and severe new-onset preeclampsia. The preeclampsia was thought to be the leading etiology of hepatic encephalopathy, prompting emergent Cesarean delivery at 24 2/7 weeks. Hepatic encephalopathy, blood pressure, and laboratory derangements improved promptly post-delivery.</p><p>Preeclampsia can trigger acute hepatic dysfunction, including hepatic encephalopathy, in the setting of previously compensated preexisting liver disease. Recognizing this association has important implications for management and treatment.</p></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"41 ","pages":"Article e00587"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214911224000080/pdfft?md5=6c717fa2dfdacc4b9ec0bc4ca3e7e912&pid=1-s2.0-S2214911224000080-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139887730","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: 0

Neo-adjuvant methotrexate to aid minimally invasive surgery in cervical ectopic pregnancy: A case report 新辅助甲氨蝶呤辅助宫颈异位妊娠微创手术：病例报告

Case Reports in Women's Health Pub Date : 2024-03-01 DOI: 10.1016/j.crwh.2024.e00593

Matteo Di Carlofelice, Danica Vress

{"title":"Neo-adjuvant methotrexate to aid minimally invasive surgery in cervical ectopic pregnancy: A case report","authors":"Matteo Di Carlofelice, Danica Vress","doi":"10.1016/j.crwh.2024.e00593","DOIUrl":"https://doi.org/10.1016/j.crwh.2024.e00593","url":null,"abstract":"<div><p>Cervical ectopic pregnancies account for <1% of ectopic pregnancies. Early diagnosis may reduce the morbidity and mortality associated with treatment.</p><p>A 43-year-old woman, gravida 4 para 2, presented at 5 + 6 weeks of gestation of pregnancy via in vitro fertilisation with painless vaginal bleeding. Her initial serum β-hCG level was 51,495 mIU/mL. Ultrasound showed a live ectopic pregnancy within the upper cervical canal with no sliding sign. Surgery was avoided initially due to risk of haemorrhage. Multi-dose systemic intramuscular methotrexate was used in an alternate-day regimen with rescue folic acid to arrest further pregnancy development. Repeat ultrasound seven days later showed absent cardiac activity. Serum β-hCG remained high at 91,764 mIU/mL. A suction dilatation and curettage was performed to remove the pregnancy from the cervix, with an estimated blood loss of 50 mL. The patient was discharged and her serum β-hCG declined to an undetectable level over three months of follow-up.</p><p>This case adds to the small body of evidence in the management of live cervical ectopic pregnancy. Neo-adjuvant multi-dose methotrexate was successfully used to reduce the risk of haemorrhage associated with surgical management.</p></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"41 ","pages":"Article e00593"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214911224000146/pdfft?md5=721c8902597c568e64473ccce904011f&pid=1-s2.0-S2214911224000146-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140052431","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: 0

Complicated pancreatic fistula after gynecologic surgery for left fallopian tube carcinosarcoma: A case report 左侧输卵管癌的妇科手术后并发胰瘘：病例报告

Case Reports in Women's Health Pub Date : 2024-03-01 DOI: 10.1016/j.crwh.2024.e00589

Kazuna Matsutani , Yasuto Kinose , Mayuko Kato, Michiko Kodama, Kenjiro Sawada, Tadashi Kimura

{"title":"Complicated pancreatic fistula after gynecologic surgery for left fallopian tube carcinosarcoma: A case report","authors":"Kazuna Matsutani , Yasuto Kinose , Mayuko Kato, Michiko Kodama, Kenjiro Sawada, Tadashi Kimura","doi":"10.1016/j.crwh.2024.e00589","DOIUrl":"https://doi.org/10.1016/j.crwh.2024.e00589","url":null,"abstract":"<div><p>Pancreatic fistulas are rare after gynecologic surgeries but are sometimes difficult to manage. A 62-year-old woman was admitted to a local hospital with acute abdominal pain. Computed tomography (CT) images showed subileus and an obstruction site in the transverse/descending colon, with invasion of peritoneal metastasis. A metal stent was placed in the bowel through colonoscopy. Suspecting advanced-stage ovarian cancer, the patient was referred to a tertiary hospital. Diagnostic laparoscopy was performed prior to neoadjuvant chemotherapy. Due to concerns raised by gastrointestinal surgeons regarding the high risk of stent perforation during chemotherapy, an abdominal colectomy of the transverse/descending colon was performed along with the removal of the disseminated tumor and the stent. Post-surgery, the patient was histologically diagnosed with stage IVB left fallopian tube carcinosarcoma. On postoperative day 3, the patient developed a fever, and CT images showed an abscess around the pancreas/spleen, prompting the placement of a drainage tube. The amylase level in the drained fluid was 258,111 U/L, leading to a diagnosis of a pancreatic fistula. Conservative management was undertaken, with drainage, fasting, and octreotide administration. After two months, the drainage tube was removed as the volume of drained fluid had decreased. After four cycles of carboplatin/paclitaxel chemotherapy, CT images showed partial response to chemotherapy, and interval debulking surgery was performed. The necessity of metallic stent placement should be carefully considered as the subileus caused by peritoneal metastasis might be alleviated by the induction of chemotherapy for gynecologic cancer.</p></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"41 ","pages":"Article e00589"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214911224000109/pdfft?md5=c315b22a6b6689a07be0ad79289ff816&pid=1-s2.0-S2214911224000109-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140000062","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: 0

Rare but should never be forgotten: HELLP syndrome 虽然罕见，但绝不应忘记：HELLP 综合征

Case Reports in Women's Health Pub Date : 2024-03-01 DOI: 10.1016/j.crwh.2024.e00584

Damali Campbell Oparaji

引用次数: 0

Critical care obstetrics: No solo heroes 产科重症监护：没有单打独斗的英雄

Case Reports in Women's Health Pub Date : 2024-03-01 DOI: 10.1016/j.crwh.2024.e00591

Danny Tucker , Melissa Freestun

引用次数: 0

From intramural ectopic pregnancy to hysterectomy: A case report 从子宫内异位妊娠到子宫切除术：病例报告

Case Reports in Women's Health Pub Date : 2024-03-01 DOI: 10.1016/j.crwh.2024.e00600

Rhys Harris , Wasim Awal , Sebastian Jacob-Rogers , Graeme Walker

{"title":"From intramural ectopic pregnancy to hysterectomy: A case report","authors":"Rhys Harris , Wasim Awal , Sebastian Jacob-Rogers , Graeme Walker","doi":"10.1016/j.crwh.2024.e00600","DOIUrl":"https://doi.org/10.1016/j.crwh.2024.e00600","url":null,"abstract":"<div><p>An intramural ectopic pregnancy is one of the rarest types of ectopic pregnancy, and due to the scarcity of reported cases there are no clear guidelines regarding diagnosis and management of the condition. We report a case of a non-viable intramural ectopic pregnancy managed with intravenous methotrexate, in a patient with no previous pregnancies but a history of uterine cornual cyst excision. The patient subsequently developed a uterine arteriovenous malformation, which was embolised. Following this, she had two pregnancies, one culminating in an elective caesarean section at term, and the other a medical termination of pregnancy at 19 weeks of gestation. As a result of post-traumatic stress disorder attributed to this complicated history, the patient requested a hysterectomy. This case demonstrates the complexity of the management of intramural ectopic pregnancy and highlights the impacts the condition can have on a patient's physical and mental health.</p></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"41 ","pages":"Article e00600"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214911224000213/pdfft?md5=704585abcbe60caa89f96533f3733166&pid=1-s2.0-S2214911224000213-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140296430","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: 0

Novel characterization of CASK variant c.1963 A>G (p.Asn655Asp) through whole-exome sequencing in a monochorionic diamniotic twin fetus with significant brain anomalies: A case report 通过全外显子组测序发现单绒毛膜双羊膜胎儿中的 CASK 变异 c.1963 A>G (p.Asn655Asp) 的新特征，该胎儿有明显的脑畸形：病例报告

Case Reports in Women's Health Pub Date : 2024-03-01 DOI: 10.1016/j.crwh.2024.e00583

Nathan A. Keller, Luis A. Bracero, Insaf Kouba, Abigail Steinberg, Jolene Muscat, David Bergman

{"title":"Novel characterization of CASK variant c.1963 A>G (p.Asn655Asp) through whole-exome sequencing in a monochorionic diamniotic twin fetus with significant brain anomalies: A case report","authors":"Nathan A. Keller, Luis A. Bracero, Insaf Kouba, Abigail Steinberg, Jolene Muscat, David Bergman","doi":"10.1016/j.crwh.2024.e00583","DOIUrl":"10.1016/j.crwh.2024.e00583","url":null,"abstract":"<div><p>Whole-exome sequencing is an evolving technology in perinatal diagnosis which allows identification of genetic etiologies that would otherwise go undetermined. In this case report, a 38-year-old Hispanic woman, G5P3013, with a monochorionic diamniotic twin gestation with one fetus displaying significant cranial abnormalities on prenatal ultrasound and magnetic resonance imaging (MRI) of the brain is presented. Fetal anomalies included bilateral ventriculomegaly, absent cavum septum pellucidum, and absent corpus callosum. Diagnostic amniocentesis with chromosome analysis, chromosomal microarray, alpha-fetoprotein, cytomegalovirus, toxoplasmosis, and parvovirus had normal results. Whole-exome sequencing for the anomalous fetus detected a de novo mosaic variant of uncertain significance (VUS) in the calcium/calmodulin dependent serine protein kinase (<em>CASK</em>) gene: <em>c.1963 A ></em> <em>G (p.Asn655Asp)</em>. This variant was absent in the normal twin fetus, the mother, and the father. Pathogenic CASK gene mutations are associated with three syndromes: FG syndrome 4, intellectual developmental disorder and microcephaly with pontine and cerebellar hypoplasia (MICPCH), and intellectual developmental disorder with or without nystagmus. Whole-exome sequencing identified a potential etiology for the anomalies detected. The variant likely arose de novo and was the potential cause of the identified cranial abnormalities in one fetus of this monochorionic diamniotic twin gestation. Whole-exome sequencing may provide additional diagnostic utility when standard diagnostic testing is noncontributory.</p></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"41 ","pages":"Article e00583"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214911224000043/pdfft?md5=515cf902f1ac486ad5fd3ddff7084a53&pid=1-s2.0-S2214911224000043-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139538491","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: 0

Intra-hepatic cholestasis of pregnancy: Management challenges 妊娠期肝内胆汁淤积症：管理挑战

Case Reports in Women's Health Pub Date : 2024-03-01 DOI: 10.1016/j.crwh.2023.e00576

Stephanie Myszkowski, Paul T.-Y. Ayuk

引用次数: 0

Fever of unknown origin in pregnancy: A case report 不明原因的妊娠发热病例报告

Case Reports in Women's Health Pub Date : 2024-03-01 DOI: 10.1016/j.crwh.2024.e00595

Gail Ohaegbulam, Laura E. Coats, Miller Carlton, Sarah Araji

{"title":"Fever of unknown origin in pregnancy: A case report","authors":"Gail Ohaegbulam, Laura E. Coats, Miller Carlton, Sarah Araji","doi":"10.1016/j.crwh.2024.e00595","DOIUrl":"https://doi.org/10.1016/j.crwh.2024.e00595","url":null,"abstract":"<div><p>Systemic lupus erythematosus is an autoimmune disease that primarily affects women of reproductive age. In pregnancy, it can lead to maternal and fetal complications. However, diagnosis in pregnancy is challenging since the disease mimics many features associated with other disorders and some complications related to pregnancy.</p><p>Here we report a 24-year-old woman at 26 weeks gestation who presented with a fever of unknown origin. She developed tachycardia, nausea, fatigue, rigors, and pancytopenia. Once sepsis and other chronic conditions were ruled out, rheumatology was consulted. Following the diagnosis of systemic lupus erythematosus, a combination of hydroxychloroquine, azathioprine, and corticosteroids was started, and the patient showed rapid improvement. She had an uncomplicated delivery at term.</p><p>This case report highlights a unique presentation of new-onset systemic lupus erythematous in pregnancy. Delay in diagnosis can lead to maternal and fetal complications; however, prompt diagnosis and treatment can improve symptoms and lead to a favorable pregnancy outcome.</p></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"41 ","pages":"Article e00595"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221491122400016X/pdfft?md5=83154694794276d377d40f75ac5e1322&pid=1-s2.0-S221491122400016X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140181336","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: 0

En bloc resection of a large bilateral vulvar lipoma through a caesarean scar: A case report 通过剖腹产疤痕全切双侧巨大外阴脂肪瘤：病例报告

Case Reports in Women's Health Pub Date : 2024-03-01 DOI: 10.1016/j.crwh.2024.e00597

Masakatsu Hihara, Michika Fukui, Toshihito Mitsui, Yuki Matsuoka, Natsuko Kakudo

引用次数: 0