J. Kummer, Yvonne Callister, Anja Jebens, Valentin Mihajlov, Luisa-Maria Pech, L. Hellmeyer
Abstract Objectives Fetal macrosomia is a term to describe excessive fetal birth weight. Fetal macrosomia is strongly associated with adverse obstetrical outcome. Case presentation We report a rare case of excessive neonatal weight in a medically unsupervised pregnancy and give a literature review on this significant subject. A 38 year-old woman (Gravida 8 Para 7) presented herself at 42 2/7 weeks of gestation at the labor ward. The pregnancy had not been supervised medically. Labor induction was initiated. Due to failure to progress and suspicion of a disproportion of the fetal head and maternal pelvis an urgent caesarean section was performed. A morbidly macrosomic male infant was delivered (birth weight: 6,760 g [>99. percentile], length: 60 cm [>99. percentile]). Conclusions The morbidity for infants and women increases with a birth weight exceeding 4,500 g. Gestational diabetes mellitus, a high pre-pregnancy body mass index and excessive gestational weight gain have been independently associated as risk factors. The increase in pregnancies complicated by maternal obesity and gestational diabetes emphasizes the necessity of evidence-based clinical interventions to prevent or reduce these diseases. If prenatal care is not frequented by mothers-to-be there are no options open for obstetricians to detect fetal macrosomia and to intervene.
{"title":"Extreme fetal macrosomia at 42 gestational weeks: a case report and literature review","authors":"J. Kummer, Yvonne Callister, Anja Jebens, Valentin Mihajlov, Luisa-Maria Pech, L. Hellmeyer","doi":"10.1515/crpm-2021-0042","DOIUrl":"https://doi.org/10.1515/crpm-2021-0042","url":null,"abstract":"Abstract Objectives Fetal macrosomia is a term to describe excessive fetal birth weight. Fetal macrosomia is strongly associated with adverse obstetrical outcome. Case presentation We report a rare case of excessive neonatal weight in a medically unsupervised pregnancy and give a literature review on this significant subject. A 38 year-old woman (Gravida 8 Para 7) presented herself at 42 2/7 weeks of gestation at the labor ward. The pregnancy had not been supervised medically. Labor induction was initiated. Due to failure to progress and suspicion of a disproportion of the fetal head and maternal pelvis an urgent caesarean section was performed. A morbidly macrosomic male infant was delivered (birth weight: 6,760 g [>99. percentile], length: 60 cm [>99. percentile]). Conclusions The morbidity for infants and women increases with a birth weight exceeding 4,500 g. Gestational diabetes mellitus, a high pre-pregnancy body mass index and excessive gestational weight gain have been independently associated as risk factors. The increase in pregnancies complicated by maternal obesity and gestational diabetes emphasizes the necessity of evidence-based clinical interventions to prevent or reduce these diseases. If prenatal care is not frequented by mothers-to-be there are no options open for obstetricians to detect fetal macrosomia and to intervene.","PeriodicalId":9617,"journal":{"name":"Case Reports in Perinatal Medicine","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90985341","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}
Fahad M. S. Arattu Thodika, E. Williams, T. Dassios, J. Adu, M. Nanjundappa, C. Harris, A. Greenough
Abstract Objectives To describe the importance of comprehensive assessment to determine the underlying diagnosis and the role of physiological pulmonary measurements in the management of congenital bilateral eventration of the diaphragm. Case presentation A female infant born at 34 weeks gestation required intubation and ventilation at birth. Chest radiographical imaging revealed bilateral density to the bases of both lung fields with raised hemi-diaphragms. Ultrasound imaging showed focal diaphragmatic eventration with bulging of the dome of the liver into the right and left hemithoraces. Assessment of the electrical activity of the diaphragm during a spontaneous breathing trial demonstrated a mean amplitude consistent with that of ventilated infants of the same gestational age with intact diaphragms. Hence she was extubated which was successful. Chest radiographic thoracic area measured post extubation was 1,654 mm2, equivalent to that of a term infant with severe congenital diaphragmatic hernia. As the electrical activity of the diaphragm was normal this suggests replacement of the diaphragmatic muscle tissue with fibrous bands was likely to be only partial, and hence why extubation was successful. She had other abnormalities presenting in the neonatal period including dermal melancytosis, central hypotonia, hyperinsulinism and poor feeding. The infant underwent extensive investigation which revealed a KMT2D gene mutation associated with Kabuki syndrome. Conclusions Physiological pulmonary measurements may add clinical management in bilateratal diaphragmatic eventration.
{"title":"Physiological pulmonary assessments in the management of bilateral diaphragmatic eventration","authors":"Fahad M. S. Arattu Thodika, E. Williams, T. Dassios, J. Adu, M. Nanjundappa, C. Harris, A. Greenough","doi":"10.1515/crpm-2021-0092","DOIUrl":"https://doi.org/10.1515/crpm-2021-0092","url":null,"abstract":"Abstract Objectives To describe the importance of comprehensive assessment to determine the underlying diagnosis and the role of physiological pulmonary measurements in the management of congenital bilateral eventration of the diaphragm. Case presentation A female infant born at 34 weeks gestation required intubation and ventilation at birth. Chest radiographical imaging revealed bilateral density to the bases of both lung fields with raised hemi-diaphragms. Ultrasound imaging showed focal diaphragmatic eventration with bulging of the dome of the liver into the right and left hemithoraces. Assessment of the electrical activity of the diaphragm during a spontaneous breathing trial demonstrated a mean amplitude consistent with that of ventilated infants of the same gestational age with intact diaphragms. Hence she was extubated which was successful. Chest radiographic thoracic area measured post extubation was 1,654 mm2, equivalent to that of a term infant with severe congenital diaphragmatic hernia. As the electrical activity of the diaphragm was normal this suggests replacement of the diaphragmatic muscle tissue with fibrous bands was likely to be only partial, and hence why extubation was successful. She had other abnormalities presenting in the neonatal period including dermal melancytosis, central hypotonia, hyperinsulinism and poor feeding. The infant underwent extensive investigation which revealed a KMT2D gene mutation associated with Kabuki syndrome. Conclusions Physiological pulmonary measurements may add clinical management in bilateratal diaphragmatic eventration.","PeriodicalId":9617,"journal":{"name":"Case Reports in Perinatal Medicine","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86815298","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}
Abstract Objectives Autoimmune polyglandular syndromes are uncommon heterogeneous conditions characterized by the association of two or more organ-specific endocrinopathies. Very few cases of these syndromes have been described during pregnancy. Here we report a case of autoimmune polyglandular syndrome type-2 presenting during pregnancy and complicated by preeclampsia with severe features. Case presentation The patient is a 35-year-old G7P0242 woman with a history of adrenal insufficiency, type 1 diabetes mellitus, and chronic lymphocytic thyroiditis. She was admitted to our institution at 34 weeks’ gestation for preterm contractions, nausea, and lower extremity edema for a few weeks prior to admission. At 35 weeks’ gestation, she developed preeclampsia with severe features requiring repeat cesarean section with good maternal and fetal outcomes. Recognizing the occurrence of this rare syndrome during pregnancy, adequate replacement of the deficient hormones, and close maternal and fetal surveillance are essential to achieving favorable outcomes. Conclusions To our knowledge, this is the first reported case of a pregnant woman with autoimmune polyglandular syndrome type-2 complicated by preeclampsia with severe features.
{"title":"Autoimmune polyglandular syndrome type 2 in pregnancy: a case report and review of the literature","authors":"David R. Bayless, Trevor Caldarera, H. Harirah","doi":"10.1515/crpm-2020-0058","DOIUrl":"https://doi.org/10.1515/crpm-2020-0058","url":null,"abstract":"Abstract Objectives Autoimmune polyglandular syndromes are uncommon heterogeneous conditions characterized by the association of two or more organ-specific endocrinopathies. Very few cases of these syndromes have been described during pregnancy. Here we report a case of autoimmune polyglandular syndrome type-2 presenting during pregnancy and complicated by preeclampsia with severe features. Case presentation The patient is a 35-year-old G7P0242 woman with a history of adrenal insufficiency, type 1 diabetes mellitus, and chronic lymphocytic thyroiditis. She was admitted to our institution at 34 weeks’ gestation for preterm contractions, nausea, and lower extremity edema for a few weeks prior to admission. At 35 weeks’ gestation, she developed preeclampsia with severe features requiring repeat cesarean section with good maternal and fetal outcomes. Recognizing the occurrence of this rare syndrome during pregnancy, adequate replacement of the deficient hormones, and close maternal and fetal surveillance are essential to achieving favorable outcomes. Conclusions To our knowledge, this is the first reported case of a pregnant woman with autoimmune polyglandular syndrome type-2 complicated by preeclampsia with severe features.","PeriodicalId":9617,"journal":{"name":"Case Reports in Perinatal Medicine","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86434497","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}
Diletta Fumagalli, T. Bignardi, A. Vanzulli, P. Corbella, M. Meroni, M. L. Interdonato
Abstract Objectives Placenta accreta spectrum (PAS) disorders are a significant cause of maternal morbidity and mortality. Traditionally women with PAS are offered surgery, while expectant management is still considered investigational. Case presentation We present a case of expectant management of PAS after pregnancy loss at 19-weeks. PAS was suspected at sonography and confirmed by MRI. Patient was offered expectant management to preserve fertility. This consisted of leaving the placenta in situ, followed by in- and out-patient clinical and sonographic examinations and blood tests. After five weeks placental detachment occurred without major complications. Conclusions Our report suggests that expectant management could be a safe option in selected cases of PAS after mid-trimester pregnancy loss. We recommend expectant management should be offered in referral centers for PAS.
{"title":"Expectant management of placenta accreta after a mid-trimester pregnancy loss: a case report and a short review","authors":"Diletta Fumagalli, T. Bignardi, A. Vanzulli, P. Corbella, M. Meroni, M. L. Interdonato","doi":"10.1515/crpm-2021-0008","DOIUrl":"https://doi.org/10.1515/crpm-2021-0008","url":null,"abstract":"Abstract Objectives Placenta accreta spectrum (PAS) disorders are a significant cause of maternal morbidity and mortality. Traditionally women with PAS are offered surgery, while expectant management is still considered investigational. Case presentation We present a case of expectant management of PAS after pregnancy loss at 19-weeks. PAS was suspected at sonography and confirmed by MRI. Patient was offered expectant management to preserve fertility. This consisted of leaving the placenta in situ, followed by in- and out-patient clinical and sonographic examinations and blood tests. After five weeks placental detachment occurred without major complications. Conclusions Our report suggests that expectant management could be a safe option in selected cases of PAS after mid-trimester pregnancy loss. We recommend expectant management should be offered in referral centers for PAS.","PeriodicalId":9617,"journal":{"name":"Case Reports in Perinatal Medicine","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75497455","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}
Ida Nađ, Dorotea Šijak, S. A. Jurica, A. Jakovčević
Abstract Objectives Hamartomas are non-neoplastic developmental anomalies, mostly congenital, characterized by uncontrolled, disorganized proliferation of local endogenous tissue, which can normally be found at the site of origin and are very often mesodermally derived. It is well known that hamartoma can be associated with congenital midline cervical cleft and therefore cause a variety of symptoms. In general, they are benign and indolent, but they can be the cause of complex morbidity if they are localized within specific regions, such as the head and neck, which represent highly sensitive and vulnerable areas. Case presentation The reported case is unusual because of the presence of a congenital mesenchymal hamartoma along with the median cervical cleft, in a 1-day-old neonate, without the presence of any respiratory symptoms or associated congenital features. Although extremely rare, hamartomas should be included in the differential diagnosis of congenital neck masses, with emphasis on diagnostic approach, to avoid overly aggressive treatment and possible complications, such as infection, further mass growth, malignant transformation and compression of the adjacent neck structures. Conclusions Appropriate and timely treatment of the hamartoma of the neck in neonates, with further follow-up is necessary to avoid an overly aggressive treatment and to distinguish benign from malignant lesions, which is necessary for successful curative outcome.
{"title":"An unusual case of the congenital mesenchymal hamartoma of the neck associated with the midline cervical cleft in neonate","authors":"Ida Nađ, Dorotea Šijak, S. A. Jurica, A. Jakovčević","doi":"10.1515/crpm-2021-0094","DOIUrl":"https://doi.org/10.1515/crpm-2021-0094","url":null,"abstract":"Abstract Objectives Hamartomas are non-neoplastic developmental anomalies, mostly congenital, characterized by uncontrolled, disorganized proliferation of local endogenous tissue, which can normally be found at the site of origin and are very often mesodermally derived. It is well known that hamartoma can be associated with congenital midline cervical cleft and therefore cause a variety of symptoms. In general, they are benign and indolent, but they can be the cause of complex morbidity if they are localized within specific regions, such as the head and neck, which represent highly sensitive and vulnerable areas. Case presentation The reported case is unusual because of the presence of a congenital mesenchymal hamartoma along with the median cervical cleft, in a 1-day-old neonate, without the presence of any respiratory symptoms or associated congenital features. Although extremely rare, hamartomas should be included in the differential diagnosis of congenital neck masses, with emphasis on diagnostic approach, to avoid overly aggressive treatment and possible complications, such as infection, further mass growth, malignant transformation and compression of the adjacent neck structures. Conclusions Appropriate and timely treatment of the hamartoma of the neck in neonates, with further follow-up is necessary to avoid an overly aggressive treatment and to distinguish benign from malignant lesions, which is necessary for successful curative outcome.","PeriodicalId":9617,"journal":{"name":"Case Reports in Perinatal Medicine","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76807650","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}
Y. Iwahata, H. Iwahata, J. Hasegawa, C. Homma, Y. Nishimura, H. Kondo, N. Suzuki
Abstract Objectives To present a case of fetal hemothorax after two times of thoracoamniotic shunting (TAS) performed to pleural effusion with hydrops fetalis, resulting in non-reassuring fetal status due to hemothorax. Case presentation This is a case of bilateral pleural effusion with hydrops fetalis and polyhydramnios at 32 weeks gestation, in which unilateral fetal TAS was performed twice, resulting in non-reassuring fetal status due to hemothorax. After delivery, the infant was diagnosed with trisomy 21 and transient myeloproliferative disorder (TMD) with disseminated intravascular coagulation and congenital systemic lymphangiopathy. Conclusions In conclusion, since TAM case do not always show hemothrax, TAM is not inhibited but technical carefulness should be necessary.
{"title":"Hemothorax after fetal pleural effusion-thoracoamniotic shunting procedure due to transient myeloproliferative disorder","authors":"Y. Iwahata, H. Iwahata, J. Hasegawa, C. Homma, Y. Nishimura, H. Kondo, N. Suzuki","doi":"10.1515/crpm-2021-0032","DOIUrl":"https://doi.org/10.1515/crpm-2021-0032","url":null,"abstract":"Abstract Objectives To present a case of fetal hemothorax after two times of thoracoamniotic shunting (TAS) performed to pleural effusion with hydrops fetalis, resulting in non-reassuring fetal status due to hemothorax. Case presentation This is a case of bilateral pleural effusion with hydrops fetalis and polyhydramnios at 32 weeks gestation, in which unilateral fetal TAS was performed twice, resulting in non-reassuring fetal status due to hemothorax. After delivery, the infant was diagnosed with trisomy 21 and transient myeloproliferative disorder (TMD) with disseminated intravascular coagulation and congenital systemic lymphangiopathy. Conclusions In conclusion, since TAM case do not always show hemothrax, TAM is not inhibited but technical carefulness should be necessary.","PeriodicalId":9617,"journal":{"name":"Case Reports in Perinatal Medicine","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81629151","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}
Angela N. Phillips, L. Kirkland, W. Wagner, Roman Melamed, David M. Tierney
Abstract Objectives To describe the integration of point-of-care ultrasound (POCUS) and rotational thromboelastometry (ROTEM) in the diagnosis and management of cardiac arrest secondary to amniotic fluid embolism (AFE). Case presentation A 29-year-old female presented for induction of labor at 39 weeks. Labor was complicated by hemorrhage and subsequent sinus tachycardia pulseless electrical activity (PEA) arrest. Intra-arrest POCUS demonstrated right ventricular dilation and hypokinesis adding to a presumed hemorrhagic arrest etiology. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) was initiated at the bedside following the POCUS findings. ROTEM further clarified the etiology of hemorrhage as disseminated intravascular coagulation (DIC), and in combination with the POCUS findings led to a final diagnosis of amniotic fluid embolism with DIC. The patient was maintained on VA-ECMO without heparin in the setting of DIC. She had a complicated hospital course but was discharged home with her healthy child and no residual physical or neurologic deficits. Conclusions In the absence of more specific testing modalities the utilization of rapidly available POCUS in conjunction with ROTEM can impact clinical decision making of cardiovascular resuscitation in patients during labor and delivery by narrowing the differential between pulmonary embolism and AFE.
{"title":"Utilization of point-of-care ultrasound and rotational thromboelastometry (ROTEM) in the diagnosis and management of amniotic fluid embolism presenting as post-partum hemorrhage and cardiac arrest","authors":"Angela N. Phillips, L. Kirkland, W. Wagner, Roman Melamed, David M. Tierney","doi":"10.1515/crpm-2022-0009","DOIUrl":"https://doi.org/10.1515/crpm-2022-0009","url":null,"abstract":"Abstract Objectives To describe the integration of point-of-care ultrasound (POCUS) and rotational thromboelastometry (ROTEM) in the diagnosis and management of cardiac arrest secondary to amniotic fluid embolism (AFE). Case presentation A 29-year-old female presented for induction of labor at 39 weeks. Labor was complicated by hemorrhage and subsequent sinus tachycardia pulseless electrical activity (PEA) arrest. Intra-arrest POCUS demonstrated right ventricular dilation and hypokinesis adding to a presumed hemorrhagic arrest etiology. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) was initiated at the bedside following the POCUS findings. ROTEM further clarified the etiology of hemorrhage as disseminated intravascular coagulation (DIC), and in combination with the POCUS findings led to a final diagnosis of amniotic fluid embolism with DIC. The patient was maintained on VA-ECMO without heparin in the setting of DIC. She had a complicated hospital course but was discharged home with her healthy child and no residual physical or neurologic deficits. Conclusions In the absence of more specific testing modalities the utilization of rapidly available POCUS in conjunction with ROTEM can impact clinical decision making of cardiovascular resuscitation in patients during labor and delivery by narrowing the differential between pulmonary embolism and AFE.","PeriodicalId":9617,"journal":{"name":"Case Reports in Perinatal Medicine","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83162030","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}
Halis Özdemir, Belma G Özdemir, Songül Yerlikaya Kavak, Şule Şık
Abstract Objectives Bilateral renal agenesis is a rare congenital anomaly that is associated with high neonatal mortality. Bilateral renal agenesis is most often present with anhydramniosis in the mid-trimester. Case presentation We report a case of bilateral renal agenesis diagnosed prenatally. We presented the ultrasound and pathology images of this fetus with a new sonographic sign, segmental anterior deviation in the abdominal aorta. Conclusions To our knowledge, this is the first reported case of a fetus with a segmental aortic anterior deviation.
{"title":"A new sonographic marker in the diagnosis of prenatal bilateral renal agenesis, segmental anterior deviation of the aorta","authors":"Halis Özdemir, Belma G Özdemir, Songül Yerlikaya Kavak, Şule Şık","doi":"10.1515/crpm-2022-0001","DOIUrl":"https://doi.org/10.1515/crpm-2022-0001","url":null,"abstract":"Abstract Objectives Bilateral renal agenesis is a rare congenital anomaly that is associated with high neonatal mortality. Bilateral renal agenesis is most often present with anhydramniosis in the mid-trimester. Case presentation We report a case of bilateral renal agenesis diagnosed prenatally. We presented the ultrasound and pathology images of this fetus with a new sonographic sign, segmental anterior deviation in the abdominal aorta. Conclusions To our knowledge, this is the first reported case of a fetus with a segmental aortic anterior deviation.","PeriodicalId":9617,"journal":{"name":"Case Reports in Perinatal Medicine","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91117986","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}
Algeri Paola, D’Oria Patrizia, Toto Valentina, Fenili Paola, Ermito Santina, Bonalumi Silvia, R. Denise, Ciammella Massimo
Abstract Objectives Müllerian anomalies are associated with infertility and worse pregnancy outcomes. Case presentation A 34-years-old primigravida patient affected by didelphys uterus and type 2 diabetes mellitus was admitted at 36.4 weeks with intrauterine fetal death. Labor was induced with oral Mifepristone and vaginal Dinoprostone. She had an uneventful vaginal delivery. Conclusions Pre-gestational evaluation should be recommended in each woman, in order to optimize clinical conditions in case of a chronic disease; moreover, if the patient is infertile Müllerian malformations should be excluded. In a didelphys uterus, the combination of Mifepristone and Dinoprostone could be a safe option for labor induction.
{"title":"Didelphys uterus: a successful induction of labor in a case of intrauterine fetal death near term","authors":"Algeri Paola, D’Oria Patrizia, Toto Valentina, Fenili Paola, Ermito Santina, Bonalumi Silvia, R. Denise, Ciammella Massimo","doi":"10.1515/crpm-2021-0078","DOIUrl":"https://doi.org/10.1515/crpm-2021-0078","url":null,"abstract":"Abstract Objectives Müllerian anomalies are associated with infertility and worse pregnancy outcomes. Case presentation A 34-years-old primigravida patient affected by didelphys uterus and type 2 diabetes mellitus was admitted at 36.4 weeks with intrauterine fetal death. Labor was induced with oral Mifepristone and vaginal Dinoprostone. She had an uneventful vaginal delivery. Conclusions Pre-gestational evaluation should be recommended in each woman, in order to optimize clinical conditions in case of a chronic disease; moreover, if the patient is infertile Müllerian malformations should be excluded. In a didelphys uterus, the combination of Mifepristone and Dinoprostone could be a safe option for labor induction.","PeriodicalId":9617,"journal":{"name":"Case Reports in Perinatal Medicine","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78357272","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}
Abstract Objectives Hansen’s disease (HD) often manifests during pregnancy and the postpartum. Patients with HD may experience reactions that mimic other conditions making diagnosis challenging. Case presentation We present a case of a patient from Chuuk, a state of the Federated States of Micronesia with a sepsis-like illness and worsening painful rash immediately postpartum. Antepartum, the patient noted a pruritic rash on her legs. Four hours after delivery, the patient became febrile and later developed systemic inflammatory response syndrome (SIRS). The rash rapidly spread to other areas of her body and became painful and edematous. Eight weeks after delivery, a skin biopsy revealed tuberculoid granulomatous dermatitis consistent with HD. Conclusions HD and its associated reactions are easily misdiagnosed. Performing a skin biopsy of unusual skin lesions or common skin lesions with severe illness in a pregnant patient can expedite diagnosis of rare conditions such as HD. Early initiation of treatment for HD and its reactions are critical to prevent serious nerve damage and permanent disability.
{"title":"Postpartum sepsis-like illness and rash associated with Hansen’s disease","authors":"Jinai Bharucha, Lynne Saito-Tom","doi":"10.1515/crpm-2021-0046","DOIUrl":"https://doi.org/10.1515/crpm-2021-0046","url":null,"abstract":"Abstract Objectives Hansen’s disease (HD) often manifests during pregnancy and the postpartum. Patients with HD may experience reactions that mimic other conditions making diagnosis challenging. Case presentation We present a case of a patient from Chuuk, a state of the Federated States of Micronesia with a sepsis-like illness and worsening painful rash immediately postpartum. Antepartum, the patient noted a pruritic rash on her legs. Four hours after delivery, the patient became febrile and later developed systemic inflammatory response syndrome (SIRS). The rash rapidly spread to other areas of her body and became painful and edematous. Eight weeks after delivery, a skin biopsy revealed tuberculoid granulomatous dermatitis consistent with HD. Conclusions HD and its associated reactions are easily misdiagnosed. Performing a skin biopsy of unusual skin lesions or common skin lesions with severe illness in a pregnant patient can expedite diagnosis of rare conditions such as HD. Early initiation of treatment for HD and its reactions are critical to prevent serious nerve damage and permanent disability.","PeriodicalId":9617,"journal":{"name":"Case Reports in Perinatal Medicine","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85688983","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}
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