Teresa Gastañaga-Holguera, V. González-González, P. Merino-Amador
Abstract Objectives Chagas disease (CD) is caused by infection with the protozoan Trypanosoma cruzi, a parasite that nests in various tissues, causing irreversible cardiac damage in 30% of patients with chronic disease and neurological or digestive lesions in 10%. CD is now found in areas receiving migrant populations where no vector-borne transmission occurs. Chagasic cardiomyopathy (CC) is the most serious complication of the chronic phase of CD and the major cause of morbidity and mortality among patients with CD. Case presentation Bolivian woman at 38 weeks of gestation was admitted at the emergency room with the diagnosis of congestive heart failure. Cesarean section was performed and maternal hypotension and uterine atony occurred. Dilated myocardiopathy with severe left ventricle dysfunction was diagnosed. The patient referred positive serology for T. cruzi and polymerase chain reaction (PCR) was positive so benznidazole therapy was started. She was discharged due to progressive improvement with cardiological treatment and implantable cardioverter defibrillator was placed 5 years later for the prevention of sudden cardiac death. Conclusions The diagnosis of CC in non-endemic areas requires a high index of suspicion and it is based on serology. Antiparasitic drugs are almost 100% effective in infected newborn babies and highly effective in the treatment of patients in the acute stage of the disease. However, the efficacy of both drugs decreases the longer a person has been infected. Treatment of CC that causes chronic heart failure is similar to that in non-Chagasic etiology.
{"title":"Chagasic heart failure in a pregnant woman in a non-endemic area: case report and long-term follow-up","authors":"Teresa Gastañaga-Holguera, V. González-González, P. Merino-Amador","doi":"10.1515/crpm-2021-0074","DOIUrl":"https://doi.org/10.1515/crpm-2021-0074","url":null,"abstract":"Abstract Objectives Chagas disease (CD) is caused by infection with the protozoan Trypanosoma cruzi, a parasite that nests in various tissues, causing irreversible cardiac damage in 30% of patients with chronic disease and neurological or digestive lesions in 10%. CD is now found in areas receiving migrant populations where no vector-borne transmission occurs. Chagasic cardiomyopathy (CC) is the most serious complication of the chronic phase of CD and the major cause of morbidity and mortality among patients with CD. Case presentation Bolivian woman at 38 weeks of gestation was admitted at the emergency room with the diagnosis of congestive heart failure. Cesarean section was performed and maternal hypotension and uterine atony occurred. Dilated myocardiopathy with severe left ventricle dysfunction was diagnosed. The patient referred positive serology for T. cruzi and polymerase chain reaction (PCR) was positive so benznidazole therapy was started. She was discharged due to progressive improvement with cardiological treatment and implantable cardioverter defibrillator was placed 5 years later for the prevention of sudden cardiac death. Conclusions The diagnosis of CC in non-endemic areas requires a high index of suspicion and it is based on serology. Antiparasitic drugs are almost 100% effective in infected newborn babies and highly effective in the treatment of patients in the acute stage of the disease. However, the efficacy of both drugs decreases the longer a person has been infected. Treatment of CC that causes chronic heart failure is similar to that in non-Chagasic etiology.","PeriodicalId":9617,"journal":{"name":"Case Reports in Perinatal Medicine","volume":"106 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91333896","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}
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":"99 1","pages":""},"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}
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":"32 1","pages":""},"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":"17 1","pages":""},"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}
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":"113 1","pages":""},"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}
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":"29 1","pages":""},"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}
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":"46 1","pages":""},"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}
Carolina Smet, L. Queiró, Edmundo Santos, A. Reis, C. Costa
Abstract Objectives Massive fetomaternal hemorrhage (FMH) is a rare and difficult to diagnose event that can have catastrophic outcomes. Although many etiologies have been associated with FMH, the majority of cases are idiopathic and affect uncomplicated pregnancies. The prevailing symptom is decreased fetal movements but some cases are asymptomatic. Changes in the fetal Doppler ultrasound, a sinusoidal cardiotocographic pattern, neonatal anemia, unexplained hydrops or stillbirth can raise suspicion that such an event has occurred. Case presentation This article presents a case series of severe FMH diagnosed in our center between 2011 and 2020 as well as a review of the current available literature. Conclusions We highlight the importance of the clinician’s awareness on detecting this rare but potentially life-threatening event.
{"title":"Massive fetomaternal hemorrhage: a case series and review of literature","authors":"Carolina Smet, L. Queiró, Edmundo Santos, A. Reis, C. Costa","doi":"10.1515/crpm-2021-0079","DOIUrl":"https://doi.org/10.1515/crpm-2021-0079","url":null,"abstract":"Abstract Objectives Massive fetomaternal hemorrhage (FMH) is a rare and difficult to diagnose event that can have catastrophic outcomes. Although many etiologies have been associated with FMH, the majority of cases are idiopathic and affect uncomplicated pregnancies. The prevailing symptom is decreased fetal movements but some cases are asymptomatic. Changes in the fetal Doppler ultrasound, a sinusoidal cardiotocographic pattern, neonatal anemia, unexplained hydrops or stillbirth can raise suspicion that such an event has occurred. Case presentation This article presents a case series of severe FMH diagnosed in our center between 2011 and 2020 as well as a review of the current available literature. Conclusions We highlight the importance of the clinician’s awareness on detecting this rare but potentially life-threatening event.","PeriodicalId":9617,"journal":{"name":"Case Reports in Perinatal Medicine","volume":"5 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84583971","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}
Toshiyuki Hata, Aya Koyanagi, Riko Takayoshi, T. Miyake, Yuichiro Nakai, K. Tani, Kei Hayata, H. Masuyama
Abstract Objectives A significant discrepancy between a large ductus arteriosus and a smaller aorta at their connection is key to diagnose coarctation of the aorta (CoA) at 14–16 weeks of gestation. CoA was associated with persistent left superior vena cava (PLSVC) in 21.3% of fetuses. HDlive Flow findings for CoA or PLSVC were obtained only in the third trimester of pregnancy. To the best of our knowledge, there has been no report on the prenatal findings of CoA and PLSVC using HDlive Flow with spatiotemporal image correlation (STIC) before 20 weeks of gestation. Case presentation We present the trans-abdominal HDlive Flow features of CoA and PLSVC at 14 weeks of gestation. With a three-vessel trachea view on multiplanar view using color Doppler with STIC, PLSVC on the left side of the pulmonary artery was noted, and a narrowing aortic isthmus was suspected. A narrowing isthmus was also suspected with an aortic arch view. HDlive Flow clearly showed the spatial relationships among the right superior vena cava, aorta with narrowing isthmus, pulmonary artery, and PLSVC. A preductal ‘shelf’ was also suspected. No other fetal anomaly was noted. Neonatal echocardiography after delivery confirmed CoA and PLSVC. Conclusions To the best of our knowledge, this is the first report on HDlive Flow features of fetal CoA and PLSVC using STIC early in the second trimester of pregnancy.
{"title":"Coarctation of the aorta and persistent left superior vena cava: HDlive Flow features at 14 weeks of gestation","authors":"Toshiyuki Hata, Aya Koyanagi, Riko Takayoshi, T. Miyake, Yuichiro Nakai, K. Tani, Kei Hayata, H. Masuyama","doi":"10.1515/crpm-2021-0066","DOIUrl":"https://doi.org/10.1515/crpm-2021-0066","url":null,"abstract":"Abstract Objectives A significant discrepancy between a large ductus arteriosus and a smaller aorta at their connection is key to diagnose coarctation of the aorta (CoA) at 14–16 weeks of gestation. CoA was associated with persistent left superior vena cava (PLSVC) in 21.3% of fetuses. HDlive Flow findings for CoA or PLSVC were obtained only in the third trimester of pregnancy. To the best of our knowledge, there has been no report on the prenatal findings of CoA and PLSVC using HDlive Flow with spatiotemporal image correlation (STIC) before 20 weeks of gestation. Case presentation We present the trans-abdominal HDlive Flow features of CoA and PLSVC at 14 weeks of gestation. With a three-vessel trachea view on multiplanar view using color Doppler with STIC, PLSVC on the left side of the pulmonary artery was noted, and a narrowing aortic isthmus was suspected. A narrowing isthmus was also suspected with an aortic arch view. HDlive Flow clearly showed the spatial relationships among the right superior vena cava, aorta with narrowing isthmus, pulmonary artery, and PLSVC. A preductal ‘shelf’ was also suspected. No other fetal anomaly was noted. Neonatal echocardiography after delivery confirmed CoA and PLSVC. Conclusions To the best of our knowledge, this is the first report on HDlive Flow features of fetal CoA and PLSVC using STIC early in the second trimester of pregnancy.","PeriodicalId":9617,"journal":{"name":"Case Reports in Perinatal Medicine","volume":"105 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80709344","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":"109 1","pages":""},"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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：