Uterine prolapse during pregnancy is rare, occurring in approximately 1 in 10,000 to 15,000 deliveries. It presents significant risks to both maternal and fetal health, and the optimal delivery method depends on the severity of prolapse, labor progression, and the well-being of both mother and baby.
A 25-year-old woman presented at 38 weeks and 4 days of gestation with vaginal mass protrusion and pain on pushing down. Examination revealed an irreducible cervical prolapse with swelling during the early stage of labor. Fetal ultrasound confirmed a normal head-down position and adequate amniotic fluid. Due to persistent fetal tachycardia, an emergency cesarean section was performed, resulting in the delivery of a healthy 3000 g male infant. Postoperatively, the mother was placed in the Trendelenburg position, which led to the spontaneous resolution of the prolapse by the third postpartum day. At the six-week follow-up, the uterine prolapse had completely resolved.
This case emphasizes the importance of individualized management and timely intervention. Postpartum uterine prolapse often resolves spontaneously with conservative care. A multidisciplinary approach is crucial for optimizing maternal and fetal outcomes, especially in resource-limited settings.
{"title":"Cervical prolapse during labor: A case report","authors":"Adugnaw Bogale Worku , Molla Asnake Kebede , Abebe Agegn Wudineh , Adefris Getachew Techane , Mekuanint Dessie Lakew , Chuchu Arega Zeleke","doi":"10.1016/j.crwh.2025.e00690","DOIUrl":"10.1016/j.crwh.2025.e00690","url":null,"abstract":"<div><div>Uterine prolapse during pregnancy is rare, occurring in approximately 1 in 10,000 to 15,000 deliveries. It presents significant risks to both maternal and fetal health, and the optimal delivery method depends on the severity of prolapse, labor progression, and the well-being of both mother and baby.</div><div>A 25-year-old woman presented at 38 weeks and 4 days of gestation with vaginal mass protrusion and pain on pushing down. Examination revealed an irreducible cervical prolapse with swelling during the early stage of labor. Fetal ultrasound confirmed a normal head-down position and adequate amniotic fluid. Due to persistent fetal tachycardia, an emergency cesarean section was performed, resulting in the delivery of a healthy 3000 g male infant. Postoperatively, the mother was placed in the Trendelenburg position, which led to the spontaneous resolution of the prolapse by the third postpartum day. At the six-week follow-up, the uterine prolapse had completely resolved.</div><div>This case emphasizes the importance of individualized management and timely intervention. Postpartum uterine prolapse often resolves spontaneously with conservative care. A multidisciplinary approach is crucial for optimizing maternal and fetal outcomes, especially in resource-limited settings.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"45 ","pages":"Article e00690"},"PeriodicalIF":0.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098558","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}
Mesenteric desmoid tumors (DTs) are rare, and there are no specific imaging features that can aid definitive diagnosis. This article presents the case of a 61-year-old woman found to have intra-abdominal DT located in the mesentery at two-year follow-up after laparoscopy-assisted anterior resection for stage I endometrial cancer. Computed tomography (CT) indicated the presence of a solitary tumor arising from the intestinal wall or mesentery. Subsequent magnetic resonance imaging and integrated positron emission tomography/CT with 2-18F-fluoro-2-deoxy-d-glucose suggested DT rather than recurrence, but surgical resection was chosen after considering the potential risks. Surgery confirmed the diagnosis, revealing a tumor at the level of the jejunal mesentery and approximately 5 cm in diameter. The mesenteric tumor was resected, along with part of the jejunum and the greater omentum. Histopathological examination of the surgical specimens confirmed the diagnosis of DT. As mesenteric DT after laparoscopic resection of stage I endometrial cancer is rare, a high degree of suspicion is necessary for diagnosis. Given that laparoscopic surgery is increasingly used in gynecological clinical practice, gynecologists and radiologists should be aware that DT should be considered in the differential diagnosis when a mesenteric mass is detected during follow-up after a surgical procedure, including laparoscopy.
{"title":"Mesenteric desmoid tumor after laparoscopic resection of stage I endometrial cancer: A case report","authors":"Mamiko Kusaka , Tetsuo Maeda , Kazuhiro Kitajima , Homare Murakoshi , Takahiro Watanabe , Shigeki Yoshida , Yuka Sano , Noriko Osumi , Mieko Inagaki","doi":"10.1016/j.crwh.2025.e00688","DOIUrl":"10.1016/j.crwh.2025.e00688","url":null,"abstract":"<div><div>Mesenteric desmoid tumors (DTs) are rare, and there are no specific imaging features that can aid definitive diagnosis. This article presents the case of a 61-year-old woman found to have intra-abdominal DT located in the mesentery at two-year follow-up after laparoscopy-assisted anterior resection for stage I endometrial cancer. Computed tomography (CT) indicated the presence of a solitary tumor arising from the intestinal wall or mesentery. Subsequent magnetic resonance imaging and integrated positron emission tomography/CT with 2-<sup>18</sup>F-fluoro-2-deoxy-<span>d</span>-glucose suggested DT rather than recurrence, but surgical resection was chosen after considering the potential risks. Surgery confirmed the diagnosis, revealing a tumor at the level of the jejunal mesentery and approximately 5 cm in diameter. The mesenteric tumor was resected, along with part of the jejunum and the greater omentum. Histopathological examination of the surgical specimens confirmed the diagnosis of DT. As mesenteric DT after laparoscopic resection of stage I endometrial cancer is rare, a high degree of suspicion is necessary for diagnosis. Given that laparoscopic surgery is increasingly used in gynecological clinical practice, gynecologists and radiologists should be aware that DT should be considered in the differential diagnosis when a mesenteric mass is detected during follow-up after a surgical procedure, including laparoscopy.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"45 ","pages":"Article e00688"},"PeriodicalIF":0.7,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098559","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}
Pub Date : 2025-01-17DOI: 10.1016/j.crwh.2025.e00687
Alice Moylan , Jewel Brown , Melissa J. Chen , Mitchell D. Creinin
The etonogestrel implant is known to have high contraceptive efficacy for up to 5 years. This case report describes etonogestrel implant failure during year 4 of use in a patient with a normal body mass index. The patient was receiving thyroid hormone replacement after a thyroidectomy and was found to have iatrogenic thyrotoxicosis in the months preceding pregnancy. Further study of the effects of thyroid hormone on etonogestrel metabolism are indicated.
{"title":"Etonogestrel implant failure in a woman taking thyroid hormone replacement: A case report","authors":"Alice Moylan , Jewel Brown , Melissa J. Chen , Mitchell D. Creinin","doi":"10.1016/j.crwh.2025.e00687","DOIUrl":"10.1016/j.crwh.2025.e00687","url":null,"abstract":"<div><div>The etonogestrel implant is known to have high contraceptive efficacy for up to 5 years. This case report describes etonogestrel implant failure during year 4 of use in a patient with a normal body mass index. The patient was receiving thyroid hormone replacement after a thyroidectomy and was found to have iatrogenic thyrotoxicosis in the months preceding pregnancy. Further study of the effects of thyroid hormone on etonogestrel metabolism are indicated.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"45 ","pages":"Article e00687"},"PeriodicalIF":0.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098560","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}
Intramural pregnancy (IMP) is an extremely rare form of ectopic pregnancy (EP), typically associated with previous uterine trauma, adenomyosis, or assisted reproductive technology (ART), such as embryo transfer (ET). Despite its potentially life-threatening nature, the absence of definitive preoperative diagnostic criteria for IMP complicates its early detection and management, especially in patients without known risk factors. Additionally, management becomes more challenging when there is an elevated risk of hemorrhage. We report the case of a 34-year-old nulligravid woman referred to a tertiary hospital with suspected EP and bilateral ovarian endometriomas following intrauterine insemination. The patient had no history of uterine trauma or ET. Blood tests and ultrasonography supported the diagnosis of EP, and computed tomography suggested peritoneal pregnancy. Upon further investigation, the patient was diagnosed with idiopathic thrombocytopenic purpura, presenting with a platelet count of 30,000/μL. Due to the associated risk of hemorrhage, we proceeded with emergency exploratory laparoscopy after platelet transfusion. Intraoperatively, when an IMP was identified, the procedure was rapidly converted to laparotomy owing to bleeding risk associated with idiopathic thrombocytopenic purpura. The gestational sac covered with the uterine serosa was dissected, and the uterine defect was repaired to preserve fertility. The blood loss was 320 mL. The patient's postoperative recovery was uneventful, and histopathological examination confirmed the diagnosis of IMP. The patient later resumed ART and successfully achieved term pregnancy, leading to a normal vaginal delivery 3 years after the initial surgery. Early diagnosis and appropriate management of IMP are critical to prevent severe intraperitoneal bleeding, while preserving future fertility.
{"title":"Intramural pregnancy after intrauterine insemination in a nulligravid patient without previous uterine trauma, complicated by idiopathic thrombocytopenic purpura: A case report","authors":"Koyo Yamamoto , Tsuyoshi Takiuchi , Kengo Kiso , Saki Ishii , Satoshi Nakagawa , Yasuto Kinose , Michiko Kodama , Yutaka Ueda , Kenjiro Sawada , Takahiro Tsuboyama , Tadashi Kimura","doi":"10.1016/j.crwh.2025.e00684","DOIUrl":"10.1016/j.crwh.2025.e00684","url":null,"abstract":"<div><div>Intramural pregnancy (IMP) is an extremely rare form of ectopic pregnancy (EP), typically associated with previous uterine trauma, adenomyosis, or assisted reproductive technology (ART), such as embryo transfer (ET). Despite its potentially life-threatening nature, the absence of definitive preoperative diagnostic criteria for IMP complicates its early detection and management, especially in patients without known risk factors. Additionally, management becomes more challenging when there is an elevated risk of hemorrhage. We report the case of a 34-year-old nulligravid woman referred to a tertiary hospital with suspected EP and bilateral ovarian endometriomas following intrauterine insemination. The patient had no history of uterine trauma or ET. Blood tests and ultrasonography supported the diagnosis of EP, and computed tomography suggested peritoneal pregnancy. Upon further investigation, the patient was diagnosed with idiopathic thrombocytopenic purpura, presenting with a platelet count of 30,000/μL. Due to the associated risk of hemorrhage, we proceeded with emergency exploratory laparoscopy after platelet transfusion. Intraoperatively, when an IMP was identified, the procedure was rapidly converted to laparotomy owing to bleeding risk associated with idiopathic thrombocytopenic purpura. The gestational sac covered with the uterine serosa was dissected, and the uterine defect was repaired to preserve fertility. The blood loss was 320 mL. The patient's postoperative recovery was uneventful, and histopathological examination confirmed the diagnosis of IMP. The patient later resumed ART and successfully achieved term pregnancy, leading to a normal vaginal delivery 3 years after the initial surgery. Early diagnosis and appropriate management of IMP are critical to prevent severe intraperitoneal bleeding, while preserving future fertility.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"45 ","pages":"Article e00684"},"PeriodicalIF":0.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058310","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}
Pub Date : 2025-01-08DOI: 10.1016/j.crwh.2025.e00682
Nour Saleh , Amin Bahabri , Ross Vander Wal
Subinvolution of the placental site can lead to severe post-partum haemorrhage, though it is a rare cause of the condition. Subinvolution of the placental site is an abnormal persistence of widely dilated uteroplacental spiral arteries in the absence of retained products of conception, and is associated with an increased risk of maternal morbidity and mortality. This report presents a case of an uneventful caesarean section that was followed by multiple presentations of major secondary post-partum haemorrhage, with a subsequent diagnosis of subinvolution of the placental site on histopathology. The patient was eventually treated with uterine artery embolisation after trials of medical and other interventional measures.
{"title":"Successful treatment of subinvolution of the placenta site with uterine artery embolisation, sparing the patient's fertility: A case report","authors":"Nour Saleh , Amin Bahabri , Ross Vander Wal","doi":"10.1016/j.crwh.2025.e00682","DOIUrl":"10.1016/j.crwh.2025.e00682","url":null,"abstract":"<div><div>Subinvolution of the placental site can lead to severe post-partum haemorrhage, though it is a rare cause of the condition. Subinvolution of the placental site is an abnormal persistence of widely dilated uteroplacental spiral arteries in the absence of retained products of conception, and is associated with an increased risk of maternal morbidity and mortality. This report presents a case of an uneventful caesarean section that was followed by multiple presentations of major secondary post-partum haemorrhage, with a subsequent diagnosis of subinvolution of the placental site on histopathology. The patient was eventually treated with uterine artery embolisation after trials of medical and other interventional measures.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"45 ","pages":"Article e00682"},"PeriodicalIF":0.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063926","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}
Primary retroperitoneal mucinous carcinoma is an extremely rare malignancy, posing diagnostic and therapeutic challenges due to its nonspecific clinical presentation and lack of established management guidelines. The present article reports the case of a 39-year-old woman with progressive abdominal bloating and ascites, initially evaluated for a suspected ovarian mass. Imaging studies revealed a large mass with cystic and solid components mimicking an ovarian origin. However, surgical exploration revealed a retroperitoneal mass. Subsequent pathological analysis confirmed the diagnosis of mucinous Mullerian carcinoma. Molecular analysis revealed several mutations, including BRAF (V600E). Surgical resection was successful in treating the mass and the patient was in full remission at two-year follow-up. Despite its rarity, mucinous carcinoma should always be considered in the differential diagnosis of retroperitoneal masses. This case report discusses the anatomopathological features of primary retroperitoneal mucinous carcinoma and highlights the need for further research to elucidate the optimal management strategies and prognostic factors for this rare malignancy.
{"title":"Primary retroperitoneal mucinous carcinoma with BRAF, KIT, NF2, and AR mutations: A case report and review of the literature","authors":"Sandrine Leponce , Frédéric Buxant , Jean-Christophe Noël","doi":"10.1016/j.crwh.2025.e00681","DOIUrl":"10.1016/j.crwh.2025.e00681","url":null,"abstract":"<div><div>Primary retroperitoneal mucinous carcinoma is an extremely rare malignancy, posing diagnostic and therapeutic challenges due to its nonspecific clinical presentation and lack of established management guidelines. The present article reports the case of a 39-year-old woman with progressive abdominal bloating and ascites, initially evaluated for a suspected ovarian mass. Imaging studies revealed a large mass with cystic and solid components mimicking an ovarian origin. However, surgical exploration revealed a retroperitoneal mass. Subsequent pathological analysis confirmed the diagnosis of mucinous Mullerian carcinoma. Molecular analysis revealed several mutations, including BRAF (V600E). Surgical resection was successful in treating the mass and the patient was in full remission at two-year follow-up. Despite its rarity, mucinous carcinoma should always be considered in the differential diagnosis of retroperitoneal masses. This case report discusses the anatomopathological features of primary retroperitoneal mucinous carcinoma and highlights the need for further research to elucidate the optimal management strategies and prognostic factors for this rare malignancy.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"45 ","pages":"Article e00681"},"PeriodicalIF":0.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078337","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}
Pub Date : 2025-01-03DOI: 10.1016/j.crwh.2025.e00680
Kate Landau, George Hardas, Gordon Thomas, Maria-Elisabeth Smet
This case report describes the difficulty in predicting the outcomes for a fetus affected with both left-sided congenital diaphragmatic hernia and second-trimester pre-viable rupture of membranes. Despite the reserved prognosis at the time of diagnosis, a favourable outcome was obtained. The case highlights the relevance of established prognosticators such as the observed/expected lung/head ratio and also underscores the importance of balanced counselling and providing parents with realistic expectations and appropriate support.
{"title":"Predicting outcomes with compounding comorbidities – Left-sided congenital diaphragmatic hernia complicated by pre-viable premature rupture of the membranes: A case report","authors":"Kate Landau, George Hardas, Gordon Thomas, Maria-Elisabeth Smet","doi":"10.1016/j.crwh.2025.e00680","DOIUrl":"10.1016/j.crwh.2025.e00680","url":null,"abstract":"<div><div>This case report describes the difficulty in predicting the outcomes for a fetus affected with both left-sided congenital diaphragmatic hernia and second-trimester pre-viable rupture of membranes. Despite the reserved prognosis at the time of diagnosis, a favourable outcome was obtained. The case highlights the relevance of established prognosticators such as the observed/expected lung/head ratio and also underscores the importance of balanced counselling and providing parents with realistic expectations and appropriate support.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"45 ","pages":"Article e00680"},"PeriodicalIF":0.7,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045478","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}
Pub Date : 2024-12-21DOI: 10.1016/j.crwh.2024.e00679
Lara Strakian , Sonal Karia
Toxic shock syndrome secondary to Group A Streptococcus infection is a rare but serious cause of women's morbidity and mortality which can easily be misdiagnosed. A 37-year-old woman presented to the emergency department in a state of shock after a two-day history of abdominal pain, fever, diarrhoea and green vaginal discharge. Following extensive investigations, she was proved to have septic shock secondary to Group A Streptococcus pyogenes. Despite receiving intravenous antibiotics, she required explorative laparotomy, which proceeded to subtotal hysterectomy and bilateral salpingectomy. Subsequently, she developed multi-organ failure, disseminated intravascular coagulation, and limb ischemia requiring below-knee amputation of the right limb. She was discharged home. The aim of this report is to raise the awareness about toxic shock syndrome from Streptococcus pyogenes. A high index of suspicion is required to promptly diagnose this rare yet potentially fatal infection.
{"title":"Toxic shock syndrome secondary to Group A Streptococcus infection: A case report","authors":"Lara Strakian , Sonal Karia","doi":"10.1016/j.crwh.2024.e00679","DOIUrl":"10.1016/j.crwh.2024.e00679","url":null,"abstract":"<div><div>Toxic shock syndrome secondary to Group A <em>Streptococcus</em> infection is a rare but serious cause of women's morbidity and mortality which can easily be misdiagnosed. A 37-year-old woman presented to the emergency department in a state of shock after a two-day history of abdominal pain, fever, diarrhoea and green vaginal discharge. Following extensive investigations, she was proved to have septic shock secondary to Group A <em>Streptococcus pyogenes.</em> Despite receiving intravenous antibiotics, she required explorative laparotomy, which proceeded to subtotal hysterectomy and bilateral salpingectomy. Subsequently, she developed multi-organ failure, disseminated intravascular coagulation, and limb ischemia requiring below-knee amputation of the right limb. She was discharged home. The aim of this report is to raise the awareness about toxic shock syndrome from <em>Streptococcus pyogenes</em>. A high index of suspicion is required to promptly diagnose this rare yet potentially fatal infection.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"45 ","pages":"Article e00679"},"PeriodicalIF":0.7,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000761","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}
Pub Date : 2024-12-17DOI: 10.1016/j.crwh.2024.e00678
Hamza A. Abdul-Hafez , Mahmoud N. Khadra , Alaa Hamed , Ibrahim Ayman Majjad , Mohammed A. Barakat , Adham B. Nazzal , Issa Al-Khdour
Acute type A aortic dissection during pregnancy is rare but life-threatening. It requires early multidisciplinary diagnosis and intervention to optimize maternal and fetal outcomes. We report the case of a 35-year-old woman (gravida 7 para 6) at 34 weeks of gestation who presented with epigastric pain, initially suspected to be gastroenteritis. Despite stable initial findings, her condition deteriorated and a CT angiogram confirmed the diagnosis of DeBakey Type I aortic dissection, which extended from the aortic root to the iliac arteries. She underwent an emergency cesarean section followed by a Bentall procedure, a surgical technique first described by Bentall and De Bono in 1968 to manage the aortic valve, root, and ascending aorta abnormalities. Both mother and baby survived, with an uneventful recovery. However, this case highlights the diagnostic challenges of aortic dissection in pregnancy, as non-specific symptoms can mimic benign conditions. Multidisciplinary management and timely surgical intervention are crucial for maternal and fetal survival.
{"title":"Successful management of acute type A aortic dissection in the third trimester of pregnancy: A case report","authors":"Hamza A. Abdul-Hafez , Mahmoud N. Khadra , Alaa Hamed , Ibrahim Ayman Majjad , Mohammed A. Barakat , Adham B. Nazzal , Issa Al-Khdour","doi":"10.1016/j.crwh.2024.e00678","DOIUrl":"10.1016/j.crwh.2024.e00678","url":null,"abstract":"<div><div>Acute type A aortic dissection during pregnancy is rare but life-threatening. It requires early multidisciplinary diagnosis and intervention to optimize maternal and fetal outcomes. We report the case of a 35-year-old woman (gravida 7 para 6) at 34 weeks of gestation who presented with epigastric pain, initially suspected to be gastroenteritis. Despite stable initial findings, her condition deteriorated and a CT angiogram confirmed the diagnosis of DeBakey Type I aortic dissection, which extended from the aortic root to the iliac arteries. She underwent an emergency cesarean section followed by a Bentall procedure, a surgical technique first described by Bentall and De Bono in 1968 to manage the aortic valve, root, and ascending aorta abnormalities. Both mother and baby survived, with an uneventful recovery. However, this case highlights the diagnostic challenges of aortic dissection in pregnancy, as non-specific symptoms can mimic benign conditions. Multidisciplinary management and timely surgical intervention are crucial for maternal and fetal survival.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"45 ","pages":"Article e00678"},"PeriodicalIF":0.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098548","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}
Uterine rupture is a rare but serious complication that predominantly occurs in the third trimester of pregnancy. It is exceptionally uncommon in the second trimester, particularly in the presence of uterine anomalies such as a bicornuate uterus or uterus didelphys. This case report presents a significant instance of second-trimester uterine rupture associated with a bicornuate uterus, resulting in a life-threatening intra-abdominal hemorrhage of approximately 4000 mL. The case report details the clinical presentation, diagnostic challenges, and management strategies used in this case, highlighting the critical importance of prompt recognition and intervention in similar scenarios to improve maternal outcomes.
{"title":"Second-trimester uterine rupture in bicornuate uterus: A case report","authors":"Mesfin Ayalew Tsegaye, Zelalem Adugna Mekonnen, Dawit Takele Lemma, Alemayehu Nigusssie Adugna, Rebecca Haile Tesfay","doi":"10.1016/j.crwh.2024.e00676","DOIUrl":"10.1016/j.crwh.2024.e00676","url":null,"abstract":"<div><div>Uterine rupture is a rare but serious complication that predominantly occurs in the third trimester of pregnancy. It is exceptionally uncommon in the second trimester, particularly in the presence of uterine anomalies such as a bicornuate uterus or uterus didelphys. This case report presents a significant instance of second-trimester uterine rupture associated with a bicornuate uterus, resulting in a life-threatening intra-abdominal hemorrhage of approximately 4000 mL. The case report details the clinical presentation, diagnostic challenges, and management strategies used in this case, highlighting the critical importance of prompt recognition and intervention in similar scenarios to improve maternal outcomes.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"45 ","pages":"Article e00676"},"PeriodicalIF":0.7,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11720432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969698","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}
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