Pub Date : 2025-07-11DOI: 10.1016/j.crwh.2025.e00732
Kathleen Lundeberg , Conner Blackwell
Abdominal ectopic pregnancies are rare and carry high maternal morbidity and mortality rates. Patients may be asymptomatic, or they may have nonspecific abdominal pain. Due to their rarity and heterogeneity in presentation, management decisions are not straightforward. There are no universally agreed recommendations regarding the role of magnetic resonance imaging (MRI), and although surgical management is the most common choice, there is a paucity of evidence to support the role of medical alternatives or adjuncts. This report concerns the case of an asymptomatic patient with an abdominal pregnancy that was initially misdiagnosed as an intrauterine pregnancy. It highlights the utility of pelvic MRI in surgical planning and features a review of management options. Key images from the patient's ultrasound, MRI, and surgery are included.
{"title":"The role of magnetic resonance imaging in fertility-sparing surgical management of abdominal pregnancy: A case report","authors":"Kathleen Lundeberg , Conner Blackwell","doi":"10.1016/j.crwh.2025.e00732","DOIUrl":"10.1016/j.crwh.2025.e00732","url":null,"abstract":"<div><div>Abdominal ectopic pregnancies are rare and carry high maternal morbidity and mortality rates. Patients may be asymptomatic, or they may have nonspecific abdominal pain. Due to their rarity and heterogeneity in presentation, management decisions are not straightforward. There are no universally agreed recommendations regarding the role of magnetic resonance imaging (MRI), and although surgical management is the most common choice, there is a paucity of evidence to support the role of medical alternatives or adjuncts. This report concerns the case of an asymptomatic patient with an abdominal pregnancy that was initially misdiagnosed as an intrauterine pregnancy. It highlights the utility of pelvic MRI in surgical planning and features a review of management options. Key images from the patient's ultrasound, MRI, and surgery are included.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"47 ","pages":"Article e00732"},"PeriodicalIF":0.7,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623520","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}
{"title":"Corrigendum to “Marginal resection preferred over radical resection for a large abdominal wall desmoid tumor during pregnancy: A case report” [Case Reports in Women's Health 46 (2025) e00701]","authors":"Riku Watanabe , Hiroki Shinmura , Yasuyuki Yokoyama , Takashi Matsushima","doi":"10.1016/j.crwh.2025.e00730","DOIUrl":"10.1016/j.crwh.2025.e00730","url":null,"abstract":"","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"47 ","pages":"Article e00730"},"PeriodicalIF":0.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145044699","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}
Pub Date : 2025-07-04DOI: 10.1016/j.crwh.2025.e00729
Mesfin Ayalew Tsegaye, Meles Tazeb Teloye
Heterotopic pregnancy is a rare condition characterized by the simultaneous presence of both an intrauterine and an ectopic pregnancy. Most cases are identified during the first trimester. This report describes the case of a woman in labor who presented with right lower quadrant abdominal tenderness. During a cesarean section performed for an obstetric indication, a tubal ectopic pregnancy with active ostial bleeding and 600 ml of hemoperitoneum was discovered. A salpingectomy was performed, and histopathology confirmed the diagnosis of tubal ectopic pregnancy. The patient was discharged on the third day of admission with stable vital signs. This is seemingly the first ever reported case of a tubal heterotopic ectopic pregnancy presenting intrapartum.
{"title":"The unfortunate twin: A case report of intrapartum diagnosis of heterotopic pregnancy","authors":"Mesfin Ayalew Tsegaye, Meles Tazeb Teloye","doi":"10.1016/j.crwh.2025.e00729","DOIUrl":"10.1016/j.crwh.2025.e00729","url":null,"abstract":"<div><div>Heterotopic pregnancy is a rare condition characterized by the simultaneous presence of both an intrauterine and an ectopic pregnancy. Most cases are identified during the first trimester. This report describes the case of a woman in labor who presented with right lower quadrant abdominal tenderness. During a cesarean section performed for an obstetric indication, a tubal ectopic pregnancy with active ostial bleeding and 600 ml of hemoperitoneum was discovered. A salpingectomy was performed, and histopathology confirmed the diagnosis of tubal ectopic pregnancy. The patient was discharged on the third day of admission with stable vital signs. This is seemingly the first ever reported case of a tubal heterotopic ectopic pregnancy presenting intrapartum.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"47 ","pages":"Article e00729"},"PeriodicalIF":0.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556629","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}
Fistula formation is a rare complication of ovarian mature cystic teratoma. This article reports a case of an ovarian mature cystic teratoma associated with fistula formation to the small bowel. A 30-year-old woman, gravida 0, presented with a 1-week history of vague lower abdominal pain and fever. Computed tomography revealed a right ovarian tumor with suspected rupture. Magnetic resonance imaging suggested a mature cystic teratoma and a possible right fallopian tube abscess. Empirical intravenous antibiotic therapy led to clinical improvement; however, the patient subsequently reported bloody stool. During laparoscopic surgery, dense adhesions were found between the right ovarian tumor and the small bowel. Dissection revealed a fistula connecting the ovarian mass to the bowel. A segmental small bowel resection and right ovarian cystectomy were performed. Histopathological analysis confirmed an ovarian mature cystic teratoma with associated intestinal inflammation, but no malignancy. This case highlights the rare but serious complication of fistula formation in ovarian mature cystic teratomas. In patients presenting with gastrointestinal symptoms, especially hematochezia, clinicians should consider the possibility of fistulization and involve gastrointestinal surgery teams as appropriate.
{"title":"Laparoscopic treatment of an ovarian teratoma with perforation of the small bowel: A case report","authors":"Naho Tokunaga, Sotaro Hayashi, Eriko Iito, Tomohito Kobiyama, Koki Yagi, Mao Sekimata, Naoki Abe, Sachino Kira, Hajime Takeuchi, Lifa Lee, Satoshi Nishiyama, Maki Goto, Hiroshi Tsujioka","doi":"10.1016/j.crwh.2025.e00728","DOIUrl":"10.1016/j.crwh.2025.e00728","url":null,"abstract":"<div><div>Fistula formation is a rare complication of ovarian mature cystic teratoma. This article reports a case of an ovarian mature cystic teratoma associated with fistula formation to the small bowel. A 30-year-old woman, gravida 0, presented with a 1-week history of vague lower abdominal pain and fever. Computed tomography revealed a right ovarian tumor with suspected rupture. Magnetic resonance imaging suggested a mature cystic teratoma and a possible right fallopian tube abscess. Empirical intravenous antibiotic therapy led to clinical improvement; however, the patient subsequently reported bloody stool. During laparoscopic surgery, dense adhesions were found between the right ovarian tumor and the small bowel. Dissection revealed a fistula connecting the ovarian mass to the bowel. A segmental small bowel resection and right ovarian cystectomy were performed. Histopathological analysis confirmed an ovarian mature cystic teratoma with associated intestinal inflammation, but no malignancy. This case highlights the rare but serious complication of fistula formation in ovarian mature cystic teratomas. In patients presenting with gastrointestinal symptoms, especially hematochezia, clinicians should consider the possibility of fistulization and involve gastrointestinal surgery teams as appropriate.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"47 ","pages":"Article e00728"},"PeriodicalIF":0.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570708","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}
Pub Date : 2025-06-27DOI: 10.1016/j.crwh.2025.e00727
Chester Chiah , Lucy Grant , Jason Yap , Fong Lien Kwong
Women with Fanconi anaemia are predisposed to developing squamous cell carcinoma in the lower genital tract at a very young age due to inherent defects in their DNA repair mechanisms. This case report discusses the clinical and psychological aspects of the management of a young virgo intacta woman who presented with an HPV-independent squamous cell carcinoma and a separate high-grade vulvar intraepithelial neoplasia on the contralateral labium. It also discusses the underlying molecular changes that predispose these women to squamous cell carcinoma and highlights the challenges in implementing screening for neoplasia of the lower genital tract in this population. Owing to the rarity of Fanconi anaemia, women with the condition should be managed by a multidisciplinary team led by gynaecologists experienced in managing neoplasia in the lower genital tract. The involvement of a young adult cancer support group is essential, as treatment can have enduring psychosexual consequences for young women.
{"title":"The challenges of managing vulval squamous cell cancer in women with Fanconi anaemia: A case report and literature review","authors":"Chester Chiah , Lucy Grant , Jason Yap , Fong Lien Kwong","doi":"10.1016/j.crwh.2025.e00727","DOIUrl":"10.1016/j.crwh.2025.e00727","url":null,"abstract":"<div><div>Women with Fanconi anaemia are predisposed to developing squamous cell carcinoma in the lower genital tract at a very young age due to inherent defects in their DNA repair mechanisms. This case report discusses the clinical and psychological aspects of the management of a young virgo intacta woman who presented with an HPV-independent squamous cell carcinoma and a separate high-grade vulvar intraepithelial neoplasia on the contralateral labium. It also discusses the underlying molecular changes that predispose these women to squamous cell carcinoma and highlights the challenges in implementing screening for neoplasia of the lower genital tract in this population. Owing to the rarity of Fanconi anaemia, women with the condition should be managed by a multidisciplinary team led by gynaecologists experienced in managing neoplasia in the lower genital tract. The involvement of a young adult cancer support group is essential, as treatment can have enduring psychosexual consequences for young women.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"47 ","pages":"Article e00727"},"PeriodicalIF":0.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517098","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}
Pub Date : 2025-06-17DOI: 10.1016/j.crwh.2025.e00726
Sarah Sebastian, Nicole Jenkins, Stephanie Pistilli
Pelvic organ prolapse (POP) during pregnancy is rare, with few cases to guide clinical management. Vaginal delivery is possible; however, it is associated with increased risk of antepartum and intrapartum complications. This report discusses a case of intrapartum severe uterine prolapse in pregnancy and management techniques which resulted in a successful vaginal delivery.
A 43-year-old grand multiparous woman (para 9) presented at 40 weeks in labor with stage III uterine prolapse. She had been diagnosed during her antepartum course, but declined a pessary and opted instead for expectant management. Her labor course was complicated by obstructed labor until she underwent manual reduction of her prolapse, subsequent bedrest, and oxytocin augmentation, leading to vaginal delivery of a term neonate. Her third stage was complicated by uterine atony, managed with bimanual massage and uterotonics.
This case illustrates that vaginal delivery is feasible in pregnancies complicated by severe uterine prolapse when pelvic anatomy is appropriately restored. Restoration may facilitate labor progression and reduce the risk of obstructed labor. However, the risk of intrapartum complications remains high. Awareness of these potential complications is critical as impaired uterine contractility from uterine prolapse may limit effective labor mechanics in all stages of labor.
{"title":"Navigating vaginal delivery in a patient with severe uterine prolapse: A case report","authors":"Sarah Sebastian, Nicole Jenkins, Stephanie Pistilli","doi":"10.1016/j.crwh.2025.e00726","DOIUrl":"10.1016/j.crwh.2025.e00726","url":null,"abstract":"<div><div>Pelvic organ prolapse (POP) during pregnancy is rare, with few cases to guide clinical management. Vaginal delivery is possible; however, it is associated with increased risk of antepartum and intrapartum complications. This report discusses a case of intrapartum severe uterine prolapse in pregnancy and management techniques which resulted in a successful vaginal delivery.</div><div>A 43-year-old grand multiparous woman (para 9) presented at 40 weeks in labor with stage III uterine prolapse. She had been diagnosed during her antepartum course, but declined a pessary and opted instead for expectant management. Her labor course was complicated by obstructed labor until she underwent manual reduction of her prolapse, subsequent bedrest, and oxytocin augmentation, leading to vaginal delivery of a term neonate. Her third stage was complicated by uterine atony, managed with bimanual massage and uterotonics.</div><div>This case illustrates that vaginal delivery is feasible in pregnancies complicated by severe uterine prolapse when pelvic anatomy is appropriately restored. Restoration may facilitate labor progression and reduce the risk of obstructed labor. However, the risk of intrapartum complications remains high. Awareness of these potential complications is critical as impaired uterine contractility from uterine prolapse may limit effective labor mechanics in all stages of labor.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"47 ","pages":"Article e00726"},"PeriodicalIF":0.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365406","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}
Pub Date : 2025-06-04DOI: 10.1016/j.crwh.2025.e00723
Fong Lien Kwong , Mark Davies , Jason K.W. Yap
The management of groin recurrences in women with vulval cancer presents a significant therapeutic challenge. Groin recurrences, particularly those involving the femoral vessels, are associated with poor outcomes. Historically, surgery was often not offered in such cases, exposing patients to the risk of fatal complications from femoral vessel blow-out, leading to exsanguination. This report describes the management of a right large vulval groin recurrence involving the femoral vein, treated successfully with femoral vein ligation. The patient's postoperative recovery was largely uneventful. This case highlights the feasibility of femoral vein ligation when performed with early involvement of vascular surgeons and a multidisciplinary team approach. Femoral vein ligation should be considered in cases of vessel invasion as it can be both life-saving and limb-sparing. Additionally, the report discusses the development of collateral venous circulation, which often compensates for femoral vein obstruction.
{"title":"Femoral vein ligation for groin recurrence in a woman with vulval squamous cell carcinoma: A case report","authors":"Fong Lien Kwong , Mark Davies , Jason K.W. Yap","doi":"10.1016/j.crwh.2025.e00723","DOIUrl":"10.1016/j.crwh.2025.e00723","url":null,"abstract":"<div><div>The management of groin recurrences in women with vulval cancer presents a significant therapeutic challenge. Groin recurrences, particularly those involving the femoral vessels, are associated with poor outcomes. Historically, surgery was often not offered in such cases, exposing patients to the risk of fatal complications from femoral vessel blow-out, leading to exsanguination. This report describes the management of a right large vulval groin recurrence involving the femoral vein, treated successfully with femoral vein ligation. The patient's postoperative recovery was largely uneventful. This case highlights the feasibility of femoral vein ligation when performed with early involvement of vascular surgeons and a multidisciplinary team approach. Femoral vein ligation should be considered in cases of vessel invasion as it can be both life-saving and limb-sparing. Additionally, the report discusses the development of collateral venous circulation, which often compensates for femoral vein obstruction.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"47 ","pages":"Article e00723"},"PeriodicalIF":0.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241168","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}
Pub Date : 2025-06-03DOI: 10.1016/j.crwh.2025.e00722
Matisse Uluilelata , Judy Ormandy
Spontaneous haemoperitoneum in pregnancy is defined as a sudden non-traumatic intra-abdominal haemorrhage in pregnancy or the postpartum period. With an incidence of 1/25000, it has been associated with endometriosis and assisted reproductive technology, and with significant perinatal morbidity and mortality. This report describes a postpartum case of spontaneous haemoperitoneum in pregnancy complicated by pulmonary embolism. The patient, who had a history of endometriosis, underwent a ventouse birth following term induction of labour. Six hours later she developed abdominal pain and bilateral pain in the shoulder tips, associated with a drop in haemoglobin. A computerised tomography scan of the abdomen demonstrated a haemoperitoneum with no actively bleeding vessels. She was managed conservatively with blood transfusion, tranexamic acid, and analgesia. Anticoagulation was withheld due to concerns over bleeding risk. On day 4 postpartum, she developed chest pain and was diagnosed with a pulmonary embolus. Most previously reported cases occurred antenatally and required an emergent laparotomy for fetal concerns. As this case occurred postnatally, fetal well-being did not need to be considered, and non-surgical management was successfully employed. This case also highlights difficulties with decisions regarding anticoagulation in patients at high risk of both bleeding and venous thromboembolism.
{"title":"Spontaneous haemoperitoneum in pregnancy complicated by a pulmonary embolus: a case report","authors":"Matisse Uluilelata , Judy Ormandy","doi":"10.1016/j.crwh.2025.e00722","DOIUrl":"10.1016/j.crwh.2025.e00722","url":null,"abstract":"<div><div>Spontaneous haemoperitoneum in pregnancy is defined as a sudden non-traumatic intra-abdominal haemorrhage in pregnancy or the postpartum period. With an incidence of 1/25000, it has been associated with endometriosis and assisted reproductive technology, and with significant perinatal morbidity and mortality. This report describes a postpartum case of spontaneous haemoperitoneum in pregnancy complicated by pulmonary embolism. The patient, who had a history of endometriosis, underwent a ventouse birth following term induction of labour. Six hours later she developed abdominal pain and bilateral pain in the shoulder tips, associated with a drop in haemoglobin. A computerised tomography scan of the abdomen demonstrated a haemoperitoneum with no actively bleeding vessels. She was managed conservatively with blood transfusion, tranexamic acid, and analgesia. Anticoagulation was withheld due to concerns over bleeding risk. On day 4 postpartum, she developed chest pain and was diagnosed with a pulmonary embolus. Most previously reported cases occurred antenatally and required an emergent laparotomy for fetal concerns. As this case occurred postnatally, fetal well-being did not need to be considered, and non-surgical management was successfully employed. This case also highlights difficulties with decisions regarding anticoagulation in patients at high risk of both bleeding and venous thromboembolism.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"47 ","pages":"Article e00722"},"PeriodicalIF":0.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241167","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}
Pub Date : 2025-06-01DOI: 10.1016/j.crwh.2025.e00699
Ruth Abrams
{"title":"Supporting women's reproductive health at work","authors":"Ruth Abrams","doi":"10.1016/j.crwh.2025.e00699","DOIUrl":"10.1016/j.crwh.2025.e00699","url":null,"abstract":"","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"46 ","pages":"Article e00699"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253869","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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