Case Reports in Women's Health最新文献

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Obstetric and neonatal emergencies are still global health issues 产科和新生儿紧急情况仍然是全球性的健康问题

IF 0.6 Q4 OBSTETRICS & GYNECOLOGY

Case Reports in Women's Health

Pub Date : 2025-03-22 DOI: 10.1016/j.crwh.2025.e00705

Peter Chedraui , Faustino R. Pérez-López

引用次数: 0

Uterine rupture in labor after prior ultrasound-guided percutaneous microwave ablation of uterine fibroids: A case report 超声引导下经皮微波子宫肌瘤消融后分娩子宫破裂1例

IF 0.7 Q4 OBSTETRICS & GYNECOLOGY

Case Reports in Women's Health

Pub Date : 2025-03-14 DOI: 10.1016/j.crwh.2025.e00702

Yucui Zeng, Yanlan Wang, Xiaoyan Guang

Ultrasound-guided percutaneous microwave ablation for the treatment of uterine fibroids has gained widespread clinical application due to its efficacy. However, reports on fertility outcomes and pregnancy complications following this treatment remain scarce. This report presents the case of a 31-year-old woman who underwent ultrasound-guided percutaneous microwave ablation for uterine fibroids. Regular postoperative follow-up revealed a significant reduction in the size of the uterine fibroids. Six months later, the patient successfully achieved natural conception, and her pregnancy progressed without any abnormalities. Given her strong preference for vaginal delivery, she was admitted to hospital at 40 weeks of gestation for monitoring when she began to exhibit signs of labor. However, uterine rupture occurred without any apparent warning during the labor. Following emergency surgical intervention, the neonate and the patient had a favorable outcome. This case underscores the efficacy of percutaneous microwave ablation for uterine fibroids but also emphasizes the need for postoperative follow-up to promptly identify any complications during the third trimester of pregnancy.

超声引导下经皮微波消融治疗子宫肌瘤因其疗效得到广泛的临床应用。然而，关于这种治疗后的生育结果和妊娠并发症的报道仍然很少。本报告报告一例31岁妇女接受超声引导下经皮微波消融子宫肌瘤。术后定期随访显示子宫肌瘤大小明显减小。6个月后，患者顺利自然受孕，妊娠进展顺利，无任何异常。由于她强烈倾向于阴道分娩，她在怀孕40周时入院接受监测，当时她开始出现分娩迹象。然而，子宫破裂发生在分娩过程中没有任何明显的警告。经过紧急手术干预，新生儿和患者都有良好的结果。本病例强调了经皮微波消融治疗子宫肌瘤的疗效，但也强调了术后随访的必要性，以及时发现妊娠晚期的任何并发症。

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引用次数: 0

Marginal resection preferred over radical resection for a large abdominal wall desmoid tumor during pregnancy: A case report 妊娠期腹壁大硬纤维瘤边缘切除优于根治性切除1例

IF 0.7 Q4 OBSTETRICS & GYNECOLOGY

Case Reports in Women's Health

Pub Date : 2025-03-13 DOI: 10.1016/j.crwh.2025.e00701

Riku Watanabe , Hiroki Shinmura , Yasuyuki Yokoyama , Takashi Matsushima

Desmoid tumors are locally aggressive soft-tissue tumors known for their lack of metastatic potential but high recurrence rate after resection. Few cases of desmoid tumors during pregnancy have been reported, making treatment decisions more challenging.

This report presents the case of a woman with an abdominal wall desmoid tumor resected at 17 weeks of gestation. The large mass (13.4 cm × 7.4 cm) was compressing the uterus, which necessitated surgical intervention. Marginal resection of the tumor was performed with microscopically positive margins. The patient's postoperative course was uneventful, and she had a normal vaginal delivery at 38 weeks. No recurrence of the tumor was observed at 24-month follow-up. This case represents the largest pregnancy-related abdominal desmoid tumor (22 cm × 12 cm) resected marginally during pregnancy. The procedure allowed for a vaginal delivery rather than a cesarean section.

Surgical management of desmoid tumors in pregnancy should aim to remove the tumor while preserving function and anatomical integrity. While this approach is feasible for smaller tumors, larger tumors, as in this case, may result in loss of function and anatomical structure. This raises the question of whether marginal resection should be considered when preservation of function and structure is not feasible with radical resection. This case reinforces the fundamental surgical principle that when clear surgical margins cannot be achieved without compromising function and structure, marginal resection should be considered.

硬纤维瘤是一种局部侵袭性软组织肿瘤，因其缺乏转移潜力而闻名，但术后复发率高。妊娠期间发生硬纤维瘤的病例很少，这使得治疗决策更具挑战性。本报告提出的情况下，一个妇女与腹壁硬纤维瘤切除在妊娠17周。大肿块（13.4 cm × 7.4 cm）压迫子宫，需要手术干预。肿瘤的边缘切除在显微镜下呈阳性。患者的术后过程很顺利，她在38周时正常阴道分娩。随访24个月未见肿瘤复发。本病例为最大的妊娠相关腹部硬纤维瘤（22 cm × 12 cm），在妊娠期间被边缘切除。该手术允许阴道分娩而不是剖宫产。妊娠期硬纤维瘤的手术治疗应以切除肿瘤为目标，同时保留其功能和结构的完整性。虽然这种方法对较小的肿瘤是可行的，但像本病例一样，较大的肿瘤可能导致功能和解剖结构的丧失。这就提出了一个问题，当根治性切除不能保留功能和结构时，是否应该考虑边缘切除。本病例强化了外科手术的基本原则，即当不能在不损害功能和结构的情况下获得清晰的手术切缘时，应考虑边缘切除。

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引用次数: 0

Glanzmann's thrombasthenia in a twin pregnancy: A case report 双胎妊娠的Glanzmann血栓缺乏症1例

IF 0.7 Q4 OBSTETRICS & GYNECOLOGY

Case Reports in Women's Health

Pub Date : 2025-03-07 DOI: 10.1016/j.crwh.2025.e00697

Vicky X. Xu , Shaun P. Brennecke

Glanzmann's thrombasthenia (GT) is a rare autosomal recessive bleeding disorder caused by deficient or defective integrin αIIbβ3 on platelets, leading to impaired platelet aggregation. Pregnancy in women with GT poses significant challenges due to the increased risk of bleeding antenatally, intrapartum, and postpartum, as well as potential complications for the neonate, such as neonatal alloimmune thrombocytopenia (NAIT). This case report details the contemporary, multidisciplinary management of a 35-year-old primigravid woman with a dichorionic, diamniotic twin pregnancy and GT which included an elective caesarean section under general anaesthesia performed at 36 + 5 weeks of gestation, with recombinant factor VIIa (NovoSeven) and tranexamic acid (TXA) treatment preoperatively and pre-emptive uterotonic administration intraoperatively to minimise haemorrhage. Postpartum management included a seven-week course of TXA. This case highlights the importance of a proactive, multidisciplinary care plan to optimize pregnancy outcomes in women with GT, with a focus on minimizing the risk of severe haemorrhage.

Glanzmann's thrombasthenia （GT）是一种罕见的常染色体隐性出血性疾病，由血小板上整合素α ib β3缺乏或缺陷引起，导致血小板聚集受损。由于产前、产时和产后出血的风险增加，以及新生儿的潜在并发症（如新生儿同种免疫性血小板减少症（NAIT））， GT妇女的妊娠面临重大挑战。本病例报告详细介绍了一名35岁双绒毛膜双羊膜双胎妊娠和GT的初孕妇女的当代多学科治疗，包括在妊娠36 + 5周全麻下择期剖宫产，术前使用重组VIIa因子（NovoSeven）和氨甲环酸（TXA）治疗，术中先发制人的子宫扩张给药以减少出血。产后管理包括7周的TXA疗程。本病例强调了积极主动的多学科护理计划的重要性，以优化GT妇女的妊娠结局，重点是尽量减少严重出血的风险。

引用次数: 0

Vaginocutaneous fistula caused by recurrent labial abscess: A case report 复发性唇脓肿致阴道皮肤瘘1例

IF 0.7 Q4 OBSTETRICS & GYNECOLOGY

Case Reports in Women's Health

Pub Date : 2025-03-06 DOI: 10.1016/j.crwh.2025.e00698

Komkrit Aimjirakul, Teerapan Seehanantawong, Apisith Saraluck

Urogenital fistulas are characterized by communication tracts that connect two surfaces or distinct organ systems. A vaginocutaneous fistula is a rare type of urogenital fistula that is characterized by persistent perineal discharge. This case report describes a female patient who suffered from recurrent labial abscesses and a fistula that connected the lower vagina to the inner thigh. There were symptoms of persistent perineal discharge, and the patient had an offensive odor. The patient had a history of six recurrent right labial abscesses over a period of two years prior to the formation of two fistulous openings. The right medial aspect of the inner thigh, adjacent to the labia majora, was found to have a 0.7 cm opening, which was confirmed by magnetic resonance imaging. Intraoperatively, the fistulous tract was readily delineated using dye. Complete fistulectomy was performed. This report highlights an unusual presentation of a urogenital fistula, the diagnostic challenges, and the management strategies. It emphasizes the need for timely identification and intervention in such cases.

泌尿生殖系统瘘的特征是连接两个表面或不同器官系统的通讯束。阴道皮肤瘘管是一种罕见的泌尿生殖瘘管，其特征是持续的会阴分泌物。本病例报告描述了一名女性患者，她患有复发性唇脓肿和连接阴道下部和大腿内侧的瘘管。有持续的会阴分泌物的症状，病人有一种难闻的气味。患者有6次复发性右唇脓肿的历史，在形成两个瘘口之前的两年。右侧大腿内侧内侧，靠近大阴唇，发现有一个0.7 cm的开口，磁共振成像证实了这一点。术中，用染料很容易地描绘了瘘道。行全瘘管切除术。本报告强调了泌尿生殖瘘管的一个不寻常的表现，诊断的挑战，和管理策略。它强调需要及时查明和干预这类案件。

引用次数: 0

Dengue fever in pregnancy 孕期登革热

IF 0.7 Q4 OBSTETRICS & GYNECOLOGY

Case Reports in Women's Health

Pub Date : 2025-03-01 DOI: 10.1016/j.crwh.2025.e00685

Adesh Sirjusingh

引用次数: 0

Prolapse in pregnancy 妊娠脱垂

IF 0.7 Q4 OBSTETRICS & GYNECOLOGY

Case Reports in Women's Health

Pub Date : 2025-03-01 DOI: 10.1016/j.crwh.2025.e00686

Annika Taithongchai, Dudley Robinson

引用次数: 0

Towards a greater understanding of uterine sarcomas 对子宫肉瘤有更深入的了解

IF 0.7 Q4 OBSTETRICS & GYNECOLOGY

Case Reports in Women's Health

Pub Date : 2025-03-01 DOI: 10.1016/j.crwh.2025.e00683

Raji Ganesan

引用次数: 0

Isolated abdominal wall metastasis 42 years after curative surgery for ovarian cancer: A case report 卵巢癌根治术后42年孤立性腹壁转移1例

IF 0.7 Q4 OBSTETRICS & GYNECOLOGY

Case Reports in Women's Health

Pub Date : 2025-02-20 DOI: 10.1016/j.crwh.2025.e00696

Roland Csorba , Paul Buderath , Marc Ingenwerth , Sa'ed Almasarweh , Zeynep Atas Elfrink

Despite the rarity of abdominal or chest wall metastases in ovarian cancer patients, reports have described instances of isolated late recurrence at surgical incision sites. We report the case of an 85-year-old woman who present with a massive metastatic tumor on the right anterior abdominal wall 42 years after undergoing a total abdominal hysterectomy and bilateral salpingo-oophorectomy for primary ovarian cancer. The abdominal wall tumor was resected en bloc, and abdominal wall reconstruction was performed using a mesh. Histology revealed a low-grade serous carcinoma.

This report highlights the possibility of abdominal wall metastases after prolonged survival following the treatment of ovarian cancer. Surgical excision combined with mesh reconstruction represents an adequate treatment approach for such cases. Caution should be exercised during laparotomy to ensure complete removal of malignant tissue and to prevent parietal dissemination. Long-term follow-up is crucial for ovarian cancer patients, as late recurrences, although rare, can occur even decades after initial treatment.

尽管卵巢癌患者很少发生腹壁或胸壁转移，但仍有报告描述了手术切口部位出现孤立性晚期复发的情况。我们报告了一例 85 岁妇女的病例，她因原发性卵巢癌接受全腹子宫切除术和双侧输卵管切除术 42 年后，右前腹壁出现大块转移性肿瘤。腹壁肿瘤被整体切除，并使用网片进行了腹壁重建。组织学检查显示为低分化浆液性癌。该报告强调了卵巢癌治疗后长期存活后发生腹壁转移的可能性。手术切除结合网片重建是治疗此类病例的适当方法。开腹手术时应小心谨慎，确保完全切除恶性组织，并防止腹壁旁扩散。长期随访对卵巢癌患者至关重要，因为晚期复发虽然罕见，但在初次治疗后数十年仍有可能发生。

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引用次数: 0

Transient bacteraemia secondary to imiquimod use as a treatment for cervical high-grade squamous intraepithelial lesions – A case report 咪喹莫特治疗宫颈高级别鳞状上皮内病变继发短暂性菌血症1例报告

IF 0.7 Q4 OBSTETRICS & GYNECOLOGY

Case Reports in Women's Health

Pub Date : 2025-02-11 DOI: 10.1016/j.crwh.2025.e00694

Caroline L.P. Muntinga , Sophieke C.H.A. van der Steen , Edith M.G. van Esch , Sander Kelderman

Imiquimod is an immunomodulating cream used in the treatment of cervical high-grade squamous intraepithelial lesions (cHSIL). Side-effects are common and mostly well tolerated, but can be severe. A woman using imiquimod for recurrent cHSIL presented with signs of a distributive shock nearly three weeks after the start of imiquimod treatment, for which she was admitted to a medium care unit. No infectious source was identified. The woman recovered well with conservative treatment. This case demonstrates the importance of monitoring patients for side-effects during imiquimod treatment. Side-effects, including the possibility of severe side-effects, should be discussed during patient counselling on therapy options for cHSIL treatment.

咪喹莫特是一种免疫调节乳膏，用于治疗宫颈高级别鳞状上皮内病变（cHSIL）。副作用很常见，而且大多数都能很好地耐受，但也可能很严重。一名使用咪喹莫特治疗复发性cHSIL的妇女在开始咪喹莫特治疗近三周后出现了分布性休克的迹象，为此她住进了中等护理病房。未发现传染源。经保守治疗，患者恢复良好。本病例表明在咪喹莫特治疗期间监测患者副作用的重要性。副作用，包括严重副作用的可能性，应在患者咨询cHSIL治疗方案时讨论。

引用次数: 0

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