1/79. Acute abdominal pain and urgency to defecate in the young and the old: a useful symptom-complex?In the belief that "pattern recognition" is an important first step of the diagnostic process, we report our observation of an uncommon and heretofore poorly documented symptom-complex in 10 patients, and suggest that the constellation of abdominal pain and urgency to defecate in the acutely ill surgical patient should raise the diagnostic possibility of intra-abdominal bleeding. In our experience, this is statistically likely to be associated with a ruptured abdominal aortic aneurysm in the old and a ruptured ectopic pregnancy in the young.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/79. Severe hemolytic disease from rhesus anti-C antibodies in a surrogate pregnancy after oocyte donation. A case report.BACKGROUND: Maternal sensitization with rhesus anti-C antibodies is comparatively rare and usually benign. In pregnancies conceived using donor oocytes, the mother's blood group may differ from that of both the father and the oocyte donor, making blood group incompatibility more likely. CASE: twins, the result of a surrogate pregnancy using donor oocytes, were born with severe hemolytic disease due to rhesus anti-C antibodies. Both infants required exchange transfusion for profound anemia at birth. Isoimmunization in the surrogate mother was not detected antenatally. The twins were delivered by emergency cesarean section due to fetal compromise, detected fortuitously when the mother attended for routine fetal assessment at 35 weeks' gestation. CONCLUSION: Isoimmunization with anti-C antibodies is not always benign and may cause significant hemolytic disease. With the success of in vitro fertilization and oocyte donation, more infertile couples may use these methods to conceive, with or without surrogacy arrangements. In such cases, the provision of antenatal care may become a complex matter, involving several parties, and good communication between everyone involved is vital. In pregnancies conceived with donor oocytes, there may be a higher risk of blood group incompatibility, and special vigilance is warranted.- - - - - - - - - - ranking = 5.323110600686keywords = pregnancy, gestation (Clic here for more details about this article) |
3/79. Extensor tendon lacerations in a preterm neonate.A fetus of 30-weeks' gestation sustained 2 extensor tendon lacerations as an intraoperative complication of an emergency cesarean section. This report describes treatment of the tendon lacerations in the preterm neonate using 2 different repair techniques which both yielded an excellent clinical outcome.- - - - - - - - - - ranking = 0.32311060068595keywords = gestation (Clic here for more details about this article) |
4/79. Outcome of twin pregnancies in patients with haemoglobinopathies--case reports.pregnancy in patients with haemoglobinopathy is associated with increased risk of maternal and perinatal morbidities and mortalities. Multiple pregnancy is potentially more hazardous than singleton pregnancy. There is a dearth of information concerning multiple pregnancies in patients with haemoglobinopathy. Four of such patients seen in the obstetric service of the University College Hospital, Ibadan are presented here and discussed. Increased surveillance and elective caesarean delivery are suggested in the management of these patients.- - - - - - - - - - ranking = 2keywords = pregnancy (Clic here for more details about this article) |
5/79. Laparoscopic surgery with intraoperative autologous blood transfusion in patients with heavy hemoperitoneum due to ectopic pregnancy.patients with ectopic pregnancy complicated by heavy hemoperitoneum generally undergo immediate laparotomy, and homologous blood transfusion is sometimes started before the operation. Two women underwent laparoscopic surgery for heavy hemoperitoneum (2600 and 1900 ml) due to ectopic pregnancy. The aspirated blood was reinfused during operation through a leukocyte-reduction filter after lavage with an autologous blood-salvage transfusion apparatus.- - - - - - - - - - ranking = 6keywords = pregnancy (Clic here for more details about this article) |
6/79. Spontaneous hepatic rupture in pregnancy.The HELLP-syndrome (haemolysis, elevated liver enzymes, low platelets) is associated with pre-eclampsia and may cause subcapsular liver haematomas. When hepatic rupture occurs the mortality of mother and unborn is high. rupture remains a surgical emergency with control of bleeding based on trauma principles. We report a case and discuss the diagnosis and management.- - - - - - - - - - ranking = 4keywords = pregnancy (Clic here for more details about this article) |
7/79. Cervical pregnancy: a case report.This is a case report of an uncommon but dangerous form of ectopic pregnancy. The incidence of cervical pregnancy may be increasing, and it should be included in the differential diagnosis of vaginal bleeding in pregnancy. Included in this case report are discussions of the incidence, causes, predisposing factors, diagnostics, and treatment options.- - - - - - - - - - ranking = 7keywords = pregnancy (Clic here for more details about this article) |
8/79. Unnecessary emergency caesarean section due to silent CTG during anaesthesia?We present a case of a probably unnecessary Caesarean section due to misinterpretation of the cardiotocography (CTG) trace during general anaesthesia. A 27-yr-old patient in her 30th week of an uneventful, normal first pregnancy presented with a deep venous thrombosis in the pelvic region. She was to undergo an emergency thrombectomy under general anaesthesia. During the operation, the CTG showed a lack of beat-to-beat heart rate variation (silent pattern CTG) with normal fetal heart rate. This silent CTG pattern was probably a result of the effect of general anaesthesia on the fetus. The CTG pattern was interpreted as indicating fetal distress, and an emergency Caesarean section was performed after the thrombectomy. The infant was apnoeic and had to be resuscitated and admitted to the neonatal intensive care unit. The pH at delivery was 7.23 and the baby was extubated 2 days later. Mother and child recovered without short-term sequelae. In the absence of alternative explanations, reduced fetal beat-to-beat variability with a normal baseline heart rate during general anaesthesia is probably normal.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
9/79. Acute fatty liver of pregnancy: a case report.The third trimester of pregnancy has several unique disease entities that challenge the anesthetist. Acute fatty liver of pregnancy (AFLP) is an increasingly recognized metabolic disorder found late in pregnancy. Current research estimates the incidence of AFLP at 1 per 6,659 births. Improved maternal morbidity and mortality is credited to early recognition and termination of the pregnancy. The decline in hepatic cellular activity is evident by the deterioration in metabolic, synthetic, and excretory functions of the liver. This obstetrical emergency can lead to death of both mother and child if not diagnosed in time to prevent coagulopathic complications.- - - - - - - - - - ranking = 8keywords = pregnancy (Clic here for more details about this article) |
10/79. Urgent laparoscopic splenectomy in a morbidly obese pregnant woman: case report and literature review.Laparoscopic splenectomy (LS) has undergone significant evolution since its introduction more than a decade ago. It clearly has been shown to be advantageous in comparison with open splenectomy and is considered by some to be the treatment of choice for routine uncomplicated elective splenectomy. When LS was first introduced, contraindications to the procedure included pregnancy, obesity, and splenomegaly. Both technologic advances and experience with the technique have enabled surgeons to perform LS for a growing number of indications with seemingly fewer contraindications. Here, we present a case of successful LS in a morbidly obese pregnant woman with splenomegaly and hemolysis secondary to hereditary spherocytosis.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
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