1/77. pre-eclampsia and the hellp syndrome still cause maternal mortality in The netherlands and other developed countries; can we reduce it?maternal mortality in developed countries does not seem to have decreased during the past decade, despite good prenatal care. Hypertensive disorders of pregnancy are the main cause of maternal mortality in most countries. In more than half of these cases, the hellp syndrome is involved. In this article attention is drawn again to the life-threatening complications that might occur in cases of pre- eclampsia and the hellp syndrome. Two case histories with fatal outcomes are described to provide extra emphasis. The literature indicates that some cases of maternal mortality might be avoidable. From a review of the literature, suggestions and recommendations are made about how to achieve a decrease in maternal mortality from pre-eclampsia/the hellp syndrome. The most important are the making of an early, correct diagnosis, anticipating the possibilities of serious complications, and, if necessary, early referral to a regional centre with special expertise.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/77. Resolution of presumed arachnoid cyst in utero.We present a case of presumed arachnoid cyst that was diagnosed at 18.5 weeks' gestation, developed a hematoma at 28 weeks and had virtually resolved by 32 weeks. Expectant management of antenatally diagnosed cases is suggested.- - - - - - - - - - ranking = 0.55525348667571keywords = gestation (Clic here for more details about this article) |
3/77. prenatal diagnosis of a subamniotic hematoma.A case of a subamniotic hematoma was diagnosed at 34 weeks of gestation. pregnancy and delivery were uneventful. The ultrasound features of a subamniotic hematoma, and the differential diagnosis with lesions of less favorable outcome are described.- - - - - - - - - - ranking = 0.55525348667571keywords = gestation (Clic here for more details about this article) |
4/77. 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) |
5/77. A case of massive subchorionic thrombohematoma diagnosed by ultrasonography and magnetic resonance imaging.Massive subchorionic thrombohematoma is uncommon but associated with a poor perinatal prognosis. Placental enlargement was detected in a 25-year-old Japanese primipara woman with fetal growth retardation and oligohydramnios at 23 weeks' gestation. ultrasonography (USG) showed an abnormal sonolucency within the placenta at 28 weeks' gestation, but could not give an unequivocal differentiation from placental abnormalities such as hematomas, cysts and other tumors. magnetic resonance imaging (MRI) pointed to a large hematoma in the subchorionic region. Simultaneously, the amniotic fluid was brownish colored. From these findings, it was possible to have prenatal diagnosis of massive subchorionic thrombohematoma. At 32 weeks' gestation, the fetus died in utero and was stillborn 3 days later. Pathological findings for the placenta revealed a large hematoma diffused between the villous chorion and the chorionic plate, with wide necrosis of placental tissue, likely due to formation of multiple thrombi. The clinical and pathological findings were compatible with massive subchorionic thrombohematoma. MRI might be useful for the detection of massive subchorionic thrombohematoma and help its clinical management in combination with USG and pulse Doppler imaging.- - - - - - - - - - ranking = 1.6657604600271keywords = gestation (Clic here for more details about this article) |
6/77. Massive subchorionic hematoma (Breus' mole) complicated by intrauterine growth retardation.We present here a case of massive subchorionic hematoma complicated by intrauterine growth retardation and oligohydramnios diagnosed at 22 weeks' gestation. The patient was managed with the following medications: (1) tocolysis with ritodrine infusion, (2) 10%maltose infusion therapy (1500mL/day), (3) antibiotic infusion (cefotaxim sodium, 2 g/dayx7) and (4) kampo therapy with Sairei-to until delivery. At 33 weeks and 0 days' gestation, a female baby weighing 1,342 g was delivered without complication by caesarean section. During surgery, an escape of about 500~600 g of dark brown blood with no clots was noted from the subchorionic space of the placenta. Examination of the placenta showed a large fibrosis with well-defined margins on the fetal surface.- - - - - - - - - - ranking = 1.1105069733514keywords = gestation (Clic here for more details about this article) |
7/77. An unusual cause of pelvic mass.BACKGROUND: pelvic pain with an associated pelvic mass is a common problem in the emergency room (ER) or physician's office. Concerns about ectopic pregnancy, infection, or malignancy usually dominate the diagnostic evaluation. At the same time, domestic violence as the cause of a pelvic mass is seldom suspected by physicians. CASE: A 38-year-old woman came to the ER with left lower quadrant pain and a left pelvic mass. After four hospital days and multiple diagnostic imaging studies, the diagnosis of hematoma caused by physical trauma to the abdomen was elucidated. CONCLUSION: Proper diagnosis of the cause of the pelvic mass could have been made earlier by careful attention to the social history and by recognizing the high incidence of domestic violence as opposed to the relative infrequency of some other diagnostic entities for which the patient was tested.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
8/77. Rectus sheath hematoma in pregnancy.Although spontaneous hemorrhage into the sheath of the rectus abdominis muscle is uncommon in pregnancy, rectus sheath hematomas (RSHs) should be considered in patients who present with an acute onset of abdominal pain in the latter half of pregnancy or the immediate postpartum period. Both sonography and CT are useful in diagnosing RSHs. We report a case of pregnancy-associated RSH initially suspected of being a degenerating leiomyoma or torsed ovary. Sonography showed a large mass of mixed echogenicity with no internal vascularity. CT confirmed that the lesion was suprafacial.- - - - - - - - - - ranking = 7keywords = pregnancy (Clic here for more details about this article) |
9/77. Hemorrhagic complication of anticoagulation during pregnancy in a woman with lupus anticoagulant.BACKGROUND: Lupus anticoagulant is an acquired antiphospholipid antibody that can increase greatly the risk of thromboembolism during pregnancy. Because a baseline elevated activated partial thromboplastin time (PTT) is associated frequently with this antibody, monitoring anticoagulant effect with activated PTT can be unreliable. CASE: A pregnant woman with lupus anticoagulant being treated with adjusted dose heparin experienced concurrent severe thrombotic and hemorrhagic complications. CONCLUSION: This case illustrates the pitfall of activated PTT monitoring when administering anticoagulation therapy to a patient with a baseline elevated activated PTT. We propose that heparin levels be used to monitor anticoagulation in these patients.- - - - - - - - - - ranking = 5keywords = pregnancy (Clic here for more details about this article) |
10/77. Successful laparoscopic treatment of a ruptured primary ovarian pregnancy.A 26-year-old woman had classic symptoms of primary ovarian pregnancy. Ultrasound examination disclosed a cystic mass surrounded by a complex mass that was compatible with hematoma in the pouch of Douglas, as well as an intrauterine device (IUD) displaced near the isthmic portion of the uterine cavity. laparoscopy revealed a ruptured gestational sac in the cul-de-sac that was encapsulated by a hematoma originating from the right ovary. All deep-seated products of conception were excised from the ovary, and the IUD was removed. Treatment was successful and avoided more invasive intervention.- - - - - - - - - - ranking = 5.5552534866757keywords = pregnancy, gestation (Clic here for more details about this article) |
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