11/118. Hypofibrinogenaemia with compound heterozygosity for two gamma chain mutations - gamma 82 Ala-->Gly and an intron two GT-->AT splice site mutation.We investigated the molecular basis of hypofibrinogenaemia in a woman with a history of recurrent, pregnancy-associated bleeding, and miscarriage. She had a Clauss fibrinogen of 0.9 mg/ml and SDS PAGE of purified fibrinogen showed a normal pattern of chains. However careful inspection of reverse phase chain separation profiles showed apparent homozygosity for a more hydrophilic form of the gamma chain. dna Sequencing showed only heterozygosity for a CGT-->GGT (Ala-->Gly) mutation at codon gamma82, but further sequencing showed an additional GT splice sequence mutation at the 5' end of intron 2 of the gamma gene. Translation of mRNA containing this intron would result in premature truncation explaining the phenotypic homozygosity of the gamma82 Ala-->Gly substitution. The patient's sister had a mild bleeding disorder with hypofibrinogenaemia and she too was a compound heterozygote for the y mutations. Her nephew had only the novel splice site mutation, while her mother and daughter inherited only the gamma82 Ala-->Gly substitution.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
12/118. Tubal pregnancy: a report of a very early luminal form of imbedding.A specimen of a very early ovum, 4 to 6 days old, shown in the luminal form of imbedding before any hemorrhage has taken place, confirms that the luminal form of imbedding does occur. This case probably represents the earliest tubal pregnancy reported.- - - - - - - - - - ranking = 5keywords = pregnancy (Clic here for more details about this article) |
13/118. Combined intrauterine and extrauterine gestation. A rare cause of acute abdominal pain.This is the report of a patient, that had without using any assisted reproduction technology (ART) the rare event of a heterotopic pregnancy. After verifying the intrauterine pregnancy by ultrasound, the ectopic tubal pregnancy (EP) was detected at an emergency abdominal surgery as the cause of an intraabdominal hemorrhage. After removal the further pregnancy was uncomplicated.- - - - - - - - - - ranking = 5.2319381432857keywords = pregnancy, gestation (Clic here for more details about this article) |
14/118. 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) |
15/118. Massive acute thymic haemorrhage and cerebral haemorrhage in an intrauterine fetal death.Massive acute thymic haemorrhage in the neonate occurs extremely rarely and is associated with haemorrhagic disease of the newborn. A 30 year old woman with an unremarkable previous obstetric history presenting at 37 weeks and 4 days gestation with the complaint of loss of fetal movement was found to have a male fetus with findings at necropsy of massive acute thymic haemorrhage, acute intracranial haemorrhage, and hydrops fetalis. This is the first report of massive acute thymic haemorrhage in utero. Massive thymic haemorrhage should be added to the reported causes of lethal non-immunological hydrops.- - - - - - - - - - ranking = 0.30798453582143keywords = gestation (Clic here for more details about this article) |
16/118. Severe abdominal bleeding 51 days after laparoscopic salpingostomy for ectopic pregnancy: a case report.Conservative management of ectopic pregnancy is important because it allows preservation of the fallopian tube. It has been reported to result in extratubal secondary trophoblastic implants (ESTI) in 3% to 22% of cases. The aim of this case report is to highlight the factors predicting the risk of ESTI.- - - - - - - - - - ranking = 5keywords = pregnancy (Clic here for more details about this article) |
17/118. Diagnostic and therapeutic dilemma with large prenatally detected cystic adrenal masses.OBJECTIVES: The prenatal finding of a large cystic adrenal mass raises the dilemma of the differential diagnosis between adrenal hemorrhage and cystic neuroblastoma. The possibility of a neuroblastoma usually leads to surgical excision of such tumors. Nevertheless, an adrenal hemorrhage has to be recognized, so that unnecessary surgery may be avoided. methods: Three cases of large prenatally detected adrenal masses managed nonoperatively are reported. Data studied were: age at the diagnosis, prenatal and postnatal ultrasonographic consistency, and tumor marker levels. Size and sonographic evolution were also studied. RESULTS: In all 3 cases, a cystic mass, measuring more than 40 mm in size, was detected during the 3rd trimester of pregnancy. The sonographic appearance evolved from a sonolucent tumor to a heterogeneous mass with hyperechoic areas. The tumor marker levels were normal. All infants had a documented decrease in mass size at birth and were managed nonoperatively. All these tumors were considered adrenal hemorrhages. CONCLUSIONS: Prenatal ultrasonography rarely permits to distinguish an adrenal hemorrhage from a cystic neuroblastoma. The differential diagnosis, even in large masses, is based on close postnatal follow-up with serial sonography. Surgery is not mandatory, unless the size does not decrease. However, without pathologic proof, it is not possible to differentiate an adrenal hemorrhage from a spontaneously resolved neuroblastoma.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
18/118. Anaesthetic management of splenectomy in Evan's syndrome during pregnancy with pregnancy induced hypertension.The management of idiopathic thrombocytopenic purpura (ITP) during pregnancy, especially with ongoing bleeding diathesis, has not been highlighted sufficiently in the literature. Aortocaval compression and reduction in uteroplacental circulation resulting in foetal hypoxia and acidosis, Mendelson's syndrome due to gravid uterus, trauma to airway with resultant haemorrhage and aspiration into lungs, compromised airway due to short neck, anasarca and heavy breast, limitation in using invasive monitoring and regional anaesthesia and uncontrolled bleeding leading to placental hypoperfusion and foetal hypoxia are some of the important risks. In the present case report, anaesthetic management for splenectomy during pregnancy complicated with pregnancy induced hypertension and bleeding diathesis secondary to ITP is described with reference to above risks.- - - - - - - - - - ranking = 11keywords = pregnancy (Clic here for more details about this article) |
19/118. Red degeneration of a leiomyoma masquerading as retained products of conception.BACKGROUND: The incidence of leiomyomas in pregnancy is approximately 1%. Their presence has been linked to spontaneous abortion, premature labor, soft tissue dystocia, uterine inertia, fetopelvic disproportion, malposition of the fetus, retention of the placenta, and postpartum hemorrhage. CASE: This case report documents a seldom-described event of a submucous leiomyoma masquerading as retained products of conception. The patient presented 4 weeks postpartum with complaints of urinary retention and heavy bleeding with cramping. Examination revealed a large mass resembling placental tissue filling the vaginal vault. The necrotic mass was removed with blunt and sharp dissection. The final pathology report revealed a degenerating leiomyoma. CONCLUSION: Complicating factors associated with this fibroid included a history of spontaneous abortion and preterm labor, as well as fetal malpresentation and carneous degeneration of the leiomyoma. Gestational myomas, although rare, can have an unusual appearance that may be misinterpreted.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
20/118. Fetal axillary hemangiolymphangioma with secondary intralesional bleeding: serial ultrasound findings.A case of fetal axillary hemangiolymphangioma coexisting with intralesional hemorrhage is presented. At 27 weeks' gestation, the fetus was found to have a 52 x 43-mm left axillary multilocular cystic mass which showed no signals on color Doppler. The mass was composed mostly of sonolucent spaces. At 29 weeks' gestation, an arterial flow signal (15 cm/s) was detected within the mass. In addition, two low-density echogenic cystic spaces with bidirectional flow waveforms were found, which raised the suspicion of intratumoral bleeding. Two weeks later, a fine-needle aspiration of the mass revealed both straw-colored and chocolate-colored fluid. The tumor size increased from 52 x 43 mm at 27 weeks to 100 x 79 mm at 37 weeks. blood clots developed gradually in the hemorrhagic spaces. The pregnancy proceeded smoothly to term and at 38 weeks an elective cesarean section was performed. After a surgical excision of the mass at the age of 4 days, a mixed cavernous hemangioma and cystic lymphangioma with secondary intralesional hemorrhage was confirmed histopathologically.- - - - - - - - - - ranking = 1.6159690716429keywords = pregnancy, gestation (Clic here for more details about this article) |
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