Cases reported "Ovarian Diseases"

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1/66. broad ligament twin pregnancy following in-vitro fertilization.

    We report the first case of an ectopic twin pregnancy in the broad ligament following in-vitro fertilization and embryo transfer in a patient with a previous ipsilateral (left) salpingo-oophorectomy. The previous surgery was for endometriosis. We discuss the possible contribution of the embryo transfer technique, limitations of preventive measures and importance of transvaginal ultrasound in establishing the diagnosis.
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ranking = 1
keywords = pregnancy
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2/66. Ruptured tuboovarian abscess in late pregnancy. A case report.

    BACKGROUND: Tuboovarian abscess is an unusual obstetric complication that causes maternal and fetal morbidity and mortality. CASE: A woman, G1, P0, with a 32-week pregnancy presented with abdominal pain. physical examination on admission revealed fever and unremarkable abdominal signs. Eleven hours after admission, signs of peritonitis became prominent, necessitating emergency laparotomy. Surgical findings included an 8-cm, right, ruptured tuboovarian abscess with massive purulent contamination of the abdominal cavity. Cesarean hysterectomy with bilateral salpingo-oophorectomy was performed. Neither the newborn nor the mother had postoperative complications. CONCLUSION: Since there are discrepancies in the incidences of tuboovarian abscess in pregnant and nonpregnant groups, the pathogenesis of tuboovarian abscess may be different in the two populations. In pregnancy, diagnosis and management are also more difficult than in the nonpregnant state. Clinical data may not reveal the diagnosis until surgery is mandatory. Because most pregnant women with tuboovarian abscesses are young, conservative surgery should be attempted if the pathology is limited to only one side of the adnexa and further reproduction is desired.
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ranking = 1.2
keywords = pregnancy
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3/66. Pelvic abscess in the second half of pregnancy after oocyte retrieval for in-vitro fertilization: case report.

    We describe a very late manifestation of pelvic abscesses after oocyte retrieval for in-vitro fertilization (IVF). In a twin pregnancy achieved after intracytoplasmic sperm injection, rupture of bilateral ovarian abscesses occurred at the end of the second trimester. An emergency laparotomy was necessary because of an acute abdomen. This complication led to severe maternal and neonatal morbidity, preterm birth and neonatal death. The rare occurrence of acute abdomen in pregnancy due to pelvic infection and the non-specific symptoms of a pelvic abscess after oocyte retrieval for IVF are discussed.
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ranking = 1.2
keywords = pregnancy
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4/66. Ovarian abscess and heterotopic triplet pregnancy: two complications after IVF in one patient.

    A patient is reported, who suffered from ovarian abscess after ovarian puncture of a functional ovarian cyst. The cyst has developed after administration of a GnRH agonist depot preparation in the preceeding luteal phase. She was planned to be stimulated for IVF according to the long luteal protocol. The abscess was removed by laparoscopy. and stimulation started two months later after administration of two further GnRH against depot preparations. The patient got pregnant after embryo transfer of three embryos. and a heterotopic triplet pregnancy, with intrauterine twins and a tubal singleton was established. Bilateral salpingectomy was performed, because of bilateral haematosalpinx and previously described bilateral tubal occlusion. The further pregnancy was uncomplicated.
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ranking = 1.2
keywords = pregnancy
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5/66. Reduction of ovarian torsion 1 week after embryo transfer in a patient with bilateral hyperstimulated ovaries.

    OBJECTIVE: To report a rare case of unilateral ovarian torsion 1 week after embryo transfer in a patient with bilateral hyperstimulated ovaries. DESIGN: Case report and literature review. SETTING: Reproductive Endocrine division in a university teaching hospital. PATIENT(S): infertility patients undergoing IVF-ET. INTERVENTION(S): Laparoscopic reduction of adnexa 1 week after ET. MAIN OUTCOME MEASURE(S): Successful preservation of the affected adnexa. RESULT(S): Delivery of 3.324 kg male infant with preservation of the affected ovary. CONCLUSION(S): Untwisting of the affected ovary at laparoscopy without aspiration reduction of cystic masses is appropriate. The outcome of the pregnancy (even very early) in patients with torsion of the adnexa may be favorable after a laparoscopic unwinding of the affected adnexa.
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ranking = 0.2
keywords = pregnancy
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6/66. 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.
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ranking = 1.4
keywords = pregnancy
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7/66. Laparoscopic unwinding and cystectomy of twisted dermoid cyst during second trimester of pregnancy.

    A woman in the sixteenth week of pregnancy experienced acute abdominal pain, and magnetic resonance imaging suggested a dermoid cyst. Laparoscopic unwinding and cystectomy of the twisted cyst was performed successfully.
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ranking = 1
keywords = pregnancy
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8/66. Ovarian granulosa cell 'tumorlet' and mature follicles with ectopic decidua in pregnancy--a case report.

    Non-neoplastic, tumor like lesions are encountered in the ovaries during pregnancy. Of these pregnancy luteoma is the most common lesion mimicking an ovarian neoplasm. Ovarian granulosa cell proliferations are also reported in the ovaries removed during pregnancy as an incidental finding. The granulosa cell proliferation occurs due to the follicular stimulating hormone (FSH) like activity of human chorionic gonadotropin (hCG). We report a case of second gravida who developed uterine atonia, necessitating emergency hysterectomy. Right ovary showed extensive ectopic decidua, numerous well-formed follicles and granulosa cell tumor-like proliferation. Usually follicles are not formed in the ovaries during pregnancy. The same FSH like activity of hCG might have been responsible for the formation and maturation of follicles in this case.
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ranking = 1.6
keywords = pregnancy
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9/66. Unruptured pelvic abscesses in pregnancy: report of two cases.

    Pelvic abscess is a rare entity in pregnancy. The true etiology is uncertain but a flare-up of an old pelvic inflammatory disease is most likely. Usually, these patients undergo laparotomy and these abscesses are discovered incidentally, as described in our series. Surgical drainage and conservative surgical procedures under antibiotics are recommended during pregnancy albeit there is no consensus on patient management. Through this report, we aim to discuss this clinical entity and to underline the importance of patient management in case of its diagnosis.
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ranking = 1.2
keywords = pregnancy
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10/66. Markedly elevated beta-hCG levels in a normal singleton gestation with hyperreactio luteinalis.

    BACKGROUND: Human chorionic gonadotropin (hCG) is produced by the trophoblast early in pregnancy and peaks at a level of approximately 100,000 IU/liter around the ninth week of gestation. Abnormally high levels are usually noted in association with multiple gestation, molar gestation, and specific ovarian or gestational malignancies. CASES: A multiparous patient in the second trimester was referred for evaluation after a maternal triple marker screen was incalculable due to a beta-hCG level of 2.1 million IU/L. Targeted sonography revealed bilateral complex adnexal masses with a solid component of the left ovary, a normal fetus, and normal placenta. The patient underwent an exploratory laparotomy at 18 weeks' gestational age. A left oophorectomy was performed. pathology confirmed hyperreactio luteinalis. The remainder of the pregnancy was remarkable for preterm labor and delivery at 35 weeks' gestational age. At delivery, the hCG level was noted to be 24,210 IU/L, and the fetus and placenta were normal. CONCLUSION: Markedly elevated hCG levels rarely occur in normal singleton pregnancy and can be associated with hyperreactio luteinalis. When noted, a work-up to evaluate possible malignancy, molar gestation, and multiple gestation should be pursued.
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ranking = 0.8511813824861
keywords = pregnancy, gestation
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