1/23. Heterotopic pregnancy with term delivery after rupture of a first-trimester tubal pregnancy. A case report.BACKGROUND: Because heterotopic pregnancy is rare, the presence of an intrauterine pregnancy tends to impede early diagnosis and definitive intervention for the ectopic component. Delay in diagnosing the condition and failure to proceed quickly with the requisite anesthesia and surgery can jeopardize both maternal well-being and survival of the intrauterine fetus. CASE: A patient with heterotopic pregnancy carried the intrauterine pregnancy to term following first-trimester rupture of the tubal pregnancy, with hypovolemic shock. CONCLUSION: Prompt diagnosis, rapid fluid and blood resuscitation, heart-sparing anesthesia and gentle, expeditious surgery collectively contributed to the favorable outcome for the mother and surviving infant.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/23. Hypovolaemic shock.Measured blood loss up to 1000 ml is well tolerated by healthy pregnant women. This is partly due to physiological increases in plasma volume and red cell mass during pregnancy. Nevertheless, hypovolaemic shock is a major cause of maternal mortality. Management requires teamwork, co-ordination, speed and adequate facilities to be life-saving. The first priority is rapid fluid replacement. Evidence from randomized trials has established that crystalloids are the fluids of choice over colloids and particularly albumen, which was associated with increased mortality. Rapid access to blood or blood products for transfusion is necessary, as well as laboratory back-up. Further management includes accurate assessment of the site of bleeding; control of the bleeding; diagnosis and management of the underlying condition; supportive therapy; and monitoring of the clinical, haematological and biochemical response to treatment. Bedside diagnostic ultrasound has several applications in the evaluation of obstetric hypovolaemic shock.- - - - - - - - - - ranking = 0.076923076923077keywords = pregnancy (Clic here for more details about this article) |
3/23. Primary splenic pregnancy. A case report.BACKGROUND: Ectopic pregnancy in the upper abdominal organs is very rare but has been known to occur in the liver, spleen and lesser sac. Primary splenic pregnancy is considered the rarest form of extrauterine pregnancy, with only few well-documented cases reported. CASE: Intraperitoneal bleeding and shock resulted from a primary splenic pregnancy in a 37-year-old woman. CONCLUSION: Primary splenic pregnancy usually presents with upper left abdominal pain and intraperitoneal bleeding. It requires an emergency splenectomy and should be considered in the differential diagnosis of acute abdomen in reproductive-age women.- - - - - - - - - - ranking = 0.69230769230769keywords = pregnancy (Clic here for more details about this article) |
4/23. Extensive hepatic necrosis in a premature infant.A fatal case of fulminant hepatic failure that occurred in the neonatal period is reported in a premature infant born after 27 4/7-weeks' gestation. Immediately after birth the infant had severe hypoxia and hypotension resulting from birth asphyxia, hypovolemic shock, and septicemia. At autopsy, histological appearance of the liver showed virtually total hepatocellular necrosis without features of fibrosis. Although the exact cause of hepatocellular injury cannot be fully ascertained, it is assumed that hypoxia and hypotension must have been the predominant factors leading to massive hepatic necrosis.- - - - - - - - - - ranking = 0.01170441778176keywords = gestation (Clic here for more details about this article) |
5/23. Delivery related rupture of the gravid uterus: imaging findings.Rupture of the gravid uterus is a rare, life-threatening obstetric complication. Major symptoms are hypovolemic shock and abdominal pain during late pregnancy or after vaginal delivery. Immediate surgical therapy is required. We report a case of uterine rupture after vaginal delivery diagnosed by means of ultrasonography and computed tomography.- - - - - - - - - - ranking = 0.076923076923077keywords = pregnancy (Clic here for more details about this article) |
6/23. Postcoital haemoperitoneum: a cause for shock.Postcoital haemoperitoneum rarely occurs without evident vaginal injury. A 21-year-old second gravida woman presented to the ED in shock with a history of 8 weeks amenorrhoea and abdominal pain of 20 h duration. The ultrasound examination revealed a live intrauterine pregnancy and fluid in peritoneal cavity. There was a history of coitus 2 hours prior to the onset of pain. At laparotomy, more than 2 L of free blood was found in the peritoneal cavity. A small bleeding peritoneal vessel in pouch of Douglas was identified and ligated.- - - - - - - - - - ranking = 0.076923076923077keywords = pregnancy (Clic here for more details about this article) |
7/23. Spontaneous midtrimester uterine rupture: a case report.BACKGROUND: Spontaneous mid trimester rupture of the uterus is uncommon. AIM: To report a case of spontaneous mid trimester uterine rupture in a patient with a previous caesarean section scar. METHOD: A review of the case record of a patient managed for spontaneous mid-trimester uterine rupture and the relevant literature. RESULTS: A 30-year old unbooked gravida 6, para 1( 4) house wife with a previous caesarean section scar presented with features of an acute surgical abdomen with hypovolaemic shock at 24 weeks gestation. She had an emergency laparotomy at which she was noted to have a uterine rupture. She had a repair of the uterus and bilateral tubal ligation. Her post operative state was uneventful. CONCLUSION: There should be a high index of suspicion of uterine rupture in a gravid woman with a previous uterine scar presenting with abdominal pain and shock.- - - - - - - - - - ranking = 0.01170441778176keywords = gestation (Clic here for more details about this article) |
8/23. Low-energy radiofrequency catheter ablation as therapy for supraventricular tachycardia in a premature neonate.A premature neonate with hydrops was born at 32 weeks of gestation after successful direct fetal amiodarone therapy via cordocentesis for incessant supraventricular tachycardia. After birth the tachycardia could not be controlled despite high doses of amiodarone and flecainide and the patient developed severe respiratory and circulatory failure. After 3 weeks, weighing 2 kg, he underwent successful and uncomplicated catheter ablation of a left free-wall accessory pathway using low-energy radiofrequency. Conclusion:radiofrequency catheter ablation is rarely used in neonates, but when used with caution may provide the optimal treatment.- - - - - - - - - - ranking = 0.01170441778176keywords = gestation (Clic here for more details about this article) |
9/23. A case report of an extremely low birthweight infant with circulatory collapse accompanied by cerebral infarction after the acute period.A male infant (gestational age, 26 weeks and 1 day; birthweight, 752 g) was treated for respiratory distress syndrome and thereafter required mechanical ventilation due to chronic pulmonary insufficiency. On the 34th day after birth, urine volume suddenly decreased and hypotension, oliguria, and generalized edema developed. Laboratory studies revealed rapid progression of severe hyponatremia and hyperkalemia. Although hypovolemic shock was suspected, the patient did not respond to conventional treatment of volume expansion and inotropic support. Only treatment with glucocorticoids was effective. Two weeks later, cranial ultrasonography revealed multiple, right-sided, cystic lesions that were subsequently diagnosed as cerebral infarction by magnetic resonance imaging. Several cases of extremely low birthweight infants with circulatory collapse after the acute period have been described recently, but the cause has been unclear. There has been no previous report of a case accompanied by cerebral infarction.- - - - - - - - - - ranking = 0.01170441778176keywords = gestation (Clic here for more details about this article) |
10/23. Postpartum hemoperitoneum due to avulsion of pelvic uterine adhesion band.A 31-year-old nulliparous woman presented in labor with preterm rupture of membranes at 35 weeks of gestation. The ensuing intrapartum course was uneventful, and she delivered a healthy infant (birth weight, 2,850 g) vaginally. Four hours after delivery, the patient had a syncopal episode due to hypovolemic shock. At laparotomy, a fibrous band between the right fallopian tube and uterus was found to be avulsed and actively bleeding, confirming preoperative findings obtained with multidetector row computed tomographic angiography.- - - - - - - - - - ranking = 0.01170441778176keywords = gestation (Clic here for more details about this article) |
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