1/42. Focal aneurysmal dilatation of subchorionic vessels simulating chorioangioma.Subchorionic vascular aneurysms of the placenta are rare lesions and may present confusion with chorioangioma or focal mesenchymal dysplasia on sonography. To our knowledge, the findings of placental aneurysms have not been reported in the ultrasound literature. We present a case with detailed sonographic evaluation, including spectral and color Doppler and pathological analysis, that was mistaken for chorioangioma prenatally. knowledge of this benign entity may allow the sonologist to recommend conservative management in similar cases.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/42. Diffuse alveolar hemorrhage and pulmonary capillaritis due to propylthiouracil.propylthiouracil (PTU) has recently been observed to be associated with antineutrophil cytoplasmic antibody (ANCA)-positive small vessel vasculitis, resulting in crescentic glomerulonephritis and, infrequently, diffuse alveolar hemorrhage (DAH). We describe a case of a 23-year-old pregnant woman who developed a perinuclear ANCA and antimyeloperoxidase-positive small vessel vasculitis manifesting as DAH and crescentic glomerulonephritis after she began taking PTU. An open lung biopsy was consistent with pulmonary capillaritis. She responded to corticosteroid therapy and discontinuation of PTU. DAH can be caused by pulmonary capillaritis, bland hemorrhage, or diffuse alveolar damage. To our knowledge, this represents the first documentation of an underlying pulmonary capillaritis in a case of PTU-induced DAH.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
3/42. Hemorrhagic moyamoya disease during pregnancy.BACKGROUND: Intracranial hemorrhage in pregnant patients with moyamoya disease is rare. We review the case of one such patient who presented with pre-eclampsia and a catastrophic intracerebral hemorrhage in order to highlight the associated management difficulties. methods: A case of a pregnant (31 weeks) female brought to the emergency department with hypertension and a progressive decrease in her level of consciousness is presented. She rapidly developed a dilated right pupil and left extensor posturing. A CT scan of her head showed a large putamenal intracerebral hemorrhage. She was intubated, ventilated and given intravenous mannitol and magnesium sulfate. She underwent a simultaneous craniotomy and cesarean section. Post-operatively the patient's ICP and jugular venous saturation were monitored in the intensive care unit. RESULTS: The patient delivered a 1185 g infant who did well. The patient's ICP was well controlled until the tenth post-operative day when she developed malignant brain edema and died. CONCLUSION: This case highlights three important points. First, simultaneous craniotomy and cesarean section can be performed. Second, intraoperative control of bleeding Moyamoya vessels is described. Third, the difficult post-operative management of these cases is highlighted. The literature regarding moyamoya disease and pregnancy is reviewed and some recommendations for the management of this rare but potentially deadly condition are presented.- - - - - - - - - - ranking = 0.25keywords = vessel (Clic here for more details about this article) |
4/42. Epidural anaesthesia for caesarean section in a patient with severe Takayasu's disease.Takayasu's arteritis or disease is a rare, idiopathic, chronic inflammatory disease which causes narrowing, occlusion or aneurysms of blood vessels. It preferentially affects large arteries such as the aorta and its branches and hence its alternative names of pulseless disease, occlusive thromboaortopathy or aortic arch syndrome. Although most commonly found in oriental women, it occurs sporadically throughout the world. We present the case of an elderly primigravida with long-standing Takayasu's disease complicated by hospital and needle phobia who underwent a successful Caesarean section under epidural anaesthesia. Her management is discussed in the light of current opinion regarding pregnancy and Takayasu's disease.- - - - - - - - - - ranking = 0.25keywords = vessel (Clic here for more details about this article) |
5/42. vasa previa: prenatal detection by three-dimensional ultrasonography.OBJECTIVE: To describe three-dimensional (3D) ultrasonography (US) for the antepartum diagnosis of vasa previa. DESIGN: This was a descriptive study of two pregnant women who were suspected to have vasa previa by conventional gray-scale ultrasonography. Three-dimensional studies were also performed during the early third trimester to further investigate the possibility of this condition. RESULTS: In the first case, 3D US provided gray-scale multiplanar and surface-rendered views of an aberrant vessel over the internal cervical os. For the second case, a 'flight-path' technique allowed the examiner to follow axial views of the endocervical canal toward the internal os until an aberrant vessel was verified. The 'niche-mode' analysis, with and without color power Doppler ultrasonography, was also used to confirm the diagnosis. CONCLUSION: Three-dimensional ultrasonography offers several additional imaging tools that are not currently provided by more conventional ultrasonography for the detection of vasa previa. It represents an important adjunct to two-dimensional (2D) studies, especially when this diagnosis is questionable.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
6/42. Schonlein-Henoch purpura during pregnancy with successful outcome for mother and newborn.BACKGROUND: Schonlein-Henoch purpura is a systemic vasculitis that affects vessels of a small caliber and rarely reported in the literature. CASE PRESENTATION: We report on a 35-year-old woman who developed palpable purpura with necrotizing cutaneous lesions on the lower limbs at 27 weeks of gestation. She also complained of epigastric pain and arthralgias. Histologic examination of a skin biopsy showed leukocytoclastic vasculitis with intravascular fibrin thrombi. The direct immunofluorescence analysis evidenced vascular deposits of IgA and C3 in the upper and mid-dermis. These findings were consistent with Schonlein-Henoch purpura. There was no evidence of renal involvement or placental dysfunction. The patient was treated with low-dose oral corticosteroids and a healthy infant was delivered by cesarean section. Examination of the placenta and the navel string disclosed no signs of vasculitis or infarction. CONCLUSION: Schonlein-Henoch purpura is rarely reported in pregnancy. Treatment with orally administered corticosteroids may lead to a beneficial outcome for mother and newborn.- - - - - - - - - - ranking = 0.25keywords = vessel (Clic here for more details about this article) |
7/42. Asymptomatic coronary artery disease in a pregnant patient. A case report and review of literature.BACKGROUND: Acute myocardial infarction during pregnancy has been reported and has been shown to be associated with poor maternal and fetal outcomes. However, the vast majority of these patients do not have previously recognized ischemic heart disease. pregnancy and delivery pose significant cardiac stress and risk to the mother and fetus. However, it is unknown how available therapies can be utilized in the pregnant patient with identified ischemic heart disease to minimize these risks. CASE REPORT: We present a 39-year-old asymptomatic diabetic female with a positive stress echocardiogram at 16 weeks of pregnancy who remained asymptomatic throughout pregnancy with medical management and went on to have a normal vaginal delivery in the process suffering a small non-ST elevation myocardial infarction with pulmonary edema following delivery due to volume overload. She ultimately underwent cardiac catheterization and successful four-vessel CABG 1 months after her delivery. CONCLUSION: We present this patient to suggest a successful strategy of managing a patient with non-revascularized asymptomatic coronary artery disease during pregnancy. In addition to reviewing the appropriate medical therapy during pregnancy, we discuss the data on revascularization procedures as well as recommendations for delivery and stress testing for such patients.- - - - - - - - - - ranking = 0.25keywords = vessel (Clic here for more details about this article) |
8/42. Spontaneous rupture of ovarian artery aneurysm in the puerperium. Two case reports and a review of the literature.A case of spontaneous puerperal rupture of an aneurysm of a branch of the right ovarian artery is reported and the histological and histochemical changes in the vessel wall are described. Identical changes were also seen in a similar case, previously reported. Some of the factors involved in the pathogenesis of these unusual vascular lesions are discussed.- - - - - - - - - - ranking = 0.25keywords = vessel (Clic here for more details about this article) |
9/42. An unusual cause of hypertension in pregnancy.aortic coarctation is an unusual cause of hypertension in pregnancy. We report the case of a 34-year-old woman with severe hypertension after surgical repair of aortic coarctation in childhood. An MRI showed a residual stenosis of the aortic arch and a small aneurysm. Pregnant postcoarctectomy patients are at an increased risk for developing hypertension during pregnancy due to residual aortic gradients and abnormal vascular reactivity of the precoarctation vessels. Women after repair of aortic coarctation should be closely monitored for blood pressure during pregnancy.- - - - - - - - - - ranking = 0.25keywords = vessel (Clic here for more details about this article) |
10/42. Spontaneous rupture of the uterine vessels in pregnancy.BACKGROUND: hemoperitoneum resulting from spontaneous rupture of the uterine vessels in pregnancy is rare and associated with high maternal and fetal mortality. CASE: A woman presented with acute abdominal pain and hypovolemic shock at 20 weeks of gestation. Immediate laparotomy revealed massive hemoperitoneum resulting from spontaneous rupture of the left uterine vessels associated with a left adnexal mass consisting of decidualized endometriosis. The fetus was delivered by hysterotomy, hemostasis was achieved, and the woman made a good recovery. CONCLUSION: We report a case of hemoperitoneum in pregnancy that resulted from spontaneous rupture of the uterine vessels associated with decidualized endometriosis.- - - - - - - - - - ranking = 1.75keywords = vessel (Clic here for more details about this article) |
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