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1.
Eur J Obstet Gynecol Reprod Biol ; 299: 124-130, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38852318

RESUMO

BACKGROUND: Vestibular schwannomas - benign tumours originating from the vestibular nerve - are rare during pregnancy. The intricate interplay between the gravid uterus, maternal physiology and neoplastic growth imposes complexities that demand a careful and tailored approach. CASE REPORT: This article reports a case of a pregnant woman in her 30 s diagnosed with a large vestibular schwannoma exhibiting brainstem compression, peritumoral oedema and cranial nerve encasement at 36 + 5 weeks of gestation. A multi-disciplinary team collaborated to devise a treatment plan considering the delicate balance between fetal well-being and the urgent need for intervention. A conservative approach involving close monitoring, corticosteroid therapy to manage peritumoral oedema, and detailed fetal assessments was initially employed. As the patient neared full term, a carefully planned caesarean section was performed, followed by a successful craniotomy to resect the vestibular schwannoma. Both the mother and the newborn showed favourable outcomes postoperatively. In addition, a literature review of cases of vestibular schwannoma in pregnancy was undertaken to inform optimal management strategies and enhance understanding of this complex scenario. CONCLUSION: This case highlights the complexity of managing vestibular schwannomas in pregnant women, and underscores the importance of a tailored, collaborative approach. The condition was resolved successfully, emphasizing the significance of timely diagnosis, meticulous planning and a patient-centred approach in these rare and intricate cases.


Assuntos
Neuroma Acústico , Complicações Neoplásicas na Gravidez , Humanos , Feminino , Gravidez , Neuroma Acústico/cirurgia , Complicações Neoplásicas na Gravidez/cirurgia , Complicações Neoplásicas na Gravidez/diagnóstico , Adulto , Cesárea
2.
Heliyon ; 10(5): e27158, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38455545

RESUMO

Background: Women experiencing domestic violence might have restrictions in the pregnancy-related decision-making and care-seeking process leading to adverse pregnancy outcomes. We explored the association between domestic violence and undesirable pregnancy events. Methods: 63,796 women aged 18-49 years covered under the domestic violence module of National Family Health Survey-5, 2019-21. Stratification and clustering in the complex sampling design of the survey were accounted in analysis. Using Poisson regression, prevalence ratio (PR) was reported to provide association of domestic violence with undesirable pregnancy events. Results: Prevalence of undesirable pregnancy events was 25.0% (95%CI: 24.4%-25.7%) amongst women aged 18-49 years. Prevalence of unintended, terminated pregnancy and complications during pregnancy was 3.2%, 5.1% and 20.9%, respectively. Women aged ≥35 years, educated, unemployed, primi or multi parity, intimate partner/husband being uneducated, facing problem with access to healthcare, belonging to large number of household members (≥4) and poorest or poorer quintile had significantly higher chance of having undesirable pregnancy events. Sexual violence (aPR: 1.11, p = 0.02) had higher chance of having undesirable pregnancy events. Conclusion: One-fourth of reproductive-age group women had undesirable pregnancy events. Sexual violence was significantly associated with these events. Effective policy should protect women from domestic violence to promote maternal well-being.

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