RESUMO
BACKGROUND: The diagnosis and management of meningioma during pregnancy is challenging, and a multidisciplinary approach is warranted. We present a case of meningioma during pregnancy with one year of follow-up. CASE: A 37-year-old, Caucasian female who presented at 28 weeks' gestation with meningioma was managed conservatively until 31.4 weeks' gestation. Worsening symptoms prompted cesarean delivery. Nine days after childbirth a craniotomy was performed due to worsening of her symptoms. Subsequent treatment included proton therapy with dramatic results. CONCLUSION: The diagnosis of meningioma during pregnancy represents a challenge, with growth and regression both reported.
Assuntos
Neoplasias Meníngeas/diagnóstico , Meningioma/diagnóstico , Complicações Neoplásicas na Gravidez/diagnóstico , Adulto , Cesárea , Craniotomia , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Imageamento por Ressonância Magnética , Masculino , Neoplasias Meníngeas/patologia , Neoplasias Meníngeas/cirurgia , Meningioma/patologia , Meningioma/cirurgia , Gravidez , Complicações Neoplásicas na Gravidez/patologia , Complicações Neoplásicas na Gravidez/cirurgia , Terapia com PrótonsRESUMO
Second trimester pregnancy loss and preterm delivery may be considered an obstetrical syndrome. A multifactorial approach to the diagnosis of true cervical insufficiency is paramount. Surgical modification of the cervix benefits those with at least 3 second trimester losses or preterm deliveries, those with 2 early second trimester losses when no other cause for loss is identified, and those with a previous second trimester loss or preterm birth with ultrasound findings of a short cervix defined as less than 25 mm. Multifetal pregnancies do not benefit from cerclage and causes harm in those with ultrasound or physical examination identified cervical changes.
Assuntos
Cerclagem Cervical , Aborto Habitual , Cerclagem Cervical/métodos , Colo do Útero/anormalidades , Colo do Útero/diagnóstico por imagem , Colo do Útero/cirurgia , Feminino , Ruptura Prematura de Membranas Fetais , Humanos , Exame Físico , Gravidez , Resultado da Gravidez , Segundo Trimestre da Gravidez , Nascimento Prematuro/prevenção & controle , Ultrassonografia , Incompetência do Colo do Útero/diagnóstico por imagem , Incompetência do Colo do Útero/cirurgiaRESUMO
OBJECTIVE: The purpose of this study was to assess the outcome after transabdominal-cerclage placement during pregnancy in women with previous unsuccessful transvaginal cerclage. STUDY DESIGN: We conducted a retrospective case series that described pregnancy outcome in women who were treated with transabdominal cerclage between 1994 and 2006. RESULTS: Seventy-five women with negative evaluation for recurrent pregnancy loss and > or = 1 previous unsuccessful transvaginal cerclage procedures were treated with transabdominal cerclage. The median gestational age at the time of cerclage placement was 13 weeks, and the median gestational age at delivery was 36 weeks. Seventy-two women delivered after 24 weeks of gestation, and 3 women delivered < or = 24 weeks of gestation. The fetal-salvage after transabdominal cerclage was 96%. CONCLUSION: Our findings suggest that, in women with a history of > or = 1 failed transvaginal cerclage, transabdominal cerclage is an effective procedure.