Ovarian Fibroma Commonly Misdiagnosed as Uterine Leiomyoma.

Ovarian fibroma usually misdiagnosed preoperatively as uterine leiomyoma. A 36-year-old woman, presented with abdominal pain and vomiting, provisionally diagnosed as complicated ovarian cyst. The transvaginal ultrasound and Doppler showed left solid adnexal mass with preserved ovarian blood flow. Magnetic resonance imaging showed a well-defined solid mass in the left side of the pelvis, measuring 8 cm × 10 cm most probably subserous uterine leiomyoma. At laparotomy, the solid ovarian mass was originating from the left ovary, and the microscopic examination confirmed the diagnosis of the ovarian fibroma. This report represents the preoperative misdiagnosis of the ovarian fibromas and the conservative ovarian surgery for the ovarian fibromas and the importance of the follow-up for future fertility and/or recurrence of the fibromas in young women.

Delayed second twin delivery: benefits and risks.

BACKGROUND: An increasing number of reports describe the delayed second twin delivery for days, or weeks with good results in the majority of the cases, and different survival rate between centers, without reported randomized controlled trials (RCTs). OBJECTIVES: This study was designed to evaluate the suggested management of the delayed second twin delivery in the Sabah Maternity Hospital regarding its outcome, possible risks, and benefits. PATIENTS AND METHODS: Forty-seven twin pregnancies with preterm labor (PTL) of the first fetus between 20-30 weeks, and delayed delivery of the second twin were included in this study. Studied women signed informed consent about the possible risks of keeping the live fetus in the hostile intrauterine environment, and benefits of the prolonged gestation for the second twin. Throughout the conservative treatment of the second twin, the studied women were hospitalized with regular follow up for infections, consumptive coagulopathy parameters, and wellbeing of the second twin. RESULTS: There was significant difference in the gestational age at delivery between the first and second twin (22.6 ± 3.4 versus 34.3 ± 2.5 weeks; respectively, p = .01). There was significant difference in the birth weight between the first and second twin (435 ± 91.2 versus 1472 ± 61.5 g; respectively, p = .004). The rate of the cesarean delivery was significantly high during delivery of the second twin compared with the first twin (23.4% (11/47) versus 0% (0/47); respectively, p = .0001) with high survival rate for the second twin (85.1% (40/47)) after the delayed second twin delivery. CONCLUSIONS: The birth weight, the gestational age, and the survival rate of the studied second twin significantly increased after the suggested management of the delayed second twin delivery.