Pelvic actinomycosis presenting as a single episode of postmenopausal bleeding in a 60-year-old woman whose intrauterine contraceptive device had been removed 10 years previously: A case report.

Actinomycosis is a rare opportunistic infection caused by Actinomyces bacteria entering tissue through a disruption in the normal mucosal barrier and spreading in a slow, progressive manner. Patients often present with mass lesions and abscesses which mimic malignancy. We present the case of a 60-year-old postmenopausal woman who presented with a single episode of spotting with no other symptoms. On hysteroscopic examination no abnormalities were found and Actinomyces spp. were cultured from an endometrial biopsy. The patient had last used an intrauterine contraceptive device (IUCD) 10 years previously; it had been removed at menopause. This is a rare presentation that highlights that pelvic actinomycosis can be precipitated by factors other than IUCD use. Biopsy is important, as ultrasound is not diagnostic.

Ehlers-Danlos Syndrome in Pregnancy: A Review.

Ehlers-Danlos syndrome (EDS) is a group of connective tissue disorders that can result in a range of complications during pregnancy. Pregnant EDS patients generally have a favourable outcome, but those with vascular EDS are more likely to suffer from severe maternal complications. Early diagnosis of EDS and subtype characterization can aid in pre-pregnancy counselling, planning of antenatal care, risk assessment of obstetric and neonatal complications, and influence both obstetric and anaesthetic management of these patients. This piece aims to outline the obstetric implications of classical, hypermobile, and vascular EDS, and review the current literature regarding their optimal obstetric management.