Respiratory perspective of COVID-19 in pregnancy.

The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a global pandemic in March 2020 by the World Health Organization (WHO). By February 2022, the disease had infected more than 500 million people globally. COVID-19 frequently manifests as pneumonia and mortality is mainly caused by acute respiratory distress syndrome (ARDS). Previous studies have reported that pregnant women are at a higher risk of SARS-CoV-2 infection and complications can happen due to alterations in the immune response, respiratory physiology, hypercoagulable state, and placental pathology. Clinicians face the challenge of selecting the proper treatment for pregnant patients with different physiological characteristics compared with the non-pregnant population. Furthermore, drug safety for both the patient and the fetus should also be considered. Efforts to prevent COVID-19, including prioritizing vaccination for pregnant women, are essential to break the chain of COVID-19 transmission in the pregnant population. This review aims to summarize the current literature regarding the effect of COVID-19 in pregnant women, its clinical manifestations, treatment, complications, and prevention.

A rare case of pelvic pain caused by Herlyn-Werner-Wunderlich Syndrome in an adult: A case report.

INTRODUCTION: Herlyn-Werner-Wunderlich Syndrome (HWWs) is a rare congenital anomaly. This abnormality has 5% percentage of the total Mullerian dysgenesis. The symptomatic patients come with varies condition, such as urinary incontinence, urinary retention endometriosis, pelvic infection and acute pelvic pain. Here we present investigation and management of HWWs with pelvic pain in adult woman. PRESENTATION OF CASE: A 23 years old woman came with pelvic pain. We found abnormalities of HWW syndrome i.e. uterus didelphys with obstructed hemivagina and right renal agenesis through ultrasound imaging, CT scan and MRI. After concluding the diagnosis, the patient underwent vaginal septum excision and vaginoplasty procedures to relieve obstruction which was the cause of pelvic pain. The symptom was improved after surgery and she felt no more pain after a year of follow up. DISCUSSION: The main symptom of HWWs is dysmenorrhea associated with obstruction mass or endometriosis. MRI with capability of tissue differentiation is the gold standard for diagnostic. The primary purpose of surgery is to release the obstruction and to prevent further complication. CONCLUSION: Rarely, HWWs causes an acute pelvic pain with secondary cystic mass finding. Surgery aimed to release obstruction will improve this symptom.

Adenocarcinoma of the lung with positive epidermal growth factor receptor mutation in pregnancy.

Lung cancer during pregnancy is a rare condition. We report a case of 28-year-old nonsmoker female, who was admitted to our hospital with massive left pleural effusion in the 21st week of gestation. Chest radiograph showed total left hemithorax opacity with contralateral mediastinal deviation. Pleural biopsy and cytological examination of pleural fluid revealed adenocarcinoma invasion with positive epidermal growth factor receptor mutation status. Cesarean section was performed at 32 weeks of pregnancy, and targeted therapy was given to this patient after delivery. Computed tomography of the thorax showed a mass lesion in the left hemithorax with liver metastases. Unfortunately, the patient died 10 days after delivery.