RESUMEN
OBJECTIVE: To reinforce the risk of heterotopic pregnancy in a natural cycle when intrauterine pregnancy and abdominal pain co-exist. METHOD: A single case report with a literature review. RESULTS: Our case was associated with significant haemorrhage, laparotomy and salpingectomy. The obstetric outcome was favourable in this case. The literature review demonstrates the diagnostic difficulties as well as treatment options. CONCLUSIONS: Sonographic diagnosis of a heterotopic pregnancy is not always possible. Patients with abdominal pain and intrauterine pregnancy should heighten the clinician's suspicion of a heterotopic pregnancy.
Asunto(s)
Dolor Abdominal/etiología , Anexos Uterinos/diagnóstico por imagen , Embarazo Tubario/diagnóstico , Ultrasonografía Prenatal , Dolor Abdominal/diagnóstico por imagen , Adulto , Cesárea , Diagnóstico Diferencial , Femenino , Humanos , Nacimiento Vivo , Embarazo , Reducción de Embarazo Multifetal , Embarazo Tubario/diagnóstico por imagen , Embarazo Tubario/etiología , Embarazo Tubario/cirugía , Factores de Riesgo , Rotura Espontánea/complicaciones , Rotura Espontánea/diagnóstico por imagen , Rotura Espontánea/etiologíaRESUMEN
Congenital anomalies causing airway obstruction in the newborn are potentially fatal. However if an effective airway can be maintained the long-term prognosis is often excellent. We present four cases of airway obstruction, three of which were diagnosed antenatally. We discuss the role of antenatal imaging and review delivery options including the need for a multidisciplinary team approach. In conclusion, we recommend antenatal imaging with both ultrasound scan and magnetic resonance to inform perinatal management. Polyhydramnios, in association with suspected neonatal airway obstruction, should alert clinicians to a high-risk situation. We recognize that even in skilled hands, securing an airway can be very difficult and alternatives such as maintenance of the fetomaternal circulation or extra-corporeal life support should be considered.
Asunto(s)
Obstrucción de las Vías Aéreas/diagnóstico , Anomalías Congénitas , Atención Perinatal , Adulto , Obstrucción de las Vías Aéreas/terapia , Resultado Fatal , Femenino , Humanos , Recién Nacido , Linfangioma Quístico , Imagen por Resonancia Magnética , Masculino , Grupo de Atención al Paciente , Polihidramnios , Embarazo , PronósticoRESUMEN
We report a twin pregnancy complicated by fetal goitrous hypothyroidism secondary to dyshormonogenesis caused by thyroglobulin deficiency. Antenatal treatment with intra-amniotic thyroxine was considered but not performed, given the late gestational age at diagnosis and the multiple nature of the pregnancy. Both twins developed airway obstruction at delivery, requiring intubation and ventilation. We review the literature and describe the practical issues relating to the antenatal assessment and perinatal management of fetal goitre.
Asunto(s)
Hipotiroidismo Congénito , Enfermedades en Gemelos , Bocio , Obstrucción de las Vías Aéreas/etiología , Obstrucción de las Vías Aéreas/terapia , Hipotiroidismo Congénito/complicaciones , Hipotiroidismo Congénito/diagnóstico , Hipotiroidismo Congénito/terapia , Parto Obstétrico , Femenino , Bocio/complicaciones , Bocio/diagnóstico , Bocio/terapia , Humanos , Recién Nacido , Imagen por Resonancia Magnética , Embarazo , Diagnóstico Prenatal , Tiroglobulina/deficienciaRESUMEN
We evaluated inter-assay variation in anticardiolipin antibody status, comparing three centres, and using different assays among 36 women with recurrent miscarriage and 26 controls. There was no more agreement between the laboratories than would be predicted on the basis of chance for IgM and only fair agreement among the laboratories for IgG. None of the tests were significantly more likely to be positive in the cases compared with the controls.