ABSTRACT
One of the rarest types of ectopic pregnancy, with an incidence of 1:1,800, is cesarean scar ectopic pregnancy. Here, we report the case of a 28-year-old woman who had undergone two previous cesarean sections. She arrived at our labor room with per vaginal spotting and abdominal pain with an ultrasound that revealed a cesarean scar ectopic pregnancy. The initial beta-human chorionic gonadotropin (ß-hCG) value upon admission was 27,133 mIU/mL. Her ultrasound findings were confirmed with magnetic resonance imaging. Opting for combined medical management, we successfully treated her using systemic methotrexate and mifepristone, avoiding surgical intervention despite high ß-hCG values. There is currently no established standardized treatment for cesarean scar ectopic pregnancies, and we feel that treatment must be tailored to every patient's individual needs. Our experience suggests that combining mifepristone and systemic methotrexate can be an effective approach with better curative effects, emphasizing the need for further research.
ABSTRACT
Recurrent pregnancy loss, premature birth, and associated complications exhibit a multifactorial etiology and persist as substantial challenges during pregnancy, despite the notable advancements in the medical field. Among several factors, cervical insufficiency or incompetence emerges as a prominent causal factor, characterized by painless softening and shortening of the cervix associated with absent contractions. The implementation of emergency cerclage represents a pivotal intervention in mitigating preterm birth among individuals with advanced cervical insufficiency. By extending gestational age, this procedure increases the likelihood of neonatal survival without elevating the risk of chorioamnionitis or preterm rupture of the membranes. In this study, an antenatal woman presented with advanced changes in the cervix along with intravaginal bulging amniotic membranes at 18 weeks and underwent a rescue cervical cerclage, resulting in a successful pregnancy.
ABSTRACT
Uterine torsion is an exceedingly rare obstetric emergency representing pelvic organ torsion, characterized by the uterus rotating more than 45 degrees around the longitudinal axis. This torsion predominantly occurs at the junction of the cervix and uterine corpus. Albeit the infrequent prevalence, this condition can arise in any reproductive group. Oligohydramnios is defined as an amniotic fluid volume of 2 cm or less in the single deepest vertical pocket. During pregnancy, uterine torsion is known to be associated with severe maternal and perinatal consequences encompassing placental abruption, maternal mortality, and intrauterine fetal demise. Here, we present a specific case of a woman who experienced uterine torsion during pregnancy, leading to complications such as uteroplacental and fetoplacental insufficiency, severe fetal growth restriction, and persistent oligohydramnios throughout the pregnancy.
ABSTRACT
An actual knot that forms during pregnancy is known as a true knot of the umbilical cord (TKUC) which is seen in 0.3% to 1.2% of pregnancies. TKUC is noteworthy because it can lead to a variety of adverse perinatal outcomes, including infants with low Apgar scores, small for gestational age (SGA) fetuses, fetal hypoxia, and also in some cases fetal death. Here, we present instances of TKUC of three patients and the various associated perinatal outcomes.
ABSTRACT
Contraceptive methods have taken various shapes since their inception and the most widely used are oral contraceptive pills (OCPs). In addition to contraception, OCPs have a variety of uses in the treatment of a number of gynaecological disorders, including polycystic ovary syndrome (PCOS), endometriosis, irregular menses, menorrhagia and dysmenorrhea. Since they were first introduced, OCPs have been linked to a higher risk of intracranial haemorrhage (ICH) and stroke. We report a case where the patient irrationally took OCPs for a long period of time and presented to the emergency department in a state of altered sensorium with symptoms of vomiting and headache which are suggestive of hemorrhagic stroke.
ABSTRACT
BACKGROUND AND OBJECTIVES: Genital endometriosis is still an unclear enigma of the female. It occurs in approximately 20% to 35% of all women of reproductive age. The urinary tract is seldom affected. METHODS: We report on a patient with bladder endometriosis with recurrent heavy pain at menstruation within the framework of 5 similar cases. RESULTS: A combined vaginal and laparoscopic treatment with excision of the lesion reaching into the dome of the bladder and vaginal wall was performed. The bladder opening was sutured in 2 layers. CONCLUSION: Laparoscopic treatment of bladder endometriosis requires a combined surgical treatment by a gynecologist and urologist or an experienced laparoscopist.
