RESUMO
Conservative management is typically recommended for postpartum diastasis of the pubic symphysis, despite significant functional disability and chronic pain associated with this condition. With a reported incidence of 1:500, the authors describe diagnosis and management controversies with an additional review of relevant literature related to the management of this orthopedic condition. The case is of a 27-year-old woman diagnosed with 5.5-cm diastasis of the pubic symphysis after spontaneous vaginal delivery of a 5 lb 5 oz infant. She underwent early orthopedic surgical correction via open reduction and internal fixation. The patient achieved pain-free ambulation within 3 months of surgery, and returned to full activity at 6 months. Postpartum diastasis of the pubic symphysis is typically treated conservatively; however, the authors illustrate that early orthopedic consultation and intervention at diastasis greater than 5 cm may improve recovery and functional outcome.
Assuntos
Fixação Interna de Fraturas , Diástase da Sínfise Pubiana/cirurgia , Sínfise Pubiana/cirurgia , Adulto , Feminino , Humanos , Período Pós-Parto , Resultado do TratamentoRESUMO
Rhabdomyoma is the most common primary cardiac tumor identified in utero and in infancy. Usually it has a benign course, which has prompted an expectant approach to its management. We report herein the cases of three patients who presented prenatally with cardiac rhabdomyomas. Only one of them had a benign course. The other two patients provided recognizable characteristics of rhabdomyomas with an unfavorable course and demonstrated that fetal rhabdomyomas can have a fatal outcome.
Assuntos
Neoplasias Cardíacas/diagnóstico , Diagnóstico Pré-Natal , Rabdomioma/diagnóstico , Adulto , Diagnóstico Diferencial , Evolução Fatal , Feminino , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/embriologia , Neoplasias Cardíacas/patologia , Humanos , Recém-Nascido , Gravidez , Terceiro Trimestre da Gravidez , Rabdomioma/diagnóstico por imagem , Rabdomioma/embriologia , Rabdomioma/patologia , UltrassonografiaRESUMO
BACKGROUND: The caudal appendage, or human tail, is a rare congenital anomaly that arises from the lumbosacrococcygeal region. CASE: A pregnant woman was referred after ultrasound revealed a possible neural tube defect. A sonogram in our unit revealed a posterior, echogenic protrusion superior to the fetal buttocks. Examination of the infant revealed a fetal caudal appendage at the level of S-4. Ultrasound imaging of the neonatal spine demonstrated a tethered spinal cord extending to the level of S-4 and exiting toward the caudal appendage. CONCLUSION: A fetal caudal appendage should be included in the differential diagnosis of an echogenic protrusion near the lumbosacral spine on ultrasound. The finding of a caudal appendage in a neonate mandates a careful search for an underlying spinal cord defect.