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"Pseudosarcoma" in a pregnant woman
Amarjit Anand, Eva Tsapakis, Ali A Narvani, Ali Alhakim, Steve R Cannon, Eleftherios Tsiridis
World Journal of Surgical Oncology , 2007, DOI: 10.1186/1477-7819-5-7
Abstract: We report a case of IVF in a 16-week pregnant lady affecting the hypothenar eminence of the hand associated with the ulnar artery.The characteristic involvement of muscular arteries and veins by reactive myofibroblastic proliferation in IVF suggests a malignant component and often leads to an inappropriate diagnosis for this benign condition. We propose that hormone-related changes associated with pregnancy may play an important role in the aetiopathogenesis of this myofibroblastic lesion.Intravascular fasciitis (IVF) is a term originally described by Patchefsky and Enzinger to describe this distinctive variant of nodular fasciitis [1]. It is a benign, reactive myofibroblastic proliferative lesion that arises from the superficial or deep fascia and involves predominately small to medium-size arteries and/or veins. It presents as a well-defined nodule in the subcutis or muscle. The involvement of muscular vessels can lead to an erroneous assumption of malignant vascular invasion. It is considered to be very rare and since its first description in 1981, only a few isolated cases have been documented in the literature [2-8].In August 2003, a 20-year-old 16-week pregnant mother of one, presented to the orthopaedic outpatient clinic with a 2-month history of a slowly growing painless mass located in the right hypothenar eminence. She was right-hand dominant and a housewife. There was no history of trauma, insect bites or drainage from the area. There was no significant past medical or surgical history. She was not on any prescribed medication. There was no family history of tumours. She denied smoking, alcohol and drug abuse. On examination, a non-tender, firm to palpation, well-demarcated and tethered to the subcutaneous tissues mass, surrounded by mild erythema, and measuring approximately 2.5 cm × 3.0 cm was revealed, in the absence of palpable lymph nodes at the ipsilateral elbow or axilla. There were no other abnormal signs.Haematological and biochemical investigati
Acute Cardiac Failure in a Pregnant Woman due to Thyrotoxic Crisis
Nao Okuda,Mutsuo Onodera,Yumiko Tsunano,Emiko Nakataki,Jun Oto,Hideaki Imanaka,Masaji Nishimura
Case Reports in Cardiology , 2012, DOI: 10.1155/2012/393580
Abstract: Introduction. Cardiac failure during pregnancy is usually related to preeclampsia/eclampsia, rarely to hyperthyroidism. While hyperthyroidism can easily lead to hypertensive cardiac failure and may harm the fetus, it is sometimes difficult to distinguish hyperthyroidism from normal pregnancy. Case Presentation. We encountered a case of 41-year-old pregnant woman with hypertensive cardiac failure. Because we initially diagnosed as pre-eclampsia/eclampsia, Caesarian section was performed. However, her symptoms still persisted after delivery. After thyroid function test results taken on the day of admission were obtained on the fourth day, we could diagnose that her cardiac failure was caused by thyrotoxic crisis. Conclusions. Hypertensive cardiac failure due to hyperthyroidism during pregnancy is rare and difficult to diagnose because of similar presentation of normal pregnancy. However, physicians should be aware of the risks posed by hyperthyroidism during pregnancy.
Pseudomembranous colitis in a pregnant woman  [PDF]
T Mridula,R R Pai,A M Mathai,B V Tantry,P Adhikari
Kathmandu University Medical Journal , 2010, DOI: 10.3126/kumj.v8i3.6226
Abstract: Pseudomembranous colitis in association with pregnancy has not been well described in English literature. Recent studies show a drastic increase in the incidence and severity of Pseudomembranous colitis in pregnant women, who were once thought to be at low risk. We report here a case of Pseudomembranous colitis in a young healthy immunocompetent pregnant lady. An early suspicion of this entity with the characteristic appearance of pseudomembranes on colonoscopy and histology confirmed the diagnosis enabling prompt treatment and complete recovery without any serious consequences. DOI: http://dx.doi.org/10.3126/kumj.v8i3.6226 Kathmandu Univ Med J 2010;8(3):345-7 ?
A pregnant Japanese woman returning from Africa with recurrent fevers  [cached]
Tsukadaira A,Sekiguchi T,Ashida T,Murashita C
International Medical Case Reports Journal , 2011,
Abstract: Akihiro Tsukadaira1, Tomohiro Sekiguchi1, Takashi Ashida2, Chinatsu Murashita3, Nobuo Itoh3, Mikiko Kobayashi4, Takashi Kagoshima4, Yoshitaka Yamazaki41Department of Internal Medicine, 2Department of Obstetrics and Gynecology, 3Division of Clinical Pathology, Iida Municipal Hospital, Yawatacho 438, Iida, Japan; 4Department of Internal Medicine, Suzaka Prefectural Hospital, Suzaka 1332, Suzaka, JapanAbstract: Certain clinical aspects of vivax malaria are no longer defined as benign. We present a case of vivax malaria with three relapses in a pregnant Japanese woman who had returned to Japan from the Comoros Islands in East Africa. Data on the successful delivery, examination of Duffy-blood group antigen, and microscopic findings of growing stages of Plasmodium vivax are thought to be of considerable interest.Keywords: vivax malaria, Duffy-blood group, pregnancy
Chloroquine resistant vivax malaria in a pregnant woman on the western border of Thailand
Marcus J Rijken, Machteld E Boel, Bruce Russell, Mallika Imwong, Mara L Leimanis, Aung Phyo, Atis Muehlenbachs, Niklas Lindegardh, Rose McGready, Laurent Rénia, Georges Snounou, Pratap Singhasivanon, Fran?ois Nosten
Malaria Journal , 2011, DOI: 10.1186/1475-2875-10-113
Abstract: Chloroquine (CQ) remains the recommended first-line treatment for Plasmodium vivax globally except for Indonesia, Papua New Guinea, the Solomon Islands and Vanuatu where widespread CQ resistance prompted a change in treatment policy [1,2]. Clinical monitoring of CQ efficacy is confounded by relapses derived from the activation of hypnozoites (dormant hepatic forms characteristic of P. vivax), making it difficult to categorize post-treatment episodes as recrudescences, re-infections or relapses [3]. Moreover measurement of the intrinsic sensitivity to CQ has been hampered by the difficulty to maintain P. vivax in culture. Nonetheless cases of CQ-resistant P. vivax have been reported from all continents where malaria is endemic, but never in pregnancy [1]. Previous clinical studies in the non pregnant Thai population where CQ was combined with primaquine did not show cases of highly suspect CQ resistant vivax [4-6]. Combined clinical and laboratory data from a closely monitored Karen pregnant woman on the western border of Thailand highly indicative of CQ resistance by molecular genotyping is presented in this report.A 38 year-old pregnant Karen woman (blood group B, G6PD level normal and HIV negative) in her third pregnancy registered at a gestational age of 20+5 weeks (confirmed by abdominal ultrasound) [7]. She lived and worked in the forests on the Thai-Myanmar border and provided written informed consent to participate in a "postpartum susceptibility to malaria" study approved by the Ethics Committees of Oxford University (OxTREC (002_007) and Mahidol University (MUTM 2007-023) which included repeated blood sampling and publication of any data. She gave birth to a growth restricted live born singleton boy without congenital abnormality of 2,540 (±10) grams at a gestational age of 41+1 weeks (<10th percentile) on 19 December 2008. On the day of registration (D0) she presented with fever and was diagnosed with P. vivax malaria on the presence of asexual forms in pe
Acute Cardiac Failure in a Pregnant Woman due to Thyrotoxic Crisis  [PDF]
Nao Okuda,Mutsuo Onodera,Yumiko Tsunano,Emiko Nakataki,Jun Oto,Hideaki Imanaka,Masaji Nishimura
Case Reports in Cardiology , 2012, DOI: 10.1155/2012/393580
Abstract: Introduction. Cardiac failure during pregnancy is usually related to preeclampsia/eclampsia, rarely to hyperthyroidism. While hyperthyroidism can easily lead to hypertensive cardiac failure and may harm the fetus, it is sometimes difficult to distinguish hyperthyroidism from normal pregnancy. Case Presentation. We encountered a case of 41-year-old pregnant woman with hypertensive cardiac failure. Because we initially diagnosed as pre-eclampsia/eclampsia, Caesarian section was performed. However, her symptoms still persisted after delivery. After thyroid function test results taken on the day of admission were obtained on the fourth day, we could diagnose that her cardiac failure was caused by thyrotoxic crisis. Conclusions. Hypertensive cardiac failure due to hyperthyroidism during pregnancy is rare and difficult to diagnose because of similar presentation of normal pregnancy. However, physicians should be aware of the risks posed by hyperthyroidism during pregnancy. 1. Introduction Cardiac failure during pregnancy is usually related to pre-eclampsia/eclampsia. While hyperthyroidism rarely causes cardiac failure in the parturient, it does weaken cardiac function and is harmful to the fetus. Early diagnosis and treatment are important to rescue both the mother and the fetus. 2. Case Presentation A 41-year-old pregnant woman—para III, gravida III—visited our hospital because of premature rupture of membrane at the 32nd week of gestation. She was 155?cm tall and weighed 49?kg. She had no appreciable past history before pregnancy. She was pointed out hypertension without proteinuria during pregnancy, but no medication had been prescribed. She was alert but showed severe hypertension and tachycardia. Her oxygen saturation rapidly deteriorated to 94% with reservoir mask supplying 10?L/min oxygen, she was intubated and transferred to our ICU. On admission, her blood pressure was 250/170?mmHg, pulse rate 180?beats/min, and body temperature 38.0°C. Laboratory data showed mild hepatic dysfunction and proteinuria. Chest X-ray exhibited bilateral pulmonary infiltration and cardiac dilatation (cardiothoracic ratio, 62%) (Figure 1). Echocardiography showed decreased wall motion (ejection fraction, 43%) and diffuse hypertrophy in the left ventricle. Figure 1: Chest X-ray on admission showing bilateral pulmonary infiltration and cardiac dilatation. She was initially treated as having acute cardiac failure due to pre-eclampsia/eclampsia. Nitroglycerin (0.5–1?μg/kg/min), carperitide (0.05?μg/kg/min), and furosemide (10?mg bolus) were administered to decrease preload and
Hemorrhagic Valsalva Retinopathy in a Pregnant Woman  [PDF]
Charles Geraud Fredy Nganga Ngabou, Chantal Makita, Bénédicte Diatewa
Case Reports in Clinical Medicine (CRCM) , 2018, DOI: 10.4236/crcm.2018.72008
Abstract: Valsalva retinopathy is caused by a sudden increase in intra-thoracic or abdominal pressure, following forced expiration, with mouth and nose closed (Valsalva maneuver). We report a case of Valsalva retinopathy in a pregnant woman. A 36 years old patient, pregnant at 24 weeks of amenorrhea, who consulted for sudden visual acuity decrease of the left eye, evolving since 24 hours after Valsalva maneuvers to calm down her panic and control her breathing. The refraction has demonstrated a decrease of visual acuity in the left eye to “can see a hand moving”, while the visual acuity remained normal in the right eye. Spontaneous evolution was marked by a fast and progressive reduction of hemorrhage and progressive recovery of vision in the left eye. Valsava retinopathy was first described in 1972 by Thomas Duane. Physical activity is usually found before it occurs. Many situations are usually associated to this occurrence among which: pregnancy, vomiting, weightlifting or trauma. Regression of this hemorrhage without sequelae is usual. But sometimes, we need a Nd:Yag laser treatment or surgery to evacuate the blood.
A fatal case of acute hepatitis E among pregnant women, Central African Republic
Charles M Goumba, Emmanuel R Yandoko-Nakouné, Narcisse P Komas
BMC Research Notes , 2010, DOI: 10.1186/1756-0500-3-103
Abstract: Twenty one pregnant women attended the Maternity Center of Begoua in the Central African Republic during an outbreak of hepatitis E virus between July and October 2002 with symptoms of acute liver disease. Their mean gestational period was 29.9 (SD 8.3 weeks) and they were aged from 15 to 39 years old. The serology IgM showed that seven women (33%) had acute hepatitis E. Among them, one woman, aged 35 and her newborn died after an apparently normal preterm delivery. The 6 remaining young women, age 18 - 22, had preterm deliveries which included three live babies and three stillborn with one macerated.These results suggest that maternal age, in addition to hormonal, immunological and environmental factors, may be a risk factor for fatal outcome.Hepatitis E virus (HEV) infection, a common cause of water-borne epidemics, is endemic and frequently responsible for acute viral hepatitis in developing countries. On the contrary, in the industrialized world, anti-HEV antibodies are detected in the general population [1] with no significant morbidity. Transmission is usually feco-oral, although person-to-person transmission has also been reported. Usually, an acute HEV infection is self-limiting, shows no evidence of chronic HEV infection in humans, and has a case-fatality rate of less than 0.1%. However, this disease is responsible for high maternal mortality during the third trimester of pregnancy in India while reports from Egypt, Europe and the USA have shown that the course and severity of HEV during pregnancy is no different from that observed in non-pregnant women [2]. No clinical case was reported in the Central African Republic until 2001 although hepatitis E (IgG) antibodies have been regularly detected in the healthy population [3]. The first epidemic cases of HEV in the Central African Republic were reported in 2002 [4] and, since then sporadic epidemic outbreaks of hepatitis E were observed. Currently in the Central African Republic, pregnant women are not routi
Ectopic Intrauterine Device in the Bladder of a Pregnant Woman
Zehra Kurdoglu,Kadir Ceylan,Mertihan Kurdoglu,Ayse Guler,Hanim Guler Sahin
Case Reports in Medicine , 2010, DOI: 10.1155/2010/181032
Abstract: Background. Uterine perforation and transvesical migration of an intrauterine device are rare complications. Case. A 28-year-old woman who had an intrauterine device was admitted to our outpatient clinic with complaints of amenorrhea lasting 5 weeks and pelvic pain lasting a year. Transvaginal ultrasonography revealed embedding of the intrauterine device in the bladder. The misplaced device was removed by laparotomy. Conclusion. The followup of intrauterine device localization with transvaginal ultrasonography is essential for early detection of possible serious complications.
A ruptured uterus in a pregnant woman not in labor
D Punguyire, KV Iserson
Pan African Medical Journal , 2011,
Abstract: Reducing maternal mortality constitutes one of the eight Millennium Development Goals. While significant progress has been made, system issues and professional training continue to affect maternal survival, especially when unusual, but deadly, complications arise. This rare case of survival after the rupture of an unscarred uterus in a grand multiparous woman from a remote village in Ghana illustrates how systemic transportation issues and limited access to advanced medical care put women with obstetric complications at risk. The usual clinical presentation of ruptured uteri and methods to prevent this catastrophic event are discussed. This case illustrates the systemic transportation issue that often limits access to prenatal and emergency care throughout much of the developing world and demonstrates how advanced training for emergency nurses and the use of ultrasound diagnosis can expedite difficult diagnoses and lead to maternal survival, even in the most adverse circumstances.
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