-
Case Report12-21-2020
Coronavirus 2019, Thrombocytopenia and HELLP Syndrome: Association or Coincidence?
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(10):669-671
Abstract
Case ReportCoronavirus 2019, Thrombocytopenia and HELLP Syndrome: Association or Coincidence?
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(10):669-671
Views155See moreAbstract
The present report describes the case of a 31-year-old primigravida, with dichorionic twins at 31 weeks. She presented with history of myalgia, jaundice, and abdominal discomfort. No flu-like symptoms as fever or cough. She was not aware of exposure to COVID-19. Normal blood pressure and O2 saturation. Laboratory tests showed platelet count of 218,000 mm3, alanine aminotransferase (ALT) 558 IU and serum creatinine 2.3 mg/dl. Doppler ultrasound in one twin was compatible with brain sparing. Partial hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome was the hypothesis, and a cesarean section was performed. On day 2, the white-cell count reached 33,730, with decreased consciousness and mild respiratory distress. Tomography revealed both lungs with ground-glass opacities. Swab for COVID-19 polymerase chain reaction (PCR) was positive. Thrombocytopenia in patients with COVID-19 appears to be multifactorial, similar to what occurs in preeclampsia and HELLP syndrome. We assume that the synergism of these pathophysiological mechanisms could accelerate the compromise of maternal conditions and could be a warning to the obstetric practice.
Views155
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Case ReportCoronavirus 2019, Thrombocytopenia and HELLP Syndrome: Association or Coincidence?
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(10):669-671
Views155See moreAbstract
The present report describes the case of a 31-year-old primigravida, with dichorionic twins at 31 weeks. She presented with history of myalgia, jaundice, and abdominal discomfort. No flu-like symptoms as fever or cough. She was not aware of exposure to COVID-19. Normal blood pressure and O2 saturation. Laboratory tests showed platelet count of 218,000 mm3, alanine aminotransferase (ALT) 558 IU and serum creatinine 2.3 mg/dl. Doppler ultrasound in one twin was compatible with brain sparing. Partial hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome was the hypothesis, and a cesarean section was performed. On day 2, the white-cell count reached 33,730, with decreased consciousness and mild respiratory distress. Tomography revealed both lungs with ground-glass opacities. Swab for COVID-19 polymerase chain reaction (PCR) was positive. Thrombocytopenia in patients with COVID-19 appears to be multifactorial, similar to what occurs in preeclampsia and HELLP syndrome. We assume that the synergism of these pathophysiological mechanisms could accelerate the compromise of maternal conditions and could be a warning to the obstetric practice.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Case Report12-21-2020
Serous Retinal Detachment in Pre-eclampsia: Case Report and Literature Review
- Joana Teresa Botelho Vasconcelos Raposo
, - Bruna Carina Da Silva Melo ,
- Nuno Filipe Bernardo Belo Maciel ,
- Sara Dias Leite ,
- Óscar Renato Coutinho Rebelo , [ ... ],
- Ana Maria Furtado Lima
Abstract
Case ReportSerous Retinal Detachment in Pre-eclampsia: Case Report and Literature Review
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(11):772-773
- Joana Teresa Botelho Vasconcelos Raposo ,
- Bruna Carina Da Silva Melo ,
- Nuno Filipe Bernardo Belo Maciel ,
- Sara Dias Leite ,
- Óscar Renato Coutinho Rebelo ,
- Ana Maria Furtado Lima
Views275See moreAbstract
Pre-eclampsia (PE) is an obstetric disease with a multifactorial cause that affects ∼ 5% of pregnant women. Vision can be affected with varying severity, and retinal detachment is a very rare complication. It tends to be bilateral, diagnosed postpartum, and more prevalent in women who are primiparous and/or undergo caesarean delivery. The condition typically resolves completely and rarely causes total visual loss in the affected women. Fluorescence angiographic findings support the hypothesis that retinal detachment in PE is secondary to choroidal ischemia from intense arteriolar vasospasm. The present article is related to a case of a 37-year-old pregnant woman who had PE associated with a progressive blurred vision, diagnosed by ophthalmology as serous macular detachment of the retina.
Views275This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Case ReportSerous Retinal Detachment in Pre-eclampsia: Case Report and Literature Review
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(11):772-773
- Joana Teresa Botelho Vasconcelos Raposo ,
- Bruna Carina Da Silva Melo ,
- Nuno Filipe Bernardo Belo Maciel ,
- Sara Dias Leite ,
- Óscar Renato Coutinho Rebelo ,
- Ana Maria Furtado Lima
Views275See moreAbstract
Pre-eclampsia (PE) is an obstetric disease with a multifactorial cause that affects ∼ 5% of pregnant women. Vision can be affected with varying severity, and retinal detachment is a very rare complication. It tends to be bilateral, diagnosed postpartum, and more prevalent in women who are primiparous and/or undergo caesarean delivery. The condition typically resolves completely and rarely causes total visual loss in the affected women. Fluorescence angiographic findings support the hypothesis that retinal detachment in PE is secondary to choroidal ischemia from intense arteriolar vasospasm. The present article is related to a case of a 37-year-old pregnant woman who had PE associated with a progressive blurred vision, diagnosed by ophthalmology as serous macular detachment of the retina.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Joana Teresa Botelho Vasconcelos Raposo
-
Review Article12-21-2020
Clinical Procedures for the Prevention of Preeclampsia in Pregnant Women: A Systematic Review
- Nádya Santos Moura ,
- Maria Luziene Sousa Gomes ,
- Ivana Rios Rodrigues ,
- Daniel Lorber Rolnik ,
- Fabrício Silva Costa , [ ... ],
- Mônica Oliveira Batista Oriá
Abstract
Review ArticleClinical Procedures for the Prevention of Preeclampsia in Pregnant Women: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(10):659-668
- Nádya Santos Moura ,
- Maria Luziene Sousa Gomes ,
- Ivana Rios Rodrigues ,
- Daniel Lorber Rolnik ,
- Fabrício Silva Costa ,
- Mônica Oliveira Batista Oriá
Views334See moreAbstract
Objective
To identify the most effective procedures recommended for the prevention of preeclampsia.
Data Sources
A systematic review was performed in the following databases: Pubmed/MEDLINE, CINAHL, Web of Science, Cochrane and LILACS via the Virtual Health Library (VHL). A manual search was also performed to find additional references. The risk of bias, the quality of the evidence, and the classification of the strength of the recommendations were evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.
Selection of Studies
In the initial search in the databases, the total number of articles retrieved was 351, and 2 were retrieved through the manual search; after duplicate articles were removed, 333 citations remained. After a thorough review of the titles and abstracts, 315 references were excluded. Accordingly, 18 articles were maintained for selection of the complete text (phase 2). This process led to the exclusion of 6 studies. In total, 12 articles were selected for data extraction and qualitative synthesis.
Data Collection
The articles selected for the study were analyzed, and we inserted the synthesis of the evidence in the online software GRADEpro Guideline Development Tool (GDT) (McMaster University and Evidence Prime Inc. All right reserved. McMaster University, Hamilton, Ontário, Canada); thus, it was possible to develop a table of evidence, with the quality of the evidence and the classification of the strength of the recommendations.
Data Synthesis
In total, seven studies recommended the individual use of aspirin, or aspirin combined with calcium, heparin or dipyridamole. The use of calcium alone or in combination with phytonutrients was also highlighted. All of the studies were with women at a high risk of developing preeclampsia.
Conclusion
According to the studies evaluated, the administration of aspirin is still the best procedure to be used in the clinical practice to prevent preeclampsia.
Views334This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Review ArticleClinical Procedures for the Prevention of Preeclampsia in Pregnant Women: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(10):659-668
- Nádya Santos Moura ,
- Maria Luziene Sousa Gomes ,
- Ivana Rios Rodrigues ,
- Daniel Lorber Rolnik ,
- Fabrício Silva Costa ,
- Mônica Oliveira Batista Oriá
Views334See moreAbstract
Objective
To identify the most effective procedures recommended for the prevention of preeclampsia.
Data Sources
A systematic review was performed in the following databases: Pubmed/MEDLINE, CINAHL, Web of Science, Cochrane and LILACS via the Virtual Health Library (VHL). A manual search was also performed to find additional references. The risk of bias, the quality of the evidence, and the classification of the strength of the recommendations were evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.
Selection of Studies
In the initial search in the databases, the total number of articles retrieved was 351, and 2 were retrieved through the manual search; after duplicate articles were removed, 333 citations remained. After a thorough review of the titles and abstracts, 315 references were excluded. Accordingly, 18 articles were maintained for selection of the complete text (phase 2). This process led to the exclusion of 6 studies. In total, 12 articles were selected for data extraction and qualitative synthesis.
Data Collection
The articles selected for the study were analyzed, and we inserted the synthesis of the evidence in the online software GRADEpro Guideline Development Tool (GDT) (McMaster University and Evidence Prime Inc. All right reserved. McMaster University, Hamilton, Ontário, Canada); thus, it was possible to develop a table of evidence, with the quality of the evidence and the classification of the strength of the recommendations.
Data Synthesis
In total, seven studies recommended the individual use of aspirin, or aspirin combined with calcium, heparin or dipyridamole. The use of calcium alone or in combination with phytonutrients was also highlighted. All of the studies were with women at a high risk of developing preeclampsia.
Conclusion
According to the studies evaluated, the administration of aspirin is still the best procedure to be used in the clinical practice to prevent preeclampsia.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Nádya Santos Moura
-
Original Article05-18-2020
Is there an Increased Risk for Unfavorable Obstetric Outcomes in Women with Endometriosis? An Evaluation of Evidences
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(4):200-210
Abstract
Original ArticleIs there an Increased Risk for Unfavorable Obstetric Outcomes in Women with Endometriosis? An Evaluation of Evidences
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(4):200-210
Views178Abstract
Objective
The present study is a systematic review of the literature to assess whether the presence of endometriosis determines or contributes to adverse obstetric outcomes.
Data Sources
The present work was carried out at the Hospital Israelita Albert Einstein, São Paulo, state of São Paulo, Brazil, in accordance to the PRISMA methodology for systematic reviews. A review of the literature was performed using PubMed, Web of Science and Scopus databases. The keywords used were: pregnancy outcome, pregnancy complications, obstetrical complications, obstetrics, obstetric outcomes and endometriosis. The survey was further completed by a manually executed review of cross-referenced articles, which was last performed on November 30, 2018.
Selection of studies
The survey disclosed a total of 2,468 articles, published from May 1946 to October 2017. A total of 18 studies were selected to be further classified according to their quality and relevance.
Data Collection
The Newcastle-Ottawa Quality Assessment Scale was used for classification. Five studies of greater impact and superior evidence quality and 13 studies of moderate evidence quality were selected. We analyzed the studies for the characteristics of their patients plus how endometriosis was diagnosed and their respective obstetric outcomes taking into account their statistical relevance.
Data Synthesis
Analyses of the higher impact and better quality studies have shown high incidence of preterm birth and placenta previa in patients with endometriosis.
Conclusion
Placenta previa and preterm birth are the most statistically significant outcomes related to endometriosis, as indicated by our systematic review. The present information is useful to alert obstetricians and patients about possible unfavorable obstetric outcomes.
Key-words EndometriosisObstetric complicationsobstetric outcomesPregnancy complicationspregnancy outcomesSee moreViews178This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleIs there an Increased Risk for Unfavorable Obstetric Outcomes in Women with Endometriosis? An Evaluation of Evidences
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(4):200-210
Views178Abstract
Objective
The present study is a systematic review of the literature to assess whether the presence of endometriosis determines or contributes to adverse obstetric outcomes.
Data Sources
The present work was carried out at the Hospital Israelita Albert Einstein, São Paulo, state of São Paulo, Brazil, in accordance to the PRISMA methodology for systematic reviews. A review of the literature was performed using PubMed, Web of Science and Scopus databases. The keywords used were: pregnancy outcome, pregnancy complications, obstetrical complications, obstetrics, obstetric outcomes and endometriosis. The survey was further completed by a manually executed review of cross-referenced articles, which was last performed on November 30, 2018.
Selection of studies
The survey disclosed a total of 2,468 articles, published from May 1946 to October 2017. A total of 18 studies were selected to be further classified according to their quality and relevance.
Data Collection
The Newcastle-Ottawa Quality Assessment Scale was used for classification. Five studies of greater impact and superior evidence quality and 13 studies of moderate evidence quality were selected. We analyzed the studies for the characteristics of their patients plus how endometriosis was diagnosed and their respective obstetric outcomes taking into account their statistical relevance.
Data Synthesis
Analyses of the higher impact and better quality studies have shown high incidence of preterm birth and placenta previa in patients with endometriosis.
Conclusion
Placenta previa and preterm birth are the most statistically significant outcomes related to endometriosis, as indicated by our systematic review. The present information is useful to alert obstetricians and patients about possible unfavorable obstetric outcomes.
Key-words EndometriosisObstetric complicationsobstetric outcomesPregnancy complicationspregnancy outcomesSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Original Article04-17-2020
Gestational Outcomes in Patients with Severe Maternal Morbidity Caused by Hypertensive Syndromes
- Daisy de Lucena Feitosa Lins Pinheiro ,
- Francisco Edson de Lucena Feitosa ,
- Edward Araujo Júnior ,
- Francisco Herlânio Costa Carvalho
Abstract
Original ArticleGestational Outcomes in Patients with Severe Maternal Morbidity Caused by Hypertensive Syndromes
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(2):74-80
- Daisy de Lucena Feitosa Lins Pinheiro ,
- Francisco Edson de Lucena Feitosa ,
- Edward Araujo Júnior ,
- Francisco Herlânio Costa Carvalho
Views210See moreAbstract
Purpose
To evaluate the impact of the presence of criteria for severe maternal morbidity and maternal near miss associated with hypertensive disorders on maternal and perinatal outcomes in a maternity school.
Methods
The present is a sub-analysis of a larger study involving 27 centers in Brazil that estimated the prevalence of serious maternal morbidity and near miss. It is an analytical and cross-sectional study with a quantitative approach, involving 928 women who were cared for at Maternidade Escola Assis Chateaubriand (MEAC, in Portuguese), Universidade Federal do Ceará (UFC, in Portuguese), from July 2009 to June 2010. The women were diagnosed with near miss according to the World Health Organization (WHO) criteria. The sample was divided into 2 groups: patients with (n = 827) and without hypertension (n = 101). The results were considered statistically significant when p < 0.05. The Pearson chi-squared and Fisher Exact tests were used for the categorical variables, and the Mann–Whitney U test was used for the continuous variables.
Results
In total, 51 participants with maternal near miss criteria were identified, and 36 of them had hypertensive disorders. Of these, 5 died and were obviously excluded from the near miss final group. In contrast, we observed 867 cases with non-near miss maternal morbidity criteria. During this period, there were 4,617 live births (LBs) in the institution that was studied.
Conclusion
In the severe morbidity/maternal near miss population, the presence of hypertensive complications was prevalent, constituting a risk factor for both the mother and the fetus.
Views210This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleGestational Outcomes in Patients with Severe Maternal Morbidity Caused by Hypertensive Syndromes
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(2):74-80
- Daisy de Lucena Feitosa Lins Pinheiro ,
- Francisco Edson de Lucena Feitosa ,
- Edward Araujo Júnior ,
- Francisco Herlânio Costa Carvalho
Views210See moreAbstract
Purpose
To evaluate the impact of the presence of criteria for severe maternal morbidity and maternal near miss associated with hypertensive disorders on maternal and perinatal outcomes in a maternity school.
Methods
The present is a sub-analysis of a larger study involving 27 centers in Brazil that estimated the prevalence of serious maternal morbidity and near miss. It is an analytical and cross-sectional study with a quantitative approach, involving 928 women who were cared for at Maternidade Escola Assis Chateaubriand (MEAC, in Portuguese), Universidade Federal do Ceará (UFC, in Portuguese), from July 2009 to June 2010. The women were diagnosed with near miss according to the World Health Organization (WHO) criteria. The sample was divided into 2 groups: patients with (n = 827) and without hypertension (n = 101). The results were considered statistically significant when p < 0.05. The Pearson chi-squared and Fisher Exact tests were used for the categorical variables, and the Mann–Whitney U test was used for the continuous variables.
Results
In total, 51 participants with maternal near miss criteria were identified, and 36 of them had hypertensive disorders. Of these, 5 died and were obviously excluded from the near miss final group. In contrast, we observed 867 cases with non-near miss maternal morbidity criteria. During this period, there were 4,617 live births (LBs) in the institution that was studied.
Conclusion
In the severe morbidity/maternal near miss population, the presence of hypertensive complications was prevalent, constituting a risk factor for both the mother and the fetus.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Daisy de Lucena Feitosa Lins Pinheiro
-
Original Article06-19-2019
Maternal and Perinatal Outcomes in Pregnant Women with Cystic Fibrosis
- Gilmar de Souza Osmundo Junior ,
- Rodrigo Abensur Athanazio,
- Samia Zahi Rached,
- Rossana Pulcineli Vieira Francisco
Abstract
Original ArticleMaternal and Perinatal Outcomes in Pregnant Women with Cystic Fibrosis
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(4):230-235
- Gilmar de Souza Osmundo Junior ,
- Rodrigo Abensur Athanazio,
- Samia Zahi Rached,
- Rossana Pulcineli Vieira Francisco
Views128See moreAbstract
Objectives
To assess the perinatal and maternal outcomes of pregnant women with cystic fibrosis (CF) and severe lung impairment.
Methods
This was a series of cases aiming to review the maternal and fetal outcomes in cases of singleton pregnant women with a diagnosis of CF. We have included all of the cases of singleton pregnancy in patients with CF who were followed-up at the obstetrics department of the Medical School of the Universidade de São Paulo, between 2003 and 2016. The exclusion criteria were the unattainability of the medical records of the patient, and delivery at other institutions. A forced expiratory volume in 1 second < 50% was considered as severe lung impairment. We have also analyzed data regarding maternal hospitalization and respiratory exacerbations (REs).
Results
Pregnant women with CF and severe lung impairment did not present an association with spontaneous prematurity, fetal growth restriction or fetal demise. All of the cases involved multiple RE episodes requiring antibiotic therapy. The median (range) of events per patient was of 4 (2-4) events.
Conclusion
Cystic fibrosis patients with severe lung impairment may achieve successful term pregnancies. However, pregnancies of women with CF are frequently complicated by REs, and this population may require hospital admission during the course of the pregnancy. Cystic fibrosis patients should be followed by a specialized team with experience in treating respiratory diseases.
Views128This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleMaternal and Perinatal Outcomes in Pregnant Women with Cystic Fibrosis
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(4):230-235
- Gilmar de Souza Osmundo Junior ,
- Rodrigo Abensur Athanazio,
- Samia Zahi Rached,
- Rossana Pulcineli Vieira Francisco
Views128See moreAbstract
Objectives
To assess the perinatal and maternal outcomes of pregnant women with cystic fibrosis (CF) and severe lung impairment.
Methods
This was a series of cases aiming to review the maternal and fetal outcomes in cases of singleton pregnant women with a diagnosis of CF. We have included all of the cases of singleton pregnancy in patients with CF who were followed-up at the obstetrics department of the Medical School of the Universidade de São Paulo, between 2003 and 2016. The exclusion criteria were the unattainability of the medical records of the patient, and delivery at other institutions. A forced expiratory volume in 1 second < 50% was considered as severe lung impairment. We have also analyzed data regarding maternal hospitalization and respiratory exacerbations (REs).
Results
Pregnant women with CF and severe lung impairment did not present an association with spontaneous prematurity, fetal growth restriction or fetal demise. All of the cases involved multiple RE episodes requiring antibiotic therapy. The median (range) of events per patient was of 4 (2-4) events.
Conclusion
Cystic fibrosis patients with severe lung impairment may achieve successful term pregnancies. However, pregnancies of women with CF are frequently complicated by REs, and this population may require hospital admission during the course of the pregnancy. Cystic fibrosis patients should be followed by a specialized team with experience in treating respiratory diseases.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Gilmar de Souza Osmundo Junior
-
Case Report06-19-2019
Spontaneous Heterotopic Triplet Pregnancy with a Two Viable Intrauterine Embryos and an Ectopic One with Right Tubal Rupture
- Adriano Carvalho Guimarães ,
- Luciano Dias de Oliveira Reis,
- Fabio Chaves Leite,
- Cassiana Franco Dias dos Reis,
- Alex Paula Costa, [ ... ],
- Walter Junior Boim de Araujo
Abstract
Case ReportSpontaneous Heterotopic Triplet Pregnancy with a Two Viable Intrauterine Embryos and an Ectopic One with Right Tubal Rupture
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(4):268-272
- Adriano Carvalho Guimarães ,
- Luciano Dias de Oliveira Reis,
- Fabio Chaves Leite,
- Cassiana Franco Dias dos Reis,
- Alex Paula Costa,
- Walter Junior Boim de Araujo
Views231Abstract
Heterotopic pregnancy (HP) is defined as the simultaneous development of an intra- and an extra uterine gestation. The occurrence of a spontaneous triplet HP is an exceptionally rare medical condition. We report the case of a young woman with spontaneous heterotopic triplets at 8weeks of gestation, with amisdiagnosis of topic twins and acute appendicitis. The ectopic tubal pregnancy was ruptured and a salpingectomy was performed by laparotomy. The intrauterine pregnancy progressed uneventfully. The two healthy babies were delivery by cesarean section at 36 ± 2 weeks of gestation. Heterotopic triplets with ruptured tubal ectopic pregnancy represent a special diagnostic and therapeutic challenge for the obstetrician. A high rate of clinical suspicion and timely treatment by laparotomy or laparoscopy can preserve the intrauterine gestation with a successful outcome of the pregnancy.
Key-words heterotopic pregnancyMultiple pregnancyobstetrical surgeryPregnancy complicationstubal pregnancySee moreViews231This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Case ReportSpontaneous Heterotopic Triplet Pregnancy with a Two Viable Intrauterine Embryos and an Ectopic One with Right Tubal Rupture
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(4):268-272
- Adriano Carvalho Guimarães ,
- Luciano Dias de Oliveira Reis,
- Fabio Chaves Leite,
- Cassiana Franco Dias dos Reis,
- Alex Paula Costa,
- Walter Junior Boim de Araujo
Views231Abstract
Heterotopic pregnancy (HP) is defined as the simultaneous development of an intra- and an extra uterine gestation. The occurrence of a spontaneous triplet HP is an exceptionally rare medical condition. We report the case of a young woman with spontaneous heterotopic triplets at 8weeks of gestation, with amisdiagnosis of topic twins and acute appendicitis. The ectopic tubal pregnancy was ruptured and a salpingectomy was performed by laparotomy. The intrauterine pregnancy progressed uneventfully. The two healthy babies were delivery by cesarean section at 36 ± 2 weeks of gestation. Heterotopic triplets with ruptured tubal ectopic pregnancy represent a special diagnostic and therapeutic challenge for the obstetrician. A high rate of clinical suspicion and timely treatment by laparotomy or laparoscopy can preserve the intrauterine gestation with a successful outcome of the pregnancy.
Key-words heterotopic pregnancyMultiple pregnancyobstetrical surgeryPregnancy complicationstubal pregnancySee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Adriano Carvalho Guimarães
-
Case Report03-13-2019
Embolization of Ruptured Renal Angiomyolipoma in Puerpera
- Adenauer Marinho de Oliveira Góes Junior ,
- Salim Abdon Haber Jeha,
- Carolina Pinheiro de Oliveira,
- Daniel Arthur Santos dos Santos
Abstract
Case ReportEmbolization of Ruptured Renal Angiomyolipoma in Puerpera
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(3):199-202
- Adenauer Marinho de Oliveira Góes Junior ,
- Salim Abdon Haber Jeha,
- Carolina Pinheiro de Oliveira,
- Daniel Arthur Santos dos Santos
Views156See moreAbstract
Angiomyolipomas (AMLs) are rare benign tumors derived from mesenchymal tissue and composed of varying degrees of adipose tissue, muscle and blood vessels. Renal AMLs (RAMLs) are the result of a sporadic event, and, in most of cases, the diagnosis is usually incidental, but hemorrhage and shock may be present. During pregnancy, the size of AMLs may increase and they may rupture, probably due to the high expression of hormone receptors, and the increase in maternal circulation and abdominal pressure. The authors present a case of a woman with ruptured RAML submitted to urgent endovascular treatment four days after giving birth by cesarean section.
Views156This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Case ReportEmbolization of Ruptured Renal Angiomyolipoma in Puerpera
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(3):199-202
- Adenauer Marinho de Oliveira Góes Junior ,
- Salim Abdon Haber Jeha,
- Carolina Pinheiro de Oliveira,
- Daniel Arthur Santos dos Santos
Views156See moreAbstract
Angiomyolipomas (AMLs) are rare benign tumors derived from mesenchymal tissue and composed of varying degrees of adipose tissue, muscle and blood vessels. Renal AMLs (RAMLs) are the result of a sporadic event, and, in most of cases, the diagnosis is usually incidental, but hemorrhage and shock may be present. During pregnancy, the size of AMLs may increase and they may rupture, probably due to the high expression of hormone receptors, and the increase in maternal circulation and abdominal pressure. The authors present a case of a woman with ruptured RAML submitted to urgent endovascular treatment four days after giving birth by cesarean section.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Adenauer Marinho de Oliveira Góes Junior
Pregnancy complications Archives - Page 4 of 11 - Revista Brasileira de Ginecologia e Obstetrícia
