A near-fatal case of intussusception and ischaemic perforation of stomach in first-trimester pregnancy: eight years after laparoscopic Roux-en-Y gastric bypass

The increasing demand and popularity of bariatric surgery are not only due to the ever-increasing obesity epidemic but to tackle obesity-related comorbidities like diabetes and hypertension. However, bariatric surgery is not free of complications. One rare complication is intussusception, jejuno-jejunal intussusception being the most common. Intussusception has been defined both in pregnant and in non-pregnant women as well as men. We describe the case of a 40-year-old woman in the first trimester of pregnancy came to the hospital with worsening abdominal pain, was found to have intussusception of small bowel involving the jejunum, along with ischaemic perforation and necrosis of the fundus of the stomach. Postsurgery, the patient had a complete recovery and eventually, she successfully delivered an intact, viable fetus.

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SARS-CoV-2 in first trimester pregnancy – does it affect the fetus?

10.1101/2020.06.08.20125195 ◽

2020 ◽

Cited By ~ 1

Author(s):

Nina la Cour Freiesleben ◽

Pia Egerup ◽

Kathrine Vauvert Römmelmayer Hviid ◽

Elin Rosenbek Severinsen ◽

Astrid Marie Kolte ◽

...

Keyword(s):

Pregnant Women ◽

Pregnancy Loss ◽

Viral Infections ◽

First Trimester ◽

Nuchal Translucency ◽

Grey Zone ◽

First Trimester Pregnancy ◽

Trimester Pregnancy ◽

First Trimester Of Pregnancy ◽

Test Serum

AbstractBackgroundSeveral viral infections are known to be harmful to the fetus in the first trimester of pregnancy and can cause increased nuchal translucency thickness and pregnancy loss. Currently, no evidence exists regarding possible effects of SARS-CoV-2 in first trimester pregnancies.MethodsCohort 1 included pregnant women with a double test taken between Feb. 17 and Apr. 23, 2020, during the SARS-CoV-2 epidemic peak in Denmark. The double test was taken as part of the first trimester risk assessment. Cohort 2 included women with a first trimester pregnancy loss before double test. Serum from the double test or from a blood sample, in case of pregnancy loss, was analyzed for SARS-CoV-2 antibodies. The results were correlated to the nuchal translucency thickness and the number of pregnancy losses.ResultsIn total, 1,019 pregnant women with double test and 36 women with pregnancy loss participated in the study. Thirty (2.9%) women had SARS-CoV-2 antibodies in the serum from the double test. All women with pregnancy loss prior to the double test were negative for SARS-CoV-2 antibodies. There were no significant differences in nuchal translucency thickness for women testing positive (n=14) versus negative (p=0.20) or grey zone (n=16) versus negative (p=0.28). In total, 54 women experienced a pregnancy loss of whom two had grey zone or positive SARS-CoV-2 antibodies.ConclusionMaternal SARS-CoV-2 infection did not seem harmful in first trimester pregnancies. Infection had no effect on the nuchal translucency thickness and women with SARS-CoV-2 antibodies were not overrepresented among women with pregnancy loss.

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Pitfalls in Emergency Department Focused Bedside Sonography of First Trimester Pregnancy

Emergency Medicine International ◽

10.1155/2013/982318 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Kerri Layman ◽

Michael Antonis ◽

Jonathan E. Davis

Keyword(s):

Emergency Department ◽

Clinical Decision Making ◽

Case Reports ◽

Clinical Decision ◽

First Trimester ◽

Intrauterine Pregnancy ◽

Diagnostic Modality ◽

First Trimester Pregnancy ◽

Trimester Pregnancy ◽

First Trimester Of Pregnancy

Background. Bedside sonography performed by emergency physicians is frequently utilized for real-time clinical decision-making in the emergency department (ED) setting. This includes the sonographic evaluation of pain or bleeding in the first trimester of pregnancy. The detection of intrauterine pregnancy (IUP) or life-threatening conditions, including ectopic pregnancy, is critical.Objectives. This paper will review several important pearls and avoidable pitfalls of this diagnostic modality by brief presentation of illustrative cases followed by discussion of key principles.Case Reports. Three patients evaluated in the ED for bleeding or pain occurring during the first trimester of pregnancy will be presented.Conclusions. When conducting emergency bedside ultrasound for the evaluation of first trimester pregnancy, it is important to avoid common pitfalls that can place your patient at risk.

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Association of TSH level above 2.1 mlU/L and first trimester pregnancy loss in anti-TPO antibody negative women

10.1101/018051 ◽

2015 ◽

Author(s):

Yisrat Jahan ◽

Enayetur Raheem ◽

Mohammad Akteruzzaman ◽

M Anwar Hussain ◽

Rezaul Karim ◽

...

Keyword(s):

Pregnancy Loss ◽

Local Level ◽

First Trimester ◽

Control Group ◽

Case Group ◽

Thyroid Autoantibody ◽

First Trimester Pregnancy ◽

Trimester Pregnancy ◽

Group I ◽

First Trimester Of Pregnancy

Although the exact level of TSH that is indicative of risk of pregnancy loss is not known, a number of studies have suggested a range of values for TSH level that are associated with first trimester pregnancy loss. We conducted an unmatched case-control study to test if a TSH level above 2.1 mlU/L is associated with first trimester pregnancy loss in anti-TPO antibody negative women. We found relatively higher number of women in the case group (18) whose TSH level was above 2.1 mlU/L compared to 7 women in control group. When considered patients in Group I (TSH ≤2.1 mlU/L), 45.74% had miscarriage while 54.26% did not have miscarriage within first trimester of pregnancy. Among the Group II patients (TSH >2.1 mlU/L), 78% had miscarriage and 28% did not have miscarriage. Noticeably there is a larger proportion of miscarriage among the women with TSH level above 2.1 mlU/L. The association between TSH level and first trimester pregnancy loss was statistically significant (p=.0196). From the multivariate analysis, odds ratio for TSH level (OR 4.0, 95% CI: 1.44-11.16) indicates that odds of having miscarriage whose TSH level is above 2.1 mlU/L is 4 times compared to those with TSH level below 2.1 mlU/L after adjusting for the effects of age and BMI. At a global level, the findings of this study provide evidence to the existing discussion on redefining the upper limit of TSH level that is related to first trimester pregnancy loss. At the local level, the results will have direct implication in facilitating management of future pregnancies particularly during the first trimester among Bangladeshi thyroid autoantibody negative women.

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