Pulmonary carcinoid presenting in pregnancy with an unusual radiological feature

Pulmonary carcinoid tumours are a rare form of malignancy that often present with clinical heterogeneity and are challenging to diagnose. Diagnosis during pregnancy is further complicated by delays in imaging and procedures to minimise harm to the fetus. This case describes a primigravid healthcare worker who was diagnosed with pulmonary carcinoid in her first trimester of pregnancy, with particular focus on the unique radiological findings of subpleural blebs as a feature.

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Axial torsion of Meckel’s diverticulum causing acute peritonitis in the first trimester of pregnancy: a case report

Surgical Case Reports ◽

10.1186/s40792-019-0754-y ◽

2019 ◽

Vol 5 (1) ◽

Author(s):

Hiromitsu Nagata ◽

Hiroyasu Nishizawa ◽

Susumu Mashima ◽

Yasuyuki Shimahara

Keyword(s):

Clinical Diagnosis ◽

Meckel’S Diverticulum ◽

Ileocecal Valve ◽

First Trimester ◽

Meckel's Diverticulum ◽

Ileocecal Resection ◽

Bowel Loop ◽

Axial Torsion ◽

First Trimester Of Pregnancy ◽

In Pregnancy

Abstract Background Meckel’s diverticulum is considered the most prevalent congenital anomaly of the gastrointestinal tract. Approximately 4% of patients are symptomatic with complications such as bleeding, intestinal obstruction, and inflammation, while axial torsion of Meckel’s diverticulum is rare, particularly in pregnancy. Case presentation A 31-year-old woman in week 15 of pregnancy complained of epigastric pain, nausea and vomiting. Clinical diagnosis was severe hyperemesis gravidarum. Because the symptoms persisted during hospitalization, CT was performed and revealed dilated small bowel loops with multiple air-fluid levels. In the right mid-abdomen, there was a large part of air containing a cavity connected to the small intestine, which was considered a dilated bowel loop. Emergency laparotomy was performed and axial torsion of a large Meckel’s diverticulum measuring 11 cm was found at a few centimeters proximal to the ileocecal valve. Ileocecal resection including Meckel’s diverticulum was performed. The postoperative course was uneventful. At 40 weeks gestation, she had vaginal delivery of normal baby. Conclusion The physiological and anatomical changes in pregnancy can make a straightforward clinical diagnosis difficult. Prompt diagnosis and management were needed in order to avoid significant maternal and fetal risks. The use of imaging examinations, especially CT examination, with proper timing may be helpful to prevent delay in diagnosis and surgical intervention. Here, we report the case of a patient with axial torsion of Meckel’s diverticulum in pregnancy. To our knowledge, axial torsion of Meckel’s diverticulum in the first trimester of pregnancy has not been reported in the English medical literature.

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A Very Rare Form of Conjoined Twinning: Diprosopus Twins Diagnosed in the First Trimester of Pregnancy by Transvaginal Ultrasonography

Turkiye Klinikleri Journal of Medical Sciences ◽

10.5336/medsci.2011-22783 ◽

2012 ◽

Vol 32 (5) ◽

pp. 1453-1456

Author(s):

Mehmet Metin ALTAY ◽

Ahmet Okyar EROL ◽

Çiğdem ÖZYÜREK KILIÇ ◽

Serdinç ÖZDOĞAN ◽

Rahmi Sinan KARADENİZ

Keyword(s):

First Trimester ◽

Transvaginal Ultrasonography ◽

Rare Form ◽

First Trimester Of Pregnancy

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Effectiveness of Ginger in Treating Nausea and Vomiting of Pregnancy

Eureka Herba Indonesia ◽

10.37275/ehi.v3i1.46 ◽

2021 ◽

Vol 3 (1) ◽

pp. 120-124

Author(s):

Ahmad Ramadhanu

Keyword(s):

Lifestyle Modification ◽

First Trimester ◽

Nausea And Vomiting ◽

Main Complaint ◽

Significant Burden ◽

First Trimester Of Pregnancy ◽

Cns Side Effects ◽

Possible Cause ◽

In Pregnancy

Nausea and vomiting in pregnancy (NVP) is one of the common main complaint in pregnancy. NVP can be a significant burden to the patient, make a decrease in quality of life, pregnancy threatening or even worse can lead to nutritional loss and death. NVP diagnosed when in first trimester of pregnancy and the other possible cause of NVP is excluded. Management of NVP is included maintaining hydration, nutrition, and lifestyle modification. Also avoiding the smells, food, or activity that can cause nause are necessary. There are some methods to treat NVP including pharmalogical or non-pharmalogical. The non-pharmalogical approach is change nutritional habits, lifestyle and medications. Several pharmalogical agents that can be used to relief the symptoms of NVP are pyridoxine, anti- histamines, metoclopramide, pyridoxine/doxylamine, promethazine and metoclopramide. Some patients also want to try more “natural” medications for NVP like ginger. The pharmacological activity is thought to stand in the pungent principles (gingerols and shogaols) and volatile oils (sesquiterpenes and monoterpenes). The true mechanism of action of ginger is probable to be a gastric effect, to increase tone and peristaltic due to anticholinergic and antiserotonin act. Ginger acts straight to the digestive tract and avoids the CNS side effects common to centrally acting antiemetics. Ginger is available in capsule or syrup form or in candy, cookies, beer, tinctures, teas, sodas, and jam. Nowadays, true dosing is available only if one uses standardized extracts; however, women may choose to use another form of ginger.

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Suicide due to fear of COVID-19, in pregnancy, lead to Neonatal malformations: A case report

10.22541/au.162373187.73918053/v1 ◽

2021 ◽

Author(s):

Javad Boskabadi ◽

Saeed Kargar-Soleiman abad ◽

shahrokh mehrpishe ◽

Elham Pishavar ◽

Roya Farhadi

Keyword(s):

Mental Health ◽

Case Report ◽

Antipsychotic Drugs ◽

First Trimester ◽

Limited Data ◽

First Trimester Of Pregnancy ◽

In Pregnancy

There is limited data about various effect of COVID-19 in pregnancy. The Covid-19 pandemic can increase anxiety or schizophrenia exacerbation. Neonatal malformations from antipsychotic drugs exposures during first trimester of pregnancy have been reported. However, their effect near delivery have been less studied. Keywords: Covid-19, pregnancy, mental health, neonatal malformations

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Myasthenia Gravis in Pregnancy Treated With Daily Massive Vitamin D Dose

Asploro Journal of Biomedical and Clinical Case Reports ◽

10.36502/2020/asjbccr.6208 ◽

2020 ◽

Vol 3 (2) ◽

pp. 171-177

Author(s):

Silva LFF ◽

Martins MC ◽

Caplum MC ◽

Luz MS ◽

Amaral VM ◽

...

Keyword(s):

Vitamin D ◽

T Cells ◽

Myasthenia Gravis ◽

Striated Muscle ◽

First Trimester ◽

Effector T Cells ◽

Myasthenic Crisis ◽

First Trimester Of Pregnancy ◽

Muscle Groups ◽

In Pregnancy

Myasthenia gravis (MG) is an autoimmune disease affecting the motor endplate of striated muscle. It is caused by antibodies that act in the cholinergic receptors at the post-synaptic portion of the neuromuscular junction, which results in asthenia and fatigue in some muscle groups. In pregnancy, it’s unpredictable, because pregnant women can present MG exacerbation, remission, stability, or even a myasthenic crisis during pregnancy. Complications are more frequent in the first trimester of pregnancy and the first 30 days of puerperium. Vitamin D and its metabolites are potent immunomodulators since their immuno-regulatory effect directly inhibits effector T cells and induces regulatory T cells (Treg) to decrease the production of inflammatory cytokines. The authors present a case report of a patient with MG who was treated throughout pregnancy with massive doses of vitamin D, obtaining good results.

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Drug-induced cytolytic syndrome in pregnancy: clinical and biochemical diagnostic criteria

Journal of obstetrics and women s diseases ◽

10.17816/jowd65628-35 ◽

2016 ◽

Vol 65 (6) ◽

pp. 28-35

Author(s):

Irina V Borisova

Keyword(s):

Pregnant Women ◽

Hormone Therapy ◽

Clinical Manifestations ◽

First Trimester ◽

Gamma Glutamyl Transpeptidase ◽

Drug Induced ◽

Planning Stage ◽

Protein Levels ◽

First Trimester Of Pregnancy ◽

In Pregnancy

The aim of the study was evaluation of clinical and laboratory manifestations of drug-induced cytolytic syndrome in pregnancy. In the research group included 62 pregnant women with drug-induced liver injury (DILI) in the first trimester of pregnancy. These pregnant women received hormone therapy at the planning stage and/or during pregnancy for the prevention and treatment of miscarriage and had clinical and biochemical manifestations of cytolytic syndrome. Pregnancy after IVF and ovulation induction was in 60.8% of cases. Hormone therapy for pregnant patients received long-term, 85% of pregnant women used estrogen and progestin drugs. DILI during pregnancy characterized by low-symptom or asymptomatic clinical manifestations. DILI manifested cytolytic biochemical syndrome, in which there is isolated increase of transaminase levels, in some cases accompanied by increased level of gamma glutamyl transpeptidase, liver glutamate dehydrogenase and decreased total protein levels, in the first place due to the albumin fraction.

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Implementing standardised rhodes index to measure the efficacy of ginger extract (Zingiber officinale) in pregnancy induced nausea and vomiting

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20173273 ◽

2017 ◽

Vol 6 (8) ◽

pp. 1932

Author(s):

Asha P. Dass ◽

Priyadarshini Deodurg ◽

Sandhiya Rajappan

Keyword(s):

Zingiber Officinale ◽

First Trimester ◽

Nausea And Vomiting ◽

Ginger Extract ◽

Natural Signs ◽

End Of Treatment ◽

First Trimester Of Pregnancy ◽

Baseline Values ◽

Moderate Nausea ◽

In Pregnancy

Background: Although nausea and vomiting are natural signs of pregnancy affecting about half the pregnant women during their first trimester of pregnancy, it is unpleasant and difficult symptom to deal with. Considering the fact that medication during pregnancy is not advised, we decided to study the efficacy of a natural product to control nausea and vomiting during early pregnancy. Our study was directed to estimate the efficacy of ginger extract (Zingiber officinale) in pregnancy induced nausea and vomiting.Methods: A total of 30 women with pregnancy of 4-16 weeks, suffering from nausea and vomiting were included in this study (n=30). Subjects were given ginger extract 250mg, to be taken 3 times a day half an hour before food for 1 week. Severity of vomiting was assessed by Rhodes Index of Nausea and Vomiting by the patients. Baseline scores were compared with the score at the end of 7 day. The findings were analysed statistically.Results: Effect with the ginger extract in pregnancy induced nausea and vomiting was assessed at the end of treatment (day 7) and compared with the baseline values. Four patients reported symptoms of heartburn. Otherwise, there were no other reports of any adverse effects. The results showed significance (p <0.005).Conclusions: Ginger extract (Zingiber officinale) helps in reducing severity and frequency of pregnancy induced nausea and vomiting. Therefore, we conclude that ginger extract can be used for mild to moderate nausea and vomiting induced by pregnancy during first trimester.

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Ramadan fasting and newborn's birth weight in pregnant Muslim women in The Netherlands

British Journal Of Nutrition ◽

10.1017/s0007114514002219 ◽

2014 ◽

Vol 112 (9) ◽

pp. 1503-1509 ◽

Cited By ~ 18

Author(s):

Ary I. Savitri ◽

Nasim Yadegari ◽

Julia Bakker ◽

Reyn J. G. van Ewijk ◽

Diederick E. Grobbee ◽

...

Keyword(s):

Birth Weight ◽

The Netherlands ◽

Medical Records ◽

Muslim Women ◽

First Trimester ◽

Strict Adherence ◽

Ramadan Fasting ◽

First Trimester Of Pregnancy ◽

In Pregnancy

Many Muslim women worldwide are pregnant during Ramadan and adhere to Ramadan fasting during pregnancy. In the present study, we determined whether maternal adherence to Ramadan fasting during pregnancy has an impact on the birth weight of the newborn, and whether the effects differed according to trimester in which Ramadan fasting took place. A prospective cohort study was conducted in 130 pregnant Muslim women who attended antenatal care in Amsterdam and Zaanstad, The Netherlands. Data on adherence to Ramadan fasting during pregnancy and demographics were self-reported by pregnant women, and the outcome of the newborn was retrieved from medical records after delivery. The results showed that half of all the women adhered to Ramadan fasting. With strict adherence to Ramadan fasting in pregnancy, the birth weight of newborns tended to be lower than that of newborns of non-fasting mothers, although this was not statistically significant ( − 198 g, 95 % CI − 447, 51, P= 0·12). Children of mothers who fasted in the first trimester of pregnancy were lighter at birth than those whose mothers had not fasted ( − 272 g, 95 % CI − 547, 3, P= 0·05). There were no differences in birth weight between children whose mothers had or had not fasted if Ramadan fasting had taken place later in pregnancy. Ramadan fasting during early pregnancy may lead to lower birth weight of newborns. These findings call for further confirmation in larger studies that should also investigate potential implications for perinatal and long-term morbidity and mortality.

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Progesterone and estrogen are potential mediators of gastric slow-wave dysrhythmias in nausea of pregnancy

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.1996.270.3.g506 ◽

1996 ◽

Vol 270 (3) ◽

pp. G506-G514 ◽

Cited By ~ 9

Author(s):

J. W. Walsh ◽

W. L. Hasler ◽

C. E. Nugent ◽

C. Owyang

Keyword(s):

Pregnant Women ◽

Slow Wave ◽

First Trimester ◽

Additive Effect ◽

Signal Power ◽

Recording Time ◽

Gastric Slow Wave ◽

Gastric Dysrhythmias ◽

First Trimester Of Pregnancy ◽

In Pregnancy

Women in pregnancy experience nausea, which correlates with gastric slow-wave rhythm disruption. Mediators of these dysrhythmias were explored. To quantitate slow-wave disruption, eight pregnant women with first-trimester nausea underwent electrogastrography after a 250-kcal meal. Results were compared with nonpregnant women with nausea during a prior pregnancy who received estradiol and/or progesterone to levels of the first trimester of pregnancy. Five pregnant women exhibited dysrhythmias, with increases in combined recording time in tachygastria plus bradygastria, as well as decreases in the percentage of electrogastrography signal power in the normal 3 cycle/min range (cpm), compared with nonpregnant women (P<0.05). Estradiol did not evoke dysrhythmias in nonpregnant women; however, progesterone induced increases in recording time in bradygastria plus tachygastria and increases in bradygastric signal power with corresponding decreases in signal power in the 3-cpm range (P<0.05). With estradiol and progesterone coadministration, an additive effect was observed at 3.3 +/- 0.8 h, with increased recording time in bradygastria alone and in bradygastria plus tachygastria with corresponding increases in bradygastric signal power and decreases in power in the 3-cpm range (P<0.05). In conclusion, women with nausea of pregnancy exhibit slow-wave rhythm disruption. Similar dysrhythmias are evoked in nonpregnant women by progesterone alone or in combination with estradiol in doses that reproduce levels in pregnancy. Thus gastric dysrhythmias in pregnancy may be due to a combination of elevated progesterone and estrogen levels.

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Malignant Phylloides Tumor in Pregnancy

The American Surgeon ◽

10.1177/000313481007600312 ◽

2010 ◽

Vol 76 (3) ◽

pp. 302-305 ◽

Cited By ~ 5

Author(s):

Kristen M. Blaker ◽

Sunati Sahoo ◽

Maria R. Schweichler ◽

Anees B. Chagpar

Keyword(s):

Histopathological Examination ◽

First Trimester ◽

Breast Conserving Surgery ◽

Third Trimester ◽

High Power Field ◽

Cystosarcoma Phylloides ◽

First Case ◽

First Trimester Of Pregnancy ◽

High Mitotic Count ◽

In Pregnancy

Malignant phylloides tumors are exceedingly rare with few cases being reported in pregnancy. We describe the first case ever reported of a malignant phylloides tumor presenting in the first trimester of pregnancy and provide insight into the complexities of management as well as a review of the known literature. An extensive PubMed literature search for “cystosarcoma,” “phylloides,” and “pregnancy” was performed. References of each citation were reviewed. Only six previous cases of phylloides tumor in pregnancy were found, none of which were in the first trimester. Medical records of a patient presenting to our institution at 9 weeks gestation with a malignant phylloides tumor were reviewed. We further provide a review of the current literature of the management of phylloides tumor in pregnancy. A 27-year-old white G2P0SA1 woman with no family history of breast cancer presented with a right breast mass at her first prenatal examination at 9 weeks of pregnancy. Ultrasound confirmed a solid mass measuring 24 mm. Core needle biopsy demonstrated a malignant phylloides tumor. She previously had a fibroadenoma removed from the same breast 7 years previously. The current tumor was excised to clear margins. Histopathological examination revealed a 4-cm fibroepithelial tumor with marked stromal cellularity and a high mitotic count (five to seven mitoses/high-power field), confirming the diagnosis of malignant phylloides tumor. The patient continued her pregnancy without complications. Six other cases of phylloides tumor presenting in pregnancy have been reported in the literature, one of which had bilateral disease. Of these, the average patient age was 32 years (range, 28 to 35 years). The majority of these patients presented in their third trimester (mean, 29 weeks; range, 20 to 36 weeks) and often had large tumors (mean, 15 cm; range, 5 to 21 cm). Four of the seven tumors (57%) required a mastectomy. Previous cases have shown phylloides tumors to present in the third trimester as large masses that require mastectomy. With early detection, malignant phylloides tumors can present in the first trimester of pregnancy at smaller sizes; in these patients, breast-conserving surgery is possible.

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