scholarly journals Antenatal Spontaneous Renal Forniceal Rupture Presenting as an Acute Abdomen

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Jennifer Travieso ◽  
Omar M. Young
Keyword(s):  
Acute Abdomen ◽  
Delayed Diagnosis ◽  
Kidney Injury ◽  
Percutaneous Nephrostomy ◽  
Gravid Uterus ◽  
Intractable Pain ◽  
Second Trimester ◽  
Improved Outcomes ◽  
Maternal And Neonatal Outcomes ◽  
In Pregnancy

Background. Renal forniceal rupture is a lesser-known cause of acute abdomen in pregnancy. The ureteral compression by the gravid uterus places pregnant women at a higher risk. Sequelae in pregnancy could include intractable pain, acute kidney injury, and preterm birth.Case. A 22-year-old primigravida with no prior medical history presented with an acute abdomen in her second trimester. The diagnosis of renal forniceal rupture was made by a radiologist using MRI. A percutaneous nephrostomy catheter was placed, and the patient’s pain was relieved. She subsequently delivered at term.Conclusion. Upon presentation of an acute abdomen in pregnancy, providers may not include renal forniceal rupture in their differential as readily as obstetric or gynecologic causes, resulting in delayed diagnosis, unnecessary invasive interventions, and potentially adverse maternal and neonatal outcomes. Increasing provider awareness could result in improved outcomes.

scholarly journals Peritoneovaginal Fistula and Appendicitis-Related Pelvic Abscess in Pregnancy

2020 ◽  
Vol 10 (02) ◽  
pp. e129-e132
Author(s):  
Mona Saleh ◽  
Antonia Francis Kim ◽  
Andrew Gardner ◽  
Katherine Sun ◽  
Sara Brubaker
Keyword(s):  
Pregnant Patient ◽  
Pelvic Abscess ◽  
Acute Onset ◽  
Gravid Uterus ◽  
Second Trimester ◽  
Appendiceal Abscess ◽  
Speculum Examination ◽  
Complete Physical Examination ◽  
Criteria For Diagnosis ◽  
In Pregnancy

AbstractAppendicitis in pregnancy is the most common nonobstetric surgical emergency. Pregnancy causes changes in anatomy, which could lead to uncertainty regarding the diagnosis of appendicitis. This case report describes a case of appendicitis presenting with peritoneovaginal fistula in a pregnant woman in the second trimester, with interesting finding of isolated appendiceal endometriosis on pathology. The importance of complete physical examination, including speculum examination, is emphasized in the pregnant patient presenting with acute-onset abdominal pain. Imaging criteria for diagnosis of appendicitis should be adjusted to account for the gravid uterus, which may cause appendiceal abscess to appear in a variety of locations, such as posterior to the cervix, as in this case.

scholarly journals Small Bowel Obstruction due to Meckel's Diverticulitis Presenting in pregnancy

The Physician ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. 1-4
Author(s):  
Chaitra Naik Khanna ◽  
Paul Richard Harris ◽  
Gemma Faulkner
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Gravid Uterus ◽  
Second Trimester ◽  
Ileal Loop ◽  
Stapling Device ◽  
Delay In Diagnosis ◽  
Meckel’S Diverticulitis ◽  
In Pregnancy

Meckel’s diverticulitis is an extremely rare cause of acute abdomen during pregnancy. Depending on the clinical presentation it can be managed either by laparoscopy or laparotomy. We report the case of a 29-year-old pregnant female, presenting with abdominal pain and distension in the early second trimester. The abdominal ultrasound was inconclusive. Magnetic resonance imaging showed small bowel obstruction with a dilated ileal loop due to an inflamed Meckel’s diverticulum adherent to the fundus of the gravid uterus was identified during laparotomy. Diverticular resection was carried out with a stapling device. The diagnosis of Meckel’s diverticulitis can be challenging, especially in pregnancy, and a delay in diagnosis can be detrimental to the mother and foetus. Although laparoscopic management has been reported to be safe in the second trimester, in this case, the abdominal distension would have made access challenging and unsafe, and hence the decision to perform a laparotomy was taken. 

scholarly journals A retrospective study on maternal and perinatal outcome in pregnancy requiring DJ stent and PCN during pregnancy

2019 ◽  
Vol 8 (10) ◽  
pp. 3903
Author(s):  
Liji David ◽  
Swati Rathore ◽  
Neeraj Kulkarni ◽  
Batiston Decruse Waanbah ◽  
Benedict Paul Samuel ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Perinatal Outcome ◽  
Symptom Relief ◽  
Percutaneous Nephrostomy ◽  
Severe Form ◽  
Gravid Uterus ◽  
Team Approach ◽  
Tertiary Center ◽  
Dj Stent ◽  
In Pregnancy

Background: Gestational hydronephrosis (GH) is result of dilatation effect of the progesterone and mechanical compression of the gravid uterus. Management during pregnancy is challenging as routine radiological investigations and surgical treatments cannot be applied due to the potential harm to the fetus. Intervention is indicated in women who fail to respond to conservative management. Acute hydronephrosis and renal colic are common etiologies for loin pain, and can lead to severe form of urinary tract infection affecting perinatal outcome. Ureteric stenting and percutaneous nephrostomy (PCN) during pregnancy are safe, requiring no intra-operative imaging, and inserted under local anaesthesia. It provides good symptom relief, low complication rate, efficient and safe modality for women with refractory symptoms.Methods: A retrospective study of pregnant women admitted under obstetric units with acute hydronephrosis requiring DJ stenting and/or PCN. Aim was to evaluate the course and pregnancy outcomes in a tertiary center of Southern India over a period of five years.Results: Descriptive statistical analysis was done in 12 women with acute hydronephrosis in pregnancy. 66.7% were nulliparous and mean gestational age at admission was 31 weeks. Diagnosis was done by USG. One-fourth had pyelonephritis and calculus being the main pathology (n=9;75%).Women requiring DJ stent and PCN were 41.6% and 58.4% respectively. 41.7% had preterm labour. 66.7% delivered vaginally, birth weight was more than 2.5kg in 50%.Conclusions: Maternal and neonatal outcome mainly depends on the early diagnosis. In this study we emphasize on the importance of multidisciplinary team approach in the management of women with acute hydronephrosis. DJ stent and PCN are efficient and safe modalities in women with refractory symptoms.

scholarly journals Right ovarian torsion and oophorectomy in second trimester of pregnancy with subsequent live birth at term

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Omotade A Ijarotimi ◽  
◽  
Olumide A Adeniyi Omitinde ◽  
Stephen O Omitinde ◽  
Akaninyene E Ubom ◽  
...  
Keyword(s):  
Acute Abdomen ◽  
Live Birth ◽  
Surgical Intervention ◽  
Delayed Diagnosis ◽  
Exploratory Laparotomy ◽  
First Trimester ◽  
Ovarian Torsion ◽  
Polycystic Ovaries ◽  
Case Presentation ◽  
In Pregnancy

Introduction: Ovarian torsion is a cause of acute abdomen in pregnancy with an incidence of less than 1% occurring most commonly in the first trimester. The symptoms are non-specific with a propensity for missed or delayed diagnosis which may worsen the morbidity associated with this condition. Management is mainly surgical and pregnancy outcome is usually satisfactory. Case presentation: We present the case of a 29-year-old G2 P0 +1 with background polycystic ovaries who complained of abdominal pains at an Estimated Gestational Age (EGA) of 21 weeks in pregnancy. Clinical suspicion was confirmed with a 2D abdominopelvic ultrasound and she subsequently had emergency exploratory laparotomy with right oophorectomy. Pregnancy progressed well and she had a live birth at term. Conclusion: Ovarian torsion is rare in pregnancy. Complications following prompt surgical intervention are however, few and pregnancy outcomes are usually favourable. Keywords: Ovarian cyst; torsion; acute abdomen; cyst accident; pregnancy.

Neurological manifestation in severe hypothyroidism in pregnancy

2020 ◽  
Vol 13 (12) ◽  
pp. e238069
Author(s):  
Aparna Sharma ◽  
Nilofar Noor ◽  
Vatsla Dadhwal
Keyword(s):  
Peripheral Neuropathy ◽  
Facial Palsy ◽  
Caesarean Delivery ◽  
Thyroid Stimulating Hormone ◽  
Neurological Manifestations ◽  
Second Trimester ◽  
Pituitary Hyperplasia ◽  
Very High ◽  
In Pregnancy

Neurological manifestations of hypothyroidism include peripheral neuropathy and pituitary hyperplasia. However, these associations are rarely encountered during pregnancy. We report a case of a known hypothyroid with very high thyroid stimulating hormone (TSH) values (512 μIU/mL) in the second trimester. At 24 weeks she developed facial palsy and pituitary hyperplasia which responded to a combination of steroids and thyroxine. She had caesarean delivery at 35 weeks and 3 days gestation in view of pre-eclampsia with severe features and was discharged on oral antihypertensives and thyroxine. On follow-up at 5 months, TSH normalised and pituitary hyperplasia showed a greater than 50% reduction in size. To our knowledge, this is the first reported case of facial palsy and pituitary hyperplasia associated with hypothyroidism during pregnancy.

Comparison of pregnancy outcomes after second trimester amniocentesis between procedures performed by experts and non-experts

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Tanapak Wisetmongkolchai ◽  
Fuanglada Tongprasert ◽  
Kasemsri Srisupundit ◽  
Suchaya Luewan ◽  
Kuntharee Traisrisilp ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Loss Rate ◽  
Fetal Loss ◽  
Adverse Pregnancy Outcomes ◽  
Expert Group ◽  
Second Trimester ◽  
Single Institution ◽  
Adverse Pregnancy ◽  
In Pregnancy ◽  
Singleton Pregnancies

AbstractObjectivesTo compare the rate of fetal loss in pregnancy after second trimester amniocentesis between procedures performed by experts and non-experts and to assess other pregnancy complications as secondary outcomes.MethodsA retrospective cohort study was performed on singleton pregnancies that underwent mid-trimester amniocenteses in a single institution. The fetal loss rates of procedures performed by experts and non-experts were collected and analyzed. Other adverse pregnancy outcomes were also examined.ResultsIn total, 14,450 amniocenteses were performed during the study period. These included 11,357 (78.6%) procedures in the group expert operators and 3,093 (21.4%) procedures in the group non-expert operators. In the non-expert group, the fetal loss rate was slightly increased but not significantly (p=0.24).In addition, the higher number of spontaneous abortions was associated with blood-stained amniotic fluid sample (p<0.001; RR=9.28). Multiple needle insertions also increased in the non-expert group significantly. However, no difference in pregnancy outcomes was found between in single and multiple needle insertions.ConclusionsThe amniocentesis procedures performed by the non-experts was not increase the fetal loss rate. However, the other adverse pregnancy outcomes, including preterm birth, low birth weight and fetal growth restriction were significantly increased in the non-expert group.

scholarly journals Serum cystatin is not a marker of glomerular filtration rate in pregnancy

2009 ◽  
Vol 2 (3) ◽  
pp. 121-122 ◽  
Author(s):  
Kate Bramham ◽  
David Makanjuola ◽  
Wael Hussein ◽  
Debra Cafful ◽  
Hassan Shehata
Keyword(s):  
Glomerular Filtration Rate ◽  
Observational Study ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Prospective Observational Study ◽  
Second Trimester ◽  
Third Trimester ◽  
Serum Cystatin ◽  
In Pregnancy

The role of cystatin C (Cys-C) as a marker of glomerular filtration rate (GFR) in pregnancy is undetermined. Measurements of Cys-C and creatinine (Cr) were taken at 14–17+6, 18–23+6, 27–31+6 weeks' gestation, at delivery and 2–6 weeks postpartum in a prospective observational study of 27 women. There was no difference between Cys-C levels in early and late second trimester, but they were significantly higher in early third trimester ( P < 0.001) than second trimester, despite no concurrent increase in Cr. Cys-C was also significantly higher at delivery than at all other times in pregnancy ( P < 0.001) and fell to postpartum values higher than second trimester measurements ( P < 0.01), but lower than delivery ( P<0.001). In conclusion, changes in Cys-C may be influenced by pregnancy-related changes in glomerular filtration and therefore we would advise against their use as a marker of GFR in pregnancy.

Transient ureteric obstruction following pelvic floor reconstruction

2021 ◽  
Vol 14 (5) ◽  
pp. e238669
Author(s):  
Liam Joseph Beamer ◽  
Sarah Neary ◽  
Thomas McCormack ◽  
David Ankers
Keyword(s):  
Pelvic Floor ◽  
Kidney Injury ◽  
Solitary Kidney ◽  
Percutaneous Nephrostomy ◽  
Pelvic Organ ◽  
Ureteric Obstruction ◽  
Pelvic Floor Reconstruction ◽  
Transient Nature ◽  
Recurrent Pelvic Organ Prolapse ◽  
History Of

We describe the first reported case of transient distal ureteric obstruction attributed to post-surgical oedema in a patient with a solitary kidney. This occurred following combined pelvic floor repair and sacrospinous fixation for recurrent pelvic organ prolapse and manifested clinically as anuria, radiological hydroureter and acute kidney injury in the postoperative period. The transient nature of this obstruction, which was managed by a temporary percutaneous nephrostomy, indicates that it was caused by ureteric compression secondary to soft tissue oedema following surgery. We highlight the importance of this potential complication in females with a history of nephrectomy, unilateral renal tract anomalies or severely diminished renal reserve.

Maternal and Neonatal Outcomes of Appendicitis in Pregnancy [19D]

2018 ◽  
Vol 131 ◽  
pp. 46S
Author(s):  
Michelanne Shields ◽  
Louisa R. Chatroux ◽  
Alyssa R. Hersh ◽  
Aaron B. Caughey
Keyword(s):  
Neonatal Outcomes ◽  
Maternal And Neonatal Outcomes ◽  
In Pregnancy
Sign in / Sign up

Export Citation Format

Share Document