8th Term pregnancy in uterus didelphys: a rare case report

2017 ◽  
Vol 6 (1) ◽  
Author(s):  
Banu Öndeş
Keyword(s):  
Case Report ◽  
Fallopian Tube ◽  
Apgar Score ◽  
Home Birth ◽  
Breech Presentation ◽  
Fetal Distress ◽  
Obstetric Complications ◽  
Close Monitoring ◽  
Uterus Didelphys ◽  
Emergency Cesarean

Abstract Introduction Uterus didelphys is a rarely observed Müllerian duct fusion defect. Two separately developing Müllerian ducts create two hemi uteri with separate fallopian tube, ovary and cervix which may cause obstetric complications. This case report presents a case reaching term for the 8th time, with eight live births discussed in view of the literature. Presentation of case A 38-year-old, gravid 9 para 7 abortion 1, pregnant woman applied to the hospital with breech presentation after unsuccessful home birth attempt. As a result of the indications of acute fetal distress, meconium in amniotic fluid and breech presentation emergency cesarean section was performed. A 2800 g, 49 cm long with 33 cm head circumference female infant was born with 1st min Apgar score of 6 and 5th min Apgar score of 8. During the operation it was observed that the patient had uterus didelphys with each hemi uterus having its own fallopian tube and ovary. After the operation vaginal speculum examination identified two cervices. The patient’s other seven births were homebirth and seven children were healthy and alive. Discussion It is rare for pregnancies in uterus didelphys cases to reach term. Due to the frequency of obstetric complications and negative pregnancy results, close monitoring is required before and during pregnancy.

scholarly journals VAGINAL DELIVERY VERSUS CESAREAN SECTION

2010 ◽  
Vol 17 (02) ◽  
pp. 300-303
Author(s):  
BUSHRA SHER ZAMAN ◽  
Ali Zulqarnain ◽  
RASHAD QAMAR ◽  
Anza Saleem ◽  
SUMERA SIDDIQUE
Keyword(s):  
Cesarean Section ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Apgar Score ◽  
Distress Syndrome ◽  
Breech Presentation ◽  
Neonatal Morbidity ◽  
Birth Trauma ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean

Objective: It is to compare neonatal morbidity in terms of birth trauma, respiratory distress syndrome, APGAR score in Primigravida with breech presentation delivered vaginally and emergency cesarean section. Design: Cross-sectional comparative study. Place and Duration of Study: Obstetrics and Gynaecology Unit-I, Bahawal Victoria Hospital, Bahawalpur from 1-5-2007 to 30-4-2008. Patients and Method: The study was carried out on all Primigravida with breech presentation reported through emergency in labour deliveredvaginally and by emergency cesarean section. The variable analyzed were birth trauma, respiratory distress syndrome and APGAR score at 1 and 5 minutes. Students-t test was used for comparison between means and chi square test for comparison between percentages. Significance was taken at P<0.05. Results: It was found that mean APGAR score at 1 and 5 minutes is 7.31 and 9.066 in vaginal and 8.533 and 9.644 incesarean group. Respiratory distress syndrome is more in cesarean (4.4%) than vaginal group (2.2%). Observed neonatal trauma is more in vaginal group (6.7%) than cesarean section (2.2%). Conclusion: Neonatal morbidity appears to be more in vaginal breech delivery than cesarean section for Primigravida with breech presentation at term. 

scholarly journals Relation between immediate postpartum APGAR score with umblical cord blood pH and fetal distress

2019 ◽  
Vol 8 (12) ◽  
pp. 4690
Author(s):  
Varuna Pathak ◽  
Deep Shikha Sahu
Keyword(s):  
Cesarean Section ◽  
Cord Blood ◽  
Apgar Score ◽  
Ph Value ◽  
Fetal Distress ◽  
Well Being ◽  
Emergency Cesarean Section ◽  
Medical Disorders ◽  
Blood Ph ◽  
Emergency Cesarean

Background: The one-minute Apgar score, proven useful for rapid assessment of the neonate, is often poorly correlated with other indicators of intrauterine well-being. Fetal asphyxia is directly associated with neonatal acidosis. Umbilical cord pH is best indicator of fetal hypoxemia and hypoxemia leads to neonatal acidosis. In today scenario, fetal distress is the leading indication of emergency cesarean section.Methods: A observational cross-sectional study conducted of one year between march 2017 to February 2018; of full-term obstetric patients undergoing emergency cesarean section for fetal distress as an indication. All patients included are term gestation with low risk pregnancy excluding medical disorders and other complications of pregnancy. Immediately after delivery umbilical artertial cord blood from placental site collected and sent for pH determination and Apgar score calculated of newborn.Results: Emergency cesarean section was being done for fetal distress diagnosed based on guidelines for Intermittent auscultation; maximum patients had fetal bradycardia (240) followed by fetal tachycardia (12) and irregular rhythm (18). Relation between pH value and the fetal outcome babies who had low pH value. i.e. <7.1; had maximum referrals with poor Apgar score at 1 min (<3) and at 5 min (<3). Out of 270 babies 18 had Apgar score <3 at 1 min, out of which 10 continued to have Apgar score <3 at 5 mins. These babies were referred to department of pediatrics and were not alive beyond day 2-4.Conclusions: The values of mean Apgar score and cord blood pH decreases, which is inversely proportion to duration and severity of intrauterine/intra partum asphyxia. Umbilical arterial cord blood pH correlation was found to be significant with Apgar score in neonates delivered with indication as fetal distress.

scholarly journals Analysis of Cesarean Section Using Robson’s 10-Group Classification at a Tertiary Level Hospital in Nepal

2018 ◽  
Vol 17 (2) ◽  
pp. 4-11
Author(s):  
Rosy Vaidya Malla ◽  
Chanda Hamal ◽  
Bibhusan Neupane ◽  
Ratna Khatri
Keyword(s):  
Breech Presentation ◽  
Fetal Distress ◽  
Group Classification ◽  
Close Monitoring ◽  
Multiparous Women ◽  
Obstetric Services ◽  
Group 3 ◽  
Group 5 ◽  
Level Hospital ◽  
Group 1

Introduction: Obstetric Services commenced at the teaching institute where this study was conducted from Aug 2012. Hence, a review of the data of C-section in this hospital is needed for standardisation of the obstetric services in terms of the rate of C-section, its various clinical indications and maternal and fetal outcomes.Methods: This is a retrospective study carried out over a period of 5 years from Aug 13, 2012 to Aug 11, 2017. All hospital deliveries conducted during the study period were included in this study and the patients’ details obtained from hospital records. All data obtained was recorded in master charts and analysed using SPSS version 23. The caesarean rate, its indications were calculated and categorised into groups according to Robson’s 10-group classification. Results: A total number of 4892 deliveries were conducted over this 5-year study period. C-section was performed in 1104 patients, giving a C-section rate of 22.57%. The most common indications were previous C-section (25.4%), fetal distress (14.3%) and breech presentation (10.3%). Robson’s Group 1 was the highest contributors to the overall CS rate, contributing 28% of all C-sections, followed by Group 5 (26.8%) and Group 3 (15.5%).Conclusions: Nulliparous and multiparous women in term pregnancy in labor and women with previous C-section contribute to more than 70% of overall C-sections at our centre. Hence, close monitoring of these groups of patients, increasing the use of instrumental delivery and practice of vaginal birth after C-section can significantly reduce the C-section rate in our centre. 

Anesthesia in Carvajal syndrome; the first case report

2020 ◽  
Vol 24 (1) ◽  
pp. 105-107
Author(s):  
Sedighe Shahhosseini ◽  
Reza Aminnejad ◽  
Amir Shafa ◽  
Mehrdad Memarzade
Keyword(s):  
Intensive Care ◽  
Case Report ◽  
Surgical Resection ◽  
Genetic Disorder ◽  
Anesthetic Technique ◽  
Close Monitoring ◽  
Anesthesia Management ◽  
Rare Genetic Disorder ◽  
First Case ◽  
Anesthetic Considerations

Carvajal syndrome is a rare genetic disorder. Patients reporting for surgery pose some difficulties in anesthesia management. In this case report we present the case of a 12-year-old boy, who was a known case of Carvajal syndrome, referred for surgical resection of perianal condyloma. Close monitoring of hemodynamic status is the mainstay of anesthetic considerations in such patients. As in any other challenging scenario, it should be kept in mind that ‘there is no safest anesthetic agent, nor the safest anesthetic technique; there is only the safest anesthesiologist’. Citation: Shahhosseini S, Aminnejad R, Shafa A, Memarzadeh M. Anesthesia in Carvajal syndrome; the first case report. Anaesth pain intensive care 2020;24(1):___ DOI: https://doi.org/10.35975/apic.v24i1.

scholarly journals Severe Acute Respiratory Syndrome Coronavirus 2 Placental Infection and Inflammation Leading to Fetal Distress and Neonatal Multi-Organ Failure in an Asymptomatic Woman

2020 ◽  
Author(s):  
Sam Schoenmakers ◽  
Pauline Snijder ◽  
Robert M Verdijk ◽  
Thijs Kuiken ◽  
Sylvia S M Kamphuis ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Vertical Transmission ◽  
Neonatal Intensive Care ◽  
Quantitative Polymerase Chain Reaction ◽  
Antigen Expression ◽  
Fetal Distress ◽  
Adverse Outcomes ◽  
Placental Infection ◽  
Emergency Cesarean ◽  
Increased Risk

Abstract Background In general, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy is not considered to be an increased risk for severe maternal outcomes but has been associated with an increased risk for fetal distress. Maternal-fetal transmission of SARS-CoV-2 was initially deemed uncertain; however, recently a few cases of vertical transmission have been reported. The intrauterine mechanisms, besides direct vertical transmission, leading to the perinatal adverse outcomes are not well understood. Methods Multiple maternal, placental, and neonatal swabs were collected for the detection of SARS-CoV-2 using real-time quantitative polymerase chain reaction (RT-qPCR). Serology of immunoglobulins against SARS-CoV-2 was tested in maternal, umbilical cord, and neonatal blood. Placental examination included immunohistochemical investigation against SARS-CoV-2 antigen expression, with SARS-CoV-2 ribonucleic acid (RNA) in situ hybridization and transmission electron microscopy. Results RT-qPCRs of the oropharynx, maternal blood, vagina, placenta, and urine were all positive over a period of 6 days, while breast milk, feces, and all neonatal samples tested negative. Placental findings showed the presence of SARS-CoV-2 particles with generalized inflammation characterized by histiocytic intervillositis with diffuse perivillous fibrin depositions with damage to the syncytiotrophoblasts. Conclusions Placental infection by SARS-CoV-2 leads to fibrin depositions hampering fetal-maternal gas exchange with resulting fetal distress necessitating a premature emergency cesarean section. Postpartum, the neonate showed a fetal or pediatric inflammatory multisystem-like syndrome with coronary artery ectasia temporarily associated with SARS-CoV-2 for which admittance and care on the neonatal intensive care unit (NICU) were required, despite being negative for SARS-CoV-2. This highlights the need for awareness of adverse fetal and neonatal outcomes during the current coronavirus disease 2019 pandemic, especially considering that the majority of pregnant women appear asymptomatic.

scholarly journals 237 Fallopian tube choriocarcinoma: a case report

2020 ◽  
Author(s):  
T Peshkova ◽  
S Beridze ◽  
I Nakashidze ◽  
K Kamashidze
Keyword(s):  
Case Report ◽  
Fallopian Tube

Massive Extra-Abdominal Umbilical Vein Varix: A Case Report

2021 ◽  
pp. 1-4
Author(s):  
Josef Jackson ◽  
Eumenia Castro ◽  
Michael A. Belfort ◽  
Alireza A. Shamsirshaz ◽  
Ahmed A. Nassr ◽  
...  
Keyword(s):  
Case Report ◽  
Umbilical Cord ◽  
Neonatal Period ◽  
Umbilical Vein ◽  
Fetal Distress ◽  
Fetal Anemia ◽  
Pathologic Examination ◽  
Fetal Demise ◽  
Increased Risk ◽  
Umbilical Vein Varix

Umbilical vein varices are rare umbilical cord anomalies that typically occur intra-abdominally. Extra-abdominal umbilical vein varices are exceedingly rare and usually diagnosed postnatally on gross pathologic examination. Umbilical vein varices have been associated with increased risk of fetal anemia, cardiac abnormalities, and intrauterine fetal demise. This case report discusses a patient who presented with a massive extra-abdominal umbilical vein varix, whose infant was ultimately delivered due to fetal distress and died in the neonatal period. This report also discusses associated fetal conditions and guidelines for antenatal testing and surveillance of known umbilical vein varices.

scholarly journals Formulating an anesthetic plan using a list of high-risk pregnant women on cloud-based business communication tools: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Junnosuke Kimura ◽  
Kento Kawamura ◽  
Manami Minoura ◽  
Ayako Hiramoto ◽  
Yoshifumi Suga ◽  
...  
Keyword(s):  
Case Report ◽  
High Risk ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Pregnant Women ◽  
Cesarean Delivery ◽  
Business Communication ◽  
Communication Tools ◽  
Case Presentation ◽  
Emergency Cesarean

Abstract Background We report a case in which a list of high-risk pregnant women on cloud-based business communication tools was useful in formulating an anesthetic plan for unscheduled cesarean section. Case presentation A 37-year-old woman, who had been prescribed icosapentate for hypertriglyceridemia, received an antenatal anesthetic evaluation for possible cesarean delivery, and it was agreed that the anesthetic method for emergency cesarean section was general anesthesia if the surgery would take place within 7 days after the discontinuation of the drug, and regional anesthesia if it would take place any time later. Then this agreement was uploaded on the cloud-based business communication tools, and updated until she delivered her baby via unscheduled cesarean section. Conclusions A cloud-based business communication tools was useful in formulating an anesthesia plan for a patient undergoing a cesarean delivery. However, more discussion would be needed to utilize it in security.

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