Uterine torsion in pregnancy: a rare but life-threatening condition

Midgut volvulus complicating congenital malrotation is a rare but life-threatening condition that can occur in pregnancy. We present a case of intestinal infarction resulting from midgut volvulus in a healthy 32-week pregnant woman who underwent emergency laparotomy and small bowel resection in the setting of fetal death in utero. This case highlights several challenging issues in diagnosing and managing this uncommon condition which leads to increased adverse perinatal outcomes. Prompt investigation and definitive surgical treatment are required when pregnant women present with bilious vomiting and new-onset abdominal or back pain especially beyond the first trimester.

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A Case of Macrolide-Refractory Mycoplasma pneumoniae Pneumonia in Pregnancy Treated with Garenoxacin

Case Reports in Obstetrics and Gynecology ◽

10.1155/2017/3520192 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Yoko Matsuda ◽

Yoshitsugu Chigusa ◽

Eiji Kondoh ◽

Isao Ito ◽

Yusuke Ueda ◽

...

Keyword(s):

Mycoplasma Pneumoniae ◽

Twin Pregnancy ◽

Atypical Pneumonia ◽

Drug Resistant ◽

Chest Computed Tomography ◽

Threatening Condition ◽

Life Threatening ◽

Oral Azithromycin ◽

Mycoplasma Pneumoniae Pneumonia ◽

In Pregnancy

Pneumonia in pregnancy is associated with adverse maternal and foetal outcomes, and intensive treatment with appropriate antibiotics is essential. However, cases caused by pathogens that are resistant to antibiotics suitable for the developing foetus are challenging. We herein report a case of macrolide-refractory Mycoplasma pneumoniae pneumonia in pregnancy. A 40-year-old multigravida with twin pregnancy complained of cough and fever at 13 weeks of gestation and was diagnosed with pneumonia. Even though empiric treatment with ceftriaxone and oral azithromycin was started, her condition deteriorated rapidly. The findings of chest computed tomography suggested Mycoplasma pneumoniae pneumonia. Since azithromycin did not work, this strain was considered to be macrolide-refractory. Garenoxacin, an oral quinolone, was selected and was dramatically effective. The use of quinolone could be justified with the emergence of drug-resistant bacterial/atypical pneumonia and in the maternal life-threatening condition.

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Severe Hyperlipidemia Induced Hemorrhagic Pancreatitis during Pregnancy

Obstetrics and Gynecology International ◽

10.1155/2009/383942 ◽

2009 ◽

Vol 2009 ◽

pp. 1-3 ◽

Cited By ~ 3

Author(s):

Karen L. Koscica ◽

Uzoma Nwaubani ◽

Munir Nazir ◽

Martin Gimovsky

Keyword(s):

Sudden Onset ◽

Recurrent Pancreatitis ◽

Conservative Care ◽

Hemorrhagic Pancreatitis ◽

Threatening Condition ◽

Life Threatening ◽

Familial Hyperlipidemia ◽

In Pregnancy

Background. We report a case of familial hyperlipidemia in pregnancy that resulted in hemorrhagic pancreatitis.Case. A patient at 27-week gestation was admitted for recurrent pancreatitis secondary to severe hyperlipidemia. With conservative care, the patient improved but on the fourth day of admission she experienced a sudden onset of hypotension and was diagnosed with hemorrhagic pancreatitis.Conclusion. Pancreatitis caused by hyperlipidemia is an uncommon event during pregnancy. A familiarity with the severe complications associated with this potentially life-threatening condition is important.

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Diabetic ketoacidosis in pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20182912 ◽

2018 ◽

Vol 7 (7) ◽

pp. 2945

Author(s):

Rosália S. Coutada ◽

Soraia S. Cunha ◽

Elisabete S. Gonçalves ◽

Ana P. Gama ◽

João P. Silva ◽

...

Keyword(s):

Type 1 Diabetes ◽

Pregnant Woman ◽

Diabetic Ketoacidosis ◽

Perinatal Mortality ◽

Aggressive Treatment ◽

Mortality And Morbidity ◽

Threatening Condition ◽

Life Threatening ◽

In Pregnancy

Diabetic ketoacidosis in pregnancy is a rare but potential life-threatening condition for the mother and the fetus. It tends to occur latter in pregnancy and is more common in patients with pregestational diabetes. Obstetricians should be aware of the events that can trigger diabetic ketoacidosis in pregnancy. Prompt recognition and aggressive treatment of this condition are essential in order to reduce perinatal mortality and morbidity. The authors present a case of a pregnant woman with type 1 diabetes with a poor surveillance of pregnancy and noncompliance to treatment that develops severe diabetic ketoacidosis at 34 weeks of gestation.

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Clinical Report of Probable Catastrophic Antiphospholipid Syndrome in Pregnancy

Case Reports in Obstetrics and Gynecology ◽

10.1155/2018/4176456 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3

Author(s):

Eryk Hakman ◽

Sasha Mikhael

Keyword(s):

Early Recognition ◽

Vital Signs ◽

Adverse Outcomes ◽

Laboratory Evaluation ◽

Clinical Report ◽

Elevated Liver Enzymes ◽

Threatening Condition ◽

Life Threatening ◽

History Of ◽

In Pregnancy

Background. Catastrophic APS (CAPS) is a rare but life-threatening form of APS defined as multiorgan thrombosis affecting a minimum of three organs with confirmation by histopathology of small vessel occlusions in at least one organ or tissue. The development of CAPS in pregnancy poses many diagnostic challenges as a result of its broad range of clinical presentations and its overlap with other obstetric complications and microangiopathic diseases. Because of the high associated mortality rate, prompt recognition and treatment are paramount. Case. A twenty-five-year-old G3P0111 with a history of multiple thromboembolisms presented at 21 weeks and 3 days of gestation with complaints of right upper quadrant pain, visual disturbances, headache, and syncopal episodes. Laboratory evaluation demonstrated microangiopathic disease with hemolysis (confirmed on peripheral smear), elevated liver enzymes, and abnormal 24-hour urine protein with vital signs within the normal range. Presence of significantly elevated antiphospholipid antibodies was noted, facilitating the diagnosis of probable CAPS. Proper workup was achieved based on clinical suspicion, allowing immediate and appropriate management. Conclusion. CAPS is a life-threatening condition rarely seen in pregnancy making early recognition difficult. A low threshold to initiate urgent and aggressive treatment should be maintained to minimize the risk of adverse outcomes.

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Akathisia preceding an oculogyric crisis in a patient treated with prochlorperazine for hyperemesis gravidarum

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2013-0053 ◽

2014 ◽

Vol 3 (1) ◽

Author(s):

Patrick Williams ◽

Haim Abenhaim

Keyword(s):

Hyperemesis Gravidarum ◽

Nausea And Vomiting ◽

Class I ◽

Dopaminergic Receptors ◽

Severe Nausea ◽

Behavioural Changes ◽

Oculogyric Crisis ◽

Threatening Condition ◽

Life Threatening ◽

In Pregnancy

AbstractProchlorperazine is a class I-A anti-emetic recommended for the treatment of severe nausea and vomiting in pregnancy. We present a case where a patient presented with hyperemesis gravidarum refractory to pyridoxine/doxylamine and dimenhydrinate and developed akathisia and dystonia after receiving prochlorperazine. Her condition resolved immediately following the administration of diphenhydramine. While procholorperazine is known to very rarely cause focal dystonias such as an oculogyric crisis, the influence of phenothiazines and neuroleptics on dopaminergic receptors can also trigger behavioural changes, which can rapidly evolve into a life-threatening condition.

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Pheochromocytoma during pregnancy - a rare diagnose with a complex multidisciplinary approach

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20213489 ◽

2021 ◽

Vol 10 (9) ◽

pp. 3587

Author(s):

Rita Silva ◽

Catarina R. Carvalho ◽

Madalena Andrade Tavares ◽

Celia Pedroso ◽

Paula Tapadinhas

Keyword(s):

Multidisciplinary Approach ◽

Gestational Hypertension ◽

Cardiovascular Complications ◽

Fetal Mortality ◽

Common Causes ◽

Threatening Condition ◽

Fetal Complications ◽

Life Threatening ◽

The Common ◽

In Pregnancy

Hypertension is a common problem in pregnancy that can result in significant maternal and fetal morbidity and mortality. The common causes include pre-eclampsia, gestational hypertension and essential hypertension. Although pheochromocytoma is a rare of hypertension in pregnancy, it can lead to potentially life-threatening cardiovascular complications for the mother and increased fetal mortality if left undiagnosed and untreated. Early diagnosis and timely, appropriate management reduce possible maternal and fetal complications. We report a case of a 32-week pregnant woman diagnosed with hypertension secondary to pheochromocytoma. An elective caesarian section was performed at 37 weeks of gestational age and underwent a laparoscopic left adrenalectomy with success. A multidisciplinary approach is of utmost importance and essential during the management of this life-threatening condition during pregnancy.

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Catastrophic antiphospholipid syndrome in pregnancy: a life-threatening condition

BMJ Case Reports ◽

10.1136/bcr-2019-230863 ◽

2019 ◽

Vol 12 (9) ◽

pp. e230863 ◽

Cited By ~ 4

Author(s):

Mandy Collict ◽

Whitney Sciberras Buhagiar ◽

Cecilia Mercieca ◽

John Thake

Keyword(s):

Early Diagnosis ◽

Antiphospholipid Syndrome ◽

Multiorgan Failure ◽

Fetal Outcome ◽

Catastrophic Antiphospholipid Syndrome ◽

Threatening Condition ◽

Life Threatening ◽

Vessel Thrombosis ◽

Clinical Emergency ◽

In Pregnancy

Catastrophic antiphospholipid syndrome (CAPS) is a rare and potentially life-threatening variant of the antiphospholipid syndrome which is characterised by multiple small vessel thrombosis which can lead to multiorgan failure. CAPS is a clinical emergency which all clinicians need to be aware of because early diagnosis and treatment may improve maternal and fetal outcome. Here, we report a case of CAPS in pregnancy in a 31-year-old female patient who presented at 28 weeks of gestation. A literature review of CAPS in pregnancy and the puerperium is also included.

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Problem based review: pulmonary embolism in pregnancy

Acute Medicine Journal ◽

10.52964/amja.0326 ◽

2013 ◽

Vol 12 (4) ◽

pp. 239-245

Author(s):

Francesca Neuberger ◽

Keyword(s):

Decision Making ◽

Pulmonary Embolism ◽

Healthcare Providers ◽

Normal Pregnancy ◽

Radiation Risks ◽

Threatening Condition ◽

Life Threatening ◽

In Pregnancy ◽

Significant Mortality

Pulmonary embolism (PE) in pregnancy carries a significant mortality. Pregnant patients often present via the acute medical take with symptoms of possible PE and require timely assessment and investigation. The symptoms of PE are sometimes very difficult to differentiate from those of normal pregnancy and the vast majority of patients will require imaging. The radiation risks to mother and foetus from imaging may cause considerable anxiety (to both patients and healthcare providers) and need to be explained to patients in the context of a potentially life-threatening condition so they can be actively involved in decision-making on how best to proceed. When PE is diagnosed in pregnancy, there are obstetric considerations around the time of delivery and women should receive specialist follow-up.

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