A twisted giant corpus luteum cyst in the third trimester of pregnancy in a multigravida: A case report

2021 ◽  
Vol 5 ◽  
pp. 85-88
Author(s):  
Ubong Bassey Akpan ◽  
Theophilus Ipeh Ugbem ◽  
Ezukwa Omoronyia

Corpus luteum cyst is common in early pregnancy and seldom exceeds 5 cm in diameter; many of which resolve before the end of the first trimester of pregnancy. Giant corpus luteum cyst in third trimester is very rare especially in naturally-conceived pregnancies. We hereby report a rare case of twisted giant corpus luteum cyst in the third trimester in a 33-year-old multigravida. She presented with acute abdominal pain and vomiting at a gestational age of 34 weeks. Ultrasound scan revealed a twisted giant right ovarian cyst. She underwent an emergency cesarean delivery and right oophorectomy. Histology report showed features that were diagnostic of corpus luteum cyst.

2013 ◽  
Vol 20 (3) ◽  
pp. 259-265
Author(s):  
Monica Vereş ◽  
Aurel Babeş ◽  
Szidonia Lacziko

Abstract Background and aims: Gestational diabetes represents a form of diabetes diagnosed during pregnancy that is not clearly overt diabetes. In the last trimester of gestation the growth of fetoplacental unit takes place, thus maternal hyperglycemia will determine an increased transplacental passage, hyperinsulinemia and fetal macrosomia. The aim of our study was that o analyzing the effect of maternal glycemia from the last trimester of pregnancy over fetal weight. Material and method: We run an observational study on a group of 46 pregnant women taken into evidence from the first trimester of pregnancy, separated in two groups according to blood glucose determined in the third trimester (before birth): group I normoglycemic and group II with hyperglycemia (>92mg/dl). Results: The mean value of third trimester glycemia for the entire group was of 87.13±22.03. The mean value of the glycemia determined in the third trimester of pregnancy was higher in the second group (109.17 mg/dl) in comparison to the first group (74.,21 mg/dl). The ROC curve for third trimester glycemia as fetal macrosomia appreciation test has an AUC of 0.517. Conclusions: Glycemia determined in the last trimester of pregnancy cannot be used alone as the predictive factor for fetal macrosomia.


2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Takashi Suzuki ◽  
Maiko Wagata ◽  
Hiroko Konno ◽  
Takahiro Ito ◽  
Yuichi Torii ◽  
...  

We describe a rare case of Mallory-Weiss tear with massive hematemesis at 38 weeks’ gestation. A 35-year-old woman presented with epigastralgia followed by massive hematemesis. An emergency endoscopy indicated active pulsatile bleeding at the esophagocardial junction. Although an emergency endoscopic hemostasis was successful, late decelerations without acceleration on cardiotocogram were observed. Therefore, the patient underwent emergency cesarean section, along with blood transfusion, following the endoscopic hemostasis. The hemoglobin level just before the operation was 5.1 g/dL. We suspected that massive hematemesis induced maternal acute anemia and hypovolemia, which resulted in a nonreassuring fetal status. Hence, urgent endoscopic hemostasis, adequate blood transfusion, and emergency cesarean section were needed. Mallory-Weiss tear during the third trimester may have a possibility of massive hematemesis and urgent blood transfusion, emergency endoscopic hemostasis, and emergency cesarean section may be needed.


2006 ◽  
Vol 291 (5) ◽  
pp. E878-E884 ◽  
Author(s):  
Waljit S. Dhillo ◽  
Philip Savage ◽  
Kevin G. Murphy ◽  
Owais B. Chaudhri ◽  
Michael Patterson ◽  
...  

Kisspeptin is a 54-amino acid peptide, encoded by the anti-metastasis gene KiSS-1, that activates G protein-coupled receptor 54 (GPR54). The kisspeptin-GPR54 system is critical to normal reproductive development. KiSS-1 gene expression is increased in the human placenta in normal and molar pregnancies. Circulating kisspeptin is dramatically increased in normal pregnancy, but levels in GTN have not previously been reported. The present study was designed to determine whether plasma kisspeptin levels are altered in patients with malignant GTN. Thirty-nine blood samples were taken from 11 patients with malignant GTN at presentation during and after chemotherapy. Blood was also sampled from nonpregnant and pregnant volunteers. Plasma kisspeptin IR and hCG concentrations were measured. Plasma kisspeptin IR concentration in nonpregnant ( n = 16) females was <2 pmol/l. Plasma kisspeptin IR in females was 803 ± 125 pmol/l in the first trimester of pregnancy ( n = 13), 2,483 ± 302 pmol/l in the third trimester of pregnancy ( n = 7), and <2 pmol/l on day 15 postpartum ( n = 7). Plasma kisspeptin IR and hCG concentrations in patients with malignant GTN were elevated at presentation and fell during and after treatment with chemotherapy in each patient (mean plasma kisspeptin IR: prechemotherapy 1,363 ± 1,076 pmol/l vs. post-chemotherapy <2 pmol/l, P < 0.0001; mean plasma hCG: prechemotherapy 227,191 ± 152,354 U/l vs. postchemotherapy 2 U/l, P < 0.0001). Plasma kisspeptin IR strongly positively correlated with plasma hCG levels ( r2= 0.99, P < 0.0001). Our results suggest that measurement of plasma kisspeptin IR may be a novel tumor marker in patients with malignant GTN.


1965 ◽  
Vol 33 (1) ◽  
pp. 133-143 ◽  
Author(s):  
K. FOTHERBY ◽  
FRANCES JAMES ◽  
SORAYA KAMYAB ◽  
A. I. KLOPPER ◽  
G. R. WILSON

SUMMARY The excretion of pregnanediol, pregnanetriol and the 6-oxygenated metabolites of progesterone by fifteen women has been measured throughout pregnancy. During the first trimester the level of excretion of the 6-oxygenated metabolites varied from 0·4 to 2·2 mg./day and at the end of pregnancy the range was from 3·5 to 11·6 mg./day. During the last 6 weeks of pregnancy, pregnanediol excretion was relatively constant, whereas in seven of the patients the excretion of the 6-oxygenated metabolites continued to increase. Except at the end of pregnancy there was a close correlation between the 6-oxygenated metabolites and pregnanediol excretion. The results suggest that the 6-oxygenated metabolites and pregnanediol have the same precursor and that little, if any, of a 6-oxygenated progesterone is secreted during pregnancy. There appears to be little increase in pregnanetriol excretion during pregnancy; six of the subjects showed a significantly higher excretion in the third trimester compared with the first trimester of pregnancy, but the values were not outside the normal range for non-pregnant subjects. The specificity of the method of Fotherby & Love (1960) for the estimation of pregnanetriol was examined when applied to pregnancy urine. Between 1·1 and 2·4 % of administered progesterone was excreted as the 6-oxygenated metabolites. In only one of five subjects was pregnanetriol excretion increased after progesterone administration.


2013 ◽  
Vol 57 (7) ◽  
pp. 3307-3311 ◽  
Author(s):  
Anat Bahat Dinur ◽  
Gideon Koren ◽  
Ilan Matok ◽  
Arnon Wiznitzer ◽  
Elia Uziel ◽  
...  

ABSTRACTMacrolide antibiotics are largely used in pregnancy for different bacterial infections. Their fetal safety has been studied by several groups, yielding opposing results. In particular, there have been studies claiming an association between macrolides and cardiovascular malformations. Exposure in early infancy has been associated with pyloric stenosis and intussusception. This has led to an avoidance in prescribing macrolides to pregnant women in several Scandinavian countries. The Objectives of the present study was to investigate the fetal safety of this class of drug by linking a large administrative database of drug dispensing and pregnancy outcome in Southern Israel. A computerized database of medications dispensed from 1999 to 2009 to all women registered in the Clalit health maintenance organization in southern Israel was linked with two computerized databases containing maternal and infant hospitalization records. Also, medical pregnancy termination data were analyzed. The following confounders were controlled for: maternal age, ethnicity, maternal pregestational diabetes, parity, and the year the mother gave birth or went through medical pregnancy termination. First- and third-trimester exposures to macrolide antibiotics as a group and to individual drugs were analyzed. During the study period there were 105,492 pregnancies among Clalit women that met the inclusion criteria. Of these, 104,380 ended in live births or dead fetuses and 1,112 in abortion due to medical reasons. In the first trimester of pregnancy, 1,033 women were exposed to macrolides. There was no association between macrolides and either major malformations [odds ratio (OR), 1.08; 95% confidence interval (CI), 0.84 to 1.38)] or specific malformations, after accounting for maternal age, parity, ethnicity, prepregnancy diabetes, and year of exposure. During the third trimester of pregnancy, 959 women were exposed to macrolides. There was no association between such exposure and perinatal mortality, low birth weight, low Apgar score, or preterm delivery. Similarly, no associations were demonstrated with pyloric stenosis or intussusception. Use of macrolides in the first trimester of pregnancy is not associated with an increased risk of major malformations. Exposure in the third trimester is not likely to increase neonatal risks for pyloric stenosis or intussusception in a clinically meaningful manner.


Author(s):  
І. Yu. Kostyuk ◽  
G. V. Chayka ◽  
M. S. Storozhuk ◽  
О.К. Таrаsiuk

One of the most important problems of modern urogynecology is the improvement of the treatment-diagnostic algorithm and prevention of overactive bladder syndrome (OAB). The purpose of the work is to construct and analyze discriminant models of the possibility of OAB occurrence in pregnant women of different age groups depending on the characteristics of anthropo-somatotypological indicators or hormonal background. 75 pregnant women with clinical signs of OAB syndrome and 60 healthy pregnant women had hormonal screening in the 1st and 3rd trimester of pregnancy and at 16 weeks postpartum using radioimmunoassay and immune enzyme methods (estradiol, progesterone, thyroid stimulating hormone and testosterone levels were determined). The anthropometry was carried out according to the method of V. V. Bunak, the components of the somatotype were determined according to the method of J. Carter and B. Heath, as well as the components of the body composition according to the method of J. Matiegka and the American Institute of Nutrition (AIN). By age, all pregnant women were divided into 3 subgroups: І - from 17 to 25 years, ІІ - from 26 to 35 years, ІІІ - from 36 to 41 years. A discriminant analysis of the possibility of OAB occurrence, depending on the anthropo-somatotypological or hormonal indices in women of different age groups, was conducted using the licensing program “Statistica 5.5”. When taken into account anthropo-somatotypological indices in women aged from 17 to 25 years, the model is correct in 86.7% of cases; in women aged from 26 to 35 years - in 90.9% of cases; in women between the ages of 36 and 41 years - in 89.3% of cases. Between healthy and OAB patients, women aged from 17 to 25 years discriminating variables are the width of the distal epiphysis of the shoulder (which has the greatest contribution to discrimination), conjugata externa, the muscle component of the body weight by AIN and the forearm's girth in the upper third; women from 26 to 35 years - dist. Іntеrtrochantericа, the width of the distal epiphyses of the forearm (the greatest contribution to discrimination), hip circumference, conjugata externa, mesomorphic component of the somatotype according to by Heath-Carter, fat mass component of the body by Matiegka, the forearm's girth in the upper third and the shoulder girth; women of age from 36 to 41 years - the width of the distal epiphysis of the leg (which has the greatest contribution to discrimination) and the length of the body. In general, the aggregate of all variables has a low level of discrimination between healthy and sick with OAB women between the ages of 17 and 25 (Wilkes Lambda statistics = 0.531; F = 5.521; p <0.01) and 36-41 years (Wilkes Lambda statistics = 0.445; F = 15.62; p <0.001), while among women between the ages of 26 and 35 - the average level of discrimination (Wilkes Lambda statistics = 0.386; F = 13.52; p <0.001). When taken into account characteristics of the hormonal background in women of all ages, the model is correct in 100% of cases. Between healthy and OAB patients, of 17-25 years age, discriminant variables are estradiol levels at 16 weeks of postpartum (with the largest contribution to discrimination) and prolactin levels in the first trimester of pregnancy; women aged from 26 to 35 years - estradiol levels at 16 weeks of postpartum (the most contributing to discrimination), testosterone in the third trimester of pregnancy, estradiol in the third trimester of pregnancy, prolactin in the third trimester of pregnancy, estradiol in the first trimester of pregnancy, and testosterone levels in the first trimester of pregnancy; women aged from 36 to 41 years - estradiol in the third trimester of pregnancy (has the largest contribution to discrimination) and estradiol in the 16 weeks of postpartum period. In general, the totality of all variables has a low level of discrimination between healthy and sick at OAB women between the ages of 17 and 25 (Wilkes Lambda statistics = 0.619; F = 131.4; p <0.001) and ages 26-35 (Wilks Lambda statistics = 0.493; F = 224.9; p <0.001), while among women between the ages of 36 and 41 - the average level of discrimination (Wilkes Lambda statistics = 0.371; F = 207.4; p <0.001). Thus, with the aid of discriminant analysis, reliable models of the possibility of OAB occurrence, based on anthropo-somatotypological or hormonal indices in women of different age groups, are constructed. In all age groups, the greatest contribution to discrimination between healthy and sick with OAB pregnant women, in most cases, make parameters of the width of distal epiphyses of long limb bones or the level of estradiol.


2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Theodoros Pavlis ◽  
Charalampos Seretis ◽  
Stavros Gourgiotis ◽  
Paraskevi Aravosita ◽  
Christina Mystakelli ◽  
...  

Splenic artery aneurysm (SAA) occurs predominantly in women and the majority of them are asymptomatic until rupture. In cases of spontaneous rupture of an SAA, maternal and fetal mortality rates remain extremely high. Furthermore, the spontaneous ruptures of SAAs predominantly appear during the third trimester of pregnancy. We present the third known case of spontaneous SAA rupture during the first trimester of pregnancy, which manifested as sudden hypovolemic collapse and was successfully confronted with combined aggressive resuscitation and emergency surgical operation.


2020 ◽  
pp. 201010582094361
Author(s):  
Faridah Sulung ◽  
Zeti Norfidiyati Salmuna ◽  
Azura Hussin ◽  
Zaidah Abd Rahman ◽  
Siti Asma’ Hassan

Acute hepatitis is an unusual manifestation of listeriosis. Most patients with listeriosis present with fever, flu-like illness and gastroenteritis symptoms due to consumption of contaminated food. Pregnancy-associated Listeria monocytogenes infection commonly occurs during the third trimester of pregnancy compared to early trimesters. We report a case of listeriosis in the first trimester of pregnancy, which presented with the acute onset of jaundice and was successfully treated with ampicillin.


2021 ◽  
Vol 14 (7) ◽  
pp. e244254
Author(s):  
Krystal Koh ◽  
Rajeswari Kathirvel ◽  
Manisha Mathur

Intrahepatic cholestasis of pregnancy (ICP) generally presents in the third trimester with pruritus without a rash, characterised by elevated bile acids, with or without transaminitis and hyperbilirubinaemia. Risk factors include a family history of cholestasis, South Asian ethnicity, multifetal gestation, in vitro fertilisation (IVF) and history of hepatitis or biliary disorders.IVF involves the use of high dose gonadotropin stimulation and human chorionic gonadotropin trigger. High doses of progesterone supplementation are additionally given after embryo transfer. The increase in oestrogen and progesterone levels early on in the pregnancy is a possible explanation for the development of ICP in IVF pregnancies at earlier gestations.We present a rare case of iatrogenic ICP presenting in the first trimester in a pregnancy conceived by IVF. Unlike other cases reported, our patient did not have recurrence of ICP in the third trimester, and also had no history of ICP in her first pregnancy.


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