scholarly journals Broad Ligament Pregnancy: Lessons Learnt

2014 ◽  
Vol 6 (3) ◽  
pp. 178-179
Author(s):  
Rukshana LNU ◽  
Preet Agarwal ◽  
Usha Viswanath ◽  
MS Natarajan
Keyword(s):  
South Asian ◽  
Transvaginal Ultrasound ◽  
Broad Ligament ◽  
Termination Of Pregnancy ◽  
Abdominal Pregnancy ◽  
Pregnancy Induced Hypertension ◽  
Previous Cesarean Section ◽  
Lessons Learnt ◽  
Induced Hypertension ◽  
Previous Cesarean

ABSTRACT Abdominal pregnancy is a rare obstetric condition seen by the obstetricians. Its diagnosis is usually difficult and management is a matter of debate. A 39-year-old multigravida with 20 weeks gestation complicated by pregnancy-induced hypertension, diabetes mellitus and anemia with previous cesarean section was admitted. She was not aware of her pregnancy earlier and she desired termination of pregnancy. But, termination of pregnancy failed inspite of using all possible methods of inducing labor. Diagnosis of abdominal pregnancy was made on by transvaginal ultrasound and proceeded with laparotomy. Left broad ligament pregnancy was found and the sac with fetus extracted. However, due to uncontrollable bleeding from broad ligament during placenta separation and hysterectomy was proceeded in this lady. We present our experience with the diagnosis and management of this rare case. How to cite this article Agarwal P, Viswanath U, Rukshana, Natarajan MS. Broad Ligament Pregnancy: Lessons Learnt. J South Asian Feder Obst Gynae 2014;6(3):178-179.

scholarly journals Vaginal delivery at term with previous one cesarean section: is it safe?

2018 ◽  
Vol 7 (8) ◽  
pp. 3147
Author(s):  
Surendra N. Bera ◽  
Partha P. Sharma
Keyword(s):  
Cesarean Section ◽  
Fetal Distress ◽  
Pregnancy Induced Hypertension ◽  
Early Neonatal Death ◽  
Previous Cesarean Section ◽  
Active Stage ◽  
Trial Of Labor ◽  
Emergency Cesarean ◽  
Induced Hypertension ◽  
Previous Cesarean

Background: Post cesarean pregnancies are high risk pregnancy and main concern is uterine scar rupture with increasing maternal and perinatal risks, for vaginal birth after cesarean delivery (VBAC). Objective of this study is to know neonatal and maternal outcome at term who attempt vaginal delivery with previous one cesarean section presenting in active stage of labor.Methods: A total of 277 pregnant women with single live fetus at term, cephalic presentation with previous one cesarean section, underwent a trial of labor and outcome of successful and failed vaginal birth were noted.Results: Trial of labor was successful in 52.3% and failed in 47.7% (p=0.269). VBAC was successful where the previous cesarean section indications were fetal distress (79% versus 21%, p=0.000), pregnancy induced hypertension (77.3% versus 22.7%, p=0.000) and fetal growth restriction (81.8% versus 18.2%, p=0.000), when compared with failed trial of labor who required emergency cesarean section in pre-labor rupture of the membranes (8.3% versus 91.7%, p=0.000) and dystocia (3.3% versus 96.7%, p=0.000). VBAC was successful at gestational age of 37 0/7-38 6/7 weeks (p=0.000). In the failed VBAC women who required emergency cesarean section there was significant early neonatal death (p=0.025). Scar dehiscence and hospital stay with or without complications were more in the failed VBAC group.Conclusions: Early neonatal death and duration of hospital stay were significantly more in the failed VBAC, who were posted for emergency cesarean delivery. Scar dehiscence occurred in the failed VBAC group. Women presenting at 37 0/7 to 38 6/7 weeks of gestation with cephalic presentation in active stage of labor who had previous cesarean section done for fetal distress, pregnancy induced hypertension and fetal growth restriction with inter pregnancy interval of > 24 months can be planned and counselled for VBAC trial of labor.

scholarly journals Various Types of Niche Imaging by Sonohysterography: A Pictorial Review

2014 ◽  
Vol 8 (3) ◽  
pp. 311-315 ◽  
Author(s):  
Firoozeh Ahmadi ◽  
Farnaz Akhbari ◽  
Fatemeh Niknejad
Keyword(s):  
Cesarean Section ◽  
Transvaginal Ultrasound ◽  
Subsequent Pregnancy ◽  
Previous Cesarean Section ◽  
Cesarean Section Delivery ◽  
Cesarean Scar ◽  
Pictorial Review ◽  
Scar Region ◽  
Uterine Scar ◽  
Previous Cesarean

ABSTRACT Cesarean scar defects (CSD) or niche are the myometrial discontinuity at the previous cesarean section scar region. Recently cesarean section delivery has been raised around the world markedly; therefore women with cesarean scar defects are increased and present in up to 19% of women post cesarean section. The increase of repeat cesarean section has been associated with an increase in complications in subsequent pregnancies such as scar pregnancy with life threatening bleeding, uterus rupture, placenta accreta and its subtypes and prolonged postmenstrual Spotting. The deeper the niche (or the thinner the overlying myometrium), the higher the risk for complications in a subsequent pregnancy. Although the ability of transvaginal ultrasound (TVUS) to detect cesarean scars remains unknown, its higher frequency and proximity to the pelvic organs have been used as a powerful tool for detecting the uterine scar of a previous cesarean section. Recently with the increasing use of sonohysterography (SHG) (transvaginal ultrasound with saline infusion) detection of scar defect has been enhanced frequently. How to cite this article Ahmadi F, Akhbari F, Niknejad F. Various Types of Niche Imaging by Sonohysterography: A Pictorial Review. Donald School J Ultrasound Obstet Gynecol 2014;8(3):311-315.

Successful Conservative Management of Spontaneous Unilateral Adrenal Hemorrhage in Pregnancy

2017 ◽  
Vol 9 (3) ◽  
pp. 287-288
Author(s):  
Priyankur Roy ◽  
Vineet Mishra ◽  
Rohina Aggarwal ◽  
Sumesh Choudhary ◽  
Preeti Goyal
Keyword(s):  
South Asian ◽  
Conservative Management ◽  
Adrenal Tumor ◽  
Flank Region ◽  
Rare Condition ◽  
Adrenal Hemorrhage ◽  
Pregnancy Induced Hypertension ◽  
Induced Hypertension ◽  
The Right ◽  
In Pregnancy

ABSTRACT Spontaneous adrenal hemorrhage (SAH) in the absence of trauma or adrenal tumor is a rare condition. Its incidence has been reported from 0.14 to 1.1% and it usually involves the right adrenal gland. During pregnancy, unilateral SAH has been reported very rarely. We describe a case who presented to us with pregnancy-induced hypertension and pain in right flank region for 1 day and diagnosed as a case of spontaneous right adrenal hemorrhage and managed conservatively. How to cite this article Mishra VV, Goyal P, Choudhary S, Aggarwal R, Roy P. Successful Conservative Management of Spontaneous Unilateral Adrenal Hemorrhage in Pregnancy. J South Asian Feder Obst Gynae 2017;9(3):287-288.

scholarly journals Differential Diagnosis of Cesarean Scar Pregnancies and Other Pregnancies Implanted in the Lower Uterus by Ultrasound Parameters

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Kangning Li ◽  
Qing Dai
Keyword(s):  
Differential Diagnosis ◽  
Cesarean Section ◽  
Transvaginal Ultrasound ◽  
Previous Cesarean Section ◽  
Cesarean Scar Pregnancy ◽  
Rare Type ◽  
Cesarean Section Delivery ◽  
Cesarean Scar ◽  
The Relationship ◽  
Previous Cesarean

Purpose. Cesarean scar pregnancy is an extremely rare type of ectopic pregnancy implanted in the myometrium at the site of a previous cesarean section scar. On the other hand, pregnancies are considered low implantations if they are identified in the lower third of the uterus without the sac implanted into the scar and have a better prognosis. Early diagnosis of both types of pregnancies can help avoid serious complications. This study is aimed at investigating the significance of transvaginal ultrasound in the differential diagnosis of cesarean scar pregnancies and pregnancies implanted in the lower uterus. Methods. Ninety-three patients with an average age of 32.7 years (range, 24–43 years) were enrolled in this study, including 66 cesarean scar pregnancies and 27 other pregnancies implanted in the lower uterus, and they were examined by transvaginal ultrasound. Results. We observed significant differences in the relationship between the cesarean sac and the scar, the source of the trophoblastic blood flow, and the thickness of the residual muscle between the cesarean scar pregnancy group and the lower uterus pregnancy group. We established the logistic model to improve the differential diagnosis of cesarean scar pregnancies and pregnancies implanted in the lower uterus. Conclusions. Transvaginal ultrasound is recommended in early pregnancy, especially for patients who have undergone a previous cesarean section delivery.

Termination of pregnancy in patients with previous cesarean section

Contraception ◽  
2006 ◽  
Vol 73 (3) ◽  
pp. 244-248 ◽  
Author(s):  
Chafika Mazouni ◽  
Magali Provensal ◽  
Géraldine Porcu ◽  
Béatrice Guidicelli ◽  
Hélène Heckenroth ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Termination Of Pregnancy ◽  
Previous Cesarean Section ◽  
Previous Cesarean

scholarly journals Broad Ligament Pregnancy Through A Cesarean Scar : An Unusual One

2016 ◽  
Vol 15 (1) ◽  
pp. 60-62
Author(s):  
Sabina Yeasmin ◽  
Tahera Begum ◽  
Md Jalal Uddin
Keyword(s):  
High Risk ◽  
Broad Ligament ◽  
Rare Event ◽  
Clinical Suspicion ◽  
Abdominal Pregnancy ◽  
Fetal Demise ◽  
Cesarean Scar ◽  
Ultrasound Evaluation ◽  
Gestational Sac ◽  
Previous Cesarean

Broad ligament pregnancy is an extremely rare event with high risk of maternal mortality. Diagnosis is often late in our setting and finally made during laparotomy. It is a type of secondary abdominal pregnancy.We present a case which remained undiagnosed throughout her pregnancy till she reached to 35 weeks and unfortunately had intrauterine fetal demise when she reported to our hospital.After admission her pregnancy was induced with misoprostol but did not response. On clinical suspicion,repeat ultrasound evaluation was done by senior sinologist, which picked up the diagnosis of abdominal pregnancy. On laparotomy a broad ligament pregnancy was found with a rent in the previous Cesarean scar towards the gestational sac in the broad ligament.Chatt  Shi Hosp Med Coll J; Vol.15 (1); Jan 2016; Page 60-62

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