Ovarian Cystic Teratoma in Pregnant Women: Conservative Management or Prophylactic Oophorectomy?

Aims and Background An increasing incidence of high-grade squamous intraepithelial lesion (HSIL) has been observed among young women. Consequently, an increased number of cases are being discovered during pregnancy. We analyzed the clinical and therapeutic management of HSIL during pregnancy. Methods A retrospective study was conducted from 1979 to 1998, and 58 registries of women with a cytological or histological diagnosis of HSIL during the pregnant-puerperal period were reviewed. Information obtained from medical records included age, gestational age at diagnosis, parity, age of first intercourse, number of sexual partners before pregnancy, tobacco use, cytologic and colposcopic findings, route of delivery, postpartum follow-up, and treatment. This information was compared with a non-pregnant control group with HSIL. Results The average age of pregnant women with HSIL was 27.9 ± 5.2 years. The cytologic or histologic diagnosis of HSIL was made in the first trimester in 12 (20.7%) women and in the second trimester in 30 (51.7%) women. Average parity was 2.8 ± 2 deliveries. Age of first intercourse ranged from 13 to 29 years (16.1 ± 3.3). Thirty-two women (55.1%) had more than one sexual partner before pregnancy. Thirty-seven (63.8%) refereed tobacco use. According to the aforementioned aspects, no statistical difference was found in relation to control, except to cervical ectopia, which was more frequent in pregnant women (56.9% versus 42.6%). From the total of 58 pregnant women with cytologic or biopsy HSIL diagnosis, 53 had HSIL diagnosis made on cervical biopsy directed by colposcopy performed during the pregnancy; 44 (83%) of them were submitted to conservative management. HSIL was diagnosed by cervical biopsy in postpartum evaluation in 76% pregnant women with vaginal delivery and 78.6% women who underwent cesarean section. Conclusions A conservative management of HSIL in pregnancy is proposed, with colposcopic evaluation during gestation and postpartum, regardless of route of delivery.

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Spontaneous Left Main Coronary Artery Dissection: Case Report

Indian Journal of Cardiovascular Disease in Women WINCARS ◽

10.1055/s-0041-1723919 ◽

2021 ◽

Vol 06 (01) ◽

pp. 039-041

Author(s):

S. V. V. Mani Krishna ◽

D. P. Kalyan Chakravarthy ◽

Shahood Ajaz Kakroo ◽

M. Naveen Kumar

Keyword(s):

Myocardial Infarction ◽

Case Report ◽

Coronary Artery ◽

Pregnant Women ◽

Conservative Management ◽

Left Main Coronary Artery ◽

Artery Dissection ◽

Left Main ◽

Coronary Artery Dissection ◽

Left Anterior Descending Artery

AbstractLeft main coronary artery (LMCA) dissections may be iatrogenic or spontaneous. Spontaneous coronary artery dissections (SCADs) are common in pregnant women, with predominantly left anterior descending artery (LAD) involvement. In males, coronary artery dissections may happen in alcoholics. Spontaneous LMCA dissection as the cause of myocardial infarction is very rare. We are reporting a case of spontaneous LMCA dissection in a 45-year-old male alcoholic with the involvement of LAD ostium, which resolved spontaneously with conservative management.

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CONSERVATIVE MANAGEMENT OF CERVICAL INTRAEPITHELIAL NEOPLASIA (CIN 2–3) IN PREGNANT WOMEN

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200303001-00118 ◽

2003 ◽

Vol 13 (Suppl 1) ◽

pp. 34.2-35

Author(s):

A. Rodolakis ◽

E. Diakomanolis ◽

D. Haidopoulos ◽

G. Vlachos ◽

S. Michalas

Keyword(s):

Pregnant Women ◽

Cervical Intraepithelial Neoplasia ◽

Conservative Management ◽

Intraepithelial Neoplasia

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Spontaneous Intra-leiomyoma Hemorrhage during Second Trimester of Pregnancy

European Journal of Medical and Health Sciences ◽

10.24018/ejmed.2020.2.6.618 ◽

2020 ◽

Vol 2 (6) ◽

Author(s):

Khong Jac Mun ◽

Zalina Nusee ◽

Riduan Tahar

Keyword(s):

Abdominal Pain ◽

Pregnant Woman ◽

Pregnant Women ◽

Uterine Fibroid ◽

Conservative Management ◽

Postpartum Period ◽

Hypovolemic Shock ◽

Second Trimester ◽

Premature Rupture Of Membranes ◽

Premature Rupture

Uterine fibroid affects 0.3-2.6% of pregnant women and it is usually asymptomatic during pregnancy [1]. In about 10% of these patients will have complications such as miscarriage, fetal malpresentation, premature rupture of membranes, placenta abruptio, preterm delivery, abdominal pain due to fibroid torsion or degeneration [2]. Bleeding into the uterine fibroid is extremely rare and patient can present with acute abdomen [11]. Up to date, there were only two cases reported and both occur in postpartum period. We present a case of a pregnant woman with huge uterine fibroid with spontaneous intra-leiomyoma bleeding causing hypovolemic shock at 22 weeks of gestation. Because of failure of conservative management, we performed fibroid resection at 22 weeks of gestation with preservation of the pregnancy.

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