Decidualized Endometrioma: Its Sonography and Optimal Clinical Management

Endometriosis is a condition which affects many reproductive age women. During pregnancy, an ovarian endometrioma may undergo decidualization, which may take on the sonographic appearance suggestive of malignancy. In this instance, a surgical approach for treatment may be deemed necessary. Three cases are presented with different outcomes, worthy of viewing the contrasting management. In case 1, a patient was diagnosed with a left ovarian cyst at her routine 20-week gestation sonogram. This sonographic examination was suggestive of an ovarian malignancy. The patient underwent laparoscopy with left salpingo-oophorectomy at 23 weeks gestational age, without complications. The pathologic diagnosis of the removed mass was a decidualized endometrioma. In case 2, a female patient presented with bilateral ovarian decidualized endometriomas that were demonstrated sonographically and had the appearance of malignancy. This patient was treated conservatively with serial follow-up sonograms during her pregnancy. At the 2-month post-partum follow-up sonogram demonstrated persistent bilateral endometriomas, without decidualization. However, in case 3, possible decidualization of an endometrioma was seen, and a follow-up sonogram revealed the presence of ovarian carcinoma. There is previously published support for watchful waiting when similar sonographic findings, in pregnancy, are seen.

Survival of a case of pre-eclampsia complicated with acute fatty liver of pregnancy and acute pancreatitis

Acute fatty liver of pregnancy (AFLP) and acute pancreatitis are peculiar complications of pregnancy. When acute pancreatitis occurs co-incidentally with acute fatty liver of pregnancy, mortality is high. Here, we report a case of a 22-year-old lady in her 36th week of gestation, who presented with pre-eclampsia, acute fatty liver of pregnancy and acute pancreatitis. She fulfilled six Swansea criteria for diagnosis of AFLP, and the diagnosis of acute pancreatitis was based on clinical suspicion, elevated pancreatic enzymes and the sonographic appearance of a swollen pancreatic head.

Causes of Ovarian Dysfunction and its Sonographic Findings With Respect to Infertility: A Systematic Review

Background: Ovarian dysfunction is a condition in which ovaries stop working and menstrual periods stops before age 40. This can cause fertility problems. There are several causes of ovarian dysfunction causing infertility such as endometriosis, ovarian torsion etc. Aim: To revise the current literature about causes of ovarian dysfunction and its sonographic findings in infertile women. Methods: Electronic data base search was performed (PubMed, Science direct, Google Scholar) with data range from 2000 to 2019. All the data is available online in English. Results: Seventeen articles were found regarding different causes of ovarian dysfunction and their sonographic appearance. Also our results show that ultrasound can be used as a reliable tool for detection of ovarian pathologies. Conclusion: This study supports a temporal association between various causes of ovarian dysfunction and infertility risk. Gray-scale in addition to color Doppler ultrasound serves an important role in detection of different causes of ovarian dysfunction and their sonographic appearances. Keywords: Ultrasound exam, ovarian dysfunction, ovarian volume, ovarian masses

Aspects of prenatal ultrasound diagnostics of fetal commissural pathology. Part I: normal development (the corpus callosum and other major telencephalic commissures)

The corpus callosum pathology is associated with over 350 different congenital syndromes. In this article development of the main forebrain commissures in fetus ranging from 11 to 16 weeks of gestation at prenatal ultrasound are presented. This is the first sonographic study to describe the prenatal sonographic appearance of the main forebrain commissures in fetus and we speculate that cases with pathology of the corpus callosum and normal outcome might be result of the presence a residual interhemispheric connection.