Body Mass Index Trends in Women Who Undergo External Cephalic Version in a Tertiary Hospital in Spain

The global epidemic of obesity also affects pregnant women. External cephalic version is a procedure for achieving a cephalic presentation. Obesity has been associated with lower rates of ECV success. The main objective of this article is to analyze the trends in BMI in pregnant women who underwent ECV. A descriptive retrospective analysis of ECV performed in Hospital Clinico Universitario Virgen de la Arrixaca in Murcia (Spain) between 1st of January of 2014 and 31st of December 2018 has been carried out. 417 patients were recruited. The mean maternal BMI was 25.5 kg/m2 at 36 week’s gestation. If BMI is categorized, 2.6% (N=11) of the patients had a BMI below 18.5 kg/m2, 51.1% (N=213) had a BMI between 18.5-24.9 kg/m2, 30.9% (N=129) of the patients had a BMI between 25-29.9 kg/m2 and 14.0% (N=64) had a BMI above 30 kg/ m2. Mean maternal BMI had statistically significant changes between 2014 and 2018 (p<0.001). Maternal BMI has increased over the years in patients who undergo ECV. In patients who undergo ECV, maternal BMI should be related to socio-economic inequalities and social behavior in future researches. It should be also associated with maternal BMI of pregnant women who undergo ECV with ECV success rate and with the type of delivery of those pregnancies. Keywords: External Cephalic Version; Body Mass Index; Pregnant; Obstetrics; Obesity; Overweight. Abbreviations ECV: External Cephalic Version; BMI: Body Mass Index.

Advances in the Diagnosis and Management of Ovarian Ectopic Pregnancy: A Short Review

The ovarian ectopic pregnancy OPE is one of the most serious and rarest types of extra-uterine pregnancy, where the implantation of the gestational sac occurs in the ovum. Given the rarity of this condition, in addition to the accompanied morbidity, the risk of their complications, and even death, early diagnosis and treatment are crucial. Its diagnosis is not easy and relies on criteria based on preoperative findings, with poor clinical symptomatology and a difficult ultrasound diagnosis. Its management of choice remains surgical therapy despite the progress in medical treatments with fertility preservation. Patients’ symptomatology, radiological and lab findings, addition to her obstetric history and desire for future procreation must also be taken into consideration. Keywords: Ectopic pregnancy; ovarian pregnancy; Treatment; Diagnosis. Abbreviations B-hCG: Beta-Human Chorionic Gonadotropin; EP: Ectopic Pregnancy; HP: Heterotopic Pregnancy; IUCD: Intra-utérine Contraceptive Devices; IUDs: Intra-Utérine Devices; MRI: Magnetic Resonance Imaging; MTX: Methotrexate; OPE: Ovarian Ectopic Pregnancy; PID: Pelvic Inflammatory Disease; TV-US: Transvaginal Ultrasonography.

Ileal Perforation after Intrauterine Device Insertion

The intrauterine contraceptive device is the second most popular form of contraception worldwide. Uterine perforations may rarely complicate intrauterine contraceptive device use and are believed to occur mostly at the time of insertion. In the majority of cases, perforations are not recognized by the operator and remain asymptomatic. In rare instances however, severe delayed complications involving adjacent organs may ensue. We report an unusual case of uterine perforation with bowel injury diagnosed two years after the insertion of a copper intrauterine contraceptive device. We aim to address the use of transvaginal sonography to confirm proper intrauterine contraceptive device placement following a technically challenging insertion, clinical surveillance, and prompt removal of an intraperitoneal intrauterine contraceptive deviceto prevent potential serious complications, such as bowel embedment. Keywords: Bleeding; Bowel injury; Contraception; Intrauterine contraceptive device; Uterine perforations. Abbreviations IUD: intrauterine contraceptive device; G2P2: Gravidity 2 Parity 2

Femural Fracture in Pregnancay

Ortopedic injury is rare in pregnancy with incidence of 1%.1 The most commun injury is femural fracture and it is more often in third trimester of pregnancy. We present a case of untraumatic unilateral neck fractur of femur in third trimester of pregnancy. The fracture was not surgically repaired. The patient had vaginal delivered. In meantime, befor and after delivery, she have a prophylaxis therapy with Low Molecular Heparin. Keywords: Pregnancy; Femoral Fracture; Antepartum Testing; Venous Thromboembolism Preventation; Osteoporosis in Pregnancy.