Comparison of uterine fibroids ’ growth pattern during pregnancy according to fetal sex: an observational study
AbstractBackgroundTo investigate the effect of fetal sex on fibroids ’ growth during pregnancy according to the hCG serum levelsMethodsObservational study conducted from January 2007 to December 2016 on women with ultrasound identification of uterine fibroids who had a pregnancy within 1 year from diagnosis. The fibroids diameter was determined during the pre-pregnancy ultrasound, early first trimester (5 –7 weeks), late first trimester (11–13 weeks), second trimester (19–21 weeks), and third trimester (31–33 weeks). The diameter growth was calculated in each interval between two ultrasounds. The hCG serum levels were determined both in early and late first trimester. The correlation between hCG levels and fibroid diameter was evaluated. Obstetric outcomes collected were gestational weeks at birth and the rate of cesarean section. Neonatal outcomes were birthweight and Apgar score at 1 min.ResultsEighty-seven of the included women had a male fetus, and 70 had a female fetus. A progressive increase of fibroid diameter was observed from pre-pregnancy to second trimester for both fetal sexes. In third trimester, the mean ± SD fibroid diameter of female fetuses showed a slowdown, while the mean ± SD fibroid diameter of male fetuses continued to grow. Women carrying a female fetus presented a higher fibroid diameter in early first trimester (33.5 ± 13.3 mm vs 27.4 ± 11.0 mm,p
ConclusionCombined Rendez-vous isthmoplasty is feasible, safe, and effective in experienced hands, giving the surgeon a comprehensive evaluation of the anatomy of the isthmocele, and increasing the odds of a complete resection and restoration of the anatomy 4, 5, 6, 7. In this patient, the procedure was uneventful, without any intra- or postoperative complications, and the symptoms were completely controlled.
This study is the first published case report in the literature that proves that fetal adrenal hemorrhage can intrauterin spontaneously absorb within a short period of time. Our case draws attention to the fact that adrenal bleeding may occur in the newborn regardless of birth trauma. It can also be assumed that the incidence of adrenal bleeding during pregnancy is higher than that reported in neonatal cases. Orv Hetil. 2019; 160(52): 2073-2078. PMID: 31868009 [PubMed - in process]
ConclusionKagami –Ogata syndrome should have been suspected because of the presence of polyhydramnios and omphalocele during pregnancy. Respiratory insufficiency soon after birth, because of a small thorax, is expected in this disease and a diagnosis during pregnancy may have enabled appropriate care after birth.
We present the case of a pregnant woman admitted for sudden and severe abdominal pain at 34 weeks gestation. Her previous medical history included endometriosis suspected by clinical symptoms and ultrasound. During cesarean section, performed by sustained fetal bradycardia, a large volume hemoperitoneum and multiple hemorrhagic foci in the posterior uterine wall were detected. Although rare, spontaneous hemoperitoneum may occur in pregnancy, especially in women with endometriosis. Thus, a prompt suspicion and expedite intervention are needed to improve maternal and fetal outcomes. PMID: 31703187 [PubMed - in process]
Publication date: Available online 6 November 2019Source: Annals of Medicine and SurgeryAuthor(s): Efrain Riveros-Perez, Sherwin Davoud, Maria Gabriela Sanchez, Hugo Montesinos, Alexander RocutsAbstractIntroductionA common belief has been that obese patients are prone to develop aspiration of gastric contents when general anesthesia is administered. We aimed to determine the correlation between antral cross-sectional area as a surrogate of gastric volume measured by gastric ultrasound, and body mass index (BMI) in term pregnant women scheduled for elective cesarean section.MethodsA cross-sectional observational study was c...
CONCLUSIONS: First, the method of measuring AOP with greatest reliability is the manual para-sagittal technique and future research should focus on this technique, second, over half of the variation in time to vaginal delivery can be explained by a model that combines maternal factors, pregnancy characteristics and ultrasound findings, and third, the ability of AOP to provide clinically useful prediction CS for FTP in the first stage of labour is limited. This article is protected by copyright. All rights reserved. PMID: 31692170 [PubMed - as supplied by publisher]
Conclusion: In the late-term abortions, obstetricians should be vigilant if ultrasound imaging shows suspected umbilical vascular thrombosis or shows 1 umbilical artery when there had previously been 2. The fetus should be closely monitored and interventions implemented as early as possible to improve the prenatal detection rate of umbilical vessel thrombosis and avoid adverse pregnancy outcomes.
CONCLUSIONS: The problem of unexpected non-cephalic presentation in labor can to a great extent be overcome by a routine ultrasound examination at 35+0 - 36+6 weeks' gestation. The incidence of non-cephalic presentation at the 35+0 - 36+6 weeks scan was about 5%, but, in about 40% of these cases the presentation at birth was cephalic, mainly due to subsequent spontaneous rotation and to a lesser extent as a consequence of successful ECV. This article is protected by copyright. All rights reserved. PMID: 31671470 [PubMed - as supplied by publisher]
ConclusionsThe performance of the Danish national screening program for SGA based on selective EFWus on clinical indication have improved considerably over the last 20 years. Limitations of the program are the large proportion of women referred to ultrasound scan and the low performance post ‐term.
Conclusion: Uterine artery Doppler waveform analysis as well as the assessment of the presence of a notch in the second trimester can be used as a screening method to identify women who will thereafter develop a severe adverse outcome.