ABSTRACT
In this work, study report the case of a 23-year-old primigravidae, in whom an idiopathic intracranial hypertension (IIH), formerly called pseudotumor cerebri, was diagnosed in the first trimester with visual field impairment, the management of which was similar to cases of benign intracranial hypertension in the general population. The parturient put under medical treatment with ophthalmological and obstetrical follow-up until 39 weeks of amenorrhea where she was cesarized for rescue of the visual prognosis. The objective of this work is to elucidate this pathology, caused by a defect of reabsorption of the CSF by the arachnoid plexus. The diagnosis is retained after elimination by radio-biological exploration of an infectious, tumor or traumatic etiology. Idiopathic intracranial hypertension has no impact on the evolution of pregnancy. In addition, the choice of delivery route is dependent on the patient's visual prognosis being brought into play.
ABSTRACT
Uterine torsion is defined as a rotation of uterus more than 45 degrees along its long axis. However, a pathologic rotation of the uterus beyond 45 degrees-torsion of the entire uterus-is rarely seen in obstetrical practice, authors report a case of torsion of the uterus by 90 degrees. The patient, a 30-year-old gravida 3 para 2 at 37 weeks’ gestation with a singleton pregnancy, her prior obstetrical history included two uncomplicated term vaginal deliveries, and the current pregnancy had been uncomplicated until the date of presentation was admitted to the obstetrical unit with labour at 37 weeks 5 days ,on obstetric examination the patient was in labour with transversal presentation of the fetus so an emergency caesarean section (CS) was carried out for. At the time of CS, the diagnosis of uterine torsion of 90 degrees was made. After the delivery of the baby, uterus returned to anatomical position and the torsion corrected spontaneously. The patient recovered and was discharged home with her baby on the third postoperative day. Uterine torsion is an infrequently reported and potentially dangerous complication of pregnancy that occurs mainly in the third trimester.
ABSTRACT
Partial hydatidiform mole can evolve into a metastatic trophoblastic tumor. A 36-year-old, multiparous woman, pregnant with a 22-week embryonic hydatidiform mole, having spontaneously expelled. Histopathological examination showed a non-invasive partial mole. During biological monitoring, a trophoblastic tumor was diagnosed with pulmonary metastasis on CT-scan and myometrial invasion by MRI. Authors opted for a monochemotherapy with a good evolution. The potential risk of malignant transformation of the partial hydatidiform mole requires an adequate therapeutic strategy with strict monitoring.
ABSTRACT
Gynandroblastoma is an extremely rare ovarian sex cord tumor with malignant potential. An 61-year-old woman, menopausic, consulted for an abdominal pelvic mass. a latero-uterine mass measuring 27.8 cm in diameter showed a predominantly cystic pattern with a partial solid component. A unilateral adnexectomy was performed. A histopathological examination showed gynandroblastoma composed of juvenile granulosa and Sertoli-Leydig cells, chirurgical treatment was completed by total hysterectomy with right adnexectomy, omentectomy with no proof of malignant cells. We opted for a close observation without adjuvanted chemotherapy. two years after surgery, no signs of recurrence have been noted. The present findings can help clinicians make an accurate preoperative imaging diagnosis of gynandroblastoma with a juvenile granulosa cell component and plan an adequate treatment strategy for this rare, potentially malignant neoplasm.
ABSTRACT
The puerperal uterine inversion is a rare and severe complication occurring in the third stage of labour. The mechanisms are not completely known. However; extrinsic factors such as oxytocic arrests after a prolonged labour; umbilical cord traction or abdominal expression are pointed. Other intrinsic factors such as primiparity; uterine hypotonia; various placental localizations; fundic myoma or short umbilical cord were also reported. The diagnosis of the uterine inversion is mainly supported by clinical symptoms. It is based on three elements: haemorrhage; shock and a strong pelvic pain. The immediate treatment of the uterine inversion is required. It is based on a medical reanimation associated with firstly a manual reduction then surgical treatment using various techniques. We report an observation of a 25 years old grand multiparous patient with a subacute uterine inversion after delivery at home