RESUMEN
A 27-year-old pregnant woman, para 1, was transferred to our hospital at 29+3 weeks of gestation complaining of abdominal pain. She was diagnosed with hemoperitoneum based on ultrasonography. An emergency laparotomy was performed, and the bleeding was confirmed to be caused by ruptured surface blood vessels on the uterine fundus. Hemostasis with compression was successfully performed to sustain the pregnancy, and the patient delivered a full-term baby. Spontaneous hemoperitoneum during pregnancy caused by rupture of uterine blood vessels is very rare. It requires rapid diagnosis and surgical treatment because it increases the morbidity of the fetus and mother. In most incidences of spontaneous hemoperitoneum during pregnancy, a cesarean delivery is performed along with a simultaneous emergency laparotomy. However, in this case, the pregnancy was maintained to full term after surgical hemostasis, which prevented neonatal complications due to premature birth.
Asunto(s)
Adulto , Femenino , Humanos , Embarazo , Dolor Abdominal , Vasos Sanguíneos , Diagnóstico , Urgencias Médicas , Feto , Hemoperitoneo , Hemorragia , Hemostasis , Hemostasis Quirúrgica , Incidencia , Laparotomía , Madres , Mujeres Embarazadas , Nacimiento Prematuro , Rotura , UltrasonografíaRESUMEN
Monochorionic twins with discordant karyotypes are rare and mostly caused by post-zygotic mitotic nondisjunction. A 32 year old nulliparous woman at 11 weeks of gestation with spontaneous twin pregnancy was referred to our hospital. An amniocentesis was performed in both amniotic sacs at 15 weeks of pregnancy. One fetus in monochorionic twin pregnancy was diagnosed with Turner syndrome with cystic hygroma, and the other fetus was normal. Because of high mortality rate in abnormal fetuses, the umbilical cord coagulation was performed using radiofrequency ablation to prevent the damage of co-twin that may be caused by the demise of one fetus. After delivery, chorionicity of placenta was ascertained by pathologic exam. Postnatal findings of physical exam, abdominal and brain sonography were normal in the surviving neonate.
Asunto(s)
Femenino , Humanos , Recién Nacido , Embarazo , Amniocentesis , Encéfalo , Ablación por Catéter , Corion , Feto , Cariotipo , Linfangioma Quístico , Mortalidad , Placenta , Embarazo Gemelar , Síndrome de Turner , Cordón UmbilicalRESUMEN
The American College of Obstetricians and Gynecologists (ACOG) has recommended that the most women with one previous cesarean delivery with a low-transverse incision are candidates for vaginal birth after cesarean and should be counseled about VBAC and offered a trial of labor in the hospital which has physicians immediately available to provide emergency care including cesarean section and personnel familiar with the potential complications of a trial of labor who should be vigilant for nonreassuring fetal heart rate patterns and inadequate progress of labor. The safer VBAC will be provided when the physicians and patients are alert about the risk, benefit and disadvantage of VBAC, and when the reasonable management of the labor is performed. The success of VBAC will contribute to prevent unnecessary primary cesarean and reduce the overall cesarean delivery rate.
Asunto(s)
Femenino , Humanos , Embarazo , Cesárea , Servicios Médicos de Urgencia , Frecuencia Cardíaca Fetal , Esfuerzo de Parto , Parto Vaginal Después de CesáreaRESUMEN
The American College of Obstetricians and Gynecologists (ACOG) has recommended that the most women with one previous cesarean delivery with a low-transverse incision are candidates for vaginal birth after cesarean and should be counseled about VBAC and offered a trial of labor in the hospital which has physicians immediately available to provide emergency care including cesarean section and personnel familiar with the potential complications of a trial of labor who should be vigilant for nonreassuring fetal heart rate patterns and inadequate progress of labor. The safer VBAC will be provided when the physicians and patients are alert about the risk, benefit and disadvantage of VBAC, and when the reasonable management of the labor is performed. The success of VBAC will contribute to prevent unnecessary primary cesarean and reduce the overall cesarean delivery rate.