Acute fatty liver with pancreatitis in pregnancy after in vitro fertilization - literature review and case report.

BACKGROUND: Acute fatty liver disease in pregnancy (AFLP) is a low-incidence condition that usually affects women in the third trimester of pregnancy or the early postpartum period. This article reviews recent advances in the diagnosis and treatment of AFLP with pancreatitis in pregnancy induced by in vitro fertilization (IVF). CASE REPORT: A rare case of AFLP and pancreatitis occurred in a pregnant woman with an IVF-induced twin pregnancy delivered by cesarean section. Diagnosis of this condition is difficult, and delay in accurate diagnosis and timely and appropriate treatment can lead to serious complications such as acute pancreatitis or extensive damage to multiple organs and systems, which can have significant consequences. The main therapeutic approach was the rapid administration of drugs accompanied by therapeutic measures to support liver function and pancreatic complications. CONCLUSIONS: We would like to reemphasize the importance of multidisciplinary management and rapid intervention in AFLP with acute pancreatitis after IVF.

Ovarian reserve after treatment of ovarian endometriomas by ethanolic sclerotherapy compared to surgical treatment.

OBJECTIVE: To preserve ovarian reserve, we treated ovarian endometriomas by ultrasound-guided aspiration followed by sclerotherapy of the cyst mucosa. We compared the results with laparoscopic cystectomy. PATIENTS AND METHODS: We conducted a retrospective study of 96 women with ovarian endometriomas. In 54 of the women, ultrasound-guided aspiration of the contents was performed, followed by chemical sclerotherapy of the cyst plaque with ethanol. Laparoscopic cystectomy was performed in the remaining 42 women. RESULTS: Statistical analysis of anti-Mullerian hormone (AMH) levels before and after the procedures showed a significant decrease in the case of cystectomy compared with ethanolic ovarian sclerotherapy (EOS). CONCLUSIONS: Conservative treatment by echo-assisted puncture and sclerotherapy with ethanol proved to be a viable treatment for the removal of ovarian endometriomas. It is a simple procedure that does not affect ovarian reserve or fertility.

Comparative study of placenta acute fetal distress and diabetes associated with pregnancy.

The authors analyze the main histopathological changes of placentas from pregnancies ended with fetal distress at birth and the tasks associated with diabetes. The parallel between the two types of placentas not trying to prove the existence of pathognomonic lesions. Are set out both the similarities between the two titles of placentas lesions (such as changes in microcirculation and so on) as well as particular aspects. The authors analyze a group of 19 pregnant women hospitalized in Obstetrics and Gynecology Clinics of Emergency County Hospital of Craiova, Romania, in September 2010-September 2011, who were born and who were diagnosed with diabetes. In the same period, were studied 21 pregnant women whose pregnancy ended with the birth of a child with fetal distress. Such were identified as placental lesions suggestive of fetal distress as diverse etiology of placental vascular changes and the placenta in pregnancy associated diabetes as immaturity and vascular edema and fibrinoid changes and glycogen stores. The authors have proposed to highlight some lesions suggestive of two groups of diseases but independent groups were analyzed and conclusions were drawn after discussing results. This study is justified by insufficient knowledge of the causes that lead to fetal distress regardless of its etiology. In conclusion, the authors mention both placenta's common changes as specifically changes of the placenta for each type of disorder.

Embryological, clinical and anatomopathological considerations on a very rare case of a bicephalous fetus (dicephalus dipus dibrachius).

In this paper, we present the very rare case of a 21 weeks pregnant woman, examined clinically and by ultrasound. We could observe the present of two heads and a common trunk and therefore we proceeded to the small caesarian of necessity. We examined the fetus from the clinical and pathological point of view and we could observe a rare case of pregnancy with a bicephalous malformed fetus. During the autopsy, we could reveal the common elements and the devised ones, which are described as it follows. The case is a very rare one and that probably explains the fact that until the 21 weeks examination, even if she was clinically and ultrasound examined there was the appreciation that it was a twin pregnancy with a normal evolution. In this case, it is necessary to underline that the difficulties concerning the diagnosis and the medical behavior are also because the patient was a primipara 34-year-old woman without any pathological or specific family history. This case analysis shows the necessity of a preconception genetic advice together with the extension of the analysis of the genetic risk in all mothers under 35-year-old, mandatory and supported by the medical system. At the same time, an ultrasound examination of great performance proves to be necessary in order not to prolong the development of a pathological pregnancy.