A perforated sigmoid colon cancer initially diagnosed as a tubo-ovarian abscess: A teaching case.

Given the wide range of differential diagnoses for adnexal masses, the key issue is the correct assessment of the initial location to rule out malignant or emergency cases. Here, we report a case of perforated sigmoid colon cancer initially diagnosed as a tubo-ovarian abscess.

Ovarian thecoma presenting with acute ovarian torsion in pregnancy; report of a rare case.

Thecoma is a commonly benign ovarian tumor of the group "Sex cord-stromal neoplasms." This group represents <5 percent of ovarian tumors. Thecoma is extremely rare in pregnancy. Here, we describe a 17-week pregnant woman presenting with acute ovarian pedicle torsion as a result of an ovarian thecoma.

Molar Changes With a Normal Viable Fetus: A Case Report.

Objective: The presence of a normal fetus with normal karyotype accompanied by molar changes in the placenta is a rare condition, which carries a significant risk to the mother and fetus. There is a controversy regarding the proper management of this condition. Here, we present the case of a singleton pregnancy that showed molar changes in the pathological study of the placenta, but ended up with a normal viable neonate. Case Report: A 23-year-old primigravida woman, with a 3-year history of infertility, presented with vaginal bleeding and spotting. Her ß-human chorionic gonadotropin (HCG) at 13th week was 36500 mIU/ml. Serial sonography assessments were suggestive for molar changes and a normal fetus with growth retardation but normal Doppler assessment. The patient underwent elective Cesarean section at 37 weeks gestation and a healthy female neonate with an Apgar score of 9-10, weighing 2270 g was born. Pathological assessment of the placenta confirmed the diagnosis of incomplete hydatidiform mole. After two months, the mother had no complications, her ß-HCG level was untraceable, and the infant was in good condition. Conclusion: Despite being a rare condition, partial moles can be accompanied by delivery of a normal fetus. The management of this condition still remains challenging and should be done under close monitoring with extreme caution.

First Trimester Uterine Rupture, a Rare but Life-Threatening Event: A Case Report.

Uterine rupture often occurs in the third trimester of pregnancy or during labor. Its occurrence in early pregnancy and in the absence of any predisposing factors is very rare. Untimely diagnosis and a low index of suspicion could be life-threatening. Here we report the case of a 29-year-old woman with a history of two previous cesarean sections. An ultrasound report revealed a dead fetus in the abdominal cavity at 14 weeks into the abdominal cavity due to a rupture at the site of the previous cesarean scar. Awareness of probable diagnosis of uterine rupture in a pregnant woman with abdominal pain could be important for timely diagnosis and proper management.

A case of D alloimmunization in pregnancy: successfully treated solely with therapeutic plasma exchange (TPE).

One of the most common causes of fetal anemia is red cell alloimmunization. The standard treatment in fetuses with anemia is intrauterine transfusion (IUT); but this approach may have adverse effects, or sometimes it is not available or even possible. Therefore, immune modulating approaches such as therapeutic plasma exchange (TPE) and the use of intravenous immunoglobulin should be implemented to avoid or delay IUT. We report here the successful management of a case of D alloimmunization in pregnancy solely with TPE, without the need for IUT. The patient was a 33-year-old G4, L2, and D1, who had a history of alloimmunization in her previous pregnancy. TPE was initiated at 17 weeks gestation and was repeated weekly. Altogether, 20 times of plasma exchange were performed and a normal fetus was delivered at week 37.

Cervical bacterial colonization in women with preterm premature rupture of membrane and pregnancy outcomes: A cohort study.

BACKGROUND: One of the most important etiologies in pretermpremature rupture of membranes (PPROM) is cervical bacterial colonization. OBJECTIVE: This study evaluated cervical bacterial colonization in women with PPROM and the pregnancy outcomes. MATERIALS AND METHODS: In this cohort study, 200 pregnant women with PPROM at 27-37 wk of gestation who were admitted in an academic hospital of Mashhad University of Medical Sciences from March 2015 to July 2016 were studied. samples were obtained from endocervical canal for detection of routine bacteria and Gram staining. Also, we obtained one blood culture from neonates. Maternal endocervical culture, chorioamnionitis, neonatal intensive care unit admission, neonatal positive blood culture, neonatal sepsis, and mortality were documented. RESULTS: Most common isolated microorganism of endocervical culture were Escherichia coli (24.2%), Coagulase negative Staphylococci (27.2%), Enterococcus and candida each one (11.7%). The prevalence of GBS was only 2.2%. Simultaneous positive blood cultures were seen in 3% of neonates. Among them, Gram-negative bacilli accounted for (66.6%), while Gram-positive cocci and candida made up only (16.7%). Endocervical colonization was associated with a higher admission rate (p=0.004), but there was no significant correlation between endocervical colonization and chorioamnionitis, positive blood culture and neonatal mortality rate. CONCLUSION: With regard to low GBS colonization rate, appropriate antibiotic regimens should be considered in PPROM cases according to the most prevalent micro organisms of endocervical bacterial colonization. Maybe cervical bacterial colonization had some effects on neonatal outcomes. There was no significant association between endocervical bacterial colonization and chorioamnionitis, positive neonatal blood culture and neonatal mortality.

Sudden Bilateral Sensorineural Hearing Loss Following Postpartum Hemorrhage: A Case Report.

The prevalence of bilateral sudden sensorineural hearing loss (SSNHL) is less than 5% and the etiology of most cases is unknown. Due to many structural and functional similarities between the kidney and inner ear, many conditions, diseases, and drugs have both renal and cochlear effects and toxicities. There are several reports of SSNHL in patients with CRF, uraemic patient, hemodialysis treatment, and ARF. Here, we report a rare manifestation of SSNHL following severe postpartum hemorrhage that has simultaneous renal failure and cochlear impairment. The patient was a 22-year-old primigravida woman with term pregnancy who after delivery and episiotomy hematoma and postpartum hemorrhage subsequently suffered from kidney failure, oliguria, and SSNHL that occurred after 3 days of delivery. In conditions such as severe postpartum bleeding leading to acute renal involvement, the possibility of simultaneous involvement of cochlea due to hypoxia or received drugs should be considered.