ABSTRACT
Background: Aggressive angiomyxoma is a rare entity within mesenchymal cell neoplasms, especially in pregnant women. Its main characteristic is the ability to infiltrate neighboring structures and to recur. Case Presentation: We present the case of a pregnant woman who debuted with a genital prolapse in the second trimester of pregnancy. She was diagnosed with bilateral ovarian teratomas and a pelvic mass of which the diagnosis could not be established until delivery. The route of delivery used was cesarean section since the genital prolapse behaved as a previous tumor. After the puerperium, the patient was referred for consultation to complete the study of the mass. The extension study was carried out with a negative result. The patient underwent surgery for tumor exeresis. Hormonal treatment was not administered according to the patient's preferences. Conclusions: Aggressive angiomyxoma is a benign neoplasm that should be considered in the differential diagnosis of pelvic tumors in women. In pregnant women, the vaginal route of delivery is not contraindicated as long as the tumor does not obstruct the birth canal. The definitive treatment is surgery, preferably performed in a second stage after delivery.
Subject(s)
Myxoma , Pregnant Women , Cesarean Section , Female , Genitalia , Humans , Myxoma/diagnosis , Myxoma/surgery , Neoplasm Recurrence, Local , Pregnancy , ProlapseABSTRACT
El objetivo de este artículo es realizar un protocolo de manejo perinatal para aquellos fetos/neonatos nacidos en el límite de la viabilidad (por debajo de la semana de gestación 256/7). Para ello se han revisado las principales publicaciones que hacen referencia a su asistencia en los últimos años. Partiendo de los resultados de morbimortalidad en nuestro hospital y en consenso con los neonatólogos, hemos establecido un protocolo de manejo en nuestro centro. Proponemos un esquema en el que según la edad gestacional y, en su defecto, el peso al nacimiento, establecemos cuál debe ser el tipo de vigilancia fetal anteparto, necesidad de transporte neonatal, administración de corticoides prenatales, vía del parto y tipo de reanimación al nacimiento. Todo ello se realiza en estrecha colaboración con los neonatólogos y haciendo partícipes a los progenitores en la toma de decisiones(AU)
This article aims to provide a clinical practice guideline on perinatal management in fetuses/neonates at the threshold of viability (below a gestational age of 256/7 weeks). We reviewed the main literature published in the last few years. On the basis of outcomes in morbidity and mortality in our hospital and consensus with neonatologists, we established a management protocol in our center. We propose a protocol in which, gestational age or, in its absence, birth weight are used to determine the kind of prenatal care provided, the need for neonatal transport, use of prenatal corticosteroids, mode of delivery and neonatal resuscitation. This protocol is applied in close collaboration with neonatologists and with parents participation in the decision to treat(AU)
