Hydrosalpinx with acute abdominal pain during the third trimester of pregnancy: A case report.

BACKGROUND: Acute abdomen in pregnancy is a unique clinical challenge. We report a rare case of hydrosalpinx presenting as acute abdomen in the third trimester of pregnancy in the absence of infection and hormonal treatment. CASE: A 38-year-old Caucasian woman (gravida 4, para 3), at an estimated 29 weeks of a spontaneous singleton pregnancy, presented to the emergency department with severe abdominal pain in the right lower quadrant, which had been present for three days. Magnetic resonance imaging (MRI) demonstrated a right-sided hydrosalpinx. It was successfully treated with conservative treatment and the patient delivered vaginally at term without complication. CONCLUSION: Hydrosalpinx should be considered as one of the differential diagnoses for acute abdomen during pregnancy. A multidisciplinary approach is recommended, with a careful work-up, due to the risks to both fetus and mother.

Bilateral ovarian masses with different histopathology in each ovary.

We document the rare occurrence of multiple primary benign lesions that can occur in bilateral ovarian masses with benign imaging appearances and tumor markers. In addition, this case report contributes important information that may aid physicians in guiding their patients to make optimal clinical decisions together.

The effect of endometrial thickness on pregnancy outcome in patients with Asherman's syndrome post-hysteroscopic adhesiolysis.

BACKGROUND: Hysteroscopic adhesiolysis anatomically restores the uterine cavity in cases of Asherman's syndrome (AS); however, the extent of endometrial fibrosis could determine the pregnancy outcome. OBJECTIVES: To determine whether endometrial thickness could influence pregnancy outcome of hysteroscopic adhesiolysis in women with a history of AS. SUBJECTS AND METHODS: This was a retrospective cohort study that included 41 women who attended Women's Specialized Hospital, King Fahad Medical City from December 2008 to December 2015, presented with a history of infertility or recurrent pregnancy loss, and were diagnosed with intrauterine adhesions and treated by hysteroscopic adhesiolysis. To analyze the causative factors of AS, history of curettage, miscarriage, postpartum hemorrhage, hysteroscopy, endometritis, and any uterine surgery were recorded. Patients were followed up for 2 years to account for pregnancy. Patients were divided into two groups based on measurement of endometrial thickness in the midsagittal plane at mid-cycle of a menstrual period. Group A consisted of 26 patients with endometrial thickness ≤5 mm, and group B included 15 patients with endometrial thickness >5 mm. The main outcome measures included endometrial thickness and pregnancy outcome. RESULTS: Group A had significantly (P<0.001) lower pregnancy rates compared with group B (38.4% versus 80%, respectively). Five of 10 pregnancies (50%) from group A miscarried, compared with 1 of 12 (8.3%) pregnancies in group B. This was statistically significant (P<0.001). CONCLUSION: Pregnancy rates were observed to be higher when the endometrium was >5 mm in thickness among patients with AS and miscarriage rates may be reduced in this group.