Reported is a case of a 29-year old Gravida 5 Para 4(4004), 23 6/7 weeks pregnant, known diabetic with hepatic hemangioma, who previously underwent ligation of ruptured esophageal varices, was admitted for the first time on February 21, 2015 due to left-sided hemiparesis. Identifying the cause of the pontine bleed and its possible association with coexisting medical problems was an arduous process since there are no existing management guidelines. Emergency Caesarean Section with bilateral tubal ligation under general anesthesia was done at 35 weeks AOG and a live baby girl was delivered with an Apgar score of 9,9. Magnetic Resonance Angiography (MRA) of intracranial vessels postpartum revealed a Cavernoma. This case is of particular importance due to the following reasons: 1.) Cerebral Cavernous Malformation (CCM) is a rare disease, 2.) There is scant data associating CCM with pregnancy, 3.) Current literature has not reported CCM with Hepatic Hemangioma in a single patient, 4.) No data has linked it with diabetes mellitus, 5.) There are still no management guidelines of CCM in pregnancy, 6.) A multidisciplinary approach is necessary for optimal maternal and fetal outcomes.

Human ; Female ; Adult ; Hemangioma, Cavernous

Background: Due to improving survival longevity among cervical cancer patients, ensuring the quality of life becomes important to the gynecologist. Cancer, as a chronic disease, afflicts the patient both physically and psychologically. Anxiety and depression have been the two most common psychopathologic conditions affecting the cancer patient. Hence, recognizing their presence is important for holistic management. Objective: The objective of this study is to determine the prevalence of anxiety and depression among cervical cancer patients seen in a tertiary government hospital. Methods: This is a cross-sectional study performed on 384 cervical cancer patients from a tertiary government hospital. The Hospital Anxiety and Depression Scale-Pilipino (HADS-P) was the screening tool used to determine the presence of anxiety and depression. A score of 8 and above was used to detect depression and anxiety. Data were analyzed using Stata 15. Multivariate analysis was also utilized. Pearson chi square and Fisher’s Exact tests were used. Variables that were significant were subjected to logistic regression analysis. Conclusion The prevalence rates of anxiety, depression, and anxiety and depression among cervical cancer patients in our setting are 8.6%, 35.7%, and 6.5% respectively. Factors related to anxiety included receiving psychological support from family and friends, stage III/IV cancer, and being at 4 to 6 months from time of diagnosis. Depression had significant relationships with age, employment status, chemoradiation, and stage II cancer. Although rates in general were lower compared to other countries, the mere presence of anxiety and/or depression among cervical cancer patients implies the need for the gynecologist to give attention not only to the physical aspects of cervical cancer but to the psychological effects as well. Psychological screening could be performed even if by means of a simple validated tool in order to detect psychopathology early on.
Anxiety ; Uterine Cervical Neoplasms ; Depression

Background: Although decreased potassium levels may have a role in the etiopathogenesis of preeclampsia, small number of studies has been done to determine their relationship. Objectives: This study was done to know whether serum potassium is significantly decreased in hypertensive disorders of pregnancy, to determine if the level of potassium correlates with the severity of hypertension, to know whether we can recommend serum potassium as part of preeclamptic work up, and ultimately, to determine if potassium supplementation can be advised to preeclamptic women during prenatal check-up. In this prospective, cross sectional study, subjects were 338, 169 of whom had uncomplicated pregnancies, while 169 had preeclampsia (72 of whom had systolic BP(SBP) 140-150mmHg, while 97 had SBP ?160mmHg). Baseline serum potassium were taken upon admission. The mean serum potassium was significantly lower at 3.37±0.41mmol/L (p-value<0.0003) in hypertensive women (versus 3.62±0.31mmol/L in uncomplicated pregnancies). Furthermore, the serum potassium was significantly decreased in patients with SBP>160mmHg (3.31±0.46) when compared with those with SBP140-150mmHg (3.45±0.32), with p0.013. Wilcoxon Signed-Rank Test showed Z-value -5.68 (significant at p?0.05), showing a significant difference between the level of serum potassium in normotensive compared to hypertensive patients. Chi-Square test showed X2?45.46 (in the critical region 5.9), therefore the level of serum potassium is dependent on the level of BP. Pearson Correlation coefficient showed r -0.1135 stating a negative correlation, hence, as the BP increases, serum potassium decreases. Conclusion This study suggests that hypokalemia observed in preeclamptic patients may bring about altered homeostatis in serum and therefore may act as predisposing factors in pathogenesis of preeclampsia. The authors recommend the addition of serum potassium as part of the criteria of severity of preeclampsia. Hypertensive pregnant women are advised to consume diet containing adequate amount of potassium or have a potassium supplementation during prenatal check up.
Hypokalemia ; Pre-Eclampsia

Background: Major changes in the practice of medicine have been adopted due to the COVID-19 pandemic and have not spared the practice of ultrasound among obstetrician–gynecologists, considered to have higher risk due to unique attributes of an ultrasound examination. Objectives: This study evaluated the awareness, attitudes, perceptions, and practices of the obstetric–gynecologic sonologists in the country during the pandemic, including the use of telesonography. Methodology: A descriptive, cross-sectional survey was conducted through a self-administered, structured questionnaire using an online survey software. Results: There were 120 respondents with postresidency training in ultrasound (54.2%) or in maternal and fetal medicine (43.3%), practicing in different regions, and mostly with teaching affiliations (56.7%). Most are aware of the guidelines on the practice of ultrasound this pandemic and they perceived themselves to be especially vulnerable to the infection. They admitted having feelings of stress, sadness, and depression, and their concerns centered on being infected and potentially transmitting it to their family. These perceptions translated to specific practices that include use of level 3 personal protective equipment, patient screening, triaging, and use of physical barriers to minimize environmental and contamination. While most are consistent with guidelines, some practices are neither based on sound scientific evidence nor correctly adhered to, including noncompliance with appropriate ultrasound transducer cleaning and disinfection. Regarding telesonography, only half of the respondents had good knowledge, with most having informal sources of information on the technology. Although the respondents have a good attitude toward it, only a few (15.8%) admitted to using it, mainly to confer with an expert or colleague (38.3%), and for teaching purposes (11.7%). Conclusions Obstetric–gynecologic sonologists in the Philippines are aware of the risks and have the same attitudes and perspective on COVID-19 infection as other health-care providers. Specific practices have been modified; however, the use of telesonography is not among the changes adopted.
Obstetrics ; Telemedicine