We describe a case of recurrent uterine rupture at the site of a previous rupture. Our patient had a history of right interstitial pregnancy with spontaneous uterine fundal rupture at 18 weeks of pregnancy. During her subsequent pregnancy, she was monitored closely by a senior consultant obstetrician. The patient presented at 34 weeks with right hypochondriac pain. She was clinically stable and fetal monitoring showed no signs of fetal distress. Ultrasonography revealed protrusion of the intact amniotic membranes in the abdominal cavity at the uterine fundus. Uterine rupture is a rare but hazardous obstetric complication. High levels of caution should be exercised in patients with a history of prior uterine rupture, as they may present with atypical symptoms. Ultrasonography could provide valuable information in such cases where there is an elevated risk of uterine rupture at the previous rupture site.
Abdominal Pain ; Adult ; Amnion ; diagnostic imaging ; pathology ; Female ; Humans ; Infant, Newborn ; Laparotomy ; Magnetic Resonance Imaging ; Pregnancy ; Pregnancy Complications ; diagnostic imaging ; Pregnancy Outcome ; Recurrence ; Ultrasonography ; Uterine Rupture ; diagnostic imaging ; Uterus ; diagnostic imaging ; pathology

Abdominal Wall ; Adult ; Female ; Follow-Up Studies ; Humans ; Melanoma ; pathology ; surgery ; Pregnancy ; Pregnancy Complications, Neoplastic ; pathology ; surgery ; Skin Neoplasms ; pathology ; surgery

PURPOSE: Imaging features and clinical characteristics of degenerated leiomyoma in patients referred for uterine fibroid embolization (UFE) were analyzed to assess the incidence of degenerated leiomyoma. MATERIALS AND METHODS: Patients referred for UFE between 2008 and 2009 were retrospectively analyzed (n=276). Patients ranged in age from 27 to 51 years (mean 38.0 years). All patients underwent screening MRI with contrast enhancement. Medical histories and clinical symptoms were evaluated. RESULTS: Among the 276 patients who underwent MRI, 14 (5.1%) showed degenerated leiomyomas. Symptoms were abdominal pain (n=4, 26.7%), menorrhagia (n=5, 35.7%) and bulk-related symptoms (n=5, 35.7%) and no symptoms (n=5, 35.7%). Of the 14 patients with degenerated leiomyomas, 5 (42.9%) had a history of pregnancy in the past two years. For T1-weighted imaging (T1WI), a high signal intensity (SI) of the leiomyoma was the most common finding (n=9, 64.3%) and a hyperintense rim (n=4, 28.6%) was the second most common. On T2-weighted imaging (T2WI), a low SI of the leiomyoma was found in six patients (42.9%), a high SI in four (28.6%) and a heterogeneous SI in four (28.6%) patients. Conservative management was performed in 11 (78.6%) patients, surgery in 3 (21.4%) and uterine artery embolization in one (7.1%) patient. CONCLUSION: The incidence of degeneration of leiomyoma in patients referred for UFE was 5.1%. Patients presented with variable clinical symptoms with or without a history of pregnancy. MR imaging showed a high SI on T1WI and various SIs on T2WI without contrast enhancement. An understanding of the degeneration of leiomyomata is essential when considering UFE.
Abdominal Pain/therapy ; Adult ; Female ; Follow-Up Studies ; Humans ; Incidence ; Leiomyoma/*complications/epidemiology/*pathology/*surgery ; Magnetic Resonance Imaging ; Menorrhagia/therapy ; Middle Aged ; Pregnancy ; Retrospective Studies ; Treatment Outcome ; *Uterine Artery Embolization

The intestinal obstruction during pregnancy is rare but early diagnosis and treatment is essential. This disease can be diagnosed very late because the presenting symptoms such as nausea, vomiting and abdominal pain are often seen in normal pregnancies and most pregnant women avoid radiologic examinations. Moreover, this disease can be accompanied by high aspartate transaminase/alanine transaminase (AST/ALT) which can be also found in acute fatty liver of pregnancy or preeclampsia, and it makes diagnosis to be much delayed. If the diagnosis were delayed much, maternal and perinatal mortality would be increased highly. Therefore, the previous record of abdominal surgery or above mentioned symptom should be considered as the intestinal obstruction, and simple abdominal x-ray for early diagnosis and prompt operation step are critical. We present a case of small bowel obstruction accompanied with high AST/ALT during pregnancy which had the history of previous cesarean section with a brief review of the literature.
Abdominal Pain ; Aspartic Acid ; Cesarean Section ; Early Diagnosis ; Fatty Liver ; Female ; Humans ; Intestinal Obstruction ; Nausea ; Perinatal Mortality ; Pre-Eclampsia ; Pregnancy ; Pregnancy Complications ; Pregnancy Trimester, Third ; Pregnant Women ; Vomiting

Cantrell's Pentalogy is a rare condition that consists of defects involving the abdominal wall, lower sternum, anterior diaphragm, pericardium, and heart. In the literature to date, pregnant women with Cantrell's Pentalogy have not been discussed. We performed successful vaginal delivery of a 23-yr-old nulliparous, primigravid woman who had been diagnosed with this condition. Diagnosis was based on cardiac catheterization, angiography, and echocardiogram, and abdominopelvic CT. Vaginal delivery may be an option for women with Cantrell's Pentalogy and may be attempted with caution.
Abdominal Muscles/abnormalities ; Abdominal Wall/abnormalities ; *Abnormalities, Multiple ; Diaphragm/abnormalities ; Echocardiography ; Female ; Humans ; Oligohydramnios/diagnosis ; Pregnancy ; *Pregnancy Complications ; Pregnancy Outcome ; Sternum/abnormalities ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVE: To compare pregnancy prognosis by surgical management methods for adnexal mass in pregnancy, we evaluated laparoscopic surgery and laparotomy. METHODS: Between January 2000 and April 2008, 62 patients diagnosed with adnexal mass in pregnancy from St. Mary's hospital, Kangnam St. Mary's hospital, and Daejeon St. Mary's hospital were included. We performed a systemic retrospective chart review of patient who received by exploratory laparotomy or laparoscopy. The following factors were assessed: preoperative diagnosis, gestational age at the time of surgery, operative time, hospital stay, pathology, gestational age at delivery, complication and pregnancy outcome in both groups. Student's t-test and Fisher's exact test were used for statistical analysis. P-value below 0.05 was considered statistically significant. RESULTS: Laparoscopy 23 cases and exploratory laparotomy 39 cases underwent surgery during the study period. Lower abdominal pain due to cystic mass (50.0%) was the first operative indication and cystic torsion (30.6%) was followed. There was no difference in operative time, hospital stay, pregnancy outcome (spontaneous abortion, threatened abortion, preterm labor or birth) between two groups. But threatened abortion and preterm labor were increased in emergency operation than elective operation (P=0.028). Pregnancy outcomes were similar between laparoscopy and laparotomy. CONCLUSION: There was no difference in pregnancy complication and prognosis. Laparoscopic surgery can be managed safely as laparotomy in pregnancy women with adnexal mass.
Abdominal Pain ; Abortion, Threatened ; Emergencies ; Female ; Gestational Age ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Obstetric Labor, Premature ; Operative Time ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome ; Prognosis ; Retrospective Studies

OBJECTIVE: To compare pregnancy prognosis by surgical management methods for adnexal mass in pregnancy, we evaluated laparoscopic surgery and laparotomy. METHODS: Between January 2000 and April 2008, 62 patients diagnosed with adnexal mass in pregnancy from St. Mary's hospital, Kangnam St. Mary's hospital, and Daejeon St. Mary's hospital were included. We performed a systemic retrospective chart review of patient who received by exploratory laparotomy or laparoscopy. The following factors were assessed: preoperative diagnosis, gestational age at the time of surgery, operative time, hospital stay, pathology, gestational age at delivery, complication and pregnancy outcome in both groups. Student's t-test and Fisher's exact test were used for statistical analysis. P-value below 0.05 was considered statistically significant. RESULTS: Laparoscopy 23 cases and exploratory laparotomy 39 cases underwent surgery during the study period. Lower abdominal pain due to cystic mass (50.0%) was the first operative indication and cystic torsion (30.6%) was followed. There was no difference in operative time, hospital stay, pregnancy outcome (spontaneous abortion, threatened abortion, preterm labor or birth) between two groups. But threatened abortion and preterm labor were increased in emergency operation than elective operation (P=0.028). Pregnancy outcomes were similar between laparoscopy and laparotomy. CONCLUSION: There was no difference in pregnancy complication and prognosis. Laparoscopic surgery can be managed safely as laparotomy in pregnancy women with adnexal mass.
Abdominal Pain ; Abortion, Threatened ; Emergencies ; Female ; Gestational Age ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Obstetric Labor, Premature ; Operative Time ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome ; Prognosis ; Retrospective Studies

No abstract available.
*Abdominal Wall ; Adult ; *Cesarean Section, Repeat ; Endometriosis/*diagnosis/etiology/pathology ; Female ; Humans ; Peritoneal Diseases/*diagnosis/pathology ; Postoperative Complications/*diagnosis/pathology ; Pregnancy ; Tomography, X-Ray Computed

OBJECTIVE: To analyze the clinical characteristics of post-traumatic abortion and the relationship between trauma and abortion. METHODS: We collected and analyzed 23 cases of post-traumatic abortion encountered in the department of clinical forensic medicine, faculty of forensic medicine, China Medical University in recent years. RESULTS: All 23 post-traumatic abort inns were early abortions. Their traumata were mild and external only. Vagina bleeding and abortion occurred shortly after trauma. Most patients were older, from countryside, or unemployed. CONCLUSION The causes of abortion are complex. Post-traumatic abortion can only be diagnosed after excluding non-traumatic factors. For those cases abortion occur shortly after injuries and non-traumatic factors can not be excluded, trauma should be assessed for its role in abortions as primary, secondary or induction factors correlated with clinical symptoms and pre-
Abdominal Injuries/complications* ; Abortion, Spontaneous/etiology* ; Adult ; Brain Injuries/complications* ; Diagnosis, Differential ; Female ; Forensic Medicine ; Gestational Age ; Humans ; Pregnancy ; Retrospective Studies ; Uterine Hemorrhage/etiology* ; Young Adult

OBJECTIVETo explore the characteristics of closed abdominal injury in pregnancy women and its treatment.

METHODSThe clinical data of 37 pregnancy patients with closed abdominal injury treated in our hospital from June 1993 to June 2003 were collected and analyzed.

RESULTSAll the 37 patients were treated with operation. Among them 2 early pregnancy patients with intestinal rupture and 1 patient with retroperitoneal hematoma were treated under laparoscope; in other 34 pregnancy patients laparotomy was performed. Of the 34 patients 8 used cesarean section because premature separation of placenta and enlarged womb interrupted the management of intra-abdominal organ injury. In the 37 patients 33 (89.1%) were cured, 4 (10.8%) die, postoperative complication rate was 16.2% (6/37). Two patients (5.4%) suffered from abdominal cavity infection, 3 (8.1%) from pulmonary infection, and 1 (2.7%) had multi-organ failure.

CONCLUSIONSFor pregnancy patients with closed abdominal injury, besides obsteric diseases intra-abdominal injury should be given much attention. Accurate diagnosis and timely treatment can gain the time to save the life of both mother and fetus.

Abdominal Injuries ; diagnosis ; surgery ; Adult ; Female ; Humans ; Laparoscopy ; Pregnancy ; Pregnancy Complications ; diagnosis ; surgery