Marzieh Talebian; Zohreh Talebi Mazreshahi; Elham Khosravi Mashizi; Nafiseh Khalili
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Introduction: Although 1% to 2% of all pregnancies are ectopic, ectopic pregnancy (EP) is the most frequent obstetrical disease leads to maternal mortality and morbidity at first trimester. The basic diagnostic method of EP is the human chorionic gonadotropin (HCG) test and transvaginal ultrasound. There ...
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Introduction: Although 1% to 2% of all pregnancies are ectopic, ectopic pregnancy (EP) is the most frequent obstetrical disease leads to maternal mortality and morbidity at first trimester. The basic diagnostic method of EP is the human chorionic gonadotropin (HCG) test and transvaginal ultrasound. There are some rare EP cases with negative HCG blood test. Case presentation: A 31-years old woman referred to the emergency department with hypogastric, periumbilical, and right upper quadrant intermittent pain and vaginal bleeding and prior history of EP 7-months ago that treated with methotrexate and her intra uterine device had been removed at that time. Her last menstrual period was undetermined. Although HCG blood test-qualitative was negative (2.08 IU /ml),ultrasound examination showed an 43×53 mm echogenic, heterogenic complex solid mass in the left adnexa and a large amount of echogenic fluid demonstrating hemoperitoneum. Taken surgery because of the exceeded abdominal pain revealed active bleeding in the left salpinx due to ruptured EP. Conclusion: Management of patients suspected of EP with negative HCG-blood test is difficult. In this uncommon cases in emergency, computed tomography, ultrasound and diagnostic laparoscopy or laparotomy can improve prognosis of patient.
Obstetrics and Gynecology
Marzieh Talebian; Niloofar Mehri; Maryam Mousavi Shirazi
Volume 7, Issue 5 , July and August 2022, , Pages 462-465
Abstract
Severe injury to the nervous system in pregnancy needs advanced critical care support to the mother and consideration of fetal effects. Managing persistent vegetative state (PSV) cases in pregnant patients is complex due to the lack of clear guidelines for medical and ethical reasons. This reports a ...
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Severe injury to the nervous system in pregnancy needs advanced critical care support to the mother and consideration of fetal effects. Managing persistent vegetative state (PSV) cases in pregnant patients is complex due to the lack of clear guidelines for medical and ethical reasons. This reports a gravida 4, maternal persistent vegetative state case due to a car accident for a 25-year-old woman at 20 pregnancy weeks. Aggressive support enabled the continuation of pregnancy toward 3th trimester without any impediment to the infant's development. A fetal scan for growth monitoring showed an estimated fetal weight near the 75th centile. Intervention in the pregnancy of a patient suffering PSV is not required if both mother and fetus are stable. Maternal malnutrition may adversely affect the fetus and neonate. In this case, high caloric nutrition with partial parenteral nutrition was employed. We monitored both the mother and her child in an attempt to gather data pertinent to the appropriate care of pregnancy in a persistent vegetative state and the potential sequel for offspring.
