Spontaneous Rupture of the Spleen in Late Pregnancy

Two cases of spontaneous rupture of the spleen are described. The first patient presented with fetal distress in the second stage of labour; the second with hypovolaemic shock. Both mothers and babies survived.     

Endometrioid Ovarian Carcinoma During Pregnancy Presenting With Acute Rupture

BackgroundEndometrioid ovarian carcinoma is rarely diagnosed during pregnancy and is generally asymptomatic. We present a case of endometrioid ovarian carcinoma during pregnancy that presented with acute rupture, and discuss options for management.CaseA primigravid woman presented at 26 weeks’ gestation with severe abdominal pain. At laparotomy, an adnexal mass was found to have ruptured. The mass was identified postoperatively as an endometrioid ovarian carcinoma. The decision was made to perform Caesarean section with fertility-sparing surgical management at 34 weeks to maximize maternal and fetal outcomes.ConclusionTo our knowledge, this is the first reported case of endometrioid ovarian carcinoma presenting with rupture in pregnancy. The differential diagnosis of severe abdominal pain during pregnancy should include rupture of ovarian malignancy.     

Spontaneous Rupture of the Liver during Pregnancy: A Case Report

Hepatic congestion resulting in hepatic rupture during pregnancy is a rare yet catastrophic event carrying a 60 to 70% maternal mortality rate. With preeclampsia and associated epigastric pain continuing to be a major problem confronting pregnant women, hepatic congestion may be more prevalent than believed. Current etiology, treatment, and characteristics of women who experience hepatic rupture are examined. A case report and nursing protocol are presented.     

Spontaneous Rupture of an Hepatic Adenoma in Pregnancy with Survival of Mother and Fetus

A case of spontaneous rupture of an hepatic adenoma during pregnancy is reported with survival of both mother and baby. The mother had previously taken the contraceptive pill for 9 years. Attention is drawn to the relationship between the contraceptive pill and the previously rare condition of benign liver adenoma, the need for prompt recognition, and for an intensive team effort in the management of rupture of this neoplasm.     

Splenic Rupture Complicating Pregnancy

Splenic rupture from any cause is an uncommon complication of pregnancy. Spark-man (1958) reviewed the literature and tabulated 44 cases including 2 of his own. Embrey and Painter (1962) reported a further case and mentioned 5 others. At least 4 further reports (O'Brien, 1963; Cairns et al. , 1964; Gilbert et al. , 1964; Bookstaver, 1965) have appeared in English literature and the subject has also been dealt with in the foreign literature (Huiskes, 1960; Mollegaaro, 1960; Ogien and Massi, 1963; Bertulozzo, 1964; Colombetti, 1965; Koskela, 1965). Cases occurring in Australia have been reported by Leslie (1966) and Elliott (1966).     

妊娠合并外阴阴道假丝酵母菌病的治疗对胎膜早破预防作用的研究

目的:观察妊娠合并外阴阴道假丝酵母菌病(VVC)的干预治疗对胎膜早破(PROM)的预防作用.方法:选取妊娠合并VVC治疗组30例,妊娠合并VVC未治疗组10例,足月非阴道炎胎膜早破组30例,足月正常妊娠组30例,观察前两组的妊娠结局并取羊水及胎膜做假丝酵母菌培养及分型鉴定;用免疫组织化学技术检测4组胎膜中基质金属蛋白酶-9(MMP-9)及金属蛋白酶组织抑制因子-1(TIMP-1)的表达率.结果:①未治疗组羊水和胎膜培养结果显示有1例克柔假丝酵母菌感染,治疗组羊水和胎膜培养结果均阴性;②胎膜早破组和未治疗组的MMP-9 PU值及MMP-9/TIMP-1 PU比值差异无统计学意义(P>0.05),但分别高于治疗组和正常对照组的MMP-9 PU值,MMP-9/TIMP-1 PU比值(P<0.05);③4组的TIMP-1的PU值比较差异无统计学意义(P>0.05).结论:妊娠合并VVC时,胎膜中MMP-9升高,MMP-9/TIMP-1失衡,增加了发生胎膜早破的危险性,治疗对预防妊娠合并VVC所致胎膜早破是有益的.     

Spontaneous Uterine Venous Rupture During Labour: A Case Report With Postoperative Ultrasonographic Findings

EDITORIAL COMMENT: We accepted this case for publication to remind readers that although uterine rupture during labour in a primigravida is extremely uncommon it does occur, or at any rate nulliparas can develop abdominal pain and shock in labour with a haemoperitoneum resulting from a tear in a vein in the lower posterior uterine wall. When one sees the hugely dilated uterine and ovarian venous plexuses at Caesarean section it is easy to believe that bleeding from such a vessel during labour could be prodigious. This case suggests that a dilated vein with blood flow derangements may be the cause. Nonetheless, as the authors warn us, the necessary response is not a precise diagnosis, but rapid laparotomy. See also Editorial Comment to Chin MMS, Harvey JA, Duffy BL. Uterine rupture during labour in a primigravida. Aust NZ J Obstet Gynaecol 1996; 36: 210.     

孕晚期子宫右前壁血管自发性破裂一例

孕晚期子宫血管自发性破裂是由于各种原因导致子宫动、静脉出现的自然破裂，由于孕晚期子宫血供极其丰富，一旦发生子宫血管破裂容易造成孕妇腹腔出血、休克、胎死宫内等不良事件。孕晚期子宫血管自发性破裂发病率低，但凶险性极高，诊断不及时或者漏诊将严重危害母儿安全。为提高对孕晚期子宫血管自发性破裂的认识，现回顾分析1例孕晚期子宫右前壁血管自发性破裂患者的临床资料，并复习相关文献，进一步分析其发病机制、辅助检查及临床表现，以加深临床医生对该病的认识，提高诊断和治疗水平。     

Spontaneous Rupture of a Massive Pyometra

Summary: A 66-year-old patient presented with acute peritonitis from a ruptured pyometra associated with an extensive cervical carcinoma. The relevant literature is reviewed.