Postpartum obturator neurapraxia. A case report

BACKGROUND: Obturator nerve injury is a rare complication of vaginal delivery. CASE: Postpartum obturator neurapraxia was clinically diagnosed in a 22-year-old woman on the first postpartum day after a vaginal delivery. With physical therapy, the neurologic symptoms resolved by the third postpartum month. CONCLUSION: Maternal nerve injuries are uncommon in obstetrics. The diagnosis of obturator neurapraxia is usually made clinically. The symptoms will resolve with conservative physical therapy alone in the majority of cases.     

Postpartum retinal detachment. A case report

A postpartum progression of preeclampsia ultimately resulted in bilateral serous retinal detachment.     

Postpartum herpes simplex endometritis. A case report

BACKGROUND: Herpes simplex virus (HSV) can cause postpartum endometritis. The clinical diagnosis of HSV endometritis has been reported previously. The disease is responsive to acyclovir intravenously. CASE: A 22-year-old woman, gravida 2, para 1, status post primary cesarean section for a double footling breech presentation, developed a persistent postpartum fever. Simulating the febrile course of septic pelvic thrombophlebitis, the patient's condition was unresponsive to broad-spectrum antimicrobials and heparin therapy. Active herpetic lesions and a positive cervical culture for herpes simplex prompted the use of intravenous acyclovir. Rapid resolution of the fever and the similarity to previous case reports suggested the clinical diagnosis of herpes simplex endometritis. CONCLUSION: The diagnosis of postpartum herpes simplex endometritis should be considered when managing a persistent postpartum fever unresponsive to aggressive antimicrobial and heparin therapy. Immediate resolution of the fever should occur with the use of acyclovir.     

Postpartum hemolytic-uremic syndrome associated with lupus anticoagulant. A case report.

BACKGROUND: Hemolytic uremic syndrome is a rare thrombotic microangiopathy characterized by acute renal failure, thrombocytopenia and hemolysis. The underlying abnormality is currently thought to involve enothelial injury within the microcirculation. CASE: A 30-year-old woman, gravida 2, para 1, underwent emergency cesarean delivery at 36 +/- 2 weeks' estimated gestational age for repetitive late decelerations and presumed severe preeclampsia. Postoperatively, the blood pressure remained persistently elevated despite multigent hypertensive therapy. By postpartum day 4 the patient continued to display acute oliguric renal failure, persistent severe thrombocytopenia and worsening hemolysis. Percutaneous renal biopsy was consistent with the clinical diagnosis of hemolytic uremic syndrome. Lupus anticoagulant was present, corroborated by markedly abnormal tissue thromboplastin inhibition and platelet neutralization procedures. With supportive therapy and daily plasmapheresis, the patient was discharged 22 days after delivery, with full recovery of renal function and resolution of the hemolytic process. CONCLUSION: Hemolytic uremic syndrome can be associated with lupus anticoagulant. This autoantibody may promote localized platelet aggregation, causing endothelial damage.     

产后并发血栓性血小板减少性紫癜一例分析

血栓性血小板减少性紫癜(thrombotic thrombocytopenic purpura,TTP)是临床罕见的急性严重性疾病,发病率为3.7/百万人,死亡率高达50％-80％,病因不明。目前认为,可能与感染、药物、免疫、妊娠、肿瘤等因素有关。孕产妇发生TTP更为罕见。我院产科收治1例产后并发TTP的患者,现结合文献复习报道如下。     

Sirenomelia apus. Case report

We report a case of Sirenomelia. The mother began prenatal care in the second trimester. Transabdominal ultrasound was determined anhydramnios, cardiac abnormalities and lumbosacral spine. We obtained a single fetus of 21 weeks' gestation with fused lower extremities from the hip to finish in a stump without the presence of feet. Heart with transposition of the great vessels, among other birth defects. It was classified as symelia, Apodi apus, monopodio sirenoide, siren ectropodia, type VI. It is important to diagnose early, because it is a serious and deadly disorder.     

Herlyn-Werner syndrome. Case report

The following study shows a syndrome which is commonly not diagnosed by gynaecologists. It was first described from Herlyn-Werner in 1971. In Bulgaria the same was described by I. Karagjosov in 1983 as a part of Herlyn-Werner-Wunderlich Syndrome.     

Ovarian leiomyoma. Case report

We describe a case of primary ovarian leiomyoma in a 16 year old patient; both ovaries were affected. Since at intervention normal tissue was found, the left ovary was preserved and a 30-months follow-up was carried out. Tumour markers (CA-125; alpha-fetoprotein; CEA and beta-HCG) were tested. Such a case has not previously been reported. Etiopathogenesis is also discussed.     

Fetus papyraceus. Case report

The term fetus papyraceus is used to describe a mummified fetus associated to a multi-fetal gestation. We present the case of a of 20 years old patient who entered under the diagnosis of pregnancy of 41.1 weeks of gestation by last menstrual period, and effective labor work. It was conducted labor and delivery obtaining a live, male product. The uterine cavity was revised due to suspicion of retention of placenta and/or fetal membranes and it was obtained a product of approximated 15 weeks of gestation; the patient presented uterine atony and postpartum hemorrhage (PPH) quantified in approx 1,500 cc. Therefore it was decided to perform an obstetrical abdominal hysterectomy, which took place without incidents. The patient cursed pathological puerperium and received blood transfusion for 4 U. She was discharged at the 7th day after surgery. The histopathologic result was fetus papyraceus.     

Pregnancy-related gigantomastia. Case report

The term gigantomastia has been used to describe breast enlargement to extreme size, with sloughing, haemorrhage and infection. The condition is rare and a case of pregnancy-related gigantomastia is reported.     

Uterine carcinosarcoma. Case report

The authors describe the clinical and pathologic features of uterine carcinosarcoma. In the case of a 45 year old patient the rarity of this double tumor is pointed out.