RETRACTED: Pyoderma gangrenosum in a cesarean section wound in a woman with myelodysplastic syndrome: A case report

Initial and Longitudinal Trajectories in Hemoglobin Levels Predict the Prognosis of Patients With Premature Rupture of Membranes

PROBLEM

Premature rupture of membranes (PROM) can lead to adverse maternal and neonatal outcomes. Identifying predictors of length of hospital stay (LOS) in PROM patients can aid in improving management and prognosis.

METHOD OF STUDY

The Medical Information Mart for Intensive Care IV database was searched to acquire data on PROM individuals. A univariable analysis, LASSO regression, and multivariable generalized linear model (GLM) were adopted to identify factors closely related to LOS. Next, the change trends in the key variable over multiple time points were determined using a latent class trajectory model (LCTM). The association of these trajectories with LOS was analyzed using GLMs.

RESULTS

The retrospective study finally enrolled 868 samples. The significant factors included initial hemoglobin, chorioamnionitis, premature birth, and rupture to delivery interval <24 h. Notably, higher initial hemoglobin level was independently associated with shorter LOS (β = -0.599; 95% CI = [-0.846, -0.352]; p < 0.05). The stratified analysis confirmed this association in all subgroups except those with chorioamnionitis. The LCTM identified three hemoglobin trajectories. Compared to other trajectory groups, the "lowest, declining" group had longer LOS (p < 0.05).

CONCLUSIONS

PROM patients with lower initial hemoglobin levels and the "lowest, declining" trajectory group were linked to longer LOS. Monitoring and managing hemoglobin levels is important in improving patient outcomes.

Pyoderma gangrenosum following gynaecological surgery

A perimenopausal woman with abnormal uterine bleeding underwent an uncomplicated laparoscopic hysterectomy. Postoperatively, she developed fever, abdominal erythema and pain. Imaging revealed diffuse abdominal wall skin thickening, most pronounced at the right port site with a small area concerning for developing abscess. There was high clinical suspicion for necrotising fasciitis due to rapidly progressive skin deterioration. Despite antibiotics and surgical debridement, her condition progressed. Biopsy of the inflamed tissue confirmed a diagnosis of pyoderma gangrenosum (PG), and treatment with daily prednisone led to rapid improvement of symptoms.Successful diagnosis and treatment of the patient's symptoms required multidisciplinary collaboration among gynaecology, general surgery and dermatology. PG, although a well-known condition among dermatologists, is rarely, if ever, encountered by gynaecologists, and its resemblance to conditions such as necrotising fasciitis complicates early detection and intervention. This case highlights the diagnostic and management challenges associated with PG in the gynaecological setting.