Amniotic band syndrome: A case report

Amniotic band syndrome is a rare disorder, which consists of a combination of malformations in which the main feature is the existence of an amniotic band that can envelop the limbs, the body wall, and/or the viscera. We report a case of an antenatal diagnosis of amniotic band syndrome in a 21-year-old female patient at 20 SA + 1 day, who had a medical abortion.

Heterotopic pregnancy: Five case reports diagnosed in 2021

Introduction and importance

Heterotopic pregnancy is the occurrence of pregnancies in at least two different implantation sites in the same time. The diagnosis is one of the most difficult of the gynecological emergencies. In 2021 this pathology still underdiagnosed and remains unknown by physicians. Most patients are admitted in critical stage.

Cases presentations

We reported 5 cases of heterotopic pregnancies in symptomatic women admitted from January 2021 to December 2021, in maternity department, mother and child hospital abderrahim Harouchi, Ibn Rochd University Hospital of Casablanca. The frequency of this pathology in our hospital in 2021 is about 10% of ectopic pregnancies (5/52 cases of ectopic pregnancies). All the cases were received in critical phase of the pathology (vascular collapsus or hemodynamic shock). The mean diagnostic was suspected in gray scale ultrasound that show an intrauterine pregnancy associated with adnexal mass corresponding to hematosalpinx or gestational sac in the uterine tubes with medium to high abundance hemoperitoneum. All of our cases were treated by laparotomy in emergency after resuscitation measures.

Clinical discussion

The existence of intrauterine pregnancy does not exclude an ectopic pregnancy and often confuses the physician who consults the patient in early stage of symptoms. The clinical symptomatology is often related to a threatened or ongoing abortion, the diagnosis of heterotopic pregnancy is usually made in the stage of hemoperitoneum secondary to a rupture of the ectopic pregnancy. The standard treatment is conservative surgery, preferably by laparoscopy. The manipulation of the uterus must be careful to preserve the intra uterine pregnancy. Laparotomy retains its indications especially in forms with hemorrhagic shock. The abortion is not rare after surgery. A progestin treatment is always indicated.

Conclusion

The diagnosis of heterotopic pregnancy should not be delayed by the discovery of an intra-uterine gestational sac in symptomatic women and the adnexa must be systematically examined in the first trimester sonographic exam. The Diagnosis is often difficult and management should be initiated as soon as possible given the risk of maternal mortality.

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Heterotopic pregnancy is the occurrence of pregnancies in at least two different implantation sites in the same time.

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The diagnosis of heterotopic pregnancy should not be delayed by the discovery of a intra uterin gestational sac in symtomatic women and the adnexa must be systematically examined in the first trimester by sonographic exam.

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The main treatment consists of removing the ectopic pregnancy, while preserving the intra uterine pregnancy, that make the second challenge after diagnoses.

Acquired uterine arterio-venous malformation post molar pregnancy suction-curettage: 2 case reports

Introduction

Acquired uterine AVM is an abnormal and non-functional connection between uterine arteries and veins. It is reported as a consequence of uterine trauma as curettage procedures, pelvic surgery.

Cases presentation

The authors report 2 cases of uterine AVM post suction-curettage procedure on molar pregnancy incidentally discovered in ultrasound screening in the usual follow-up of this disease, diagnosed in the Department of Maternity of Mother and Child University Hospital Abderrahim Harouchi of Casablanca.

Clinical discussion

Uterine AVMs are extremely rare and should be considered in cases of heavy and persistent uterine bleeding. Uterine AVMs are either acquired or, more rarely, congenital, due to abnormal differentiation of the primary vascular structures during embryogenesis. The invasive technique allows confirmation of the diagnosis and identification of the major feeding vessels when embolization may be indicated as a treatment option.

Conclusion

Acquired uterine arteriovenous malformation is the result of uterine trauma; it presents as uterine bleeding through the vagina that can be life threatening, the rarity of the condition makes it difficult to diagnose, however the evolution of investigative techniques helps in the diagnostic process.

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Arteriovenous malformation (AVM) also called arteriovenous fistula is a short circuit between an organ’s arterial and venous circulation.

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Acquired arteriovenous malformations are often consequences of uterine trauma

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They are also associated with infection, retained product of conception, gestational trophoblastic disease

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Uterine artery embolization remains the treatment of choice for AVMs for patients who wish to preserve their fertility.

Unusual primary location of non-Hodgkin lymphoma in the uterine body with compressive form: About case

INTRODUCTION

Primary non-Hodgkin's malignant lymphoma (NHML) of the uterine body is an extremely rare localization since only eleven cases have been reported in the literature.

CASE PRESENTATION

We report a case of primary NHML of the uterine body discovered during a hysterectomy performed for a uterine mass. The primary character of NHML of the uterine body was retained in view of the absence of extra-genital localization in the clinical, biological and radiological workup (Ann Arbor stage IE) and there were no signs of recurrence during follow-up. The patient received anti-CD20 immunochemotherapy (rituximab-CHOP and rituximab-VCAP combinations) and at 12 months follow-up, she is in complete remission.

DISCUSSION

The diagnosis of primary and isolated NHML of the uterine body is based on a clinical and further examination and regular follow-up for several months. The treatment is not codified; surgery, poly-chemotherapy and radiotherapy are the different therapeutic modalities. Rituximab-CHOP immunochemotherapy is currently the reference treatment for primary malignant lymphomas of the uterine body particularly in young patients who wish to become pregnant. The prognosis depends mainly on two factors: age and Ann Arbor stage.

CONCLUSION

Primary uterine lymphomas are rare tumors of unknown etiopathogeny and of non-specific clinical presentation, the role of the various treatments remains difficult to evaluate due to the small number of published cases.

Spontaneous uterine rupture during the first trimester of a partial molar pregnancy in a scar uterus: A rare case report

Introduction

Spontaneous uterine rupture in the first trimester is a redoubtable obstetric emergency that carries a high risk for both mother and fetus.

Cases presentation

We present the case of a spontaneous uterine rupture in a patient with a scarred uterus at 9 weeks' gestation treated by laparotomy in emergency obstetrical department of Ibn Rochd University Hospital of Casablanca; whose histological examination of the removed material found a partial mole.

Clinical discussion

Spontaneous uterine rupture in the first trimester is rare and usually occurs in a scarred or malformed uterus. Clinicians should consider this diagnosis in the presence of an acute abdominal pain in early pregnancy with or without first trimester metrorrhagia.

Conclusion

Since the rate of uterine surgeries is increasing, it is necessary to highlight the risk of uterine rupture occurring early in order to improve their management. Molar pregnancy is a factor of fragility of the uterine wall and uterine rupture must be suspected in any molar pregnancy associated with a hemoperitoneum.

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Spontaneous uterine rupture in the first trimester is rare.

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Diagnosis suspected in the presence of any acute abdominal pain in early pregnancy.

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Uterine scarring is the main factor promoting early uterine rupture

Abdominal pregnancy diagnosed by ultrasonography and treated successfully by laparotomy: Two cases report

Introduction

Abdominal pregnancy is one of the rare types of ectopic pregnancies that has a high rate of mortality. Its clinical presentation is similar to those of the other types of ectopic pregnancies.

Cases presentation

we report two cases of abdominal pregnancies whose the diagnosis was made by ultra-sonography and successfully treated by laparotomy in emergency obstetrical department of Ibn Rochd University Hospital of Casablanca.

Clinical discussion

the ultra-sonography based on precise criteria represents the fundamental paraclinical examination in the diagnosis of abdominal pregnancies. The treatment of early form is based on surgery; And despite the advent of laparoscopic surgery, laparotomy retains its indications including forms with hemorrhagic shock.

Conclusion

Due to the high risk of complications and maternal mortality, abdominal pregnancies should be surgically treated as soon as possible when the diagnosis is confirmed.

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Abdominal pregnancy is an exceptional type of ectopic pregnancies.

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Their diagnosis is difficult to distinguish from other types of ectopic pregnancies.

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Abdominal pregnancies should be surgically treated as soon as possible when the diagnosis is confirmed.