Successful Management of Heterotopic Cervical Pregnancy After In-Vitro Fertilization Presenting With Hyperemesis Gravidarum: A Case Report

Heterotopic pregnancy, defined by the simultaneous existence of intrauterine and ectopic pregnancy, is a rare pathological condition. In women undergoing assisted reproduction techniques, the frequency is higher. The possibility of the simultaneous existence of an ectopic pregnancy, when the certainty of an endometrial pregnancy has been assured, should always be considered with special care. The case of a patient with heterotopic pregnancy with assisted conception and the only symptom being nausea and vomiting is presented.

Ovarian cyst torsion in a pre-menopausal woman causing intestinal obstruction: a case report

Intestinal obstruction due to adnexal torsion is a rare complication that can be occurred during torsion of an ovarian cyst. A premenopausal woman presented to the emergency department with complaints of abdominal distension, abdominal pain, and obstipation for 2 days. An abdominal radiograph showed signs of large bowel partial obstruction. Hence admission to the surgical department was ordered. Due to deterioration of the patient, a gynaecological evaluation took place. Ultrasonography demonstrated a large ovarian cyst, which was also confirmed by an abdominal computed tomography scan and thus immediate laparotomy was decided. Abdominal hysterectomy with bilateral salpingo-oophorectomy was performed due to torsion of a giant ovarian cyst, which caused intestinal obstruction by compression. The post-operative course of the patient was uneventful. Ovarian torsion should not be eliminated from differential diagnosis when it comes to female patients with clinical presentation relevant to small and/or large bowel obstruction.

A rare case of a giant placental chorioangioma with favorable outcome

Chorioangioma is the most common type of placental tumor. A primigravida woman was noted on routine scan at 21 weeks of gestation to have a placental mass measuring 1.8 x 2.2cm. A detailed ultrasound scan revealed a well circumscribed, hypoechoic lesion protruding into the amniotic cavity; hence a preliminary diagnosis of placental chorioangioma was made and close prenatal surveillance was scheduled. At 34 weeks of gestation, the mass was measuring 6.27 x 5.38cm. The patient experienced reduced fetal movements at 37 weeks gestation. A small-for-gestational age but normal female neonate was delivered by caesarean section. Histopathological analysis of the placenta confirmed the diagnosis. According to our case, a giant placental chorioangioma may have a favorable outcome without any medical intervention.