Microparticles hyperactivity in a case of intrauterine growth restriction

A case of a residual intrauterine fetal growth is described in a primiparous woman, aged 33 years, undergoing the 37th week of pregnancy. The patient was admitted to the outpatient department of the present clinic complaining of decreased fetal movement in the past few days. The cardiotocography (CTG) was non reactive, with reduced variability for a period of more than 30 minutes. The evaluation of the activity of microparticles (MPs) showed a value of 48.90 nM, which was 21.26 times higher than the mean of normal women of comparable pregnancy age (2.31 ± 1.95 nM) and 18.11 times higher than that of the average women who had intrauterine growth retardation (2.70 ± 2.63 nM). The reasons for this increase in the activity of the MPs are discussed in this case report.

A unique case of ruptured ectopic pregnancy in a patient with negative preg-nancy test - a case report and brief review of the literature

INTRODUCTION

Despite the major advances made in the diagnosis and management of ectopic pregnancies in the last two decades, an accurate diagnosis can sometimes still be quite challenging, since it relies on the combination of ultrasound findings and serial serum beta-human chorionic gonadotrophin (β-hCG) measurements.

CASE PRESENTATION

This paper describes the case of a 36-year-old woman of Caucasian origin who was admitted to the emergency department of our clinic with clinical symptoms of hemorrhagic shock in combination with two negative pregnancy tests done by her at home and a negative urine test which was performed on her admission to the hospital. Quantitative measurement of β-hCG in the serum of the patient was 13 mIU/mL. On admission, right tubal pregnancy was diagnosed on ultrasound and she underwent an emergency laparotomy due to signs of hemodynamic shock.

CONCLUSION

It is sometimes a considerable challenge to identify a patient with an ectopic pregnancy at risk of rupture. This case of ectopic pregnancy which was followed by a negative pregnancy test illustrates the magnitude of the difficulties involved in the diagnosis of ectopic pregnancy. It also demonstrates the need to maintain a high clinical index of suspicion and to undertake careful clinical examination of the patient on the basis of the clinician's diagnostic research. Hippokratia 2014; 18 (3): 282-284.