Pregnancy in a woman with a continent appendicovesicostomy: a case report

BACKGROUND: Few cases of pregnancy following the Mitrofanoff procedure (continent appendicovesicostomy) have been reported, but in those cases there was an increased rate of cesarean delivery with no long-term consequences to renal function or to the urinary diversion. CASE: A 15-year-old primagravida with a prior nephrectomy for a dysplastic kidney and prior continent appendicovesicostomy for urinary retention due to spina bifida occulta and neurogenic bladder had a pregnancy complicated by preterm premature rupture of membranes, preterm labor, breech presentation and cesarean delivery with the assistance of a urologist. The patient had a minimal decline in renal function, and she and the infant did well. CONCLUSION: Cesarean delivery should be reserved for obstetric indications. Surgical assistance by a urologist at the time of cesarean delivery may be helpful.     

Prenatal MRI in a fetus with a giant neck hemangioma: a case report

We report a fetus with a giant neck hemangioma which was examined by MRI in utero. The initial diagnosis was made by ultrasonography. The sonolucent aspect of the mass, together with the presence of pulsating Doppler flow signals, was highly suggestive of a fetal hemangioma. In late pregnancy, fetal MRI revealed the location, size and characteristics of the neck tumor. Following prenatal corticosteroid treatment and premature delivery of the pregnancy due to fetal cardiac failure, the newborn received angiography and coil embolization of the tumor vessels. Despite vigorous treatments, the newborn died 12 h after birth. Evaluation of a fetal neck hemangioma by MRI is recommended late in pregnancy for precise information on the tumor and adjacent organs since the image is valuable for planning optimal perinatal treatment.     

Vaginal Dystocia in a Patient with a Double Uterus and a Longitudinal Vaginal Septum

A case of a breech straddling a vaginal septum requiring urgent division is reported. This case demonstrates some of the obstetric complications associated with congenital genital tract anomalies.     

Branchial-cleft sinus presenting with a retropharyngeal abscess for a newborn: a case report

A retropharyngeal abscess rarely occurs in the neonate. We report a neonate without apparent trauma who presented with a left neck mass and respiratory distress at the fourth day of age. A lateral neck X-ray revealed a widened retropharyngeal space. A neck computed tomography (CT) scan revealed a space-occupying lesion with air content in the left retropharyngeal area, although direct laryngoscopy, endoscopy, and a pharyngoesophagogram did not demonstrate the presence of any fistula tract. Due to the high index of suspicion for an aero-digestive tract fistula, diluted contrast medium was injected into the cyst while performing a CT-guided aspiration, and opacification was found in the oropharynx, thus a branchial-cleft sinus appeared to be most likely. The follow-up neck CT scan revealed no evidence of any recurrence. We suggest that CT-guided aspiration and cystography are useful for the diagnosis and treatment of some neonatal neck cystic lesions.     

Pregnancy in a patient with a displaced levonorgestrel-releasing intrauterine system: a case report

We report the case of a 39-year-old woman who became pregnant despite a levonorgestrel-releasing intrauterine system (LNG-IUS), which was inserted 40 months before the pregnancy was detected. When a Caesarean section was performed, the LNG-IUS was found within the omentum majus. It has been reported, that displaced LNG-IUS can cause amenorrhea and high plasma levels of LNG in affected women, probably due to the higher resorptive capacity of the peritoneum, recommending a removal of the displaced LNG-IUS. Our case report demonstrates that a dislocated LNG-IUS does not necessary has the ability to suppress ovulation and therefore pregnancy. Therefore, every gynaecologist should be aware of a pregnancy despite a dislocated LNG-IUS.     

Pregnancy in a woman with a prior myocardial infarction: a case report]

Myocardial infarction during pregnancy is a rare event but is considered to be associated with very high mortality of both mother and fetus. We report uncomplicated cesarean section in the 3rd pregnancy in woman with a prior myocardial infarction that occurred during the first hours after cesarean section delivery of the 2nd pregnancy. Intensive cardiological and obstetrical supervision are required for correct management of the pregnancy.