Cases reported "Breech Presentation"

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1/18. Twin pregnancy following gonadotrophin therapy in a patient with Sheehan's syndrome.

    A case of Sheehan's syndrome presented with secondary amenorrhea and was put on L-thyroxine, prednisolone and cyclical estrogen and progestin. ovulation induction with gonadotrophins and intrauterine insemination with husband's semen resulted in a twin pregnancy. Antepartum course was complicated by bronchial asthma, gestational diabetes and pregnancy-induced hypertension. Cesarian section was done at 34 weeks gestation for preterm rupture of membranes and breech presentation. Both babies and their mother were doing well at 6 months of follow-up.
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2/18. prenatal diagnosis of meconium peritonitis in a twin pregnancy after intracytoplasmic sperm injection. A case report.

    BACKGROUND: meconium peritonitis occurring in pregnancies following artificial reproductive techniques (ART) is rare. We report the first case of meconium peritonitis following intracytoplasmic sperm injection (ICSI). CASE: A 37-year-old woman attended our in vitro fertilization (IVF) program because her husband suffered from hypospermatogenetic azoospermia due to cancer surgery and radiotherapy. The patient achieved a twin pregnancy through ICSI from testicular sperm extraction at our IVF center. meconium peritonitis, fetal ascites, polyhydramnios, bowel dilatation, hydrocele and intraabdominal calcification were noted in one of the twins on ultrasound at 30 weeks' gestation. cesarean section due to breech presentation in labor was performed at 36 weeks' gestation. A normal female and male infant with a distended abdomen were delivered. Emergency laparotomy was performed on the male twin because of dyspnea. A 0.2-cm perforation was found in the terminal ileum. Ileotomy was performed and closed after 27 days. CONCLUSION: prenatal diagnosis of meconium peritonitis is possible through careful ultrasonographic examination, and early surgical intervention and intensive postoperative support are required to improve the prognosis.
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3/18. Ectopic hydronephrotic kidney masquerading as an ovarian cyst during pregnancy.

    An ectopic iliopelvic kidney with hydronephrosis causing fetal malpresentation is a rare occurrence. We describe this case for its unusual presentation which was mistaken for an ovarian cyst. The difficulty in diagnosis and the need for a high index of suspicion is highlighted.
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4/18. Ultrasound assessment of biometric trends in a case of thanatophoric dysplasia.

    We present a case of thanatophoric dysplasia diagnosed at the 21st week of gestation. Serial ultrasound was performed throughout pregnancy. The scans showed a distinctive pattern of development of the fetal long bones. Up to week 25, the fetal long bones appeared to grow steadily but slower compared to normal measurements (4-5 SD below the mean); then, between weeks 26 and 30, long bone growth was further and more severely hampered, until it almost stopped altogether approaching term, with measurements 9-12 SD below the mean at week 38.
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5/18. A case of primary Addison's disease with hyperemesis gravidarum and successful pregnancy.

    We followed up a pregnant woman with Addison's disease diagnosed before conception. She presented with hyperemesis gravidarum. Throughout pregnancy, she received prednisone and the basic disease did not deteriorate during pregnancy. She was delivered by caesarean section due to breech presentation. The fetal prognosis was good.
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6/18. nuchal cord type B associated with an excessively long umbilical cord as a cause of stillbirth: a case report.

    nuchal cord (NC) is defined as the umbilical cord being wrapped 360 degrees around the fetal neck. It is one of the most common complications of the umbilical cord and any pregnancy might be complicated with a nuchal cord. If a nuchal cord occurs in a pregnant woman with decreased fetal movements, it should be considered to be at high risk, particularly for fetuses with multiple nuchal cords. We report a case in breech presentation with an excessively long umbilical cord (190 cm) which was complicated with five nuchal loops around the fetal neck and resulted in intrauterine death at the 37th week of pregnancy.
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7/18. Anaesthetic management of aortic coarctation in pregnancy.

    We report two cases of aortic coarctation in pregnancy. The first was a 20-year-old nulliparous woman who underwent an aortic coarctation repair when she was 23 weeks old and subsequently developed an aneurysm at the site of initial repair. The second was a 20-year-old nulliparous woman with a severe uncorrected congenital aortic coarctation and upper body hypertension, who became pregnant whilst awaiting transcatheter dilatation of the coarctation. Antenatal care involved a multidisciplinary approach with obstetric, anaesthetic and cardiology input. Both parturients were delivered by elective caesarean section. A cautious, incremental regional anaesthetic technique was used, with no associated maternal or neonatal morbidity. Perioperative management focused on minimising haemodynamic disturbances. The management is discussed, together with the potential maternal and fetal complications of aortic coarctation in pregnancy.
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8/18. pregnancy and delivery after right common carotid artery endarterectomy.

    BACKGROUND: Carotid artery atherosclerosis and essential hypercholesterolemia can add a predisposing risk factor for coagulation in pregnancy. Careful management of anticoagulation during labor, delivery, and puerperium is called for in such a case. CASE: A 41-year-old woman, gravida 2, para 1, with a previous endarterectomy at the right common carotid artery because of atherosclerotic plaques, underwent anticoagulation studies and prophylactic antithrombotic therapy. Low-molecular-weight heparin was administrated during pregnancy and puerperium. She successfully delivered by cesarean at 36 weeks of gestation. CONCLUSION: Low-molecular-weight heparin treatment is an effective and safe therapy in pregnancy. The healthy course of therapy, delivery, and puerperium reported here is a reference that may support women with a similar history.
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9/18. Use of external abdominal ice to complete external cephalic version in term breech pregnancy.

    A 36-year-old multiparous woman with fetus in the breech position applied ice to the fundus of the uterus and achieved successful cephalic version. No other reports of using ice to induce cephalic version are found with medline search; however, it has been used as a folk remedy. Further research to evaluate the efficacy and safety of ice is needed to determine whether it increases cephalic vaginal birth.
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10/18. Anesthetic management of the parturient with relapsing polychondritis.

    PURPOSE: To present the anesthetic management of a parturient with relapsing polychondritis (RP) and to discuss the anesthetic implications of RP. CLINICAL FEATURES: A 28-yr-old primiparous woman with known RP, spondyloarthropathy and fibromyalgia presented for urgent Cesarean delivery for breech presentation and prodromal labour. Her pregnancy had been complicated by a hospital admission for an exacerbation of her RP as manifested by hoarseness, increased pain and tenderness of her left ear and nasal bridge cartilages, sinusitis with bloody nasal discharge and increased pain and tenderness of the anterior tracheal rings. Epidural anesthesia was administered for the Cesarean delivery. Her intraoperative and postoperative course was uneventful. Close cooperation among obstetricians, anesthesiologists and rheumatologists resulted in a successful outcome. CONCLUSION: Relapsing polychondritis is a syndrome with important anesthetic implications. Multidisciplinary cooperation is essential in managing these high risk parturients.
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