We present a case of a 26 year-old pregnant woman, who was diagnosed a serous borderline tumor of the ovary, two years ago. CA 125, CA 19-9 and HE4 was within the normal range values. A Cystectomy was performed, where too histopathological diagnosis was decided. The patient was informed in detail about the nature of the disease and the treatment methods, and was assigned the time of surgical intervention (unilateral salpingo-oophorectomy with staging has been recommended), she does not accept any treatment method. After a year of follow-up with tumor markers, an exploratory laparoscopy with ovarian biopsy was performed. Left ovary was without histopathological changes, while the right ovary had histopathological changes for serous borderline tumor of the ovary, but without storm invasion. She decided for surgery. Fifteen days before surgery, she is presented for a routine visit, where pregnancy was confirmed. She was informed about potential risk, but categorically decided to continue the pregnancy. During pregnancy, there was no complication. She is presented for birth at 39+5 weeks of gestation. Due to obstetric status, which is not conducive to vaginal delivery and previous diagnoses, in co-think with the patient, it is decided that birth should be performed with Caesarean section. During a C-section, both ovaries are inspected, there are no macroscopic changes. Biopsy was obtained in both ovaries. The result was the same as two years ago. Because of the scarce studies, it is difficult to know which are the best management practices and especially to women who desire childbearing.
Osteoporosis is a condition that rarely occurs during pregnancy, but due to loss of bone density, bones become fragile and may suffer fractures. During pregnancy, the aetiology of osteoporosis is unknown. But there are a large number of identifiable risk factors that can influence the development of osteoporosis. Generally, symptoms and signs most often begin in the third trimester of the first pregnancy and improve after delivery, as they do not usually recur in subsequent pregnancies. To diagnose osteoporosis, as well as to determine the risk of fractures and follow-up medication are used bone mineral density (BMD) measurement and determination of the level of the final products (biomarkers), which are released during bone degradation and formation. The dual-energy X-ray absorptiometry (DEXA) is the leading technique for estimating bone mineral density. So far there is no specific treatment for osteoporosis during pregnancy. In many cases, the adverse effects of osteoporosis are reversible with appropriate and timely intervention. Therefore, treatment with calcium and vitamin D supplements during pregnancy in women who have two or more risk factors for developing osteoporosis may be reasonable.
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