Highlights The therapeutic benefit of lymphadenectomy in endometrial carcinoma is controversial. Long-term survival was achieved in a stage IIIC2 patient treated with surgery alone. Pelvic and para -aortic lymphadenectomy may have a therapeutic benefit.
Stroke associated with pregnancy or puerperium is rare, but represents an important problem for women of childbearing age. We herein report a case of subarachnoid hemorrhage (SAH) due to suspected lateral posterior choroidal artery (LPChA) dissection during delivery. A 34-year-old woman developed deterioration of consciousness during delivery at a maternity clinic. Her Glasgow Coma Scale score was E3V3M6. She was sent to our hospital after 12 hr, where CT revealed SAH with intraventricular hematoma. Radiographic examinations showed contrast pooling on the left LPChA. Repeated angiography showed enlargement of the contrast pooling, which indicated pseudoaneurysm. It also showed a relatively clear but stenosed LPChA communicated with the lesion which could not be recognized in the angiography on day 0. This stenosed LPChA indicated arterial dissection. Therefore, endovascular parent artery occlusion was performed on day 11. Determining the exact extent of dissection was difficult because the LPChA was extremely narrow. Occlusion of the posterior cerebral artery was needed to achieve complete hemostasis, which, however, resulted in infarction of the medial temporal and occipital lobes. At the time of final follow-up 3 years later, the patient was alert and completely independent, but showed persistent incomplete homonymous hemianopsia. We reported a rare case of SAH from suspected LPChA dissection during delivery. Repeated angiography provided information about the source of hemorrhage and definite diagnosis, which opened the way to treatment. It is also important to recognize the difficulty in identifying the exact extent of dissection when treating dissections of small arteries.
Objective Modern technological advancements have made it possible to perform cardiotocography at home. Home‐based management of high‐risk pregnancies using a mobile cardiotocography system has been reported; however, its effectiveness in monitoring cases of fetal growth restriction (FGR) remains unclear. Therefore, the authors aimed to investigate the clinical usefulness of home‐based telemedicine for FGR management using the mobile cardiotocography (iCTG). Methods The authors conducted a single‐center, retrospective case series of patients with FGR. Seventeen women diagnosed with FGR were enrolled. Patients performed iCTG for 1 hour twice daily to examine their fetuses; data were uploaded and saved on the cloud. Results The median and minimum compliance rates were 93.33 (interquartile range [IQR], 70.00–100.00) and 40.7, respectively. The median and minimum validity rates were 100.00 (IQR, 90.48–100.00) and 36.4, respectively. In this study, many of the patients were managed at home and underwent delivery as planned. However, three patients required emergency visits; one had a nonreassuring fetal status and underwent an emergency cesarean section. Conclusion Even when the fetal prognosis is good, careful pre‐evaluation is required before initiating home care management. The current study shows that the economic burden of hospitalization for patients can be reduced by using iCTG.
Congenital defects/diseases Background:Agnathia-otocephaly complex (AOC) is a rare congenital malformation due to a first-branch arch disorder and has been considered lethal. However, milder variants of the isolated type of AOC have been reported as nonlethal. The ex-utero intrapartum treatment (EXIT) procedure is basically indicated for a fetus with a high risk of airway obstruction immediately after birth; it is not indicated for all AOC cases but is chosen to treat cases until the airway can be evaluated to achieve a better prognosis. Case Report:A 37-year-old woman was referred with reported fetal facial deformity and polyhydramnios at 27 weeks of gestation. Our fetal ultrasound scans showed agnathia, microstomia, and synotia, but not holoprosencephaly. Isolated AOC was diagnosed prenatally. Magnetic resonance imaging and microbubble tests revealed delayed fetal lung maturation, although it was not completely unmatured. With patient agreement, an emergency cesarean section with EXIT was performed because of clinical chorioamnionitis at 35 weeks of gestation.Tracheostomy was attempted for 16 min during EXIT and was completed 4 min after delivery. Despite this, the neonate died 12 h after delivery from severe respiratory failure and a tension pneumothorax caused by a hypoplastic lung. Conclusions:There is controversy surrounding the non-lethality of all isolated AOC cases and the non-contraindication of EXIT procedures. Our case was estimated as the milder variant, and the EXIT procedure was indicated; however, the neonate died of the hypoplastic lung. The evaluation methods of lung maturation are inconsistent, and the indication of the invasive EXIT procedure must be carefully considered.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.