Oophoritis, or inflammation of the ovaries, occurs as a result of certain viral infections and may impair ovarian function. Oophoritis has been attributed to cytomegalovirus, mumps virus, Zika virus, hepatitis B virus, and hepatitis C virus due to isolation of these viruses from the ovaries, histologic evidence of ovarian inflammation, and/or signs of ovarian dysfunction in infected people or animal models. These viruses cause inflammation of the ovaries by hematogenous spread, ascending infection of the female reproductive tract, or vascular changes in the ovary, including virus-induced vasculitis. Viral oophoritis has been studied as a potential cause of irregular menstruation, premature menopause, infertility, and ovarian cancer, although evidence of these associations remains limited and inconclusive. Risk factors for developing oophoritis with resultant ovarian dysfunction have additionally been investigated and may include sexual transmission, infection during pregnancy, and peripubertal infection depending on the virus. Despite the potential adverse effects of viral oophoritis, relatively little research has been performed on this condition, perhaps because of its rarity and underdiagnosis. This review summarizes the current literature regarding the most common histologic features of viral oophoritis, its pathogenesis, and its reported or suspected consequences on reproductive function. Furthermore, it highlights gaps in knowledge and areas requiring deeper investigation to inform future research. (Fertil Steril Rev Ò 2021;2:342-52. Ó2021 by American Society for Reproductive Medicine.
Liver herniation commonly associated with omphalocele occurs in only approximately 2.3% to 16% of fetuses with gastroschisis. Liver herniation in such cases is associated with considerably decreased survival rates (43% vs 97% with or without liver herniation, respectively). Rarely, abnormally positioned fetal hepatic vasculature has been reported mainly in association with congenital diaphragmatic hernia. In these rare cases, intrathoracic depiction of hepatic venous vasculature has assisted in confirming intrathoracic displacement of the fetal liver. We present a case of a large gastroschisis with complete herniation of the fetal liver in which prenatal sonography depicted an extracorporeal ductus venosus.
Objectives
To determine if 17α-hydroxyprogesterone caproate (17OHPC) or vaginal progesterone use for patients at risk for preterm birth has changed since the publication of the 17-OHPC to Prevent Recurrent Preterm Birth in Singleton Gestations (PROLONG) trial, and to assess which organizations’ (Food and Drug Administration’s [FDA], American College of Obstetrics and Gynecology’s [ACOG] or Society of Maternal Fetal Medicine’s [SMFM]) statements most influenced change.
Methods
Through a vignette-based physician survey, we sought to measure (by Likert scale) how counseling tendencies regarding 17OHPC and vaginal progesterone have changed since the PROLONG trial publication. Participants were also asked which organizations’ statements most influenced change.
Results
With response rate of 97 % (141/145), a pre-to-post PROLONG trial comparison revealed significant changes in counseling for progesterone. Respondents were less likely to recommend 17OHPC (p<0.001) and more likely to recommend vaginal (p<0.001). The FDA statement most influenced the decision not to recommend 17OHPC for the prevention of preterm birth (r=−0.23, p=0.005).
Conclusions
Providers have made significant changes in their counseling regarding progesterone use for patients at risk for preterm birth after the publication of the PRLONG trial.
Introduction: Cervical endometriosis is a very rare site for endometriosis, with a reported incidence of 0.11–2.4%.
Case Report: We present a histologically proven case of cervical endometriosis in a 33-year-old pregnant woman who presented with post-coital bleeding during the first trimester of her pregnancy, with subsequent spontaneous regression, and successful vaginal delivery.
Conclusion: This case emphasizes the importance of a thorough pelvic examination in patients presenting with bleeding in early pregnancy and biopsy of any lesions as long as it is safe. Cervical endometriosis should be added to the list of differential diagnoses of bleeding in pregnancy after the more common causes have been excluded.
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