Septic pelvic thrombophlebitis (SPT) was initially diagnosed and described in the late 1800's. The entity had a high incidence and mortality during this period of time, and a surgical therapeutic approach was the treatment of choice. Since then, the diagnosis, incidence, and management of the entity evolved. This evolution followed the development of newer diagnostic tools such as computed tomography (CT), magnetic resonance imaging (MRI), and a better understanding of the pathophysiology of the disease. The treatment of SPT has had significant changes as well, from a surgical approach at the end of the 19th century to a medical approach after the 1960's. By using an adequate broad-spectrum antibiotic therapy, mortality has decreased. However, controversy in the management of this entity remains even till today.

Introduction: Nexplanon is a 4 cm rod-shaped barium sulphate coated contraceptive implant with a usual subdermal insertion in the inner non-dominant upper arm. Complications proper to subdermal contraceptive implants are unusual and principally localized and minor, comprising infection at the site of implantation, hematoma, abnormal scar development, or local nerve and blood vessel injuries. Infrequently, contraceptive implant migration can happen, though habitually not far from the site of insertion. Pulmonary embolization of the device is remarkably rare and can present with symptoms such as chest pain or dyspnea. Patient concerns and diagnosis: We report one of the rare cases of asymptomatic Nexplanon pulmonary embolism in a 26-year-old female. Interventions and outcomes: An endovascular intervention successfully retrieved the device from the lateral segment right middle lobe pulmonary artery without any complications. Conclusion: Several cases of contraceptive implant migration into the pulmonary artery have been reported to this day. Preventing this life-threatening complication is challenging, and yet, no clear guidelines have been established.

Collagen expression seems to be reduced in the postpartum cervix, particularly after labor has ensued.

Uterine anomalies are rare entities, vary from 0.1 to 4%, and are related to an increase risk of obstetrical complications. We report a case of a uterine anomaly, diagnosed during the management of a patient who presented with a missed abortion.

BackgroundClinical fetal weight estimation is a common practice in obstetrics. This study aims to evaluate the accuracy of fetal weight estimation by midwives, and to identify factors that may lead to overestimation or underestimation of fetal weight.MethodsA cohort prospective study in a Lebanese university hospital, included weight estimation of singleton pregnancies above 35 weeks. Multiple pregnancies, unclear dating, growth retardation, malformations and stillbirths cases are excluded. The estimated fetal weight is recorded by midwives in a sealed envelope and compared to true weight later. The effects of BMI, weight gain, parity, diabetes, hypertension, neonate’s sex and weight, uterine contractions, rupture of membranes and daytime or nighttime shift on these estimations were assessed.ResultsOne hundred and sixty-six patients were included. Mean birth weight was 3246 ± 362 g. Mean absolute percentage error of weight estimation was 8.5 ± 6.7% (0–30.9%). Estimation was within the correct range of ±10% in 63% of cases. Maternal and fetal factors did not significantly change weight estimation. Fetuses with birth weights more than 4000 tended to be underestimated by midwives. Estimation improved over time (nonsignificant).ConclusionsMaternal and fetal factors, except for macrosomia, have limited impact on estimation of fetal birth weight. Macrosomia is challenging because of a consistent tendency of underestimation by midwives.

The purpose of this study was to determine whether testing for cystic fibrosis (CF) and cytomegalovirus (CMV) infection is necessary in African-American and Hispanic gravidas in whom the fetus had an echogenic bowel. This retrospective study consisted of only African American and Hispanic patients in whom the fetus had an echogenic bowel, referred to the Maternal and Fetal Medicine unit at New Jersey Medical School for a specialized ultrasound, between June 30, 2004, and March 31, 2005. Sixty-five patients met the inclusion criteria for our study. Maternal serum testing for CF was done in 32 patients and all newborns were screened for the disease. There were no positive results for CF. CMV serology was tested in 38 patients and there were no cases of acute congenital CMV infection. In our population of 65 patients, there was one intrauterine growth restricted (IUGR) fetus and five intrauterine fetal demise (IUFD). Although all patients who were tested for CMV infection tested negative, the true incidence in our selected population may be underestimated because some of our patients were not tested. There were no cases of congenital CMV infection and all newborn screening tests for CF were negative. Prenatal diagnosis of fetal echogenic bowel was associated with a 7.6% incidence of IUFD and 1.6% incidence of IUGR.

Follicular dendritic cell (FDC) sarcoma is a rare tumor. Most cases that have been described involve lymph nodes in young adults, but have not been reported in pregnancy. We describe the case of a 20-year-old woman with a FDC sarcoma diagnosed during pregnancy that initially presented as a painful mass in the right axilla. The patient underwent a tumor excision and chemotherapy. The intrapartum course was uncomplicated and she delivered a live female child at 34 weeks. During her postpartum course, she received radiation therapy and chemotherapy.

The transobturator sling procedure is a relatively new technique as compared to the retropubic version. The functional differences between these two procedures are largely unknown. Two cases of failed transobturator slings are reported. In both cases, the procedure was done under local anesthesia and a cough stress test was performed to adjust the tape. The transobturator slings were unable to stop the leakage and we replaced them with the retropubic versions, which were successful. Even when pulled very tightly, some transobturator slings will fail to stop stress incontinence that is amenable to cure from a typically placed "tension-free" retropubic sling. The cough stress test can identify such cases.