Objective Circumvallate placenta has a suggested association with adverse pregnancy outcomes (antenatal bleeding, placental abruption, preterm birth, emergency cesarean, small for gestational age infants, and stillbirth). The aim was to determine if prenatal diagnosis of circumvallate placenta is associated with these adverse pregnancy outcomes. Study Design Pregnancies with a singleton gestation prenatally diagnosed with circumvallate placenta between January 1, 2012 and March 31, 2021 were identified. Adverse pregnancy outcomes were obtained. Rates of adverse pregnancy outcomes were compared among those with prenatally diagnosed circumvallate placentas to those without this prenatal diagnosis with a 4:1 control matched group. Pregnancies with known fetal anomalies or other placental abnormalities were excluded. Statistical analyses included Student's t-test and Χ 2 with p < 0.05 considered significant. Results Prenatal ultrasound findings of circumvallate placenta were seen in 179 pregnant people (0.20% of all anatomic US studies and 0.17% of all deliveries). Diagnosis was made at a mean gestational age of 19.8 ± 2.4 weeks. Adverse pregnancy outcomes were similar between groups. Conclusion Prenatal ultrasound findings of circumvallate placenta do not correlate with adverse pregnancy outcomes. Given overall good prognosis, prenatal diagnosis of circumvallate placenta may not warrant additional surveillance during pregnancy. Key Points
disparities in maternal mortality rates in Black versus non-Hispanic White women, the rate of maternal mortality rates in Hispanic women has not been well characterized. This study specifically addresses disparities in maternal mortality rates in Latin American countries. It also explores factors contributing to high MMR including socioeconomic status, age, comorbidities, ethnicity, and access to health care.METHODS: Four bibliographic databases were searched for keywords, including "maternal mortality," "ethnic groups," and "racial disparities." Inclusion criteria were manuscripts that discussed Latin American countries; exclusion criteria included "wrong outcome" and studies only discussing maternal morbidity. Quality assessments for each study were completed.RESULTS: Bolivia (650/100,000), Mexico (413.5/100,000), and Ecuador (321.1/100,000) have the highest average MMR. Caribbean countries tend to have the lowest recorded MMR, whereas countries in Central and South America have the highest MMRs in Latin America. The most common factor associated with mortality was hypertensive disorders. Low socioeconomic status (SES) and extremes of maternal age were correlated with higher mortality rates.CONCLUSION: Many comorbidities contribute to mortality among pregnant women throughout Latin America, including human immunodeficiency virus, SES, extremes of maternal age, and access to care. This study shows a need for further research to help identify disparities in MMR across different Latin American countries.
We report a case of stage IVB ovarian clear cell carcinoma in a 35-year-old female with a long-standing history of biopsy-proven pelvic and thoracic endometriosis. At the time of her ovarian cancer diagnosis, her tumors were found to be isolated to the sites of her previously known endometriotic lesions, suggesting that malignant transformation of her endometriosis to ovarian cancer had occurred. She underwent primary tumor debulking, then received six cycles of intravenous carboplatin and paclitaxel, and is now free of disease. We have conducted a literature review of ovarian cancers arising from endometriosis as well as a summary of the molecular basis on the relationship between endometriosis and malignant ovarian carcinoma.
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