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PAS or Not PAS? The Sonographic Assessment of Placenta Accreta Spectrum Disorders and the Clinical Validation of a New Diagnostic and Prognostic Scoring System.
J Imaging
December 2024
Obstetrics and Gynaecology Unit, Department of Interdisciplinary Medicine (DIM), University of Bari, 70124 Bari, Italy.
This study aimed to evaluate our center's experience in diagnosing and managing placenta accreta spectrum (PAS) in a high-risk population, focusing on prenatal ultrasound features associated with PAS severity and maternal outcomes. We conducted a retrospective analysis of 102 high-risk patients with confirmed placenta previa who delivered at our center between 2018 and 2023. Patients underwent transabdominal and transvaginal ultrasound scans, assessing typical sonographic features.
View Article and Find Full Text PDFRational approach to fetal heart rate monitoring and management during the second stage of labor.
Eur J Obstet Gynecol Reprod Biol
February 2025
Direttore UOC Ostetricia e Ginecologia, Azienda Ospedaliera Universitaria di Parma, Professore Ordinario di Ginecologia e Ostetricia, Direttore della Scuola di Specializzazione in Ostetricia e Ginecologia, Presidente del CdS OstetriciaUniversità di Parma, Italy. Electronic address:
Second stage of labor is considered to be associated with an increased risk of intrapartum fetal hypoxic injury. This is due to a combination of several risk factors such as -the increased frequency, strength and duration of uterine contractions due to higher number and affinity of myometrial oxytocin receptors; -the Ferguson's reflex which leads to a reflex release of endogenous oxytocin in response of the distension of the cervix by descending fetal head in late stages of labor; maternal expulsive efforts with the Valsalva manoeuvre that may reduce maternal oxygenation, as well as reduce the venous return and maternal cardiac output due to increased intrathoracic pressure, winch may lead to reduced placental oxygenation; - and increased fetal intracranial pressure due to head compression leading to a potential decrease in fetal cerebral oxygenation. In addition, the umbilical cord often forms one or more loops around the fetal neck, which may get tightened as the head descends leading to an acute and intermittent cessation of fetal oxygenation.
View Article and Find Full Text PDFCervical sliding sign; does it have a contribution in cases of threatened preterm labor in singleton pregnancies with intact membranes?
Eur J Obstet Gynecol Reprod Biol
November 2024
Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara Bilkent City Hospital, Ankara, Turkey.
Objective: To investigate the contribution of the cervical sliding sign to conventional cervical length measurement in patients at risk of preterm labor.
Methods: The study, performed as a prospective cohort study, included patients admitted to a tertiary research hospital with a diagnosis of threatened preterm labor. The participants were divided into two groups: those who gave birth before and after 37 weeks of gestation.
Invasive Ductal Breast Carcinoma Metastasis to the Uterine Cervix Presenting As Heavy Vaginal Bleeding: A Case Report and a Literature Review.
Cureus
June 2024
Department of Radiation Oncology, Wayne State University School of Medicine, Detroit, USA.
Breast carcinoma metastasis to the uterine cervix is a rare occurrence with diagnostic intricacies. We present a case of a 38-year-old woman diagnosed with bilateral stages IIIA and IIIB invasive ductal carcinoma of the breast who developed heavy vaginal bleeding post-treatment, revealing metastatic involvement of the cervix, confirmed by CT imaging and pathological examination, as the presenting sign of widely metastatic disease. This case underscores the importance of a thorough review of systems and physical exams as well as considering uncommon metastatic sites in breast cancer patients.
View Article and Find Full Text PDFA Case Report of Uterine Torsion in a Postmenopausal Female with a Large Leiomyoma.
J Radiol Case Rep
June 2024
Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco; San Francisco, USA.
This case report discusses a diagnosis of uterine torsion in an 84-year-old woman who presented with five days of right lower quadrant abdominal pain, nausea, vomiting, constipation, and poor intake. Computed tomography (CT) imaging demonstrated a whorled configuration at the junction of the cervix and lower uterine segment, with the left gonadal vein crossing midline, and two previously known right leiomyomas now appearing on the left. These findings were consistent with the diagnosis of uterine torsion.
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