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Ovarian Torsion Diagnosed in Term Pregnancy

Cagle-Colon, Kayla J.; Cagle, Tyler; Sze, Angelica
Background: Severe unexplained abdominal pain during pregnancy can be a challenging clinical conundrum. Adnexal torsion is a rare condition in pregnancy, and a gravid uterus at term makes it difficult at times to determine the cause of the severe pain. Case: A 21-year-old gravida 1, para 0, female, at 38 weeks 3 days of gestation, presented with intractable right-sided abdominal and flank pain that did not respond to administration of narcotic medicine. Transabdominal ultrasonography revealed a 10-cm cyst. This finding, with the potential of ovarian torsion and her clinical presentation of intractable pain, led to a decision to perform an urgent cesarean delivery with a right ovarian cystectomy and adnexal detorsion under regional anesthesia. The operation revealed that she did have ovarian torsion. Results: Pathologic analysis of the excised tissues revealed that she had a mucinous cystadenoma. Postoperatively, the patient reported resolution of her pain, and she was discharged routinely on postoperative day 3. Conclusions: Diagnosis of ovarian torsion should be considered in a term pregnancy when a patient presents with a sudden onset of severe lower-abdominal pain and an adnexal mass. This situation should be treated as an emergency. (J GYNECOL SURG 36:220).
SCOPUS:85093095646
ISSN: 1042-4067
CID: 4649642

Multimodal Therapy as an Effective and Bloodless Treatment for Cervical Pregnancy

Cagle-Colon, K J; Sze, A; Tsai, M
Background: Cervical pregnancy (CP) is a rare form of ectopic pregnancy. Profuse and uncontrolled bleeding remains a concern when treating CP. Although many therapeutic approaches have been proposed with various outcomes, however, the optimal treatment of CP remains elusive. Case: Two patients diagnosed with CP were successfully treated with a novel multimodal therapy.
Result(s): After uterine artery embolization, intracervical vasopressin infiltration, bilateral cervical stay suture placement, and suction dilation and curettage (D&C), both CPs had a complete resolution with negligible blood loss.
Conclusion(s): The use of multimodal therapy for the treatment of CP is safe and effective. This treatment approach significantly reduces blood loss during suction D&C and can be used as a planned elective outpatient procedure.
EMBASE:630253364
ISSN: 1557-7724
CID: 4253062

Placenta Previa

Chapter by: Anderson-Bagga, Frances M.; Sze, Angelica
in: StatPearls by
Treasure Island FL : StatPearls, 2019
pp. -
ISBN:
CID: 3812092