Ahmed M. Abbas

First trimester spontaneous rupture of an unscarred uterus in a multiparous woman: a case report

The rupture of an unscarred uterine is a rare lifethreatening event that usually occurs late in pregnancy or during labor. Spontaneous uterine rupture, as in our case, is extremely uncommon and rarely diagnosed before laparotomy. Herein, we present a case of spontaneous uterine rupture in a 32 year old multiparous woman with no previous uterine surgery. The patient presented with acute abdomen at 11 weeks of gestation. Preoperative diagnosis based on clinical and ultra-sonographic findings was ruptured ectopic pregnancy. However, emergency laparotomy showed uterine rupture with extrusion of a dead fetus within intact amniotic sac in the abdomen. The defect was repaired in layers and the patient was discharged in a good condition after five days of hospital stay. Multiparity is a risk factor for spontaneous uterine rupture even in the first trimester. It should be kept in mind in any pregnant multiparous woman presenting with acute abdomen and shock. The absence of vaginal spotting and lack of history of uterine surgery give a false sense of security. Department of Obstetrics and Gynecology, Faculty of Medicine; Assiut University, Assiut, Egypt Faculty of Medicine; Assiut University, Assiut, Egypt

Recurrent spontaneous third-trimester uterine rupture after hysteroscopic resection of myoma: a case report

Uterine rupture is a catastrophic obstetrical emergency with serious effects on both women and fetuses. Operative hysteroscopic procedures can add more risk factor for occurrence of this tragedy. Here, we report a case of spontaneous recurrent rupture uterus at 33 weeks of gestation in a 32 years old woman with previous history of hysteroscopic resection of submucous myoma after development of acute abdomen. Uterine repair of fundal rupture was performed through emergency exploratory laparotomy. Surgeons should explain to their patients the hazards of probable risk of recurrent and multiple uterine rupture in the future pregnancy and to document this discussion in the medical records before proceeding to operative hysteroscopic procedures. Department of Obstetrics and Gynecology, Faculty of Medicine; Assiut University, Assiut, Egypt Faculty of Medicine; Assiut University, Assiut,

Effects of irregular antenatal care attendance in primiparas on the perinatal outcomes: a cross sectional study

Aim: Antenatal care (ANC) is a key strategy for reducing maternal and neonatal morbidity and mortality rates because adequate utilization of antenatal health care services is associated with improved maternal and neonatal health outcomes. The current study aims to identify the factors causing lack of regular attendance at ANC clinics in primiparas and to determine the effects of lack of antenatal care on perinatal

Preoperative evaluation of patients with ovarian masses using the risk of malignancy index 4 model

Objective: To evaluate the performance of the RMI 4 in discriminating benign from malignant

A rare case of lethal campomelic dysplasia

Campomelic dysplasia is a rare and mostly lethal congenital malformation. It is known as an autosomal dominant disorder due to mutations in SOX9, a member of the SOX (SRY-related HMG box) gene family. Here we report a case of a 26 years old primigravida married for 3 years with a history of consanguinity. She was impregnated by intracytoplasmic sperm injection (ICSI) due to male factor infertility. This mostly lethal skeletal anomaly was diagnosed by detailed ultrasonography in the late second trimester. She underwent an induction of labor termination due to intrauterine fetal demise. Fetal Medicine Unit, Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt Department of Obstetrics and Gynecology, Faculty of Medicine; Assiut University, Assiut, Egypt Faculty of Medicine; Assiut University, Assiut,

A rare case of posterior uterine rupture with neonatal survival during trial of vaginal birth after cesarean section

Posterior wall uterine rupture is a rare complication. Trial of vaginal birth after cesarean section (CS) is a predisposing factor especially when associated with augmentation of labor. Here we report a case of intrapartum uterine rupture during the second stage of labor in a multiparous woman trying vaginal birth after previous CS. Emergency laparotomy was done and the baby was saved. Repair of the site of the rupture in layers with complete hemostasis

The effect of regular daily walking on adverse pregnancy outcomes among overweight primigravidas: a prospective cohort study

Objective: The study aims to evaluate the effect of regular daily walking on the occurrence of adverse pregnancy outcomes among overweight

Herniated gravid uterus through an infra-umbilical laparotomy scar: a case report

Herniation of a gravid uterus through the abdominal wall is a rare and potentially serious condition due to its antecedent complications. Management is determined by gestational age. Simultaneous hernioplasty with cesarean section is considered safe. Clinical awareness of this complication will prevent delay in its diagnosis and treatment. Delay in recognition of this condition can lead to incarceration and subsequent strangulation of the gravid uterus. Strangulation at or near term appears to be a genuine indication for early hospitalization and elective cesarean section, possibly combined with hernia repair. Here we report the case of a middle aged woman who presented with abdominal pain at 28 weeks of gestation with an unusual bulge of her abdomen. The lower abdominal bulge turned out to be her gravid uterus herniated through the anterior abdominal wall. Cesarean delivery with herniorrhaphy was done for the large abdominal defect. Department of Obstetrics and Gynecology, Faculty of Medicine; Assiut University, Assiut, Egypt Faculty of Medicine; Assiut University, Assiut,

Full term delivery of a Harlequin ichthyosis baby: a case report

Harlequin ichthyosis (HI) is one of the most severe and rare autosomal recessive congenital ichthyosis (ARCI), characterized by severe hyperkeratosis, extensive fissuring and a variable degree of cutaneous malformations. Here we report a case of 22 years old female patient in her first pregnancy. The baby was born at 39 weeks of gestation from nonconsanguineous parents. At birth the baby had thick skin with deep fissures. The baby was admitted to the neonatal intensive care unit and survived for 11 days. Department of Obstetrics and Gynecology, Faculty of Medicine; Assiut University, Assiut, Egypt Faculty of Medicine; Assiut University, Assiut,

Recurrent second-trimester intrauterine fetal death due to undiagnosed atrioventricular block: a case report

Fetal cardiac abnormalities are one of the common causes of non-immune fetal hydrops. Early diagnosis and treatment may prevent the late consequences that can occur as heart failure and intrauterine fetal death. Herein we report the case of a 32-year-old patient with a history of recurrent second trimester intrauterine fetal death. She presented with fetal hydrops at 23 weeks. A detailed echocardiography revealed that the fetus had a third degree atrioventricular block and advanced hydropic changes due to heart failure. Corticosteroid therapy was started but the fetus died in utero after 2 weeks. Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt Faculty of Medicine; Assiut University, Assiut,