M. Cathleen McCoy

Pelvic magnetic resonance imaging in the evaluation of uterine torsion

Background Uterine torsion is defined as the rotation of more than 45° around the long axis of the uterus. An uncommon but potentially fatal event, uterine torsion is rarely diagnosed until the time of surgery. With magnetic resonance imaging (MRI), however, an accurate diagnosis of uterine torsion may now be made preoperatively. Case We describe a patient with uterine torsion in whom the correct diagnosis was made prenatally with the use of MRI, by the demonstration of an X-shaped configuration of the upper vagina. Conclusion Distinctive features suggestive of uterine torsion were demonstrated by MRI and enabled an accurate preoperative diagnosis. To our knowledge, this is the first reported case of uterine torsion diagnosed on MRI.

Pravastatin to prevent recurrent fetal death in massive perivillous fibrin deposition of the placenta (MPFD)

Abstract Massive perivillous fibrin deposition of the placenta (MPFD) or maternal floor infarction (MFI) is a serious condition associated with recurrent complications including fetal death and severe fetal growth restriction. There is no method to evaluate the risk of adverse outcome in subsequent pregnancies, or effective prevention. Recent observations suggest that MFI is characterized by an imbalance in angiogenic/anti-angiogenic factors in early pregnancy; therefore, determination of these biomarkers may identify the patient at risk for recurrence. We report the case of a pregnant woman with a history of four consecutive pregnancy losses, the last of which was affected by MFI. Abnormalities of the anti-angiogenic factor, sVEGFR-1, and soluble endoglin (sEng) were detected early in the index pregnancy, and treatment with pravastatin corrected the abnormalities. Treatment resulted in a live birth infant at 34 weeks of gestation who had normal biometric parameters and developmental milestones at the age of 2. This is the first reported successful use of pravastatin to reverse an angiogenic/anti-angiogenic imbalance and prevent fetal death.

Combined abdominal-perineal sonography to assist in diagnosis of transverse vaginal septum

Background Transperineal sonography has been used to detect incompetent cervices, placenta previa, cervical pregnancy, and vaginal and cervical atresia. Case Transperineal sonography was used to investigate primary amenorrhea in a 14-year-old girl. A mid-transverse septum was found and confirmed surgically. Conclusion Transperineal or translabial sonography assisted in the differentiation of primary amenorrhea, when adequate vaginal access was prohibited.

Confined placental mosaicism for trisomy 8 and intra‐uterine growth retardation

This report describes a case of apparent confined placental mosaicism for trisomy 8 in a pregnancy which produced a male infant with intra‐uterine growth retardation. Postnatal cytogenetic and molecular studies were consistent with biparental disomy 8. Postnatally, the infant experienced a period of rapid catch‐up growth and exhibited no clinical features of trisomy 8 mosaicism. His development was age appropriate. Copyright

Romano Ward Syndrome in Pregnancy

Romano-Ward syndrome is an unusual and potentially devastating disorder manifested by prolongation of the QT interval. Persons with this syndrome are at risk for sudden death from ventricular dysrhythmis. A case of a gravid woman with the disorder is presented

Pravastatin for the prevention of adverse pregnancy outcome: preeclampsia and more?

Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD and Detroit, MI, USA, Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA, Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA, Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA, Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA, Perinatal Unit, Winchester Obstetrics and Gynecology, Winchester Medical Center, Winchester, VA, USA, and Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea