Isolated fallopian tube torsion (IFTT) is a rare emergency condition affecting young females. Due to the diagnostic dilemma, diagnosis of IFTT is often delayed leading to tubal necrosis and salpingectomy as the only choice of treatment. If diagnosed early, it can be managed conservatively by detorsion. Salpingopexy is an option described in the literature to prevent recurrence of this condition; however, evidence is scarce. This case report highlights the role of prompt diagnosis and management of IFTT. It describes a case of IFTT with paratubal cysts and a long tube in a young female, which was timely diagnosed and managed conservatively by laparoscopic detorsion, paratubal cystectomy, and ipsilateral salpingopexy.
Pregnancy with an autoimmune disorder is faced with several risks for mother and fetus. The aim of the present study is to analyze the course and outcome of pregnancy in women with autoimmune disorders (AIDs).
MethodsA retrospective cohort study was conducted at a tertiary care teaching hospital. The hospital records of 153 pregnancies with autoimmune disorders and 1095 low-risk pregnant women who served as controls were reviewed. An adverse perinatal outcome was defined as the presence of any obstetric complications, including preeclampsia, eclampsia, abruption, antepartum hemorrhage (APH), prematurity, fetal growth restriction (FGR), intrauterine death (IUD), intrapartum event, mode of delivery, birth weight, neonatal intensive care unit (NICU) stay, or disease-specific neonatal complications. For all statistical tests with twotailed probability, p<0.05 was considered statistically significant.
ResultsA high incidence of adverse perinatal outcomes was observed in all women with AIDs when compared with age-matched controls. The highest incidence of adverse perinatal outcomes was observed in women with Takayasu's arteritis. The incidence of abortions was more in women with antiphospholipid antibody syndrome (APS) and Grave's disease (22.2% and 33.3%, respectively). The incidence of prematurity, fetal growth restriction (FGR), and low birth weight were highest in women with systemic lupus erythematosus (SLE). Pregnancy with myasthenia gravis and rheumatoid arthritis did not have any significant adverse impact on pregnancy outcomes.
ConclusionWe found a strong association between autoimmune disorders and obstetric complications. The multidisciplinary team approach and pre-pregnancy optimization of the disease improve maternal and fetal outcomes.
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