Sigmoid volvulus is a rare complication of pregnancy and the puerperium. We report a case of sigmoid volvulus complicating the the postpartum periodin a 35-year-old patient who presented on day 5 postoperative of a cesarean section performed in the EL HAROUCHI maternity at the IBN ROCHD CHU in CASABLANCA, in a table of occlusive syndrome. The diagnosis was made on abdominopelvic CT. An exploratory laparotomy revealed a necrotic volvulus of the severely distended sigmoid colon. In our case, the sigmoid volvulus is likely to have been precipitated by the rapid change in the size of the uterus after childbirth. Prompt surgical evaluation of an acute abdomen during the postpartum period is essential; delayed diagnosis and treatment can lead to significant maternal morbidity and mortality.
Subcapsular hematoma of the liver Subcapsular hematoma of the liver (SCLH) is defined as an anatomical-clinical entity corresponding to the appearance of a hematic collection located between the intact GLISSON capsule and the hepatic parenchyma. It is a rare complication of pregnancy with a high maternal-fetal mortality, occurring most often in the context of pre-eclampsia or HELLP syndrome (Hemolysis, Elevated Liver Enzymes, and Low Platelets Syndrome). We report the case of a 25-year-old parturient, primiparous woman, with no previous history, admitted to the emergency room for shock in a 29-week amenorrhea pregnancy. Ultrasound examination revealed a ruptured sub capsular hematoma of the liver. An urgent surgical exploration was required, during which a rupture of the subcapsular hematoma of the liver was revealed, accompanied by a state of hemorrhagic shock. The management consisted in a polytransfusion with suture of the hepatic lesion without paking. The evolution was favorable with clinico-biological normalization and the patient was declared discharged at D10 of her hospitalization.
Objective: We aim to study the clinicalcharacteristics, the evolution of COVID-19 on pregnant women and survival factors. Study design: Its a prospective cohortstudy in a large tertiary maternity unit within the Mother and Child University Hospital Ibn Rochd of Casablanca with an average annual birth of over 6950 births. We prospectively collected and analyzed data for a cohort of 40 pregnant patients tested positive for COVID-19 between January 2020 and December 2020 inclusive to assess the effect of COVID-19 on pregnancy. Results: Forty pregnant patients testedpositive for COVID-19, 36 patients gave birth and 4 patients died pregnant. The severity of the symptoms ranged from mild in 20/40 (50%) of the patients, moderate in 7/40 (17,5%), and severe in 13/40 (32,5%). Thirteen of our patients were admitted to invasive care units, six were in their third trimester, and seven in their second trimester nine were intubated and ventilated prior to delivery and three of them required Extracorporeal membrane oxygenation. Among these patients intubated only two survived. Most common comorbidities were gestational diabetes 4/40 (10 %), asthma 4/40 (10 %), preeclampsia 7/40 (17,5%). Of the 40 pregnant patients 31 (77,5%) were in their third trimester, 8 (20%) women in their second trimester, and one in her first trimester. Of the 36 patients who delivered, 12/36 (33,3 %) were preterm delivered by elective C-sections. The death rate was 17,5% (7/40). Conclusion: COVID-19 is associated with high prevalence of preterm birth, caesarean section, and a high mortality rate.
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