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Congenital cardiac fibromas are very rare and prenatal diagnosis has been reported in just a few cases. We describe a four-month-old infant presenting a symptomatic giant right ventricular fibroma discovered during prenatal scanning at 33 weeks of gestation, which was confirmed after delivery on echocardiogram and cardiac magnetic resonance imaging. Due to progressive hemodynamic deterioration, partial surgical resection was performed and the patient recovered uneventfully. We report the successful management during early infancy of a giant cardiac fibroma prenatally diagnosed.

Methods: All medical articles and congress abstracts are included in the national review system, similar to PubMed. We searched this system using the terms ''abdominal pregnancy'' and identified 69 articles, including 95 cases of AP with sufficient clinical information, including our previously reported case. There were 86 early (E) APs and 9 advanced (A) APs. There were eight MTX-indispensable EAPs. Results: Among the EAPs, MTX was administered after primary surgery in eight (9%, 8/86). The patient's background, pregnancy weeks, implantation site, operation, blood loss, blood transfusion, reason for MTX therapy and MTX schedule are examined. Pregnancy weeks were documented in six cases and were 5 (2 cases), 6, 7, 8 and 10 weeks respectively. Implantation sites varied. Blood loss ranged from 225-2,000 g in five of the eight cases and blood transfusion was performed in one case. MTX was administered to one patient (12.5%) who did not undergo surgical extraction because of liver pregnancy, one patient (12.5%) without tumor extraction for fear of massive bleeding and to the remaining six patients (75%) because of incomplete extraction or residual pathological changes. MTX was mostly administered according to the usual regimen for trophoblastic disease. Objectives: To investigate the acceptability of transvaginal ultrasound scans to women attending for first trimester scans and assess psychological morbidity associated with transvaginal sonography. ConclusionsMethods: This was a cross-sectional questionnaire survey of 250 women attending for early pregnancy scan in Nigeria. The impact of the scan was assessed at the 18-22 weeks anomaly scan by a questionnaire. Patient's acceptability, pre-and post-scan anxiety assessed with the Spielberger State-trait Anxiety Inventory, pain/discomfort by visual analogue scale and psychological trauma by Impact of Event Scale were assessed. Results: Acceptability rate for TVS exceed two-third (77%). Women were more likely to accept offer of TVS if they have had TVS previously, were multiparous or have concerns with index pregnancy. The main reasons for declining TVS offer were fear of miscarriage and pain/discomfort. The mean anxiety score was 12.9 immediately before TVS and 12.7 immediately after. Pain was mild, reported by about a third (37%). Significant psychological morbidity was elicited in 3.1% of the women. Conclusions: Antenatal transvaginal ultrasound for assessing early pregnancy is acceptable to the majority of pregnant population, but some women suffer psychological morbidity with its use, raising the need for proper counselling before its use. We report four cases where a rare anomaly of amniotic membrane wrapping the fetus at 11-13 weeks of pregnancy results in talipes and features of amniotic band sequence. In all cases the amniotic sac size was very small, however gestational sac and fetal dimensions were normal. On follow-up scans in three cases the process of chorion-amnion fusion failed and the amniotic membrane ruptured in the second trimester of pregnancy, resu...

Ruptured sinus of Valsalva aneurysm is rare, although if left untreated, potentially fatal disease. Surgical approach has been the main treatment in most series; nevertheless, percutaneous closure has been described in selected cases. We report a 5-year-old boy presenting with rapid clinical deterioration who underwent percutaneous closure using a patent ductus arteriosus device, with the resolution of symptoms. Descriptions of this technique being utilized in children are infrequent in the literature.