The prenatal diagnosis of umbilical cord hemangioma should be suspected when an echogenic mass is visualized within the umbilical cord.

Hormone replacement therapy (HRT) is the most effective method for relieving the effects of hypoestrogenism following menopause. Despite the benefit of the HRT, unscheduled/breakthrough bleeding decreases patients’ compliance with long-term use. The underlying mechanisms for this unpredictable breakthrough bleeding are less well understood. In the event of unscheduled bleeding, investigation may be necessary according to local protocol. Whilst the incidence of underlying benign pathology may be quite high, the likelihood of malignancy is low and unless there is particular clinical concern, these women do not need fast track referral which should be reserved for women with true postmenopausal bleeding.

Case Report. A 37 years old patient at 40 weeks gestation presented with acute severe hypoxia with a seizure followed by fetal bradycardia. Caesarean section was performed under GA and she was intubated and ventilated. History revealed longstanding right pleural endometriosis with multiple pneumothoraces and hydrothoraces. A CT chest showed extensive bilateral pnenumothoraces. Her clinical condition improved with a left-sided chest drain. Discussion. Severe hypoxia and seizures in a patient with previous history of pnenumothorax are highly suggestive of tension pneumothorax. Radiological investigations are vital for diagnosis. The traditional treatment approach to recurrent pneumothorax has been thorocotomy with bleb or bulla resection and pleurodeisis. The advantages of thorocoscopic surgical treatment over thorocotomy are decreased time of exposure to anaesthetic drugs, rapid lung expansion, decreased post operative pain, and a potentially shorter post operative recovery. In any future pregnancy due to the high risk of recurrence of pneumothorax Contemporary obstetric management should determine the method of delivery and continuous lumbar/epidural anesthesia should be used if at all feasible. Preconceptual counseling about this risk is vital, and women must be advised about potential serious adverse outcomes.

: A review of previously published cases of Wegener granulomatosis involving the uterine cervix is presented.We report the first case of Wegener granulomatosis involving the cervix without antecedent diagnosis or treatment of Wegener granuloma in any other organ.

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