Objective: Rare disease Background: Acute fatty liver of pregnancy is an obstetric emergency characterized by liver dysfunction, which can lead to severe maternal and fetal complications. Case Report: A 34-year-old woman, 37 weeks and 2 days pregnant, reported symptoms of nausea, vomiting, jaundice, and prostration. Laboratory findings revealed liver dysfunction and coagulopathy. A clinical diagnosis of acute fatty liver was made and an emergency cesarean section was performed. The postoperative period was complicated by disseminated intravascular coagulation, acute hepatic and renal insufficiency, and pancreatitis. Conclusions: Early recognition of this pathology, the interruption of pregnancy, and intensive therapy led to a favorable outcome.

Uterine fibroids can be large enough to cause mechanical obstruction of pelvic ureters, which may result in hydroureters and hydronephrosis. Renal impairment frequently results in hypertension due to increased activity of the tubuloglomerular feedback system and renin–angiotensin–aldosterone axis. This process, however, seems reversible because normalisation of blood pressure is possible after the relief of renal obstruction. We report a rare case of a nulliparous woman with a myomatous uterus and an isolated initial complaint of high blood pressure. After proper diagnostic investigation, a uterine mass of 20 cm causing bilateral hydronephrosis was discovered. A successful myomectomy was conducted, which achieved an intact endometrium lining with posterior normalisation of blood pressure.

Main outcome measures: Factors associated with the cause of the haemorrhage and the resulting morbidity. Results: There were 15 women of 6431 deliveries during the study period, giving a prevalence of 0.24%. The mean age of the women was 31.3 ± 5.3 years and mean parity was 2.9 ± 1.4. The time of presentation was 13.7 ± 14 days after delivery. Primary postpartum hemorrhage was present in one quarter of them. About 60% had vaginal delivery and the others had cesarean section. Histology confirmed retained products/placenta in eight women only. None of them needed hysterectomy. Fibroid was diagnosed in one woman. Ultrasound was not very sensitive in differentiating the retained products from blood clots. Blood transfusion was necessary in a quarter of them. Conclusion: The prevalence of secondary postpartum hemorrhage was much less than reported in the literature. Risk factors were similar to other studies. Tendency to conservative management to avoid hysterectomy prevailed due to cultural reasons.

Ewing’s sarcoma is an aggressive tumour, common in paediatric age, in which treatment often implies a decrease in reproductive potential. We describe a case of a woman who had a lumbar Ewing’s Sarcoma in 1991, at the age of 8. She was submitted to extended tumourectomy, chemotherapy and local radiotherapy without preservation techniques. In adult life, and after two in vitro fertilization (IVF) reproductive cycles without success, she spontaneously conceived at the age of 32. After an uneventful pregnancy, she delivered a healthy child by caesarean section. This is a rare successful case of a spontaneous and uneventful pregnancy without previous preservation techniques. In the last 30 years, there has been significant development in this area, and currently, there are solutions for these patients, including in prepubertal age.

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