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To compare the urine Congo‐red dot paper test (CRD) with dipstick urinalysis to screen preeclampsia (PE). A total of 409 paired spot urine samples were obtained prospectively from women with suspected pre‐eclampsia attending for routine hospital visits. Congo‐red dot paper test and dipstick urinalysis were examined and compared to screen pre‐eclampsia. The agreement between the two urinary test is modest (kappa coefficient = 0.28, 95% CI 0.14–0.42). The specificity of CRD was higher than urinalysis (97.4% vs. 90.4%, p <.001). Urinalysis performed better in sensitivity (77.3% vs. 40.9%, p =.04) and the area under the receiver operating characteristic curves (AUC) (0.84 [95% CI 0.74–0.94] vs. 0.69 [95% CI 0.55–0.83], p =.04) than CRD, respectively. The sensitivity, specificity, AUC of the parallel test of them is 86.4% (64.0%–96.4%), 89.1% (85.5%–92.0%), and 0.88 (95% CI 0.79–0.96). And the serial test is 31.8% (14.7%–54.9%), 98.7% (96.8%–99.5%), 0.65 (95% CI 0.51–0.79), accordingly. The urinalysis is a better diagnosing test for preeclampsia. CRD could aid in the diagnosis of patients with preeclampsia. Combined the two tests in suspected patients may further improve the performance in the diagnosis of preeclampsia. Further study need to be made for its potential clinical practice. [ABSTRACT FROM AUTHOR]

Objective: To estimate the association of unicornuate uterus (UU) with adverse obstetric outcomes. Methods: Using data from 26 737 singleton childbirths from a tertiary hospital from 1999 to 2019, we identified 44 births from women with a UU. A total of 367 births from women with a normal uterus were randomly selected as controls. The outcome measures were preterm birth (PTB), breech presentation, and cesarean delivery. The subdivisions of PTB and indications for cesarean delivery were described. Results: The presence of UU was associated with an increased risk of PTB (adjusted risk ratio [aRR], 2.3; 95% confidence interval [CI], 1.1–4.9), breech presentation (aRR, 6.2; 95% CI, 2.9–13.2), and cesarean delivery (aRR, 2.1; 95% CI, 1.8–2.7). For women with a UU, most PTBs (7/9) were moderate to late PTBs, and approximately half of the PTBs (4/9) were iatrogenic due to preeclampsia (PE). Breech presentation, PE, and prior surgery for rudimentary horn resection were UU‐related indications for cesarean delivery. Conclusions: Women with a UU have a higher risk of PTB, breech presentation, and cesarean delivery. Understanding of the subdivisions of PTBs and indications for cesarean delivery might help clinicians when counseling women with pregnancy complicated by a UU. [ABSTRACT FROM AUTHOR]

Background: To present a pregnancy-associated thrombotic thrombocytopenic purpura (TTP) patient with bilateral serous retinal detachment (SRD). Methods: Case report. Results: A 28-year-old nulliparous woman with 31 weeks gestation was presented to the local hospital with preeclampsia, hemolytic anemia, thrombocytopenia and bilateral blurry vision. Funduscopic examination showed bilateral macular SRD. Within the first month after delivery of a live female baby via cesarean section (at 32 weeks gestation), the patient experienced a recurrent course of hemolytic anemia and thrombocytopenia, and was then transferred to our hospital. On admission, her best corrected visual acuity (BCVA) was 0.1 OU; optical coherence tomography (OCT) confirmed the presence of bilateral macular SRD; electroretinography (ERG) examination showed diminished rod responses with reduced a and b waves in cone and mixed rod-cone responses. She was ultimately diagnosed with TTP and was treated systemically with fresh frozen plasma, rituximab, prednisone and cyclophosphamide. Despite persistent visual disturbances, she was discharged 1 month after admission with stabilization of systemic manifestations. At her first follow-up visit 6 months after discharge, surprisingly, her BCVA had improved to 1.0 OU; fundus examination and OCT confirmed the complete resolution of bilateral macular SRD and ERG revealed subnormal (right) and normal (left) electrophysiological responses. We believe that in this case, the clinical context (pregnancy) in which TTP developed, the unreported ERG characteristics and the unexpected delayed visual recovery are worth reporting. Conclusions: TTP should be considered as a potential differential diagnosis in patients with pregnancy-associated SRD. Appropriate systemic treatment might be mandatory for visual recovery. [ABSTRACT FROM AUTHOR]