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Background: Neuroendocrine carcinoma (NEC) of the cervix is rare and has high mortality and recurrence rates. The clinical symptoms of cervical NEC, such as abnormal vaginal bleeding and discharge, are similar to those of other cervical cancers. Here, we describe a case involving a 42-year-old woman with cervical NEC accompanied by an isolated large ovarian metastasis. Case Report: A 42-year-old woman had experienced abdominal discomfort for the past 4 months, along with a larger abdominal circumference. Physical examination revealed a 15-cm, solid, mobile, abdominal mass and a smooth cervix. Abdominal computed tomography revealed a hypoattenuating solid mass with a calcified component and indistinct borders, measuring 16.6×15.5 cm. Tumor marker levels were as follows: cancer antigen 125, 803.9 U/mL; carcinoembryonic antigen, 241.9 ng/mL. Preoperatively, we suspected a malignant ovarian tumor without any suspicion of cervical cancer. Intraoperatively, a 25×20-cm solid mass was found on the left adnexa with peritoneal wall and rectosigmoid adhesions. We performed a total abdominal hysterectomy with bilateral salpingo-oophorectomy, followed by peritoneal biopsy and omentectomy. Histopathological examination showed a 2.5-cm endocervical mass and a normal ectocervical epithelium. Immunohistochemistry revealed a small-cell cervical NEC with metastasis to the left ovary. The final diagnosis was a stage IB2 cervical NEC with ovarian metastasis. For treatment, we administered an etoposide-cisplatin adjuvant chemotherapy regimen. Conclusions: NEC of the cervix can manifest as a large ovarian tumor, lack the usual indications for cervical cancer, and spread to the ovaries without metastasis to other organs. [ABSTRACT FROM AUTHOR]

Preeclampsia and peripartum cardiomyopathy (PPCM) are significant obstetric problems that can arise during or after pregnancy. Both are known to be causes of maternal mortality and morbidity. Several recent studies have suggested a link between preeclampsia and the pathophysiology of PPCM. However, the common thread that connects the two has yet to be thoroughly and fully articulated. Here, we investigate the complex dynamics of preeclampsia and PPCM in this review. Our analysis focuses mainly on inflammatory and immunological responses, endothelial dysfunction as a shared pathway, and potential genetic predisposition to both diseases. To begin, we will look at how excessive inflammatory and immunological responses can lead to clinical symptoms of both illnesses, emphasizing the role of proinflammatory cytokines and immune cells in modifying vascular and tissue responses. Second, we consider endothelial dysfunction to be a crucial point at which endothelial damage and activation contribute to pathogenesis through increased vascular permeability, vascular dysfunction, and thrombus formation. Finally, we examine recent information suggesting genetic predispositions to preeclampsia and PPCM, such as genetic variants in genes involved in the management of blood pressure, the inflammatory response, and heart structural integrity. With this synergistic study, we seek to encourage more research and creative therapy solutions by emphasizing the need for an interdisciplinary approach to understanding and managing the connection between preeclampsia and PPCM. [ABSTRACT FROM AUTHOR]

This article presents seven cases of maternal deaths attributed to COVID-19 during the first year of the pandemic wave. These cases provide insights into the natural progression of COVID-19 in pregnant women who were not vaccinated. This study showed that COVID-19 significantly increased maternal and neonatal mortality and morbidity. All of the patients exhibited symptoms of fever, cough, and dyspnea upon admission to the hospital. They were admitted with elevated respiratory rates (26-32 times/minute) and low oxygen saturation (<95%). Four patients had obesity, while one patient had pregestational diabetes. The COVID-19 diagnosis was established using a rapid antibody or antigen test and chest X-ray, which indicated pneumonia. Medical interventions administered to the patients included antiviral therapy (5 patients), antibiotics (6 patients), and anticoagulants (4 patients). From a total of five babies delivered, four babies were delivered via cesarean section. Two babies were not delivered due to previability and maternal deaths before delivery. The patients passed away within 3-10 days of hospital admission. In conclusion, adequate and early intervention and management of pregnant women infected with COVID-19 are crucial in preventing maternal and neonatal deaths, especially in unvaccinated women. [ABSTRACT FROM AUTHOR]

Background: Tetralogy of Fallot (TOF) is the most common congenital heart disease in the population. Correction of TOF during infancy or childhood may increase the quality of patient’s life. Uncorrected TOF may cause further complications later on. Pregnancy with uncorrected TOF may cause complications on both maternal and fetal sides. Objective: to analyze maternal and perinatal outcomes in patients with uncorrected TOF during pregnancy. Methods: This is a retrospective study. A total of 8 pregnant women diagnosed with TOF registered in the Obstetric-Cardiac unit in 3 years (2016-2018). Medical records were reviewed for clinical assessment, echocardiography results, and therapy during hospitalization. Patients were contacted by telephone to provide an obstetric history, including details of pregnancy and delivery. Five of 7 patients able to be contacted, and home visits were done to evaluate their conditions. Results: There were 8 pregnant women with uncorrected TOF. Most cases (87,5%) were first diagnosed during pregnancy and delivery. Intra-Uterine Growth Restriction (IUGR) and abortion (62.5% and 25%, respectively) were the most obstetric complications. Cardiac complications were cardiogenic shock (12.5%), thromboembolic (12.5%), and various degree of heart failure (62.5%). The number of Small for Gestational Age (SGA) was 66.7%. Incidence of congenital heart disease (CHD) in the fetus was 20%. One death case and 2 abortions from a total of 8 cases were found. Conclusion: TOF may cause many maternal and fetal complications. The most common maternal complications are heart failure, cardiogenic shock and thromboembolic, while perinatal complications include IUGR, SGA and abortion. [ABSTRACT FROM AUTHOR]

The case of COVID-19 in Indonesia has shown a significantly increasing curve. This condition affected the regulation of maternal health services in Indonesia, especially in East Java Province. The health services structure was a challenge in itself, where hospitals must be adaptive during the COVID-19 pandemic. This situation also caused changes in several components of maternal health services. The report focused on maternal services in two hospitals at East Java, Indonesia (Soetomo General Hospital and Universitas Airlangga Academic Hospital) that described five main components, including patient screening, hospital visit policies, intrapartum management, postpartum management, protection and safety for health workers, and funding issues. [ABSTRACT FROM AUTHOR]

Preeclampsia still remains an important topic in relation to the cardiovascular system in more than 300 million women worldwide, with both short and longterm mobidities. The purpose of this study was to compare maternal cardiovascular risk of early and lateonsets of preeclampsia 5 years after labor. It was a retrospective cohort study of preeclampsia patients within the period of January 2013 to January 2014, who delivered at Dr. Soetomo General Hospital. The maternal cardiovascular risk assessment include; body mass index (kg/m²), waist circumference (cm), blood pressure (mmHg), fasting blood sugar levels (mg/dL), HDL cholesterol levels (mg/dL), LDL cholesterol levels (mg/dL), blood triglyceride levels (mg/dL), total cholesterol levels (mg/dL) and ATP-III Framingham scores. There was a higher and significant cardiovascular risk factors in relations to hypertension and/or metabolic syndrome (p 0.031) in the early-onset of severe preeclampsia group, which also supported an increase of 1.47 folds of cardiovascular risks (RR 1..471; CI 95 [1.071-2.019]) compared with the late-onset group. The incidence of metabolic syndrome 5 years after preeclampsia was higher in the early-onset of preeclampsia group compared with the late-onset. Also, the cardiovascular risk factors related to hypertension and / or metabolic syndrome were higher in the early-onset group and supported an increase in cardiovascular risk factors of 1.47 times compared with the late-onset group. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the role of three-dimensional (3D)/four-dimensional (4D) volume rendering ultrasound (VRU) in the diagnosis of abnormally invasive placenta (AIP).Materials and Methods: Twelve consecutive patients strongly suspected of having AIP on the basis of conventional ultrasound (US) and clinical history performed between September 2016 and December 2016 in the main tertiary referral hospital in Surabaya, East Java were included in this prospective observational study. A Samsung WS 80A Elite US scanner with a 3D/4D "crystal vue" and "realistic vue" volume rendering mode was used to establish the diagnosis of AIP and evaluate the site, and depth of placental invasion. The VRU images were compared with the intraoperative findings.Results: Using this novel US technique, all cases of suspected AIP were subsequently confirmed during surgery. Importantly, the new US technique provided a correct diagnosis of the degree of invasion in 11 out of these 12 suspected AIP cases: 5/5 for placenta percreta, 3/3 for placenta increta, and 2/3 for placenta accreta; one patient was misdiagnosed in terms of the degree of placenta accreta, and one patient had normal implantation).Conclusion: This new software of 3D/4D VRU represents a promising technique for the preoperative diagnosis and staging of AIP. [ABSTRACT FROM AUTHOR]

Objective: To compare the level of serum heme oxygenase 1 (HO-1), soluble FMS like tyrosine kinase (sFlt-1), and neonatal outcome in early onset preeclampsia (EO-PE), late onset preeclampsia (LO-PE), and normal pregnancy (NP).Methods: In this prospective observational case control study, HO-1 and sFlt-1 levels were measured in blood samples within 24 h of hospital admission. Preeclampsia cases were divided into two groups based on gestational age at delivery: EO-PE (<34 weeks) and LO-PE (≥34 weeks). A total of 45 patients were involved in this study.Result: Maternal serum level of sFlt-1 was higher in EO-PE than LO-PE and NP groups (mean ± SD; 14.50 ± 17.12 ng/ml vs 5.20 ± 6.69 ng/ml vs 2.72 ± 1.2 ng/ml [p = 0.020]. Maternal serum level of HO-1 was not different between EO-PE, LO-PE, and NP groups (p = 0.681). Birthweights were significantly lower in the EO-PE group compared with the LO-PE and NP groups (1580 ± 536 g vs 2635 ± 578 g vs 3010 ± 371 g [p = 0.000]). The rate of small for gestational age infant (26.7% vs 6.7% vs 0%; p = 0.046) and perinatal death (20% vs 0 vs 0; p = 0.037) was also significantly higher in EO-PE compared to LO-PE and NP. The maternal sFlt-1 level was negatively correlated with birthweight (p = 0.006; CC = -0.445).Conclusion: This study did not find a correlation between maternal HO-1 levels and sFlt-1 levels. Maternal serum sFLt-1 levels in preeclampsia were higher in EO-PE and were associated with a worse perinatal outcome. [ABSTRACT FROM AUTHOR]

Objective: s Data on the clinical manifestations and pregnancy outcomes of pregnant women with COVID-19 are limited, particularly in developing countries. The aim of this study was to analyze the clinical manifestations and pregnancy outcomes in COVID-19 maternal cases in a large referral hospital in Indonesia., Methods: This study used a prospective cohort design and included all pregnant women with suspected COVID-19. Subjects were divided into COVID-19 and non-COVID-19 groups based on the results of real-time polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2. Clinical characteristics, laboratory results, and pregnancy outcomes were compared between the two groups., Results: Of the 141 suspected maternal cases, 62 cases were COVID-19-confirmed (43.9%), while 79 suspected cases were negative (56.1%). The clinical manifestations and laboratory findings between the two groups were not significantly different (P>0.05). However, the maternal mortality directly caused by COVID-19 was significantly higher than that in the non-COVID-19 group (8.3% vs. 1.3%; P=0.044; odd ratio, 6.91; 95% confidence interval, 0.79-60.81)., Conclusion: The clinical manifestations and laboratory results of suspected pregnant women with positive and negative RT-PCR COVID-19 results were similar. However, within the Indonesian setting, COVID-19 significantly increases the risk of maternal death through both direct and indirect factors.