Abstracts – 2008 - Obstetricia Crítica

edema and dystocia in labor. Treatment options are very limited. CASE: A 33-year-old woman with spina bifida and a history of multiple intraabdominaloperations and extensive intraperitoneal adhesions was admitted in labor at36(6/7) weeks' gestation with an irreducible cervical prolapse. The cervicalprolapse was reduced by topical application of concentrated magnesium sulfate.CONCLUSION: In active labor, a prolapsed cervix that is enlarged andedematous can be managed with a topical concentrated magnesium solution toprevent cervical dystocia and lacerations.J Reprod Med. 2008 Jan;53(1):65-6.Expectant management of uterine incarceration from an anterior uterinemyoma: a case report.Rose CH, Brost BC, Watson WJ, Davies NP, Knudsen JM.Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, 200First Street, SW, Rochester, MN 55905, USA. rose.carl@mayo.eduBACKGROUND: Uterine incarceration is an infrequent complication of pregnancyin the early second trimester. Although imaging can be confirmatory, thediagnosis is made primarily on clinical grounds, and definitive treatment involvesmanual reduction to restore the proper anatomic position. Except for preexistinguterine retroversion, often this event is idiopathic. CASE: A 30-year-oldprimigrávidas presented at 15 weeks' gestation with uterine incarceration.Manual replacement was unsuccessful. Spontaneous resolution occurred at 20weeks, followed by uneventful pregnancy. The patient underwent a classicalcesarean section at term due to fetal malpresentation. CONCLUSION: Uterineincarceration may be managed conservatively, with a favorable outcome.Obstet Gynecol. 2008 Feb;111(2 Pt 2):577-9.Preoperative magnetic resonance imaging and antepartum myomectomy ofa giant pedunculated leiomyoma.Alanis MC, Mitra A, Koklanaris N.Department of Obstetrics and Gynecology, Carolinas Medical Center, Charlotte,North Carolina, USA. mca3@musc.eduBACKGROUND: Antepartum myomectomy is reserved for severe pain andprevention of fetal complications. Magnetic resonance imaging has been usefulin nonpregnant women for preoperative management and patient counseling.CASE: A primigrávidas was admitted at 12 weeks of gestation in severe acuteabdominal pain with a large abdominal mass, confirmed by magnetic resonanceimaging to be a pedunculated 30x27x19-cm uterine leiomyoma. Anuncomplicated abdominal myomectomy was performed, incorporating a flat cupvacuum device to mobilize the mass without disturbing the gravid uterus. Thepatient later had an uncomplicated term vaginal delivery and healthy newborn.CONCLUSION: Magnetic resonance imaging and a flat cup vacuum device werehelpful in preoperative planning and performing an uncomplicated abdominalmyomectomy during pregnancy, respectively.Obstet Gynecol. 2008 Feb;111(2 Pt 2):575-7.