Intracranial hemorrhage is a rare yet potentially devastating event during pregnancy with a significant risk of maternal and fetal mortality and morbidity. The risk of intracranial hemorrhage increases during the third trimester of pregnancy and is greatest during labor and the postpartum period. Interdisciplinary diagnosis and treatment of the pregnant population often begins in the emergency department setting and is key to increasing patient survival rates through immediate and adequate treatment, including emergency medicine, neurosurgical and obstetrical procedures. A unique case report with a diagnostic pathway for intracranial hemorrhage due to eclampsia in a primipara at 24 weeks of gestation is presented, illustrating potential diagnostic dilemmas as the patient rapidly progresses into hemolysis, elevated liver enzymes and low platelets syndrome. A literature review was conducted to uncover the etiology of intracranial hemorrhage during pregnancy, as well as its diagnostic challenges and treatment. Pregnancy should not be viewed as a barrier to performing angiography or endovascular treatment for vascular causes of intracranial hemorrhage. Patient transport to a tertiary reference center and the interdisciplinary cooperation of specialists are key to achieving correct and rapid treatment. Continuous prevention of preeclampsia and patient education are necessary to decrease the incidence of eclampsia and its complications. Key message: Intracranial hemorrhage and eclampsia in pregnant patients are rare yet may result in high rates of maternal and fetal morbidity and mortality. The diagnostic process is difficult and requires interdisciplinary cooperation to start the correct treatment immediately.
Fluorescence imaging in colorectal surgery is considered a novel predominantly intraoperative method of ensuring a greater surgical success. The use of fluorescence is linked to advanced tumor visualization and projection of its lymphatics, both vessels and nodes, which results in a higher chance of achieving a total excision. Additionally, iatrogenic complications prove to be reduced using fluorescence during the surgical excision. The combination of fluorescence and artificial intelligence to better facilitate oncological surgery will soon become an established approach in operating rooms worldwide.
Introduction: Toxic Epidermal Necrolysis (TEN) and Steven–Johnson Syndrome (SJS) are rare yet dangerous dermatological emergencies presenting as necrosis of the skin and mucous membranes due to an immune reaction which may be associated with the use of pharmaceuticals—predominantly non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics, and antiretroviral drugs. During the postpartum period, women are administered numerous pharmaceuticals, including NSAIDs, analgesics, and antibiotics, due to pain and their susceptibility to infections, exposing them to potential adverse effects including allergies and immune reactions. Case Report and Review: The case reported here is a rare description of a patient in the early postpartum phase who presented with epidermal necrolysis whilst remaining hospitalized after a cesarean delivery. The multidisciplinary approach, early diagnosis, and treatment ensured the patient’s full recovery. Intravenous immunoglobulin treatment resulted in a rapid therapeutic effect. This literature review offers an insight into the epidemiology, diagnostic process, and treatment of this infrequent dermatological syndrome during the postpartum period. Results: Antibiotic treatment is a common culprit of TEN in this population; hence, clinicians should remain vigilant during antibiotic administration. Differential diagnosis with toxic shock syndrome is crucial, as TEN and SJS symptoms may mimic sepsis, which is a more common diagnosis in the postpartum period. Conclusions: The condition of the skin during the postpartum period should be closely monitored, as some systemic diseases may manifest abruptly as profound, postpartum hormonal changes affect the immunological response. Upon the discovery of suspicious skin lesions concomitant with systemic symptoms, an immediate multidisciplinary approach involving obstetricians and dermatologists is key to a rapid diagnosis and treatment to avoid maternal mortality.
Background/Objectives: Perineal obstetrical trauma sustained during vaginal delivery has a profound impact on female quality of life. The aim of the cross-sectional study was to analyze the association between active bacterial cervical infection and group B Streptococcus (GBS) rectovaginal colonization in the 35th–37th weeks of pregnancy with the degree of delivery perineal trauma. Methods: The study included 778 women after vaginal delivery. Maternal characteristics, including age, concomitant diseases, parity, obstetrical history, and cervical swab results conducted at admission and rectovaginal bacterial swabs at the 35th–37th weeks of pregnancy, were analyzed. The rates of perineal tears were compared between the physiological and pathological cervical swab groups and between the GBS-positive and GBS-negative colonization groups. Results: At admission to delivery, active cervical infection was diagnosed in 269 (35.9%) women. After vaginal delivery, 361 (49.3%) women had an intact perineum, and 288 (39.3%), 78 (10.7%), 4 (0.6%), and 1 (0.1%) had 1st–4th-degree perineal tears, respectively. Statistical analyses of the logistic regression model found that GBS colonization at the 35th–37th weeks of pregnancy (OR 1.56, p = 0.035) and pathological flora at admission (OR 1.54, p = 0.019) were associated with perineal tears. A higher vaginal parity was found to be a protective factor (OR 0.49, p < 0.000). Conclusions: High birthweight, longer second stage of labor duration, and primiparity were associated with increased rates of perineal trauma. Active cervical infection at admission and GBS colonization at the 35th–37th weeks of pregnancy were found to be risk factors for perineal tears. A protective factor for an intact perineum was a higher number of prior vaginal deliveries.
Introduction: Obstructed HemiVagina and Ipsilateral Renal Anomaly (OHVIRA) syndrome, also known as Herlyn–Werner–Wunderlich syndrome, is a rare congenital Müllerian duct anomaly, characterized by uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. Symptoms typically appear shortly after menarche and include dysmenorrhea and pelvic pain. The psychological burden associated with fertility and reproductive outcomes in women with OHVIRA syndrome remains poorly investigated. Materials and methods: A 30-year-old primigravida with left renal agenesis and a history of vaginal abscess, dysmenorrhea, and chronic pelvic pain received a delayed OHVIRA syndrome diagnosis. The patient had previously been informed that spontaneous conception and an uncomplicated pregnancy were highly unlikely because of her congenital gynecological condition, resulting in significant fertility-related anxiety and psychological distress. Under careful supervision and counseling, she conceived successfully, and the pregnancy progressed without complications; an elective cesarean section was performed at term. A literature search using the PubMed and Embase databases was conducted between November 2025 to April 2026 to identify studies reporting reproductive outcomes and psychological aspects in patients diagnosed with OHVIRA syndrome and other Müllerian anomalies. Results: Evidence-based counseling contributed to improvement of quality of life and reduction of pregnancy-related anxiety of the reported patient with OHVIRA syndrome. A limited number of studies discuss the mental burden and fertility-related anxiety of patients with OHVIRA syndrome and other Müllerian anomalies. Conclusions: Spontaneous conception and uncomplicated pregnancy are possible for women with OHVIRA syndrome. The psychological burden associated with congenital gynecological conditions remains under-recognized and requires further investigation. Comprehensive counseling and interdisciplinary care are essential to improve reproductive education, mental health support, and pregnancy outcomes in patients with congenital gynecological anomalies.