Browsing by Author "Vale-Fernandes, E"
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- Assisted Reproductive Technology in Female Transplant Recipients: Experience of a Reproductive Medicine Unit and Literature ReviewPublication . Vale-Fernandes, E; Póvoa, AM; Soares, S; Calejo, L; Xavier, P; Sousa, S; Beires, J; Montenegro, NDiseases in end stage typically occur with hypothalamic-pituitary-ovarian axis disorders, with consequent anovulation and infertility. The solid organ transplantation increased survival of patients with end-stage organs disease and the vast majority of women improve their reproductive capacity after transplantation. Although adoption can always be a possibility, the transplanted infertile woman has the right to self-reproductive determination using assisted reproductive techniques. While it is known that pregnancies in transplantedwomen are at high risk, there is no evidence of differences in pregnancy outcome in pregnant transplanted subject to technical, compared with spontaneous pregnancies. The use of assisted reproductive techniques in transplanted women is a medical, ethical and psychosocial challenge, whose approach must be multidisciplinary, to ensure reproductive success without compromising the function of the transplanted organ or maternal health, allowing the birth of a healthy child. The literature remains scarce. Three clinical cases are presented.
- Late miscarriage caused by Serratia marcescens: a rare but dire disease in pregnancy.Publication . Vale-Fernandes, E; Moucho, M; Brandão, O; Montenegro, N
- Pelvic mass in a young woman with a background of ovarian dysgerminoma: differential diagnosisPublication . Vale-Fernandes, E; Rodrigues, F; Monteiro, C; Serrano, P
- Primary malignant mixed Müllerian tumour of the fallopian tube: a rare and difficult but possible diagnosis.Publication . Vale-Fernandes, E; Rodrigues, F; Serrano, P; Silva, AI
- Single Fetal Death in Monochorionic Twin Pregnancy: Co-Twin Prognosis and Neonatal OutcomePublication . Vale-Fernandes, E; Dias, J; Gil, B; Cadilhe, AThe incidence of single fetal death in twin pregnancy varies from 0.5% - 6.8%, leaving the surviving fetus with increased morbi-mortality. The prognosis is worse in monochorionic pregnancies. In addressing these cases it should be noted referral to tertiary center with differentiated perinatal support, induction of fetal lung maturation and termination of pregnancy if there's loss of fetal well-being or possibility of maternal complications and suspected neurological sequelae in the surviving fetus. The risk of iatrogenic prematurity should always be weighed with the possible consequences arising from the fetus staying in a hostile uterine environment. The authors describe a case of a 32-year-old pregnant woman with monochorionic/diamniotic twin pregnancy diagnosed with death of one of the fetuses due to fetal growth restriction and velamentous insertion of the umbilical cord at 30 weeks of gestation. The couple opted for termination of pregnancy at 33 weeks after documentation of brain changes in the surviving fetus.
- Uterine Rupture at 18 Weeks of Pregnancy in the Context of Malformed UterusPublication . Vale-Fernandes, E; Teixeira, N; Cadilhe, A; Rocha, MJBirth defects of the female genital tract are relatively common and often asymptomatic. Despite the pregnancy outcome can be favorable, adverse obstetric outcomes are described in women with uterine malformations. The authors report the case of an obstetric emergency which enhances the possibility of a very adverse and rare outcome of uterine rupture in a left hemi-cavity of a bicornuate uterus away from the term, at 18 weeks of pregnancy, in a pregnant woman with history of caesarean in the right hemi-cavity and with placenta increta. A malformed uterus with a primitive type cavity has lower distensibility of the wall with the progression of the pregnancy and facilitates the development of abnormal placentation forms, increasing the risk of uterine rupture in the first and second trimesters. The knowledge of the existence of a congenital uterine anomaly in the preconceptional period is of primary importance.