Resumen Objetivo: Este caso clínico presentó casos con hemoperitoneo espontáneo durante el embarazo. Reporte del caso: El caso 1 presentó dolor abdominal agudo con signos de shock, los casos 2 y 3 se presentaron ambos con signos vitales estables y la disminución repentina de la frecuencia cardíaca fetal. La cesárea se realizó a las 27, 36 + 4 y 34 semanas de gestación, respectivamente. Los sitios de sangrado se encontraron en la superficie del útero o el parametrio. Conclusión: Un control estricto de los signos vitales y una intervención quirúrgica oportuna son fundamentales para mejorar el pronóstico.

Abstract Objectives: This case report presented cases with spontaneous hemoperitoneum during pregnancy. Case report: Case 1 presented with acute abdominal pain with signs of shock. Cases 2 and 3 both presented with stable vital signs and the sudden decline of fetal heart rate. Cesarean section was performed at 27, 36+4, and 34 gestational weeks, respectively. Bleeding sites were founded on the surface of the uterus or the parametrium. The perinatal outcome was stillbirth, live birth, and neonatal severe asphyxia. Conclusion: Careful physical examination, strict monitoring of vital signs, and timely surgical intervention are critical for improving the prognosis.

ABSTRACT Purpose: To determine the predictive value of maternal White Blood Cells (WBC), neutrophils, and C-Reactive Protein (CRP) for diagnosing Histological Chorioamnionitis (HCA) among women with Preterm Premature Rupture of Membranes (PPROM) who underwent cervical cerclage. Methods: A retrospective cross-sectional study was conducted among women with singleton pregnancy and PPROM, who underwent cervical cerclage during 2018-2020. Results: A total of 55 eligible women were included in the final analysis, including 36 (61.02%) cases with HCA and 19 (38.98%) without HCA. Women with HCA had higher WBC count (12.31 ± 2.80) × 109/L and neutrophil count (9.67 ± 2.90)×109/L than those without HCA (10.35 ± 2.53) × 109/L and 7.82 ± 2.82 × 109/L, respectively) (both p < 0.05). The cut-off value of WBC count at 10.15×109/L was found to be the most effective in identifying HCA, with an Area Under Curve (AUC) of 0.707 (95% CI: 0.56-0.86; p = 0.012), sensitivity of 86.11%, specificity of 57.90%, Positive Predictive Value (PPV) of 79.49%, Negative Predictive Value (NPV) of 68.75%, and Youden index of 0.44. The combination of WBC + neutrophil had a slightly higher (AUC = 0.711, 95% CI: 0.57–0.86; p = 0.011), specificity (68.42%), and PPV (81.25%), but lower sensitivity (72.22%), than the WBC count alone. A cut-off value of neutrophil at 7.46 × 109/L was effective in identifying HCA, with an AUC of 0.689 (95% CI: 0.53-0.84; p = 0.022). Discussion: Combination use of WBC+neutrophil was found to be the most accurate predictor of HCA among women with PPROM after surgery of cervical cerclage. Purpose WBC, , (WBC) neutrophils CReactive C Reactive CRP (CRP (HCA (PPROM Methods crosssectional cross sectional 20182020. 20182020 2018 2020. 2020 2018-2020 Results 5 analysis 3 61.02% 6102 61 02 (61.02% 1 38.98% 3898 38 98 (38.98% 12.31 1231 12 31 (12.3 2.80 280 2 80 109L L 109 9.67 967 9 67 (9.6 2.90×109/L 290109L 2.90 ×109/L 90 10.35 1035 10 35 (10.3 2.53 253 53 782 7 82 7.8 282 2.8 respectively both 0.05. 005 0.05 . 0 05 0.05) cutoff cut off 1015109L 15 0707 707 0.70 95 (95 CI 0.560.86 056086 0.56 0.86 56 86 0.56-0.86 0.012, 0012 0.012 012 0.012) 8611 11 86.11% 5790 57 57.90% (PPV 7949 79 49 79.49% NPV (NPV 6875 68 75 68.75% 044 44 0.44 0711 711 0.711 0.57–0.86 057086 0.011, 0011 0.011 011 0.011) 68.42%, 6842 68.42% 42 (68.42%) 81.25%, 8125 81.25% 81 25 (81.25%) 72.22%, 7222 72.22% 72 22 (72.22%) alone 746 46 7.4 0689 689 0.68 0.530.84 053084 0.53 0.84 84 0.53-0.84 0.022. 0022 0.022 022 0.022) Discussion WBCneutrophil (WBC 2018202 201 202 2018-202 61.02 610 6 (61.02 38.98 389 (38.98 12.3 123 (12. 28 8 9.6 96 (9. 290 2.9 10.3 103 (10. 2.5 78 7. 2. 00 0.0 070 70 0.7 (9 560 0.560.8 05608 056 0.5 086 0.8 0.56-0.8 001 0.01 01 861 86.11 579 57.90 794 4 79.49 687 68.75 04 0.4 071 71 0.71 0.57–0.8 05708 684 68.42 (68.42% 812 81.25 (81.25% 722 72.22 (72.22% 74 068 0.6 530 0.530.8 05308 053 084 0.53-0.8 002 0.02 201820 20 2018-20 61.0 (61.0 38.9 (38.9 12. (12 9. 29 10. (10 0. 07 ( 0.560. 0560 08 0.56-0. 86.1 57.9 79.4 68.7 0.57–0. 0570 68.4 (68.42 81.2 (81.25 72.2 (72.22 06 0.530. 0530 0.53-0. 20182 2018-2 61. (61. 38. (38. (1 0.560 0.56-0 86. 57. 79. 68. 0.57–0 057 (68.4 81. (81.2 72. (72.2 0.530 0.53-0 2018- (61 (38 0.56- 0.57– (68. (81. (72. 0.53- (6 (3 0.57 (68 (81 (72 (8 (7

ABSTRACT Background: Previous studies showed consistent results for associations between circulating concentrations of vitamin D and risk of antenatal, postnatal depression. Methods: Articles published in English before November 2020 were searched in databases as follows: PubMed, EMBASE, Web of Science, Medline, Google Scholar and Cochrane. These articles explored associations between circulating concentrations of vitamin D and risk of antenatal, postnatal depression.The present meta-analysis was conducted using STATA 12.0 software. Odds ratios (ORs) and 95% confidence intervals (CIs) extracted from included studies were computed using a random effects model or a fixed effects model according to heterogeneities between included studies. Q test and I2 were used to explore heterogeneities between included studies. Results: 7 cohort studies (including 1567 depression cases and 5254 controls) and 3 case-control studies (including 995 depression cases and 1265 controls) were included in the present study. The study showed that low circulating levels of 25-hydroxy (OH) vitamin D is significantly associated with a higher risk of antenatal and postnatal depression (OR = 1.02, 95% CI 1.01 to 1.04, I2 = 90.7%, p < 0.001). Conclusion: Our results have shown that the low level of vitamin D may be an adverse factor of antenatal and postnatal depression.