Pelvic inflammatory disease in pregnancy: a systematic review focusing on perinatal outcomes

Tubo-ovarian abscess after vaginal delivery: A case report and review of current literature

Tubo-ovarian abscesses in pregnancy and the post-partum period are extremely rare. We report a case of a 31-year-old woman who presented with an acute abdomen and sepsis in the post-partum period with a background of a large endometrioma diagnosed prior to conception. Exploratory laparoscopy revealed a ruptured tubo-ovarian abscess which was surgically drained and then treated with intravenous antibiotics. This report is seemingly unique in presenting the development of antenatal endometrioma into a tubo-ovarian abscess and an unusual differential for abdominal pain to consider in the immediate postpartum period.

Tubo-ovarian abscess: A potential mimicker of urachal malignancy

Urachal cancer is a rare but aggressive malignancy. A urachal mass concerning for adenocarcinoma was identified in a 32-year-old G2P1 female on 12-week ultrasound and confirmed on pelvic MRI. Due to progressive growth of the mass and refractory abdominal pain, a multi-disciplinary meeting was held, after which the patient chose to undergo an exploratory laparotomy. A tubo-ovarian abscess was identified involving the intestine, right ovary, fallopian tube, and communicating with a patent, necrotic urachus. This is the first reported case of a tubo-ovarian abscess masquerading as a urachal malignancy, which can present similarly with abdominal pain and irritative urinary symptoms.

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Urachal adenocarcinoma is a rare but aggressive form of bladder cancer that has a 5-year survival rate of 45%.

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Pelvic inflammatory disease in pregnancy causes a decreased chance of a viable birth and an increased risk of surgery.

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Care of urologic patients in pregnancy requires a multi-disciplinary approach with an emphasis on shared decision making.