Ultrasound-guided laparoscopy for conservative management of a massive degenerated uterine fibroid during pregnancy: A case report
Bibliographic record
Abstract
Objective: To outline the key steps in the management of a massive, degenerated fibroid during pregnancy. Design: A video article demonstrating diagnostic imaging, laparoscopic anatomy, and innovative surgical technique. Setting: This video demonstrates an unusual presentation of a uterine fibroid in pregnancy. Uterine fibroids are common, with an incidence of 40%–60% by the age of 35 with a possibility of growing in pregnancy and impacting the developing fetus. Interventions: This case summarizes an innovative, safe, and efficient minimally invasive surgery approach to a patient with a 30-cm degenerated fibroid at 16 weeks gestational age of pregnancy, permitting ongoing development of the viable fetus. Review of imaging revealed a solid-cystic uterine mass, suspicious for degenerated fibroid, compressing the gestation into the right upper quadrant. The patient did not have a reported history of a uterine mass prior to pregnancy. Interdisciplinary care with maternal-fetal medicine and gynecologic oncology ensured thorough counselling and various treatment possibilities. The MIGS team performed ultrasound-guided laparoscopy involving drainage, biopsy, and insertion of a transient drain to prevent re-accumulation of fluid throughout the pregnancy. Pathology revealed fibroid degeneration with infarct-type necrosis. The patient continued successfully in pregnancy until undergoing a Cesarean section at 33 weeks after developing an abscess within the fibroid. Neonatal outcome was excellent. Conclusion: Our case demonstrates degeneration with massive expansion of a fibroid, compromising the potential of the fetus. A solution was devised and implemented, allowing for pregnancy continuation until the third trimester.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.005 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.007 | 0.005 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".