Torsion of ovarian cyst is a common emergency during pregnancy，and its diagnosis is more difficult due to special physiological changes during pregnancy.A clear history of ovarian cysts combined with typical abdominal pain symptoms should be highly suspected of ovarian cyst torsion，and ultrasound is paramount importance in differential diagnosis.Most ovarian cyst torsion requires emergency surgery.General anesthesia or intramuscular anesthesia can be selected according to the operation mode.The ovaries should be preserved as much as possible during the operation，and laparoscopy can be used as the preferred surgical option.

Cervical cancer is one of the most common gynecological malignant tumors during pregnancy.The rare combination of cancer and pregnancy is expected to rise，as already demonstrated by population-based studies，and the symptoms are easily confused with other diseases in pregnancy，making it easy to be misdiagnosed or underdiagnosed.Cervical cancer during pregnancy is probably one of the most challenging medical conditions；it requires multidisciplinary care.Both diagnosis and treatment should take into consideration maternal and fetal health while not compromising the chances for cure.Our article aims to present management strategies for cervical cancer during pregnancy based on the guidelines，expert consensus，and literature reports.

Gastric perforation during pregnancy is a rare but life-threatening disease.Due to the changes of female physiological structure and hormone level during pregnancy，the clinical manifestations and signs of patients are lack of specificity，which can easily lead to misdiagnosis and delay treatment.Obstetricians should pay attention to the identification of medical history and signs，strengthen the identification and treatment of gastric perforation during pregnancy，and reduce the risk of adverse outcomes for pregnant women and newborns.

Objective

To investigate the clinical characteristics，diagnosis，treatment，and pregnancy outcome of pregnancy complicated with acute appendicitis.

Methods

A retrospective study was conducted on 100 pregnant women with Suspected acute appendicitis.The patients were admitted to the Third Affiliated Hospital of Guangzhou Medical University from January 2008 to September 2023.Clinical characteristics，diagnosis，treatment，and pregnancy outcome of the patients were analyzed.According to the onset of gestational age，100 patients were divided into the early-pregnancy group（＜14 weeks）with 19 cases，the middle-pregnancy group（14-27⁺⁶ weeks）with 43 cases，and the late-pregnancy group（≥28 weeks）with 38 cases.

Results

（1）Clinical characteristics：All 100 patients presented with abdominal pain（100.00%），among which 88 cases had tenderness in the right lower abdomen（88.00%），and 66 cases had rebound pain（66.00%）.There were no statistically significant differences in the clinical symptoms and signs among the three groups of pregnant women（P ＞0.05）.（2）Auxiliary examination：There were no statistically significant differences in the white blood cell count，neutrophil count，and procalcitonin among the three groups of pregnant women（P ＞0.05）.The percentage of neutrophils in the late-pregnancy group was higher than that in the early-pregnancy group，and the difference was statistically significant（86.4% vs 80.3%，Z=6.890，P＜0.05）.67 cases underwent abdominal color Doppler ultrasound examination，and 33 cases underwent CT or MRI examination.There was no statistically significant difference in abdominal ultrasound，abdominal CT or MRI among the three groups of pregnant women（P ＞0.05）.74 cases underwent abdominal color Doppler ultrasound examination，11 cases underwent MRI examination，and 2 cases underwent CT examination.Additionally，16 cases received combined abdominal color Doppler ultrasound and MRI examinations，while 4 cases received combined abdominal color Doppler ultrasound and CT examinations.There were no statistically significant differences in the abdominal ultrasonography，abdominal CT，or MRI among the three groups of pregnant women（P ＞0.05）.（3）Treatment and pregnancy outcome：There were 36 cases of conservative drug treatment and 64 cases of surgical treatment.Among the 54 cases of abortion and delivery in our hospital，7 cases of abortion（12.96%），18 cases of vaginal delivery（33.33%），and 29 cases of cesarean section（53.71%）.The cesarean section rate of pregnant women in the early and middlepregnancy group was significantly lower than that of the late-pregnancy group，the difference was statistically significant（2/8 vs 6/15 vs 87.5%，χ²=14.309，P＜0.05）；the premature birth rate of pregnant women in the late-pregnancy group was higher than that of the early and middle-pregnancy groups，the difference was statistically significant（58.33% vs 2/8 vs 0，χ²=15.631，P＜0.05）.Among 47 neonates born in our hospital，there was no significant difference in neonatal asphyxia rate among the three groups（P ＞0.05）.

Conclusions

It is of paramount significance to comprehend the clinical traits of acute appendicitis in diverse gestational weeks and to accomplish early and accurate diagnosis and treatment for enhancing perinatal outcomes.

Objective

To analyze the risk of pregnancy after in vitro fertilization and embryo transfer.

Methods

A retrospective cohort study was conducted to select a total of 2729 pregnant women who gave birth in our hospital from January 2022 to July 2023，including 254 pregnant women after IVF-ET（including 148 single and 106 twin births after IVF-ET）and 2475 cases of naturally conceived pregnant women（including 2455 cases of naturally conceived single and 20 cases of naturally conceived twin）.They were divided into four groups according to the method of conception and the number of fetuses：After the IVF-ET single group，naturally conceived single group，IVF-ET twin group，and naturally conceived twin group，the general conditions，complications，and comorbiditions（pregnancy-induced hypertension，gestational diabetes， premature rupture of membranes， premature delivery， anemia， placental abnormalities，postpartum hemorrhage，low birth weight infants）and delivery mode of the four groups were compared.

Results

（1）The incidence of gestational diabetes mellitus（29.1% vs 16.3%，χ²=15.964）、placental abnormality（13.5% vs 1.4%，χ²=95.193）、postpartum hemorrhage（9.5% vs 5.2%，χ²=4.878）and cesarean section（38.5% vs 30.3%，χ²=15.964）in single pregnancy after IVF-ET was higher than that in natural single pregnancy（P＜0.05）.（2）The incidence of premature rupture of membranes in the natural conception twin group（30.0% vs 6.6%，χ²=7.586）was higher than that in the IVF-ET twin group，and the incidence of premature rupture of membranes in the IVF-ET single group（14.9 vs 6.6%，χ²=4.168）was higher than that in the IVF-ET twin group，the difference was statistically significant（P＜0.05）.（3）In the twin after IVF-ET，the rates of hypertensive disease during pregnancy（15.1% vs 2.0%，χ²=15.239），preterm birth（33.0% vs 6.8%，χ²=29.221），anemia（24.5% vs6.1%，χ²=17.691），low birth weight infants（34.9% vs1.4%，χ²=53.505）and cesarean section（74.5% vs38.5%，χ²=32.206）were higher than those in the single group after IVFET（P＜0.05）.

Conclusions

The incidence of gestational diabetes，placental abnormalities，postpartum hemorrhage，and cesarean section were higher in single pregnancy after IVF-ET than in natural single pregnancy.Compared with the single pregnancy of IVF-ET，the gestational week of delivery of the twin pregnancies after IVF-ET is lower，but the incidence rate of hypertensive diseases，premature delivery，anemia，low birth weight infants，and cesarean section is higher.The risk of pregnancy after IVF-ET，especially the twin pregnancies after IVF-FT，should be correctly evaluated，and the prevention and treatment of complications and prenatal and intra-partum monitoring should be strengthened.At the same time，it is recommended to limit the number of embryos transferred，which is helpful to reduce the incidence of twin pregnancies and complications after IVF-ET and improve the outcome of mother and child.