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Ectopic Pregnancy  


... lower back pain Continue What Causes an Ectopic Pregnancy? An ectopic pregnancy results from a fertilized egg's ... using methotrexate or additional surgery. What About Future Pregnancies? Many women who have had an ectopic pregnancy ...


Ectopic Pregnancy  


... woman is pregnant. If you have an ectopic pregnancy, the fertilized egg grows in an abnormal place, ... tubes. The result is usually a miscarriage. Ectopic pregnancy can be a medical emergency if it ruptures. ...


Ectopic pregnancy  


Tubal pregnancy; Cervical pregnancy; Tubal ligation-ectopic pregnancy ... In most pregnancies, the fertilized egg travels through the fallopian tube to the womb (uterus). If the movement of the egg ...


Ectopic Pregnancy  


... Patient Education Website of the American Society for Reproductive Medicine Ectopic pregnancy Developed in collaboration with the ... 2014 For more information on this and other reproductive health topics, visit AMERICAN SOCIETY ...


Ectopic pregnancy (image)  


An ectopic pregnancy is one in which the fertilized egg implants in tissue outside of the uterus and the placenta ... common site is within a Fallopian tube, however, ectopic pregnancies can occur in the ovary, the abdomen, and ...


[Early diagnosis of ectopic pregnancy].  


Ectopic pregnancy is a high-risk condition that occurs in 2% of reported pregnancies. This percentage is fivefold higher than that registered in the 1970s. Since 1970 there has been a two-fold increase in the ratio of ectopic pregnancies to all reported pregnancies in Hungary and in 2012 7.4 ectopic pregnancies per thousand registered pregnancies were reported. Recently, the majority (80%) of cases can be diagnosed in early stage, and the related mortality objectively decreased in the past few decades to 3.8/10,000 ectopic pregnancies. If a woman with positive pregnancy test has abdominal pain and/or vaginal bleeding the physician should perform a work-up to safely exclude the possibility of ectopic pregnancy. The basis of diagnosis is ultrasonography, especially vaginal ultrasound examination and measurement of the ?-subunit of human chorionic gonadotropin. The ultrasound diagnosis is based on the visualization of an ectopic mass rather than the inability to visualize an intrauterine pregnancy. In some questionable cases the diagnostic uterine curettage or laparoscopy may be useful. The actuality of this topic is justified by practical difficulties in obtaining correct diagnosis, especially in the early gestational time. PMID:25016448

Belics, Zoran; Gérecz, Balázs; Csákány, M György



Revisiting Ectopic Pregnancy: A Pictorial Essay  

PubMed Central

Ectopic pregnancies occur in approximately 1.4% of all pregnancies and account for 15% of pregnancy-related deaths. Considering the high degree of mortality, recognizing an ectopic pregnancy is important. Signs and symptoms of an ectopic pregnancy are nonspecific and include pain, vaginal bleeding, and an adnexal mass. Therefore, imaging can play a critical role in diagnosis. There are different types of ectopic pregnancies, which are tubal, cornual, cesarean scar, cervical, heterotopic, abdominal, and ovarian. Initial imaging evaluation of pregnant patients with pelvic symptoms is by ultrasonography, transabdominal, transvaginal or both. We review the sonographic appearance of different types of ectopic pregnancies that will aid in accurate and prompt diagnosis. PMID:25161806

Petrides, Artemis; Dinglas, Cheryl; Chavez, Martin; Taylor, Sharon; Mahboob, Sabrina



Ectopic pregnancy: a five year review.  


A survey of all women between the ages of 15-50 who underwent laparotomy at the Women's Hospital, Liverpool, from January 1970 to December 1974, was performed to identify etiological factors in ectopic pregnancy. There were 49 ectopic pregnancies during this peirod. The majority of patients were 30-35 years of age (20), 16 were in the 25-29 group. 63.3% had a previous viable pregnancy, 16.3% had a previous abortion, and 3 patients had a previous ectopic pregnancy. The major sysmptoms were vaginal bleeding followed by abdominal pain. Only 16.3% gave a history of previous pelvic infection. However, 53.5% were found to have evidence of previous pelvic infection. 4 patients. Results indicate that pelvic inflammatory disease is still the greatest cause of ectopic pregancy. PMID:952700

Weekes, A R; Hutchins, C J



Abdominal pain in pregnancy.  


Abdominal pain in pregnancy is most commonly caused by complications of the pregnancy, e.g., abortion, ectopic pregnancy and abruptio placentae. A careful history and methodical physical examination and, if necessary, simple ultrasonographic investigations will reveal the cause in most of these conditions. In a few cases of abdominal pain in pregnancy a gynaecological condition, such as torsion of an ovarian cyst, or a nongynaecological (medical or surgical) one is the cause. Some of these conditions are serious, e.g., acute appendicitis, and unless the correct diagnosis is made and the appropriate management promptly instituted both the mother and her baby may suffer tragic consequences. Moreover, these conditions are more likely to be misdiagnosed during pregnancy. This is because the anatomical and physiological changes which occur in pregnancy tend to change and obtund the expected clinical features and laboratory data which are used to diagnose these conditions. Their early diagnosis therefore requires a high index of suspicion together with awareness of the ways in which they may present in pregnancy. PMID:7941766

Klufio, C A; Amoa, A B; Rageau, O



Ectopic pregnancy: the surgical epidemic.  

PubMed Central

Ectopic pregnancy has become a major health problem in terms of its morbidity and its impact on health care resources. In a case-control study involving 40 black patients, the odds ratio of developing ectopic pregnancy in current and former intrauterine device users is 11.7, which is statistically significant. The odds ratio for patients with a history of pelvic inflammatory disease is 4.4, which is statistically insignificant. A review of the current literature indicates Chlamydia salpingitis as the major cause of the ectopic epidemic. Prompt and effective treatment of this venereal disease may curtail health care expenses and prevent suffering of thousands of women each year. PMID:2664197

Coupet, E.



MR features of ectopic pregnancy  

Microsoft Academic Search

Ectopic pregnancy (EP), in which a fertilized ovum implants outside the uterine cavity, is the leading cause of pregnancy-related\\u000a death in the first trimester. EP is usually suspected by a positive pregnancy test and an empty uterus on transvaginal sonography\\u000a (TVS). Although TVS is the initial modality of choice, it may occasionally fail to demonstrate the implantation site. When\\u000a TVS

Ken Tamai; Takashi Koyama; Kaori Togashi



Heterochronic bilateral ectopic pregnancy after ovulation induction.  


Ectopic pregnancy is identified with the widely-applied assisted reproductive technology (ART). Bilateral ectopic pregnancy is a rare form of ectopic pregnancy which is difficult to be diagnosed at the pre-operation stage. In this paper, we presented an unusual case of heterochronic bilateral ectopic pregnancy after stimulated intrauterine insemination (IUI), where there has been a delay of 22 d between the diagnoses of the two ectopic pregnancies. Literature was reviewed on the occurrence of bilateral ectopic pregnancy during the past four years in the MEDLINE database. We found 16 cases of bilateral ectopic pregnancy reported since 2008, and analyzed the characteristics of those cases of bilateral ectopic pregnancy. We emphasize that ovulation induction and other ARTs may increase the risk of bilateral ectopic pregnancy. Because of the difficulty in identification of bilateral ectopic pregnancy by ultrasonography, the clinician should be aware that the treatment of one ectopic pregnancy does not preclude the occurrence of a second ectopic pregnancy in the same patient and should pay attention to the intra-operation inspection of both side fallopian tubes in any ectopic pregnancy case. PMID:25091994

Zhu, Bo; Xu, Gu-feng; Liu, Yi-feng; Qu, Fan; Yao, Wei-miao; Zhu, Yi-min; Gao, Hui-juan; Zhang, Dan




PubMed Central

Unless an ectopic pregnancy is visible by ultrasound, diagnosis can be a challenge. Differentiating ectopic pregnancies from intrauterine pregnancies can be impossible without intervention or follow-up. This poses a clinical dilemma to the practitioner given the inherent danger to the mother of tubal rupture of an ectopic pregnancy versus the fear of intervening in the case of a desired pregnancy without certainty of diagnosis. Early diagnostic modalities are clearly lacking, and serum biomarkers are currently being investigated as a solution to need for a rapid and accurate test for ectopic pregnancy. PMID:22510623

Rausch, Mary E; Barnhart, Kurt



[Ectopic pregnancy: Its current interest in Primary Health Care].  


An ectopic pregnancy is the implantation and development of the ovum fertilized outside the endometrial cavity. Its incidence has increased in the last 30 years, and although its morbimortality has decreased, it is still the first cause of mortality in the first trimester of the pregnancy. Early suspicion is important, particularly in women of fertile age and with risk factors indicative of an extrauterine gestation. The symptomatology is usually amenorrhea, abdominal pain, metrorrhagia, general pregnancy symptoms, and even syncope and shock. The diagnosis of ectopic pregnancy is based on the clinical information, analytical results on mother blood and urine, ultrasound examination, transvaginal culdocentesis, laparoscopic or laparotomic inspection, and a histological study. The treatment can be surgical (salpingostomy or salpingectomy), medical (methotrexate) or expectant, depending on the factors of the ectopic pregnancy: early diagnosis, presence of acute complications, clinical condition of the patient, etc. PMID:24529529

López-Luque, P R; Bergal-Mateo, G J; López-Olivares, M C



Tubal ectopic pregnancy: diagnosis and management  

Microsoft Academic Search

Ectopic pregnancy is the gynaecological emergency par excellence and remains the leading cause of pregnancy-related first\\u000a trimester deaths in the UK. Its prevalence continues to rise because of increases in the incidence of the risk factors predisposing\\u000a to ectopic pregnancy. Classically, the diagnosis is based on a history of pelvic pain associated with amenorrhoea, a positive\\u000a pregnancy test with or

Vivek Nama; Isaac Manyonda



Ectopic pregnancy after infertility treatment  

PubMed Central

Early pregnancy complications are more common in women who conceive after infertility treatment. Most of these occur before 12 weeks of gestation and include miscarriage, vaginal bleeding, intrauterine hematoma, vanishing twin, and ectopic pregnancy (EP). The incidence of EPs following infertility treatment is much higher compared with that in spontaneous pregnancies. The occurrence of an EP is very distressing to an infertile couple, who has lots of hopes pinned on the treatment outcome, especially because of the cost incurred and the physical and mental trauma both have gone through during the treatment process. The association between infertility and EP is complex, as it can be a consequence of infertility as well as a cause. The two principal risk factors for an EP are genital tract infections and tubal surgeries. Though several etiologies are proposed, but patients with tubal factor infertility are at an increased risk of an EP. Earlier diagnosis of EP helps to improve prognosis and optimize subsequent fertility. It is pivotal to evaluate the likelihood of subsequent occurrence of an EP and be too vigilant when treating. The correct choice of the treatment modality should be made to prevent the recurrence. The early prediction of the pregnancy outcome therefore has great importance for both the couple and clinician. Today with the help of sensitive beta human chorionic gonadotropin (?-hCG) assays and transvaginal sonography, one can diagnose an EP prior to symptoms, and conservative treatment for the preservation of the fallopian tube is possible. Conservative management in the form of expectant and medical management should be considered as a first-line treatment modality, provided that the overall clinical picture suggests that it is safe to do so. If not, laparoscopic management of EPs appears to be the favored approach of management as compared to laparotomy. PMID:23162353

Patil, Madhuri



Ruptured Interstitial Ectopic Pregnancy at 18 Weeks Gestation Diagnosed by MRI: A Case Report  

PubMed Central

Ectopic pregnancy in the interstitial part of the fallopian tube is a rare event, associated with a high rate of complications due to delayed diagnosis. Rupture of such pregnancy often results in catastrophic hemorrhage. Several reports highlighted the role of magnetic resonance imaging in establishing the diagnosis of interstitial pregnancy, but magnetic resonance imaging findings of a ruptured advanced interstitial ectopic pregnancy have not been published before. The authors therefore present characteristic findings on magnetic resonance imaging of a ruptured interstitial ectopic pregnancy which had reached 18 weeks, in a 25-year-old woman who presented with acute abdominal pain. PMID:24421921

Hamouda, Ehab SM; Littooij, Annemieke S; Thia, Edwin WH; Ong, Chiou L



The ectopic pregnancy, a diagnostic and therapeutic challenge  

PubMed Central

The classic symptoms of ectopic pregnancy are secondary amenorrhoea, abdominal pain and vaginal haemorrhage, with a clinical picture of varying acuteness. It is among the commonest causes of maternal mortality during the first three months of pregnancy In the majority of cases (95%) the pregnancy is tubal, but other sites are possible (cervical, corneal, ovarian, peritoneal). In the treatment of sterility or medically assisted reproduction, the risk of ectopic pregnancy should be borne in mind. The individual risk factors may be cumulative, particularly with a previous history of extrauterine pregnancy or tubal surgery (including sterilisations), pelvic post–inflammatory status (adhesions proved by coelioscopy) or presence of an intrauterine device. Diagnosis is based on serum beta–hCG concentration and transvaginal ultrasound Laparoscopy is the treatment of choice for tubal pregnancies. The decision to perform salpingotomy depends on the presence/status of a contra lateral tube. In carefully selected cases local or intra–muscular administration of methotrexate allows conservative treatment, provided the patient does not present acute bleeding. It is also indicated where trophoblastic tissue persists after surgery, notably salpingostomy, and in non–tubal ectopic pregnancies. The latter are rare, however, and it is important to recognise them in view of the more serious complications. PMID:20108478

Buss, J



Pelvic Ultrasound Performed by Emergency Physicians for the Detection of Ectopic Pregnancy in Complicated First-Trimester Pregnancies  

Microsoft Academic Search

Study objective: To determine the accuracy and application of pelvic ultrasound performed by emergency physicians in detecting ectopic pregnancy (EP) in complicated first-trimester pregnancies. Methods: We studied consecutive pelvic ultrasounds performed in all women who presented with abdominal pain or vaginal bleeding during the first trimester of pregnancy over a 6-month period. Patients with clinical evidence of incomplete abortion were

Britt Durham; Larry Burbridge; Subramaniam Balasubramaniam



A rare case of term viable secondary abdominal pregnancy following rupture of a rudimentary horn: a case report  

Microsoft Academic Search

INTRODUCTION: Abdominal pregnancy is a rare event, but one that represents a grave risk to the health of the pregnant woman. An abdominal pregnancy is defined as an ectopic pregnancy that implants in the peritoneal cavity. Early abdominal pregnancy is self-limited by hemorrhage from trophoblastic invasion with complete abortion of the gestational sac that leaves a discrete crater. Advanced abdominal

Bhandary Amritha; Thirunavukkarasu Sumangali; Ballal Priya; Shedde Deepak; Rai Sharadha



Female Sterilization: Risk of Ectopic Pregnancy After Tubal Sterilization  


... Female Sterilization: Ectopic Pregnancy Back to Female Sterilization Female Sterilization: Risk of Ectopic Pregnancy After Tubal Sterilization ... and Health Promotion Home Contraception Medical Eligibility Criteria Female Sterilization Vasectomy Reproductive Health Home Data and Statistics ...


Ectopic pregnancy comparison of different treatments  

PubMed Central

Objectives: We would like to determine the best treatment option depending of ectopic pregnancy situation. Methods. This is a retrospective cohort study that registered all women admitted in Obstetrics and Gynecologic “Queen Geraldine” Hospital June 2003 until 2008 dicember. There were admitted 228 women diagnosed with Ectopic Pregnancy that were treated in our Hospital. Results: Unruptured ectopic pregnancy is diagnosed in 5,2 week of pregnancy and ruptured ectopic in an average of 6,4 weeks. Surgical intervention is registered in 170 patients and we did tubectomy. Success rate of Methotrexate application was more successful if ?-hCG level was lower. If the ?-hCG level is higher over 10 000 the success rate will decrease in 83 % and in ?-hCG levels over 15 000 the success rate will be until 50%. Conclusions: The treatment will be determined by combination of clinical symptoms, ultrasound examination and ?-hCG levels. MTX is recommended for all women without hemodinamic problems, unruptured pregnancy and low ?-hCG level (?-hCG < 5000 mlU/mL). It is confirmed that the reduction of 15% of ?-hCG in the fourth day after application of MTX is a success guide. PMID:22439058

Kopani, Fatmir; Rrugia, Arben; Manoku, Nikita



Intramural ectopic pregnancy: a case and review of the literature.  


An intramural ectopic is a rare type of ectopic pregnancy in which the gestational sac is implanted within the myometrium, separate from the endometrial cavity and Fallopian tubes. There are only 53 cases in the published literature. We report a case of intramural ectopic pregnancy treated surgically and review the published data on this rare type of ectopic pregnancy, with respect to aetiology, diagnosis and management. PMID:23375906

Kirk, Emma; McDonald, Katie; Rees, Julia; Govind, Abha



Impact of ectopic pregnancy for reproductive prognosis in next generation.  


The impact of an ectopic pregnancy in the next generation is unknown. Our aim was to compare reproductive outcomes in daughters of women with and without ectopic pregnancy. Designed as a historical prospective controlled cohort study with data collected in four Danish registries from 1977-2009, women with ectopic pregnancy during 1977-1982 were age-matched to women without ectopic pregnancy. Daughters of these two cohorts were followed until 2009. We compared 5126 daughters of women with ectopic pregnancy with 19 928 daughters of women without ectopic pregnancy. The daughters of women with ectopic pregnancy had a 1.5-fold (95% confidence interval 1.2-1.9) increased risk of ectopic pregnancy, while for deliveries this was 1.0 (1.0-1.1), for miscarriages 1.1 (1.0-1.2), and for induced abortions 1.3 (1.2-1.4). Daughters of mothers with ectopic pregnancy have a 50% higher risk of ectopic pregnancy than daughters of women without an ectopic pregnancy, but a normal delivery rate. PMID:24655061

Kårhus, Line Lund; Egerup, Pia; Skovlund, Charlotte Wessel; Lidegaard, Øjvind



Dreams of my daughter: an ectopic pregnancy.  


Autoethnographic narrative, personal journal excerpts, and artifacts were employed to narrate the story of my ectopic pregnancy and experiences with the medical field. The name "Doctor" is invoked as a way of objectifying yet protecting the anonymity of the doctor who objectified and did not protect me. A methodological discussion of the following tensions in autoethnography is presented: intimacy/professionality, art/science, showing/explaining. PMID:19092140

Lahman, Maria K E



Transvaginal Endoscopic Surgery for Tubal Ectopic Pregnancy  

PubMed Central

Objective: To explore the feasibility, safety, efficacy, and cosmetic outcomes of transvaginal endoscopic salpingectomy for tubal ectopic pregnancy. Methods: From May 2009 to May 2012, we prospectively enrolled 40 patients, each of whom had been scheduled for a salpingectomy because of a tubal ectopic pregnancy, and randomized them into two groups: transvaginal endoscopic surgery and laparoscopic approach. We recorded the estimated blood loss, time of anal exhaust, postoperative pain score, length of stay, and scar assessment scale associated with transvaginal endoscopic access (n = 18) (natural orifice transluminal endoscopic surgery) and laparoscopic salpingectomy (n = 20) (control group) for tubal ectopic pregnancy. The transvaginal salpingectomy was performed with a double-channel endoscope through a vaginal puncture. A single surgeon performed the surgical procedures in patients in both groups. Results: The group that underwent the transvaginal endoscopic procedure reported lesser pain at all postoperative visits than the group that underwent the laparoscopic approach. The duration of time for transvaginal endoscopic surgery was slightly longer than that for the laparoscopic approach. However, there was no statistically significant difference between the two groups in the duration of operative time. The group that underwent transvaginal endoscopic surgery was more satisfied with the absence of an external scar than the group that underwent the laparoscopic procedure, which left a scar. The estimated blood loss, time of anal exhaust, and length of stay were the same in both groups. Conclusion: The safety and efficacy of transvaginal endoscopic salpingectomy for tubal ectopic pregnancy are equivalent to those of the laparoscopic procedure. Lesser postoperative pain and a more satisfactory cosmetic outcome were found with the transvaginal endoscopic procedure, making it the more preferred method and superior to the laparoscopic approach. PMID:24680148

Xu, Boqun; Liu, Yawen; Fan, Zhining



Incompletely Evaluated ART Leading to Ectopic Pregnancy and Cerebral Thrombosis  

PubMed Central

We presented a cerebral venous thrombosis case associated with lack of proper medical evaluation required for confirmation of suppression and exclusion of current pregnancy before starting assisted reproductive technology (ART) cycle. This is a case-report study about a 37-year-old woman who presented to emergency room with abdominal pain and tenderness. Initial human chorionic gonadotropin (hCG) value was 17616 IU/L. Endometrium was heteregenous and incompatible with a normal intrauterine pregnancy. She had a history of antagonist protocol/controlled ovarian hyperstimulation (COH) started 38 days ago in a different in vitro fertilization (IVF) center. Because of the fertilization failure, she had no embryo transfer. With ectopic pregnancy diagnosis, we made surgical exploration and observed a material which was consistent with ectopic pregnancy on the right tuba uterina. Partial salpingectomy was applied because of actively bleeding ectopic pregnancy. Two days after discharging from hospital; she presented to emergency room again with syncope and generalized tonic-clonic seizure. By cranial tomography generalized edema, cerebral venous thrombosis was established. Enoxaparine sodium 0.6 ml twice daily was administered. Six days after hospitalisation, she was discharged with normal neurological examination under phenytoin 200 mg daily and enoxaparine sodium 0.6 ml daily. Before ART treatment, clinicians must always rule out the likelihood of existing pregnancy by measuring estradiol, follicle stimulating hormone (FSH), and luteinizing hormone (LH). On the other hand, low-molecularweight heparine may be effective in cerebral venous thrombosis treatment. Therefore, intracerebral thrombosis is one of the rare mortal complications of ART. PMID:24520477

Hassa, Hikmet; Aydin, Yunus; Oge, Tufan; Yavuz Tokgoz, Vehbi



Diagnosis and management of intramural ectopic pregnancy.  


Intramural pregnancy, a gestation completely surrounded by the myometrium located within the uterine wall with separation from the uterine cavity, is an extremely unusual form of pregnancy. Complications resulting from intramural pregnancy include inevitable uterine rupture with resultant hemorrhage and possible hysterectomy if diagnosis is not made early and treatment is not initiated. An asymptomatic patient was initially diagnosed with a missed abortion at approximately 6 weeks of gestation after a routine ultrasound. Suction curettage was performed approximately 1 month after the initial diagnosis. The pathology specimen failed to reveal placental villi. Ultimately, the diagnosis of intramural pregnancy was made via ultrasound and a computed tomography scan. She was treated with a single dose of systemically administered methotrexate. Over a period of 4 months, ?-human chorionic gonadotropin levels trended downward; however, the intramural pregnancy failed to resolve completely, and a persistent mass remained. The intramural pregnancy was removed using the da Vinci laparoscopic procedure (Intuitive Surgical, Sunnyvale, CA). If the diagnosis of intramural ectopic pregnancy is made sufficiently early, conservative measures can be taken, which can preserve a patient's future fertility. PMID:24034539

Bannon, Kimberly; Fernandez, Carlos; Rojas, David; Levine, Elliot M; Locher, Stephen



Primary ovarian choriocarcinoma mimicking ectopic pregnancy  

PubMed Central

Nongestational ovarian choriocarcinoma is an exceedingly rare and highly aggressive tumor. Although early diagnosis and timely initiation of therapy is important, it is difficult in reproductive aged patients because of the frequent elevation of human chorionic gonadotropin. We report a primarily nongestational ovarian choriocarcinoma in a 12-year-old virgin female. Initial diagnosis based on abdominopelvic computed tomography and pelvis magnetic resonance imaging was ectopic pregnancy with hemoperitoneum. A diagnostic laparoscopy of the ovarian tumor revealed choriocarcinoma. Unilateral salpingo-oophorectomy and omental sampling revealed surgical stage of IA. Six courses of adjuvant combination chemotherapy (bleomycin, etoposide, and cisplatin) followed surgery. PMID:25105109

Heo, Eun Jin; Choi, Chel Hun; Park, Jung Min; Lee, Jeong-Won; Bae, Duk-Soo



Pitfalls in sonographic diagnosis of abdominal pregnancy.  


Abdominal pregnancy is relatively rare, with an estimated frequency of 1/3,000 pregnancies in this country. We have described serial sonographic findings in an abdominal pregnancy from 28 weeks to term. Particular emphasis is placed on the pitfalls facing the sonographer in the diagnosis of advanced abdominal pregnancy. PMID:7221666

Ali, V; Saldana, L R; Balat, I Y; Katragadda, R



A Rare Localization of Ectopic Pregnancy: Intramyometrial Pregnancy in Twin Pregnancy following IVF.  


Intramyometrial pregnancy is a rare form of ectopic pregnancy. It makes a diagnostic and therapeutic challenge. If misdiagnosed the intramyometrial pregnancy can cause a uterine rupture and become life-threatening condition. We report a case of intramyometrial pregnancy in twin pregnancy following IVF with spontaneous abortion of the first twin At 9 weeks of gestation. The 10 weeks scan showed a normal fetus which was described to be highly localized in the uterus but the diagnosis of intramyometrial pregnancy was not suspected. The patient was admitted at 14 weeks of gestation with pelvic pain, hemorrhage, and shock. She was operated and the diagnosis of ruptured intramyometrial pregnancy was done and managed conservatively. This case illustrates the diagnostic difficulties of intramyometrial pregnancy. We discuss pathophysiology, diagnosis, and treatment of this exceptional form of ectopic pregnancy. PMID:24744925

Boukhanni, Lahcen; Ait Benkaddour, Yassir; Bassir, Ahlam; Aboulfalah, Abdrahim; Asmouki, Hamid; Soummani, Abderraouf



A Rare Localization of Ectopic Pregnancy: Intramyometrial Pregnancy in Twin Pregnancy following IVF  

PubMed Central

Intramyometrial pregnancy is a rare form of ectopic pregnancy. It makes a diagnostic and therapeutic challenge. If misdiagnosed the intramyometrial pregnancy can cause a uterine rupture and become life-threatening condition. We report a case of intramyometrial pregnancy in twin pregnancy following IVF with spontaneous abortion of the first twin At 9 weeks of gestation. The 10 weeks scan showed a normal fetus which was described to be highly localized in the uterus but the diagnosis of intramyometrial pregnancy was not suspected. The patient was admitted at 14 weeks of gestation with pelvic pain, hemorrhage, and shock. She was operated and the diagnosis of ruptured intramyometrial pregnancy was done and managed conservatively. This case illustrates the diagnostic difficulties of intramyometrial pregnancy. We discuss pathophysiology, diagnosis, and treatment of this exceptional form of ectopic pregnancy. PMID:24744925

Ait Benkaddour, Yassir; Bassir, Ahlam; Aboulfalah, Abdrahim; Asmouki, Hamid; Soummani, Abderraouf



[Bilateral tubal ectopic pregnancy in a spontaneous cycle--a case report].  


Ectopic pregnancy occurs in 0.5-2% of all pregnancies. A double ectopic pregnancy is very rare and has the incidence of 1 in 725 ectopic pregnancies. We describe a case of a 30-year-old patient with double ectopic pregnancy located in tubas in spontaneous cycle--diagnosed and treated at the Gynecology and Obstetrics Hospital in Walbrzych. The patient had no risk factors for ectopic pregnancy. This case shows that even the diagnosis of an evident ectopic pregnancy cannot exclude the possibility of a double ectopic pregnancy. PMID:25219147

Kubiaczyk, Filip; Suchocki, S?awomir; Puskarz, Roman; Zaborowski, Adam; Zaranek, Krzysztof



Place of Culdocentesis in the Diagnosis of Ectopic Pregnancy  

PubMed Central

In developing countries the high incidence of anaemia and pelvic infection often makes the diagnosis of ectopic pregnancy difficult. Culdocentesis has been used in 100 doubtful cases out of 144 consecutive cases of ectopic pregnancy. The preoperative diagnosis was correct in 93 out of the 100 cases. There were three false-negative and four false-positive results; only two unnecessary laparotomies were performed. It is suggested that culdocentesis has an essential place in the early diagnosis of doubtful or atypical ectopic pregnancy. It was simple, safe, and reliable. Owing to earlier diagnosis maternal mortality and morbidity and the duration of stay in hospital have all been reduced. PMID:5412946

Lucas, Cynthia



Persistent trophoblastic tissue following salpingostomy for unruptured ectopic pregnancy  

SciTech Connect

Radioimmunoassay of beta-hCG was used to diagnose an ectopic pregnancy in a 30 year old patient and the site of pregnancy was determined by ultrasonography. A salpingostomy was performed; the ectopic pregnancy and the residual trophoblastic tissue were removed. Six weeks later a right salpingectomy was performed to remove persistent trophoblastic tissue. Histologic examination of the surgical specimen demonstrated viable chorionic villi. Serial measurements of beta-hCG are recommended following conservative surgery for ectopic gestation to assure the patient and the surgeon that the tube contains no residual products of conception.

Rivlin, M.E.; Meeks, G.R.; Cowan, B.D.; Bates, G.W.



What Is the Risk for a Second Ectopic Pregnancy?  


... Reading Getting Kids Ready for School Backpack Safety Ebola: What to Know Vaccines Your Child Needs Educators: Free Health Lessons Social Media: Connect With Us What Is the Risk for a Second Ectopic Pregnancy? KidsHealth > Parents > Q& ...


Human Chorionic Gonadotropin Isoforms in the Diagnosis of Ectopic Pregnancy  

Microsoft Academic Search

Background: Early diagnosis of ectopic pregnancy uses ultrasound with serial measurements of total human chorionic gonadotropin (hCG). The objective of this study was to explore the possibility that an isolated measurement of hCG isoforms\\/subunits rather than total hCG could be used as a single test for ectopic pregnancy. Methods: Total and intact hCG, free hCG - and -sub- units (hCG

Paola T. A. Borrelli; Stephen A. Butler; Suzanne M. Docherty; Edyta M. Staite; Antonio L. Borrelli; Ray K. Iles


[The laparoscopic treatment of a rare case of intestinal obstruction due to an ectopic pregnancy].  


A rare case of intestinal occlusion due to primary abdominal pregnancy is described. Laparoscopy revealed normal appendix and bowel obstruction by adhesion between the last ileal loop and cecum. The adhesion started from a neoformation (diameter 2 cm) localised on the mesenteric side of the ileum, about 30 cm from the ileocecal valve. A resection of the adhesion and dissection of the neoformation were performed. Laparoscopic procedures lasted 30 minutes. Histologic examination of the specimen revealed to be an ectopic pregnancy. The laparoscopic technique permitted to verify the diagnosis and perform the treatment of the abdominal pregnancy in absolute conditions of safety, maintaining the fertility of the patient (actually she is presenting a regular pregnancy). PMID:10528484

Catani, M; De Milito, R; Picconi, T; Rattà, G; Manzi, P; Abati, G; Rengo, M



Clinical course of ectopic pregnancy: A single-center experience  

PubMed Central

OBJECTIVES: The objective was to highlight the frequency, clinical profile, and predisposing factors of ectopic pregnancy (EP) in a general hospital. MATERIALS AND METHODS: This descriptive study was conducted at the Obstetrics and Gynaecology department of Hera General hospital, Makkah, Saudi Arabia, from July 1, 2009 to December 29, 2010. Data were collected on chief medical complaints, sociodemographic characteristics, past obstetrics and gynecological history, management done, and outcome of management. Data were analyzed using Microsoft Office Excel (version 2007). RESULTS: Out of total 7564 pregnancies, 44 (0.58%) patients were diagnosed as EP. Out of 44, 22 (50%) patients presented within 24 h of onset of symptoms. Mean age was 28 ± 7 years. Multigravida were predominant in 25 (57%), and 21 (48%) had gestational age of 6-8 weeks at the time of presentation; the common presenting features were amenorrhea (41, 93.2%), abdominal pain (39, 88.6%), and tenderness (38, 86%). Previous pelvic surgery (13, 29.5%), infertility treatment (11, 25%), and pelvic inflammatory disease (10, 22.7%) were the common predisposing factors. Twenty-five (57%) presented with ruptured EP and were operated within 24 h, and the remaining were kept under observation till further diagnosis. After confirming the diagnosis, 12/19 underwent laparoscopy, whereas 7/19 received medical treatment. Surgery confirmed fallopian tube pregnancies in 35 (94.5%). No mortality was observed. CONCLUSION: Previous pelvic surgeries were the major etiological factor for EP. Other factors were infertility treatment and pelvic inflammatory disease. The most common site of EP was fallopian tubes. PMID:23869156

Ayaz, Aqueela; Emam, Sameh; Farooq, Mian Usman



Interstitial Ectopic Pregnancy: Conservative Surgical Management  

PubMed Central

Introduction: Interstitial pregnancy is a rare and life-threatening condition. Diagnosis and appropriate management are critical in preventing morbidity and death. Case Description: Four cases of interstitial pregnancy are presented. Diagnostic laparoscopy followed by laparotomy and cornuostomy with removal of products of conception was performed in 1 case. Laparoscopic cornuostomy and removal of products of conception were performed in the subsequent 3 cases with some modifications of the technique. Subsequent successful reproductive outcomes are also presented. Discussion: Progressively conservative surgical measures are being used to treat interstitial pregnancy successfully, with no negative impact on subsequent pregnancies. PMID:24960482

Warda, Hussein; Mamik, Mamta M.; Ashraf, Mohammad



Trends in Ectopic Pregnancies in Eastern Saudi Arabia  

PubMed Central

Background. The objective of this study was to estimate trends in ectopic pregnancies (EP) in a tertiary care center of Eastern Saudi Arabia. Method. Information about patients with ectopic pregnancies who had been admitted to King Fahd Hospital of the University, AlKhobar, between January 2000 and 31 December 2011 was collected from a computerized hospital registry. Age-specific ectopic pregnancy incidence was calculated. The data was analyzed using SPSS (Statistical Package for the Social Sciences), version 14.0 (Chicago, IL, USA). Results. There were 274 EPs during the study period; the yearly incidence in terms of 24,098 deliveries was 1.19%. The average age was 28.99?Å 5.62 years. During a three-year period (2000–2002), the incidence was 0.92%; from 2003 to 2005, the incidence was 1.01%; from 2006 to 2008, the incidence was 1.51%; and from 2009 to 2011, the incidence was 1.35%. Age-adjusted ectopic pregnancy incidence rates steadily increased from 92.23 per 10,000 women years during the period 2000–2002 to 149.408 during the 2006–2008 period; since then, it has declined to 110.313 per 10,000 women years. Conclusions. Our study reveals that the incidence of EP has decreased from what it had been during the mid-2000s but has remained significantly elevated when compared to the early 2000s. PMID:23533797

Abdulaziz Al-Turki, Haifa



A profile of ectopic pregnancy at Nepal Medical College Teaching Hospital  

Microsoft Academic Search

A retrospective study of ectopic pregnancy at Nepal Medical College Teaching Hospital between January 2001 to June 2006 was carried out to determine incidence, demographic features, clinical presentation, duration at presentation and treatment, and the management protocol. A total of 36 cases of ectopic pregnancy were treated giving the incidence of ectopic pregnancy of 10.2\\/1000 deliveries and 7.3 \\/1000 pregnancies.

Pramila Pradhan; Suman Bahadur Thapamagar; Smriti Maskey


A mediastinal germ cell tumor mimicking an ectopic pregnancy  

PubMed Central

The objective is to report the case of a 36 year-old female with a primary mediastinal germ cell tumor mimicking an ectopic pregnancy. The patient under birth control pill presented, at seven weeks of amenorrhea, a ?-human chorionic gonadotropin (?-hCG) level of 850 UI and uterine vacuity with left lateral uterine heterogeneous mass but no bleeding and no pain. She received left adnexectomy, uterine curettage and further treatment by methotrexate because of persistent high ?-hCG markers. Computed tomography scan finally permitted to discover a voluminous anterior mediastinal tumor. We may recommend investigating patients with a simple chest X-ray that present with persistent increased ?-hCG despite efficient ectopic pregnancy treatment. PMID:22247806

Poingt, Marion; Vandenbossche, Francois; Jougon, Jacques



Previous tubal ectopic pregnancy raises the incidence of repeated ectopic pregnancies in In Vitro fertilization-embryo transfer patients  

PubMed Central

Purpose To investigate the incidence of Tubal Ectopic Pregnancies (TEP) in IVF-ET patients with respect to the status of the fallopian tubes after a previous TEP. Material and methods This retrospective study compares patients undergoing 481 IVF-ET cycles after conservatively or surgically treated TEP(s) with a Control Group (idiopathic or male factor for IVF-ET indication). Medical reports of surgery and/or hysterosalpingograms prior to the IVF cycles classified the status of the fallopian tubes. Results 12 TEPs (8.95%/Pregnancies (PR)) occurred in the Study Group. In the Control Group one TEP (0.75%/PR; p?pregnancies (abortion, biochemical and ectopic PR; (p?=?0.0411)). For statistic evolution logistic regression (PROC GENMOD) and a repeated measure model were applied. Conclusion Women with a previous TEP should be informed about the significantly increased risk for a further TEP in IVF-ET treatment, especially if they are smoking. PMID:19020971

Gruber, Diego; Pernicka, Elisabeth; Bauer, Peter; Feichtinger, Wilfried



Chronic tubal ectopic pregnancy: a rare but challenging diagnosis.  


A 34-year-old woman without any medical history presented to our hospital emergency unit with a history of 4 days of progressively increasing pain in the left iliac fossa, fever and vaginal bleeding for the past 3 weeks. Urine pregnancy test and serum bhCG were negative. CT scan showed a left pelvic mass compatible with a tubo-ovarian abscess. After transfer to our gynaecology unit, transvaginal ultrasound revealed an empty uterus with a heterogeneous mass in the left adnexal area. We performed a laparoscopy, which revealed an enlarged left haematosalpinx with firm adhesions to the surrounding organs, but no abscess. A total left salpingectomy was undertaken and the histopathological examination revealed the presence of chorionic villi, suggesting the diagnosis of chronic ectopic tubal pregnancy. The postoperative course was uneventful. PMID:25082870

Drakopoulos, P; Pluchino, N; Yaron, M; Dällenbach, P



Altered innervation of the fallopian tube in ectopic pregnancy.  


Three cases of ectopic pregnancy demonstrate different patterns of abnormal innervation in the fallopian tube. In the isthmus of the fallopian tube, we observed either (1) loss of nerves in one or more muscle layers of the fallopian tube or (2) large numbers of abnormal nerve profiles in one or more layers of muscle of the fallopian tube. Each woman had a prior history of one or more surgical terminations of pregnancy at indeterminate gestational ages. A proportion of uterine and tubal nerves pass through the uterosacral ligaments to reach the endometrial-myometrial nerve plexus and terminate as the innervation to the ipsilateral fallopian tube. We propose that injuries to the uterosacral ligaments by excessive traction to the cervix, or over-vigorous curettage to the endometrial-myometrial nerve plexus may account for these neuro-immunohistochemical findings. There were no signs of chronic infection or inflammation in the fallopian tube in any of these cases. PMID:25072923

Zhang, X M; Huang, X; Xu, H; Quinn, M J



Role of Minimally Invasive Surgery in the Treatment of Ectopic Pregnancy  

Microsoft Academic Search

Ectopic Pregnancy, in which gestational sac is outside the uterus, is the most common life-threatening emergency in early pregnancy. The incidence of ectopic pregnancy (EP) has increased all over the world from 0.5% thirty years ago, to a present day 1-2%.1 This complication of early pregnancy, results in not only fetal loss, but also the potential for considerable maternal morbidity

Babita Gupta



Jehovah's Witness patients presenting with ruptured ectopic pregnancies: two case reports  

PubMed Central

Introduction The management of emergencies in Jehovah’s Witnesses presents several challenges to obstetricians and gynaecologists. We present two cases of ectopic pregnancies in Jehovah’s Witnesses recently managed in our institution. This is the first case review series of its kind that we could identify. We feel it is of clinical importance for all physicians caring for Jehovah’s Witnesses. Case presentation The first patient was a 28-year-old Caucasian Irish woman who presented in a state of collapse and a ruptured ectopic pregnancy was suspected. She refused treatment and took her own discharge against the advice of senior hospital staff. She re-presented to our Emergency Room 6 hours later in hypovolaemic shock. She ultimately consented to blood products including plasma and platelets and underwent laparoscopic left-sided salpingectomy. This consent was queried postoperatively by her next-of-kin but the validity of her consent was clarified by the hospital legal team. The second patient was a 35-year-old Nigerian woman who presented to our Emergency Room with a 2-week history of intermittent vaginal bleeding and abdominal pain with a haemoglobin of 5.4g/dL. An ectopic pregnancy was diagnosed following assessment. She refused all blood products and underwent right-sided salpingectomy. Intravenous tranexamic acid was administered and cell salvage employed intraoperatively. Conclusions We feel that this case review series emphasises the importance of appropriate management of Jehovah’s Witnesses in our units. In both of the above cases, these women were in potentially life-threatening situations. Advances in haematology and pharmaceutical therapy contributed to their survival. We welcome these advances in the treatment of this patient population. PMID:25238752



Cirugía videoendoscópica y por laparotomía en el embarazo ectópico complicado Videoendoscopic Surgery and by laparotomy in the complicated ectopic pregnancy  

Microsoft Academic Search

Taking into account that 2% of the pregnancies are ectopic and can cause maternal death, a cross- sectional and descriptive study of the operated patients and discharged with diagnostic of complicated ectopic pregnancy was carried out in \\

José Manuel Ricardo Ramírez; Carmen Cisneros Domínguez


A Rare Case of Chronic Ectopic Pregnancy Presenting as Large Hematosalpinx  

PubMed Central

Ectopic pregnancy is defined as implantation and subsequent development of an embryo outside the uterine lining. It has wide range of presentation from acute hemoperitoneum to chronic ectopic pregnancy. This is an unusual case of chronic ectopic pregnancy with large hematosalpinx without classical symptoms. A 22-year-old South Indian woman reported to the outpatient clinic with irregular spotting for a duration of 2 months which was not associated with pain. There was no preceding amenorrhea and previous menstrual cycles were regular. Clinically, the patient was hemodynamically stable but severely anemic. The abdomen was soft on palpation, cervical movements were not tender, and human chorionic gonadotropin was absent in the urine. Ultrasound revealed a complex adnexal mass. Magnetic resonance imaging (MRI) revealed a large hematosalpinx. Laparoscopic left salpingectomy was conducted and histopathology confirmed ectopic pregnancy. Ectopic pregnancy presents diagnostic dilemmas in the absence of classical symptoms. MRI and laparoscopy are important tools in such a diagnostic dilemma. PMID:24812530

Nacharaju, Madhavi; Vellanki, Venkata Sujatha; Gillellamudi, Sarath Babu; Kotha, Vamsi Krishna; Alluri, Abhinaya



Viable intrauterine pregnancy after spontaneous bilateral tubal ectopics in a multiparous woman: a case report  

PubMed Central

Introduction Bilateral ectopic pregnancies are increasing due to an increase in the incidence of pelvic inflammatory disease and increase in assisted reproductive techniques. Spontaneous conception after bilateral ectopic pregnancies is extremely rare. Case presentation A 33-year-old Indian woman presented with ruptured ectopic pregnancy associated with hemoperitoneum for which she underwent a laparotomy. The diagnosis of bilateral ectopic pregnancies was made during surgery. Salpingectomy was done on one side and the other tube was conserved with salpingostomy. Six months after surgery, she conceived spontaneously and a transvaginal ultrasound examination revealed a 5-weeks live intrauterine pregnancy. Conclusion A meticulous surgical technique conserving one fallopian tube resulted in subsequent viable intrauterine pregnancy. The approach to such a case along with steps to minimize tubal damage is presented. PMID:23786635



Linking DNA methylation to the onset of human tubal ectopic pregnancy  

PubMed Central

Ectopic pregnancy is a common reproductive disorder of unknown etiology and is a leading cause of maternal and fetal mortality. Because of the asymptomatic nature of early tubal ectopic pregnancy and the lack of specific biomarkers for early diagnosis, a better understanding of the complex cellular and molecular interactions that contribute to tubal ectopic pregnancy is required. DNA methylation is the most studied epigenetic process in various tissues and cells, and the goal of this article is to provide a brief review of recent work describing the potential mechanisms of DNA methylation and the biological function of such methylation in normal intrauterine pregnancy. Further, novel findings from our laboratory highlight the possible role of DNA methylation in human Fallopian tube dysfunction and suggest a possible correlation between methylation of estrogen receptor ? in women and the occurrence of tubal ectopic pregnancies. PMID:23573357

Wang, Lei; Feng, Yi; Zou, Shien; Brännström, Mats; He, Lin; Billig, Håkan; Shao, Ruijin



Unexpected outcome after expectant management of ectopic pregnancy in two persons  

PubMed Central

Background: Ectopic pregnancy is one of the main problems in women in reproductive age that needs special attention and appropriate strategy should be managed. In some cases expectant management seems good strategy without any medicine or surgery and their possible side effects. But are the outcomes always the same? Which outcomes should we expect? Case: We have reported 2 patients whose ectopic pregnancy had been managed conservatively and they had sustained pain for several months which needed surgery to resolve. Conclusion: In the case of ectopic pregnancy, it is important for the clinician to select the patient meticulously and be aware of common and rare consequences of her treatment. PMID:24639730

Hosseini, Reihaneh; Asgari, Zahra; Moini, Ashraf



Transabdominal ultrasonography diagnosis of ectopic twin gestation  

Microsoft Academic Search

The coexistence of ectopic and intrauterine pregnancy is rare; presence of ectopic twin is even less frequent. We report a rare case of live ectopic tubal twin gestation, which detected preoperatively at 11 weeks of gestation by transabdominal sonography, when patient experienced severe lower abdominal pain.

Gamanagatti Shivanand; Deep Narayana Srivastava; Hiralal; S. Subramanian



A successful pregnancy outcome following abdominal metroplasty.  


A 35 years old lady presented to Out Patients Department of Bangabandhu Sheikh Mujib Medical University for secondary subfertility with history of recurrent abortion. She was diagnosed a case of bicornuate uterus following laparoscopy. After 3 months of her last abortion she was advised for metroplasty. Metroplasty was done, forming a single cavity. Dye test was positive on right side and negative on left side. After 3 months of metorplasty hysterosalphingography (HSG) was done and reports shows bilateral patent uterine tubes. One year after metroplasty. She was pregnant with letrozole and Gonadotrophin. Her pregnancy was diagnosed by ultrasonography and advised for admission. She was on regular antenatal follow up and all investigation was done. Anomaly scan was done at 20 weeks of pregnancy. She was properly immunized. Pregnancy period was uneventful until 37 weeks. At 37 weeks LUCS was done. A female healthy baby was born. APGAR score was 7/10 at 1, 10/10 at 5 minutes, baby weight 2.8kg postpartum period was uneventful. After abdominal metroplasty successful pregnancy outcome was occurred. PMID:24292323

Banu, J; Fatima, P; Sultana, P; Begum, N; Anwary, S A; Chowdhury, M A



42 CFR 441.207 - Drugs and devices and termination of ectopic pregnancies.  

...SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES Abortions § 441.207 Drugs and devices and termination of ectopic pregnancies. FFP is available in expenditures for drugs...



Combination gefitinib and methotrexate treatment for non-tubal ectopic pregnancies: a case series  

PubMed Central

Non-tubal ectopic pregnancies are a rare subgroup of ectopic pregnancies implanted at sites other than the Fallopian tube. Mortality from non-tubal ectopic pregnancies is higher compared with that for tubal ectopic pregnancies, and they are becoming more common, partly due to the rising incidence of Caesarean sections and use of assisted reproductive technologies. Non-tubal ectopic pregnancies can be especially difficult to treat. Surgical treatment is complex, and follow-up after medical treatment is usually protracted. There is therefore a need for more effective medical therapies to resolve non-tubal ectopic pregnancies and reduce operative intervention. We have recently reported successful use of combination gefitinib (an orally available epidermal growth factor receptor inhibitor) and methotrexate for treatment of tubal pregnancies. To our knowledge, this combination has not been used to treat non-tubal pregnancies. Here we report the use of combination gefitinib and methotrexate to treat eight women with stable, non-tubal ectopic pregnancies at two tertiary academic teaching hospitals (Edinburgh, UK and Melbourne, Australia); five interstitial and three Caesarean section scar ectopic pregnancies. Pretreatment serum hCG levels ranged from 2458 to 48 550 IU/l, and six women had pretreatment hCG levels >5000 IU/l. The women were co-administered 1–2 doses of i.m. methotrexate (50 mg/m2 on Day 1, ± Day 4 or Day 7) with seven once daily doses of oral gefitinib (250 mg). The women were monitored until complete resolution of the ectopic pregnancy, defined as a serum hCG <15 IU/l. Time to resolution (days from first methotrexate dose until serum hCG <15 IU/l), safety and tolerability, complication rates and subsequent fertility outcomes were also recorded. All eight women were successfully treated with combination gefitinib and methotrexate. The most common side effects were transient acne/rash and diarrhoea, known side effects of gefitinib. All women promptly resumed menstruation and importantly, three women subsequently conceived spontaneously. Two have delivered a healthy infant at term and the third is currently in her second trimester of pregnancy. Hence, our case series supports a future clinical trial to determine the efficacy of combination gefitinib and methotrexate to treat non-tubal ectopic pregnancies. PMID:24812320

Horne, A.W.; Skubisz, M.M.; Tong, S.; Duncan, W.C.; Neil, P.; Wallace, E.M.; Johns, T.G.



Uterine artery embolization for management of interstitial twin ectopic pregnancy: Case report  

Microsoft Academic Search

Interstitial pregnancy is rare and dangerous variation of ectopic pregnancy. We describe a case of unilateral inter- stitial viable twin pregnancy treated by selective uterine artery embolization. A 23-year-old women with clinical and ultrasonic diagnosis of viable twin interstitial pregnancy was treated by selective uterine artery embolization after failure of systemic methotrexate treatement. Her serum b-HCG was undetectable 2 months

E. Ophir; J. Singer-Jordan; M. Oettinger; M. Odeh; R. Tendler; Y. Feldman; V. Fait; J. Bornstein



Combined use of serum HCG and sonography in the diagnosis of ectopic pregnancy  

SciTech Connect

During an 18 month period, 320 patients were referred with clinical suspicion of an ectopic pregnancy. This study is based on 19 patients with ectopic pregnancy who had both a sonographic examination of the pelvis and determination of serum beta human chorionic gonadotropin (HCG) before surgery. Emphasis is focused on the spectrum of sonographic appearances that may occur in ectopic gestation. These are illustrated, and the sonographic criteria that have been used both for a positive diagnosis and for the exclusion of ectopic pregnancy in the past are analyzed. It is suggested that the accuracy of sonography can be increased by determining the serum HCG level on the day of the scan and by interpreting the findings with reference to the discriminatory HCG zone.

Kadar, N.; Taylor, K.J.W.; Rosenfield, A.T.; Romero, R.



Advanced abdominal pregnancy: an increasingly challenging clinical concern for obstetricians  

PubMed Central

Advanced abdominal pregnancy is rare. The low incidence, high misdiagnosis rate, and lack of specific clinical signs and symptoms explain the fact that there are no standard diagnostic and treatment options available for advanced abdominal pregnancy. We managed a case of abdominal pregnancy in a woman who was pregnant for the first time. This case was further complicated by a concurrent singleton intrauterine pregnancy; the twin pregnancy was not detected until 20 weeks of pregnancy. The case was confirmed at 26 weeks gestational age using MRI to be an abdominal combined with intrauterine pregnancy. The pregnancy was terminated by cesarean section at 33 + 5 weeks gestation. We collected the relevant data of the case while reviewing the advanced abdominal pregnancy-related English literature in the Pubmed, Proquest, and OVID databases. We compared and analyzed the pregnancy history, gestational age when the diagnosis was confirmed, the placental colonization position, the course of treatment and surgical processes, related concurrency rate, post-operative drug treatment programs, and follow-up results with the expectation to provide guidance for other physicians who might encounter similar cases. PMID:25337188

Huang, Ke; Song, Lei; Wang, Longxia; Gao, Zhiying; Meng, Yuanguang; Lu, Yanping



The accuracy of transvaginal ultrasonography for the diagnosis of ectopic pregnancy prior to surgery  

E-print Network

to surgery George Condous1,4 , Emeka Okaro1 , Asma Khalid1 , Chuan Lu2 , Sabine Van Huffel2 , D Timmerman3 and Tom Bourne1 1 Early Pregnancy, Gynaecological Ultrasound and Minimal Access Surgery Unit, St George undergoing surgery for presumed ectopic pregnancy. METHODS: A prospective, observa- tional study. Women were


Outcome Analysis of a Protocol Including Bedside Endovaginal Sonography in Patients at Risk for Ectopic Pregnancy  

Microsoft Academic Search

Study objectives: To determine whether bedside endovaginal sonography (EVS) performed by emergency physicians reduces complications associated with ectopic pregnancy (EP) including missed EP and EP rupture. Methods: Our setting was an urban trauma center emergency department. We assembled a prospective convenience sample (n=314) with a historical EP control group (n=56) of women 18 years or older with a positive pregnancy

James R Mateer; Verena T Valley; E. James Aiman; Mary Beth Phelan; Margaret E Thoma; Michael P Kefer



The METEX study: Methotrexate versus expectant management in women with ectopic pregnancy: A randomised controlled trial  

Microsoft Academic Search

BACKGROUND: Patients with ectopic pregnancy (EP) and low serum hCG concentrations and women with a pregnancy of unknown location (PUL) and plateauing serum hCG levels are commonly treated with systemic methotrexate (MTX). However, there is no evidence that treatment in these particular subgroups of women is necessary as many of these early EPs may resolve spontaneously. The aim of this

Norah M van Mello; Femke Mol; Albert H Adriaanse; Erik A Boss; Antonius B Dijkman; Johannes PR Doornbos; Mark Hans Emanuel; Jaap Friederich; Loes van der Leeuw-Harmsen; Jos P Lips; Evert JP van Santbrink; Harold R Verhoeve; Harry Visser; Willem M Ankum; Fulco van der Veen; Ben W Mol; Petra J Hajenius



Genital Schistosomiasis Leading to Ectopic Pregnancy and Subfertility: A Case for Parasitic Evaluation of Gynaecologic Patients in Schistosomiasis Endemic Areas  

PubMed Central

Female genital schistosomiasis is a significant risk factor for ectopic pregnancy and infertility in schistosomiasis-endemic areas. A case of one previous ectopic pregnancy and subsequent obstruction of the contralateral tube in a secondary subfertility patient with chronic genital schistosomiasis is presented, emphasizing the need for a detailed history and parasitic evaluation of patients presenting with ectopic pregnancy or subfertility in areas where the disease is endemic. PMID:23984134

Owusu-Bempah, Atta; Odoi, Alexander Tawiah; Dassah, Edward Tieru



The Lin28/Let-7 System in Early Human Embryonic Tissue and Ectopic Pregnancy  

PubMed Central

Our objective was to determine the expression of the elements of the Lin28/Let-7 system, and related microRNAs (miRNAs), in early stages of human placentation and ectopic pregnancy, as a means to assess the potential role of this molecular hub in the pathogenesis of ectopic gestation. Seventeen patients suffering from tubal ectopic pregnancy (cases) and forty-three women with normal on-going gestation that desired voluntary termination of pregnancy (VTOP; controls) were recruited for the study. Embryonic tissues were subjected to RNA extraction and quantitative PCR analyses for LIN28B, Let-7a, miR-132, miR-145 and mir-323-3p were performed. Our results demonstrate that the expression of LIN28B mRNA was barely detectable in embryonic tissue from early stages of gestation and sharply increased thereafter to plateau between gestational weeks 7–9. In contrast, expression levels of Let-7, mir-132 and mir-145 were high in embryonic tissue from early gestations (?6-weeks) and abruptly declined thereafter, especially for Let-7. Opposite trends were detected for mir-323-3p. Embryonic expression of LIN28B mRNA was higher in early stages (?6-weeks) of ectopic pregnancy than in normal gestation. In contrast, Let-7a expression was significantly lower in early ectopic pregnancies, while miR-132 and miR-145 levels were not altered. Expression of mir-323-3p was also suppressed in ectopic embryonic tissue. We are the first to document reciprocal changes in the expression profiles of the gene encoding the RNA-binding protein, LIN28B, and the related miRNAs, Let-7a, mir-132 and mir-145, in early stages of human placentation. This finding suggests the potential involvement of LIN28B/Let-7 (de)regulated pathways in the pathophysiology of ectopic pregnancy in humans. PMID:24498170

Steffani, Liliana; Martinez, Sebastian; Monterde, Mercedes; Ferri, Blanca; Nunez, Maria Jose; AinhoaRomero-Espinos; Zamora, Omar; Gurrea, Marta; Sangiao-Alvarellos, Susana; Vega, Olivia; Simon, Carlos; Pellicer, Antonio; Tena-Sempere, Manuel



A rare case of acute leukemia relapsing with a granulocytic sarcoma causing ectopic pregnancy.  


A 33 year old female was admitted to department of obstetric and gynaecology with profuse vaginal bleeding. She was diagnosed with acute myeloid leukemia 3 months ago. Pelvic ultrasound was unremarkable. Since vaginal bleeding persisted despite normal platelet counts low dose methotrexate was administered with the presumptive diagnosis of ectopic pregnancy. A laparoscopic investigation was performed as she did not respond to this treatment which revealed an intraluminal ectopic pregnancy in her right fallopian tube. A pathological specimen was obtained. Granulocytic sarcoma is an infiltrate of immature granulocytic precursor cells in an extramedullary site. To best of our knowledge, this case is the third patient with GS in the fallopian tube and the first case causing ectopic pregnancy. PMID:25332544

Pamukçuo?lu, Merve; Acar, Kadir; Akyürek, Nalan; Sucak, Gülsan Türköz



Viable abdominal pregnancy: a case report in Yaoundé (Cameroon).  


We herein report a case of abdominal pregnancy managed in Yaounde (Cameroon). The 33 year old G5P2022 woman was referred to our setting for management of an abdominal pregnancy of 34 weeks diagnosed during the first routine obstetrical ultrasonography done two days earlier. This ultrasonography revealed a live foetus within intestinal loops with a severe oligoamnios. After two days of lung maturation, laparotomy was carried out and the live male baby weighed 2 600 grammes. The placenta was left on its implantation sites: omentun, uterine fundus and intestinal loops. The mother did well post-operatively and the resorption of the placenta took 11 months. The newborn presented compression deformities and died three days later of respiratory distress. This case illustrates that intra-abdominal fetuses can reach viability. Though rare, abdominal pregnancy remains a threat to mothers. Practitioners should therefore know the traps in its management. PMID:25419308

Fouelifack, Florent Ymele; Fouogue, Jovanny Tsuala; Fouedjio, Jeanne Hortence; Sando, Zacharie



A United Kingdom national survey of trends in ectopic pregnancy management.  


Our national survey demonstrates increased use of medical and laparoscopic management of ectopic pregnancy in the UK. In the UK in 2000, 35% of cases were managed by laparoscopy, 63% by laparotomy and 1% with medication. A recent review in the USA revealed increasing rates of medical management and decreasing rates of laparotomy; a trend driven by both cost-effectiveness and patient choice. A total of 119 early pregnancy units were surveyed regarding the nature and management of the three most recent cases of ectopic pregnancy; in addition, feasibility of training residents was also requested. Participants reported on 124 cases with a median of five cases per month per department. A total of 57% of cases were managed laparoscopically, 31% medically, 5% by laparotomy and 6% conservatively. Out of 44 centres, 29 have the facilities for training in both intermediate laparoscopic surgery and early pregnancy ultrasound. PMID:24766292

Taheri, M; Bharathan, R; Subramaniam, A; Kelly, T



Gonadotropin-producing benign cystic teratoma simulating a ruptured ectopic pregnancy.  

PubMed Central

Benign cystic teratomas are asymptomatic in many cases. There are some reports of production of thyroid-stimulating hormone, estrogen, testosterone, and prolactin by these tumors. This article reports a patient in whom a twisted cystic teratoma simulated ruptured ectopic pregnancy by beta human chorionic gonadotropin production and hemorrhage into the peritoneal cavity. PMID:7514671

Pothula, V.; Matseoane, S.; Godfrey, H.



Ectopic pregnancy treatment Australia n Malaysia n South Africa n Italy n India  

E-print Network

) and a tablet (EGFR inhibition) to medically cure ectopic pregnancies instead of surgery. The placenta is critically dependent on the Epidermal Growth Factor Receptor pathway (EGFR) to survive. Thus, blocking EGFR the highest levels of EGFR expression of any non-malignant tissue in the body. We have undertaken extensive

Albrecht, David


Conservative Management of an Advanced Abdominal Pregnancy at 22 Weeks  

PubMed Central

Objective?We report an uneventful conservative approach of an advanced abdominal pregnancy discovered at 22 weeks of gestation. Study Design?This study is a case report. Results?Attempting to extend gestation of an advanced abdominal pregnancy is not a common strategy and is widely questioned. According to the couple's request, the management consisted in continuous hospitalization, regular ultrasound scan, and antenatal corticosteroids. While the woman remained asymptomatic, surgery was planned at 32 weeks, leading to the birth of a preterm child without any long-term complications. Placenta was left in situ with a prophylactic embolization, and its resorption was monitored. Conclusion?Depending on multidisciplinary cares and agreement of the parents, when late discovered, prolonging advanced abdominal pregnancy appears to be a reasonable option. PMID:25032062

Marcellin, Louis; Menard, Sophie; Lamau, Marie-Charlotte; Mignon, Alexandre; Aubelle, Marie Stephanie; Grange, Gilles; Goffinet, Francois



[Laparoscopic resection of an interstitial ectopic twin pregnancy resection: the role of barbed sutures in haemostatic control].  


Interstitial pregnancy is a dangerous and uncommon variation of ectopic pregnancy occurring in the interstitial part of the fallopian tube and extending beyond the muscular layer of the uterus. This ectopic pregnancy-related mortality rate has been reported to be as high as 2%-2,5% due to complications involving bleeding and hypervascularity. No prospective clinical trials have evaluated available treatment options for interstitial ectopic pregnancy due to its low incidence; there is thus no consensus regarding optimal treatment. Surgical treatment can be divided into conservative approaches, such as cornuectomy or cornuostomy, and radical approaches such as hysterectomy. However, intraoperative hemorrhage is an ever-present risk, regardless of the surgical approach adopted. This paper presents a case involving a patient who underwent laparoscopic resection of an interstitial twin ectopic pregnancy; a barbed suture pursestring was used which proved useful during the surgical technique and improved hemostasia. PMID:23405508

Cardoso Medina, Byron; Hernández Giraldo, Cristian; Manual Clavijo, Juan; Sarmiento, Piedad



Is Surgical Intervention for Ectopic Pregnancy in a Low Resource Set-Up Avoidable?  

PubMed Central

Background:Ectopic pregnancy is one of the most common life threatening complications in the first trimester of pregnancy having significant adverse effects on future pregnancy outcome, particularly if salpingectomy is used as the modality of treatment. So medical management is now advocated. For that, cases need to be diagnosed at an earlier stage. Keeping these backgrounds in mind we took up this study to look into the feasibility of conservative management– both medical and surgical - in a tertiary care centre. Aims:To find out the demographic profile and risk factors of the ectopic pregnancy cases; the clinical presentation of the cases; the mode of treatment offered to the patients. Materials and Methods:It was a record based retrospective study.All the patients diagnosed as ectopic pregnancy in a tertiary care hospital from January, 2011 to December, 2012, was included in the study. Results:A total of 234 ectopic cases (1.5% of total deliveries) were recorded, constituting 5.4% of total gynaecological emergencies of this institute. Majority of patients were multigravida (74.4%) and of age group of 26-30years (35.9%). Fallopian tube was the most common site (99.1%) with only two cases in ovary. Ampulla (71.4%) was found to be most frequent site for implantation in fallopian tube. Pelvic inflammatory diseases (38.5%) and past history of induced abortion (35.9%) were major risk factors. Most patients (63.3%) did not use any contraceptives and 30.3% patients used OCP intermittently. No patient presented before 4weeks of gestation, while 69.2% presented between 4-7weeks and the rest beyond 7week. They presented with shock in 44.9% cases. Surgical treatment was offered in 98.3% cases, while medical treatment was offered to only four cases. Conclusion:There is a huge surgical burden due to ectopic pregnancy impinging on our hospital resources. Surgery is resorted to indiscriminately for even those cases that could have been medically treated otherwise. Hence, the need to change the mindset of the care-providers at all levels to opt for medical management of ectopic pregnancy wherever applicable. PMID:25386488

Babu, Anindita Sinha; Das, Dipanwita; Banerjee, Dipankar



Activin A and Follistatin as Biomarkers for Ectopic Pregnancy and Missed Abortion  

PubMed Central

Activin A as a predictor of pregnancy failure has been the focus of heated debate, but the value of a combined activin A and follistatin (FS) measurement in serum to predict pregnancy failure has not been reported yet. We assessed whether a single serum measurement of the two physiological antagonists at 6–8 weeks gestation could differentiate ectopic pregnancies (EP) or missed abortions (MA) from healthy intrauterine pregnancies (IUP). activin A concentrations were significantly lower in women with EP (n = 30, median value of 264?pg/mL) and women with MA (n = 30, median value of 350?pg/mL) compared to IUP (n = 33, median value of 788?pg/mL); P < 0.001. At a threshold value of 505?pg/mL, activin A had 87.9% sensitivity and 100% specificity and negative predictive value of 0.974 for discriminating an ectopic pregnancy from viable pregnancies. FS was able to discriminate IUP from EP (ROC curve P < 0.001) as was their ratio (ROC curve P = 0.008), but was unable to discriminate a MA from an EP. In EP, activin A did not correlate with beta HCG levels. The present findings support the thesis that activin A or FS could be considered promising biomarkers for the discrimination between an IUP and a failed pregnancy (MA or EP). PMID:24222717

Deligeoroglou, Efthimios; Garas, Antonios; Hadjichristodoulou, Christos; Messinis, Ioannis E.



Can Mean Platelet Volume and Platelet Distrubition Width be Possible Markers for Ectopic Pregnancy and Tubal Rupture? (MPV and PDW in Ectopic Pregnancy)  

PubMed Central

Objective: We aimed to evaluate the alterations in serum levels of platelet indices such as mean platelet volume (MPV) and platelet distribution width (PDW) in ectopic pregnancy (EP) and discuss the mechanism of the alterations in MPV and PDW. Methods: This retrospective evaluation of 153 tubal EP patients (39 ruptured and 114 non-ruptured) admitted to our clinic between 2009 and 2013 and 67 healthy pregnancies was conducted. The data regarding the maternal age, hemoglobin level, platelet level, MPV, PDW was analyzed. Results: MPV was lower in the EP, especially in ruptured EP, compared to control group. However, no significant difference could be found between the groups (p=0.616). PDW was higher in the EP, especially in ruptured EP, compared to control group, however there was no statistical difference between the three groups (p=0.451). Platelet counts were significantly lower in ruptured EP compared to non-ruptured ectopic pregnancies and control groups (p=0.005). Conclusions: MPV seems to be lower in ruptured EP suggesting the possible high grade inflammation in pathology. Platelet counts tend to be lower in ruptured EP suggesting the consumption of the platelets at the inflammation site. However, further studies are needed to describe the usefulness of the platelet indices in the diagnosis and clinical follow-up of EP. Our preliminary results show that MPV levels may decrease in the ruptured EP cases. At the same time, PDW levels may increase. PMID:24772142

Artunc Ulkumen, Burcu; Pala, Halil Gursoy; Calik, Esat; Oruc Koltan, Semra



The role of estrogen in the pathophysiology of tubal ectopic pregnancy  

PubMed Central

17?-estradiol, acting through estrogen receptors ? and ?, plays a fundamental role in the regulation of Fallopian tube cell homeostasis and in the modulation of normal tubal physiological processes. Fluctuations in E2 levels also play crucial roles in the initiation or progression of numerous human diseases. Fallopian tube malfunction often results in tubal ectopic pregnancy, which is one cause of maternal morbidity and mortality in women. Several factors have been proposed to be associated with increased risk of tubal ectopic pregnancy, but whether these factors are the cause of, or are merely symptoms of, such pregnancies remains unresolved due to the lack of knowledge in regards to the mechanisms by which embryos inadvertently implant in the Fallopian tube. This review summarizes recent findings, including data from our own laboratory, on E2 metabolism and estrogen receptor (ER) subtype expression within the Fallopian tube in humans and rodents. This review also outlines several important, unresolved questions in the field that, once addressed, could offer important clues into how E2/ER signaling contributes to the pathology of tubal function. A better understanding of the specific functions of estrogen receptor subtypes in vivo, as well as of the mechanism and consequences of receptor subtype interactions is critical to understanding their respective roles in Fallopian tube physiology and in the pathophysiology and etiology of tubal ectopic pregnancy. PMID:22937205

Shao, Ruijin; Feng, Yi; Zou, Shien; Weijdegard, Birgitta; Wu, Gencheng; Brannstrom, Mats; Billig, Hakan



Embarazo ectópico abdominal. Diagnóstico y tratamiento médico con metotrexato  

Microsoft Academic Search

Abdominal pregnancy is a rare form of ectopic pregnancy and is associated with high maternal and fetal morbidity and mortality. The diagnosis of this entity is difficult and is generally delayed. We report the case of a patient with an abdominal pregnancy diagnosed by transvaginal ultrasound in the first trimester of pregnancy. The patient was treated with methotrexate until complete

Yasmina José Gutiérrez; Álvaro Alvir Alvaro; José Manuel Campillos Maza; Pilar Garrido Fernández; Belén Rodríguez Solanilla; Sergio Castán Mateo



The Evolution of Methotrexate as a Treatment for Ectopic Pregnancy and Gestational Trophoblastic Neoplasia: A Review  

PubMed Central

Methotrexate was developed in 1949 as a synthetic folic acid analogue to compete with folic acid and thus interfere with cell replication. While initially developed as a potential treatment for acute lymphoblastic leukaemia, a serendipitous observation led to methotrexate's use to effect the dramatic cure of a case of advanced choriocarcinoma. This prompted the exploration for the potential of methotrexate to treat other conditions involving disordered trophoblastic tissue. Methotrexate has subsequently revolutionized the treatment of two pregnancy-related conditions—gestational trophoblastic neoplasia and ectopic pregnancy. This article reviews the development of modern treatment protocols that use methotrexate to medically treat these two important gynaecological conditions. PMID:22462004

Skubisz, Monika M.; Tong, Stephen



Can ratio of blood/curettage material HCG be used as a reliable method for differentiating miscarriage and ectopic pregnancy?  

PubMed Central

Objective : There is an increasing rate of ectopic pregnancy with the use of assisted reproductive techniques. There is currently no serum test to differentiate ectopic pregnancy from miscarriage. Early and accurate detection of ectopic pregnancy may prevent the development of complications. The aim of this study was whether the ratio of serum/curettage material hCG could provide us with reliable and early diagnosis in distinguishing miscarriage and ectopic pregnancies and also to measure the diagnostic accuracy rate of this method. Methods: A total of 24 patients were evaluated. Twelve of them were diagnosed as an ectopic pregnancy and 12 of them were diagnosed as a miscarriage. All the patients’ diagnoses were confirmed pathologically. Non-of the patient had viable fetus. All participants underwent curettage protocol. Serum and curettage material were obtained at the same time. HCG measurements were done from blood and curettage material. Results: Ratio of Blood/Curettage Material HCG provides fast and reliable results within a few hours with 91.7% accuracy rates. Conclusion: Ratio of blood/curettage material HCG can be used as a reliable method for differentiating ectopic pregnancy and miscarriage. PMID:24353723

Acmaz, Gokhan; Aksoy, Huseyin; Bayraktar, Evrim; Baser, Muruvvet; Zararsiz, Gokmen; Ipek Muderris, Iptisam



Embarazo abdominal secundario tras una esterilización tubárica  

Microsoft Academic Search

The ectopic pregnancy appears in the 10-12% of cases after tubal sterilization and it is usually located in the tube. 1% of ectopic pregnancies are abdominal and the implantation in omentum is a rare condition with only 16 described cases. According to Studdiford, they can be classified as primary or secondary depending on whether they are originated or not in

Elena M. Losa Pajares; Marco A. Arones Collantes; Leyre Gil Martínez-Acacio; Alejandro Pascual Martín; Vicente Almodóvar Rico; Gaspar González de Merlo



Acute abdominal and pelvic pain in pregnancy: ESUR recommendations.  


Acute abdominal pain in pregnancy presents diagnostic and therapeutic challenges. Standard imaging techniques need to be adapted to reduce harm to the fetus from X-rays due to their teratogenic and carcinogenic potential. Ultrasound remains the primary imaging investigation of the pregnant abdomen. Magnetic resonance imaging (MRI) has been shown to be useful in the diagnosis of gynaecological and obstetric problems during pregnancy and in the setting of acute abdomen during pregnancy. MRI overcomes some of the limitations of ultrasound, mainly the size of the gravid uterus. MRI poses theoretical risks to the fetus and care must be taken to minimise these with the avoidance of contrast agents. This article reviews the evolving imaging and clinical literature on appropriate investigation of acute abdominal and pelvic pain during established intrauterine pregnancy, addressing its common causes. Guidelines based on the current literature and on the accumulated clinico-radiological experience of the European Society of Urogenital Radiology (ESUR) working group are proposed for imaging these suspected conditions. PMID:23990045

Masselli, Gabriele; Derchi, Lorenzo; McHugo, Josephine; Rockall, Andrea; Vock, Peter; Weston, Michael; Spencer, John



Full-Term Abdominal Pregnancy: A Case Report and Review of the Literature  

Microsoft Academic Search

Background: Abdominal pregnancy is a rare, life-threatening condition. Case: A 30-year-old pregnant, gravida 3, para 1, was presented to hospital at 38 weeks gestation. She suffered from abdominal pain at 16 weeks gestation. At admission, obstetrical examination and transabdominal ultrasonography revealed that it was uterine pregnancy with a single living fetus and oligohydramnios. The diagnosis of abdominal pregnancy was made

Jianping Zhang; Fen Li; Qiu Sheng



ADAM-12 as a Novel Marker for the Diagnosis of Ectopic Pregnancy  

PubMed Central

Objective To evaluate the performance of a novel biomarker, a disintegrin and metalloprotease -12 (ADAM-12), to differentiate an ectopic pregnancy (EP) from normal intrauterine pregnancies (IUP). Design Case-control study Setting Three urban academic centers Patients Women who presented to the emergency room with pain or bleeding in the first trimester of pregnancy Intervention Sera from women with diagnosed EP or intrauterine pregnancy (IUP) were evaluated via proteomics and an ADAM-12 dissociation-enhanced lanthanide fluoroimmunoassay Main outcome measures Differences between groups, area under the receiver operating curve, sensitivity and specificity Results Via a proteomics evaluation, we found a statistically significant decrease in ADAM-12 in the sera of patients with EP, which we confirmed in a larger group of 199 patients (median IUP 18.6ng/ml versus median EP 2.5ng/ml, p <0.0001) with good discrimination between the groups as assessed by receiver operating characteristics (AUC=0.82). At a low cut-point, the sensitivity was 70% and specificity 84%, but at a higher cut-point optimizing sensitivity, the ADAM-12 test demonstrated a sensitivity of 97%. Conclusions ADAM-12 is a promising marker for the diagnosis of EP in symptomatic first trimester women, validating the proteomics findings. Further studies on additional patient populations and in combination with other biomarkers are needed. PMID:21277576

Rausch, Mary E; Beer, Lynn; Sammel, Mary D.; Takacs, Peter; Chung, Karine; Shaunik, Alka; Speicher, David; Barnhart, Kurt T



Evaluation of ADAM-12 as a Diagnostic Biomarker of Ectopic Pregnancy in Women with a Pregnancy of Unknown Location  

PubMed Central

Background Ectopic pregnancy (EP) remains the most life-threatening acute condition in modern gynaecology. It remains difficult to diagnose early and accurately. Women often present at emergency departments in early pregnancy with a ‘pregnancy of unknown location’ (PUL) and diagnosis/exclusion of EP is challenging due to a lack of reliable biomarkers. Recent studies suggest that serum levels of a disintegrin and metalloprotease protein-12 (ADAM-12) can be used differentiate EP from viable intrauterine pregnancy (VIUP). Here we describe a prospective study evaluating the performance of ADAM-12 in differentiating EP from the full spectrum of alternative PUL outcomes in an independent patient cohort. Methodology/Principal Findings Sera were collected from 120 patients at their first clinical presentation with a PUL and assayed for ADAM-12 by ELISA. Patients were categorized according to final pregnancy outcomes. Serum ADAM-12 concentrations were increased in women with histologically-confirmed EP (median 442 pg/mL; 25%–75% percentile 232–783 pg/mL) compared to women with VIUP (256 pg/mL; 168–442 pg/mL) or miscarriage (192 pg/mL; 133–476 pg/mL). Serum ADAM-12 did not differentiate histologically-confirmed EP from spontaneously resolving PUL (srPUL) (416 pg/mL; 154–608 pg/mL). The diagnostic potential of ADAM-12 was only significant when ‘ambiguous’ PUL outcomes were excluded from the analysis (AROC?=?0.6633; P?=?0.03901). Conclusions/Significance When measured in isolation, ADAM-12 levels had limited value as a diagnostic biomarker for EP in our patient cohort. The development of a reliable serum biomarker-based test for EP remains an ongoing challenge. PMID:22927907

Horne, Andrew W.; Brown, Jeremy K.; Tong, Stephen; Kaitu'u-Lino, Tu'uhevaha



The Association between Smoking and Ectopic Pregnancy: Why Nicotine Is BAD for Your Fallopian Tube  

PubMed Central

Epidemiological studies have shown that cigarette smoking is a major risk factor for tubal ectopic pregnancy but the reason for this remains unclear. Here, we set out to determine the effect of smoking on Fallopian tube gene expression. An oviductal epithelial cell line (OE-E6/E7) and explants of human Fallopian tubes from non-pregnant women (n?=?6) were exposed to physiologically relevant concentrations of cotinine, the principle metabolite of nicotine, and changes in gene expression analyzed using the Illumina Human HT-12 array. Cotinine sensitive genes identified through this process were then localized and quantified in Fallopian tube biopsies from non-pregnant smokers (n?=?10) and non-smokers (n?=?11) using immunohistochemistry and TaqMan RT-PCR. The principle cotinine induced change in gene expression detected by the array analysis in both explants and the cell line was significant down regulation (P<0.05) of the pro-apoptotic gene BAD. We therefore assessed the effect of smoking on cell turnover in retrospectively collected human samples. Consistent with the array data, smoking was associated with decreased levels of BAD transcript (P<0.01) and increased levels of BCL2 transcript (P<0.05) in Fallopian tube biopsies. BAD and BCL2 specific immunolabelling was localized to Fallopian tube epithelium. Although no other significant differences in levels of apoptosis or cell cycle associated proteins were observed, smoking was associated with significant changes in the morphology of the Fallopian tube epithelium (P<0.05). These results suggest that smoking may alter tubal epithelial cell turnover and is associated with structural, as well as functional, changes that may contribute to the development of ectopic pregnancy. PMID:24586750

Horne, Andrew W.; Brown, Jeremy K.; Nio-Kobayashi, Junko; Abidin, Hazirah B. Z.; Adin, Zety E. H. A.; Boswell, Lyndsey; Burgess, Stewart; Lee, Kai-Fai; Duncan, W. Colin



Predictors of Success of Medical Management of Ectopic Pregnancy in a Tertiary Care Hospital in United Arab Emirates  

PubMed Central

Introduction: Ectopic pregnancy is the most common cause of pregnancy related deaths in the first trimester of pregnancy. Advances in laboratory and imaging technologies in last few decades allow an early diagnosis of ectopic pregnancy, many times even before the patient develops any symptoms. Consequently in many such patients surgery is not always necessary. Expectant and medical management are feasible options in properly selected cases. In the present study, efficacy of medical management of selected cases of ectopic pregnancy with injection methotrexate and the factors influencing the success of medical management were evaluated. Materials and Methods: Retrospective study involving 40 women with ectopic pregnancy who met inclusion criteria and were managed medically with Methotrexate (MTX) in a tertiary hospital in United Arab Emirates (UAE). Various factors which could possibly influence the success of medical management were evaluated. Results: ROC analyses for day 1(pretreatment) Beta HCG levels revealed that the optimum cut off for Beta HCG level of 6000 mIU/ml on day 1 can be considered a good predictor of success of medical management with MTX. Falling serum Beta HCG between day 1-4 very well predicted success of MTX therapy (irrespective of number of doses of MTX) with a positive predictive value (PPV) of 100% and negative predictive value (NPV) of 31.25%. Similarly adnexal mass size ? 3 cms and duration of amenorrhoea < 6 weeks were found to be good predictors of success of medical management (PPV 96.66% and NPV 90% for both factors).In the present study, irrespective of number of doses received, medical management with MTX was successful in 75% cases (30 out of 40). Conclusion: Results of this study indicate that pretreatment Beta HCG level of < 6000 mIU/ml, adnexal mass size < 3 cms, amenorrhoea < 6 weeks and absence of free fluid in the pelvis are predictors of a successful treatment with MTX. In properly selected cases medical management of ectopic pregnancy with MTX is highly effective and can be considered a forward step taken towards conservation of fallopian tubes especially in countries like UAE where there is inclination towards large family size based on religious and cultural background. PMID:25302237



Abdominal Pregnancy at Term with Live Fetus: A Case Report  

Microsoft Academic Search

Gestação abdominal a termo com feto vivo representa uma raridade obstétrica que cursa com elevada morbimortalidade materna e perinatal. Neste estudo, os autores apresentam um caso de gestação abdominal em uma paciente de 43 anos, em quem o diagnóstico só foi realizado a termo (com 37 semanas), pelos achados clínicos e ecográficos. Realizou-se laparotomia exploradora com extração de recém-nascido vivo

Luiz Carlos Santos; Maria Ramos de Amorim; Edmar Miranda; Gisela de Oliveira Saunders


[Combined intra-uterine and ectopic pregnancy following the treatment with clomiphen (author's transl)].  


Report on a case of combined pregnancy in a 25 year old patient who was treated with Clomiphen for anovulatory cycles. The left tubal pregnancy was removed at 12 weeks gestation. The intra-uterine pregnancy resulted in a term delivery of a 3 kg. 670 g. normal infant. Combined pregnancies rarely occur without treatment with ovulation inducing agents by superfecundation and superfetation. Ovulation inducing agents increase the theoretical possibility of combined pregnancy. Obstetricians should be alert to the possibility of combined pregnancy following induction of ovulation. PMID:669237

Janata, J



Constitutive Activation of Ectodermal ?-Catenin Induces Ectopic Outgrowths at Various Positions in Mouse Embryo and Affects Abdominal Ventral Body Wall Closure  

PubMed Central

Vertebrate limbs originate from the lateral plate mesoderm (LPM) and the overlying ectoderm. While normal limb formation in defined regions has been well studied, the question of whether other positions retain limb-forming potential has not been fully investigated in mice. By ectopically activating ?-catenin in the ectoderm with Msx2-cre, we observed that local tissue outgrowths were induced, which either progressed into limb-like structure within the inter-limb flank or formed extra tissues in other parts of the mouse embryo. In the presumptive abdominal region of severely affected embryos, ectopic limb formation was coupled with impaired abdominal ventral body wall (AVBW) closure, which indicates the existence of a potential counterbalance of limb formation and AVBW closure. At the molecular level, constitutive ?-catenin activation was sufficient to trigger, but insufficient to maintain the ectopic expression of a putative limb-inducing factor, Fgf8, in the ectoderm. These findings provide new insight into the mechanism of limb formation and AVBW closure, and the crosstalk between the Wnt/?-catenin pathway and Fgf signal. PMID:24647475

Zhu, Xuming; Huang, Sixia; Zhang, Lingling; Wu, Yumei; Chen, Yingwei; Tao, Yixin; Wang, Yushu; He, Shigang; Shen, Sanbing; Wu, Ji; Li, Baojie; Guo, Xizhi; He, Lin; Ma, Gang



Inadvertent Superovulation and Intrauterine Insemination During Pregnancy: A Lesson from an Ectopic Gestation  

Microsoft Academic Search

It is believed that follicular development and ovulation is suppressed during the early period of gestation in humans. In this report, we describe a patient who underwent ovarian hyperstimulation following a “presumed” menstrual bleeding. The case illustrates that the ovaries during early pregnancy seem to respond normally to exogenous gonadotrophin stimulation. Despite ongoing pregnancy, the high plasma concentrations of gonadotrophins

Ho-Yen Chueh; Po-Jen Cheng; Chia-Woei Wang; Yung-Kuei Soong



A 30-year review of advanced abdominal pregnancy at the Mater Misericordiae Hospital, Afikpo, southeastern Nigeria (1976–2006)  

Microsoft Academic Search

Purpose  This analysis attempts to highlight the varied presentations, diagnostic difficulties, management and subsequent obstetric\\u000a performances of women managed for advanced abdominal pregnancy.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A retrospective analysis of all 20 cases of abdominal pregnancies between 1976 and 2006, at the Mater Misericordiae Hospital,\\u000a Afikpo, southeastern Nigeria was performed.\\u000a \\u000a \\u000a \\u000a \\u000a Results  There were 20 cases of abdominal pregnancy out of 58,000 deliveries, giving an incidence

Ileogben Sunday-Adeoye; Deirdre Twomey; Emeka V. Egwuatu; Patrick I. Okonta



Quinacrine sterilization: an assessment of risks for ectopic pregnancy, birth defects and cancer  

Microsoft Academic Search

Quinacrine sterilization (QS) involves transcervical insertion of quinacrine pellets using a modi¢ed CopperT IUD inserter. Pellets are placed at the fundus in the proliferative phase of the menstrual cycle. E?cacy is presently estimated at 1 pregnancy failure per 100 women at 2 years. Early complications are lower for QS than surgical sterilization and this is also true for risk of




Impact of Demographic Factors on Prenatal Diagnosis and Elective Pregnancy Termination because of Abdominal Wall Defects, Hawaii, 1986–1997  

Microsoft Academic Search

Objective: The intent of this study was to investigate the impact of various demographic factors on the antenatal diagnosis and elective termination of abdominal wall defect pregnancies. Method: Data were obtained from a birth defects registry in Hawaii between 1986 and 1997. Results: The antenatal diagnosis rate was higher for gastroschisis than for omphalocele (76 vs. 60%). However, gastroschisis pregnancies

Mathias B. Forrester; Ruth D. Merz



Awareness about a Life-Threatening Condition: Ectopic Pregnancy in a Network for Surveillance of Severe Maternal Morbidity in Brazil  

PubMed Central

Objective. To assess occurrence of severe maternal complications associated with ectopic pregnancy (EP). Method. A multicenter cross-sectional study was conducted, with prospective surveillance of potentially life-threatening conditions (PLTC), maternal near miss (MNM), and maternal death (MD). EP complications, patient sociodemographic/obstetric characteristics, and conditions of severity management were assessed, estimating prevalence ratios with respective 95% CI. Factors independently associated with greater severity were identified using multiple regression analysis. Results. Of the 9.555 severe maternal morbidity patients, 312 women (3.3%) had complications after EP: 286 (91.7%) PLTC, 25 (8.0%) MNM, and 1 (0.3%) MD. Severe maternal outcome ratio (SMOR) was 0.3/1000?LB among EP cases and 10.8/1000?LB among other causes. Complicated EP patients faced a higher risk of blood transfusion, laparotomy, and lower risk of ICU admission and prolonged hospitalization than women developing complications resulting from other causes. Substandard care was the most common in more severe maternal morbidity and EP cases (22.7% MNM and MD versus 15% PLTC), although not significant. Conclusion. Increased maternal morbidity due to EP raised awareness about the condition and its impact on female reproductive life. No important risk factors for greater severity were identified. Care providers should develop specific guidelines and interventions to prevent severe maternal morbidity. PMID:24772441

Filho, Edilberto Alves Rocha; Santana, Danielly Scaranello; Costa, Maria Laura; Haddad, Samira Maerrawe; Parpinelli, Mary Angela; Sousa, Maria Helena; Camargo, Rodrigo Soares; Pacagnella, Rodolfo Carvalho; Surita, Fernanda Garanhani; Pinto e Silva, Joao Luiz



Massive hemorrhage in a previously undiagnosed abdominal pregnancy presenting for elective Cesarean delivery  

Microsoft Academic Search

Purpose  To report a case of previously undiagnosed abdominal pregnancy diagnosed at the time of Cesarean section for persistent oblique\\u000a lie. Delivery of the fetus was followed by near catastrophic hemorrhage. The management of massive hemorrhage in the context\\u000a of the obstetric patient is discussed.\\u000a \\u000a \\u000a \\u000a Clinical features  A 32-yr-old, ASA l primigravida was scheduled for elective Cesarean delivery at 38 weeks gestation

Krishna Ramachandran; Paul Kirk



Rare variant of inguinal hernia, interparietal hernia and ipsilateral abdominal ectopic testis, mimicking a spiegelian hernia. Case report.  


We report a case in which the combination of an interparietal inguinal hernia and ipsilateral ectopic testicle mimicked a spigelian hernia. The patient was a 22-day-old boy who presented with a reducible mass that extended from the right lumbar region to the iliac fossa region. The right testis was palpable in the right lumbar region. Ultrasonography and magnetic resonance imaging revealed that a small bowel had herniated through the inguinal region below the external oblique aponeurosis. Surgery was performed when the patient was 23 months old. Laparoscopic examination to identify the hernia orifice revealed that it was the deep inguinal ring, and the testicular vessels and the vas deferens passed beneath the hernia sac. An inguinal incision was made, and a hernia sac was observed passing through the deep inguinal ring and extending superiorly below the aponeurosis. The testis was found in the hernia sac. Traditional inguinal herniorrhaphy and traditional orchidopexy were performed, and the postoperative course was uneventful. It is difficult to understand the surgical anatomy of interparietal hernias, but once the surgical anatomy is understood, surgical repair is simple. We report the case with a review of the literature and also emphasize that laparoscopic exploration is helpful during surgery. PMID:23868739

Hirabayashi, Takeshi; Ueno, Shigeru



Sonography of Methotrexate for Ectopics  

NASA Astrophysics Data System (ADS)

Treatment unruptured ectopic pregnancy with methotrexate (MTX) and citrovorum factor is now an established alternative to surgical therapy. Serial measurements of serum beta-HCG and early ultrasound examination have allowed detection of early and unruptured tubal ectopic pregnancies, permitting treatment without removal of the tube. It is believed that preserving the tube increases the chance of subsequent live births. Our findings suggest that outpatient transvaginal intratubal methorexate administration can provide a safe and effective alternative to surgical treatment for patients with early and unruptured tubal ectopic pregnancy.

Urzic?, Denise; Dorohoi, Dana-Ortansa



Fertility and Pregnancy Outcome After Abdominal Irradiation That Included or Excluded the Pelvis in Childhood Tumor Survivors  

SciTech Connect

Purpose: To evaluate fertility after abdominal and/or pelvic irradiation in long-term female survivors. Methods and Materials: Puberty and pregnancy outcome were analyzed in female survivors of childhood cancer (aged <18 years) treated with abdominal and/or pelvic radiotherapy (RT) at one of two French centers (Nancy and Lyon) between 1975 and 2004. Data were obtained from medical records and questionnaires sent to the women. Results: A total of 84 patients who had received abdominal and/or pelvic RT during childhood and were alive and aged more than 18 years at the time of the study made up the study population. Of the 57 female survivors treated with abdominal RT that excluded the pelvis, 52 (91%) progressed normally through puberty and 23 (40%) had at least one recorded pregnancy. Of the 27 patients treated with pelvic RT, only 10 (37%) progressed normally through puberty and 5 (19%) had at least one recorded pregnancy. Twenty-two women (seventeen of whom were treated with pelvic RT) had certain subfertility. A total of 50 births occurred in 28 women, with one baby dying at birth; one miscarriage also occurred. There was a high prevalence of prematurity and low birth weight but not of congenital malformations. Conclusions: Fertility can be preserved in patients who undergo abdominal RT that excludes the pelvis, taking into account the other treatments (e.g., chemotherapy with alkylating agents) are taken into account. When RT includes the pelvis, fertility is frequently impaired and women can have difficulty conceiving. Nevertheless, pregnancies can occur in some of these women. The most important factor that endangers a successful pregnancy after RT is the total dose received by the ovaries and uterus. This radiation dose has to be systematically recorded to improve our ability to follow up patients.

Sudour, Helene, E-mail: h.sudour@hotmail.f [Department of Paediatric Onco-Hematology, CHU Nancy, Vandoeuvre-les-Nancy (France); Chastagner, Pascal [Department of Paediatric Onco-Hematology, CHU Nancy, Vandoeuvre-les-Nancy (France); Claude, Line [Department of Radiotherapy, Centre Leon Berard, Lyon (France); Desandes, Emmanuel [Department of Statistics, Centre Alexis Vautrin, Vandoeuvre-les-Nancy (France); Klein, Marc [Department of Endocrinology, CHU Nancy, Vandoeuvre-les-Nancy (France); Carrie, Christian [Department of Radiotherapy, Centre Leon Berard, Lyon (France); Bernier, Valerie [Department of Radiotherapy, Centre Alexis Vautrin, Vandoeuvre-les-Nancy (France)



Relation between abdominal subcutaneous fat tissue thickness and inflammatory markers during pregnancy  

PubMed Central

Introduction Subcutaneous abdominal fat thickness (SCFT) is important for predisposition to metabolic and cardiovascular diseases. Our aim was to evaluate maternal SCFT and metabolic changes (such as insulin resistance and high inflammatory markers) during pregnancy. Material and methods A total of 92 pregnant women between 24–28 weeks of gestation were enrolled in the study. The SCFT was measured by ultrasonography and patients were divided into 2 groups according to thickness of maternal SCFT and body mass index (BMI). Groups were compared with each other for oral glucose loading test (OGL) results, and for haematological, biochemical and fetal biometric parameters. Results After analysis of frequency for SCFT, the most appropriate cut-off value for grouping patients was found to be 15 mm for SCFT. In 48 cases SCFT was over 15 mm. High C reactive protein (CRP) was found in 47.9% (23) of cases with SCFT over 15 mm. Serum haemoglobin A1c (HbA1c) level was significantly correlated with SCFT thickness. The most important factors for determination of OGL level were found to be serum HbA1c level, BMI and SCFT. In obese subjects (BMI ? 25 kg/m2), levels of inflammatory markers and SCFT thickness were higher. The CRP and ?-glutamyltransferase (GGT) levels were significantly correlated with BMI and SCFT. Conclusions High SCFT during pregnancy is associated with elevated inflammatory marker levels and HbA1c. Pregnant women with thicker SCFT may be susceptible to the development of metabolic complications of pregnancy, such as gestational diabetes mellitus (GDM) and hypertension, as well as risk of future metabolic and cardiovascular disease.

Kosus, Ayd?n; Turhan, Nilgun



Ectopic bilharziasis.  


Ectopic Bilharziasis is discussed and two cases of ectopic pharyngeal affections are reported. The five theories advocated to explain how ectopic lesions can develop outside the portol-caval system are discussed. The clinical picture, age, diagnosis and follow-up of such lesions are mentioned. PMID:7430777

Fatt-hi, A; Kamel, I



Tubal ectopic gestation associated with genital schistosomiasis: a case report.  


Schistosoma are trematode blood flukes of the family Schistosomidae affecting the urinary and gastro-intestinal tracts. Riverine areas of the world such as in Africa, Eastern Mediterranean, Central American and East Asia are endemic for the disease, with S. haematobium accounting for most of the symptomatic genital infection. A case of a 25-year-old woman with 8 weeks amenorrhoea, lower abdominal pain and per vaginal bleeding was managed for ruptured ectopic pregnancy and discovered to have tubal infection by Schistosoma on histological examination is presented. PMID:25022151

Aminu, Muhammad B; Abdullahi, Kabiru; Dattijo, Lamaran M



Ectopic osteogenesis in the rectus sheath.  


Although was published many cases of ectopic osteogenesis of traumatic, neurogenic cause or hereditable form, the etiology of ectopic osteogenesis remaining unknown. We present ectopic osteogenesis in the rectus abdominal sheath. The study material was represented from fragments of ectopic bones discovered in rectus sheath of four patients suffering iterative surgical abdominal interventions. The pieces of ectopic bone were decalcified and then were made to the standard techniques (paraffin inclusion, general techniques dyeing). The process of ectopic osteogenesis was analyzed through microscopically study to seriated sections of discovered piece, finding the presence of the hematopoesis foci. We conclude that is important identifying and characterizing the osteoinductor agents because these allowed the study of osteogenesis to the cellular level and make an estimation of the abnormally bone developing mechanisms. A possible osteoinductor factor has been considerate the non-absorbable wound closure material. PMID:16838064

Me?in?, C; Me?in?-Botoran, Mihaela Iustina; Dr?goi, G S; Pa?alega, M; Vîlcea, D; Vasile, I



The onset of human ectopic pregnancy demonstrates a differential expression of miRNAs and their cognate targets in the Fallopian tube  

PubMed Central

Human ectopic pregnancy (EP) is a leading cause of pregnancy-related death, but the molecular basis underlying the onset of tubal EP is largely unknown. Female Dicer1 conditional knockout mice are infertile with dysfunctional Fallopian tube and have a different miRNA expression profile compared to wild-type mice, and we speculated that Dicer-mediated regulation of miRNA expression and specific miRNA-controlled targets might contribute to the onset of tubal EP. In the present study, we used microarray analysis and quantitative RT-PCR to examine the expression of miRNAs and core miRNA regulatory components in Fallopian tube tissues from women with EP. We found that the levels of DICER1, four miRNAs (let-7i, miR-149, miR-182, and miR-424), and estrogen receptor ? distinguished the tubal implantation site from the non-implantation site. Computational algorithms and screening for interactions with the estrogen and progesterone receptor signaling pathways showed that the four miRNAs were predicted to target ten genes, including NEDD4, TAF15, and SPEN. Subsequent experiments showed differences in NEDD4 mRNA and protein levels between the implantation and non-implantation sites. Finally, we revealed that increases in smooth muscle cell NEDD4 and stromal cell TAF15, in parallel with a decrease in epithelial cell SPEN, were associated with tubal implantation. Our study suggests that changes in miRNA levels by the DICER-mediated miRNA-processing machinery result in aberrant expression of cell type-specific proteins that are potentially involved in the onset of tubal EP. PMID:24427327

Feng, Yi; Zou, Shien; Weijdegård, Birgitta; Chen, Jie; Cong, Qing; Fernandez-Rodriguez, Julia; Wang, Lei; Billig, Håkan; Shao, Ruijin



Heterotopic triplet pregnancy (twin tubal) in a natural cycle with tubal rupture: case report and review of the literature.  


The incidence of heterotopic/ectopic pregnancy has risen in recent years, largely due to more frequent use of ovulatory medicine and increased incidence of pelvic inflammatory disease. In a natural cycle, it is a very rare event. Most heterotopic/ectopic pregnancies are localized in the uterine tube and, usually, it is diagnosed when symptoms develop. We report the case of a 37 year-old, gravida 2, para 0, abortion 1 woman with no known risk factors for heterotopic pregnancy. The patient attended the emergency department because of acute abdominal pain. She was evaluated in our department and a heterotopic twin pregnancy in the tube was diagnosed by transvaginal sonography. Intrauterine pregnancy with positive fetal cardiac activity at 9 weeks of gestation according to crown-rump length measurement was detected. Laparotomy was carried out because of acute abdominal syndrome. Right ruptured tubal ectopic/heterotopic pregnancy and hemoperitoneum were diagnosed. Right salpingectomy was carried out. Pathology revealed monochorionic twin tubal pregnancy. In a review of the literature, this is first case of twin tubal pregnancy in one uterine tube. In conclusion, heterotopic pregnancy in twin form in the uterine tube is possible in natural cycles. Intrauterine pregnancy does not exclude extrauterine pregnancy in natural cycles. PMID:18840198

Simsek, Tayup; Dogan, Askin; Simsek, Mehmet; Pestereli, Elif



An interesting case of intramyometrial pregnancy.  


A 27-year-old woman, gravida 3, para 1, at 9 weeks gestation, initially presented with clinical and ultrasonographic features suggestive of a missed spontaneous abortion for which surgical evacuation was performed. A diagnosis of ectopic pregnancy was made as on histological review no fetal or chorionic tissue was seen. Medical management for an ectopic pregnancy was initiated. Following methotrexate administration she was readmitted with severe abdominal pain. Findings on diagnostic laparoscopy revealed an asymmetrically enlarged swollen fundus. Hysteroscopy was performed concurrently demonstrating an empty uterine cavity. A diagnosis of intramyometrial pregnancy was made based on these findings. An MRI scan was performed postprocedure which supported the diagnosis. In view of her parity and future fertility medical management was adopted with methotrexate. She was followed up until hormone levels returned to baseline and serial scans showed a healed solid collection. PMID:22605595

Verghese, Tina; Wahba, Karim; Shah, Ahmar



Incidence of perihepatic adhesions in ectopic gestation  

Microsoft Academic Search

Objective: To compare the incidence of perihepatic adhesions in patients undergoing surgery for ectopic pregnancy with the incidence in patients undergoing elective laparoscopic sterilization. Fitz-Hugh-Curtis syndrome is a perihepatitis that usually occurs as a complication of pelvic inflammatory disease. Perihepatic adhesions may be an aftereffect of the acute hepatic episode, and because the cause of ectopic gestation is thought to

Vaseem Ali; James F Lilja; Alice Z Chuang; Ratnasri V Mogallapu; Eric Sabonghy



Tubal conservation with ectopic gestations. A reappraisal.  


Ectopic pregnancies have shown an increasing trend during the past decade. Factors that appear to be responsible are the intrauterine device (IUD), fallopian tube surgery (ligation reversals, reconstructive tuboplasty), and more effective antibiotics against pelvic inflammatory disease (precluding radical pelvic surgery). Our ability to diagnose an ectopic pregnancy at an earlier gestation (prior to rupture) through the use of highly sensitive pregnancy tests (Beta-HCG), ultrasonography, and diagnostic laparoscopy, has significantly altered our approach in treatment. Because these ectopic gestations are seen in a younger population, older nulliparous patients, and patients who desire future fertility, earlier diagnosis precludes an emergency approach to a now-elective procedure. In this paper, we will explore the pros and cons of conservative management for ectopic pregnancies, emphasizing present day evaluation and microsurgical approaches for repair. PMID:6231872

Starks, G



Retrospective study of outcome on vaginal and abdominal delivery in twin pregnancy in which twin 1 is presenting by the breech  

Microsoft Academic Search

.   We retrospectively reviewed the perinatal outcome of twin pregnancies cohere the first baby was presenting by the breech.\\u000a 21 were delivered vaginally and 37 abdominally. Differences in perinatal outcome, as measured by Apgar score and mortality,\\u000a were not apparently different.

A. T. Abu-Heija; S. Ziadeh; F. Abukteish; A. Obeidat



Measurement of Fetal Abdominal and Subscapular Subcutaneous Tissue Thickness during Pregnancy to Predict Macrosomia: A Pilot Study  

PubMed Central

This study assessed the growth trends and reference ranges of the ultrasound parameters, fetal abdominal subcutaneous tissue thickness (ASTT) and subscapular subcutaneous tissue thickness (SSTT), in the last two trimesters of normal pregnancy in a Chinese population. We recruited 744 healthy women with singleton pregnancies. The ASTT and SSTT were evaluated at different times between 21 and 36 weeks of gestation. The correlations between these parameters and fetal gestational weeks were assessed using linear regression analysis. Both ASTT and SSTT increased with gestation, and both parameters showed a strong correlation with gestation (ASTT vs. GA, R2?=?0.792; P<0.0001; SSTT vs. GA, R2?=?0.302; P<0.0001). Time-specific reference ranges, including 5th, 50th and 95th percentiles and means ± SD, were constructed for ASTT and SSTT. These results provide a preliminary reference range to evaluate whether fetal development and maternal metabolic health is normal or not in a Chinese population. PMID:24675769

Chen, Xiao-Hui; Cao, Li; Wu, Yun; Zhu, Li-Jun; Lv, Kang-Tai; Ji, Chen-Bo; Guo, Xi-Rong



Intrahepatic pregnancy: A unique opportunity for evaluation with sonography, computed tomography, and magnetic resonance imaging  

SciTech Connect

The incidence of ectopic pregnancy ranges from one in 84 to one in 357 live births. The most common site of implantation is within the fallopian tubes; abdominal pregnancies are unusual, and primary hepatic pregnancies are extremely rare. A computer search revealed only six case of placental attachment to the liver in the English-language literature since Cornell and Lash reported eight cases in 1933. Newer imaging techniques have a greater ability to define tissue planes, thus allowing more accurate diagnosis and preoperative planning by the surgical team. The authors take this opportunity to present radiological and other images, obtained by ultrasonography, CT, and MR to demonstrate a primary hepatic pregnancy.

Harris, G.J.; Al-Jurf, A.S.; Yuh, W.T.C.; Abu-Yousef, M.M. (Univ. of Iowa Hospitals and Clinics, Iowa City (USA))



Thickness of Rectus Abdominis Muscle and Abdominal Subcutaneous Fat Tissue in Adult Women: Correlation with Age, Pregnancy, Laparotomy, and Body Mass Index  

PubMed Central

Background Rectus abdominis muscle and abdominal subcutaneous fat tissue are useful for reconstruction of the chest wall, and abdominal, vaginal, and perianal defects. Thus, preoperative evaluation of rectus abdominis muscle and abdominal subcutaneous fat tissue is important. This is a retrospective study that measured the thickness of rectus abdominis muscle and abdominal subcutaneous fat tissue using computed tomography (CT) and analyzed the correlation with the patients' age, gestational history, history of laparotomy, and body mass index (BMI). Methods A total of 545 adult women were studied. Rectus abdominis muscle and abdominal subcutaneous fat thicknesses were measured with abdominopelvic CT. The results were analyzed to determine if the thickness of the rectus abdominis muscle or subcutaneous fat tissue was significantly correlated with age, number of pregnancies, history of laparotomy, and BMI. Results Rectus abdominis muscle thicknesses were 9.58 mm (right) and 9.73 mm (left) at the xiphoid level and 10.26 mm (right) and 10.26 mm (left) at the umbilicus level. Subcutaneous fat thicknesses were 24.31 mm (right) and 23.39 mm (left). Rectus abdominismuscle thickness decreased with age and pregnancy. History of laparotomy had a significant negative correlation with rectus abdominis muscle thickness at the xiphoid level. Abdominal subcutaneous fat thickness had no correlation with age, number of pregnancies, or history of laparotomy. Conclusions Age, gestational history, and history of laparotomy influenced rectus abdominis muscle thickness but did not influence abdominal subcutaneous fat thickness. These results are clinically valuable for planning a rectus abdominis muscle flap and safe elevation of muscle flap. PMID:23094250

Kim, Jungmin; Lim, Hyoseob; Lee, Se Il



Cornual Heterotopic Pregnancy after Bilateral Salpingectomy and Uterine Septum Resection Resulting in Term Delivery of a Healthy Infant  

PubMed Central

Heterotopic pregnancy is the simultaneous occurrence of two or more implantation sites. A 25-year-old infertile patient with a history of bilateral salpingectomy, uterine septum resection, and left cornual resection was diagnosed with heterotopic pregnancy in her second in vitro fertilization trial. She attended our clinic when she was 7-week pregnant, complaining initially of severe abdominal pain. Findings associated with peritoneal irritation were positive during the physical examination. Transvaginal ultrasound revealed right cornual ectopic pregnancy with a live fetus in the middle of the uterine cavity. Also free fluid was noted in the pelvis. A diagnosis of heterotopic pregnancy with rupture of the cornual pregnancy was made. She underwent emergency laparoscopy with aspiration of the ruptured ectopic pregnancy, suturing to the entire visible cornual margins, and assurance of good haemostasis. Her recovery was uneventful and she continued receiving care in our obstetric unit. She delivered a healthy newborn by cesarean section at term.

Oral, Serkan; Akpak, Ya?am Kemal; Karaca, Nilay; Babacan, Ali; Savan, Kadir



Endometrium implantation and ectopic pregnancy  

Microsoft Academic Search

Embryo in uterine implantation is a complex and multifactor-related process and is a downstream and ideal point for woman\\u000a fertility control. Understanding the cellular and molecular mechanism of implantation is a prerequisite for development of\\u000a anti-implantation contraceptives. In spite of considerable accumulation of information from the laboratory animals that has\\u000a been achieved, it is difficult to generate such information in

Liu Yixun



In Subfertile Couple, Abdominal Fat Loss in Men Is Associated with Improvement of Sperm Quality and Pregnancy: A Case-Series  

PubMed Central

Background The impact of overweight among men of reproductive-age may affect fertility. Abdominal fat, more than body mass index, is an indicator of higher metabolic risk, which seems to be involved in decreasing sperm quality. This study aims to assess the relationship between abdominal fat and sperm DNA fragmentation and the effect of abdominal fat loss, among 6 men in subfertile couples. Methods Sperm DNA fragmentation, abdominal fat and metabolic and hormonal profiles were measured in the 6 men before and after dietary advices. Seminal oxidative stress and antioxidant markers were determined. Results After several months of a lifestyle program, all 6 men lost abdominal fat (patient 1: loss of 3 points of abdominal fat, patient 2: loss of 3 points, patient 3: loss of 2 points, patient 4: loss of 1 point, patient 5: loss of 4 points and patient 6: loss of 13 points). At the same time, their rate of sperm DNA fragmentation decreased: 9.5% vs 31%, 24% vs 43%, 18% vs 47%, 26.3% vs 66%, 25.4% vs 35% and 1.7% vs 25%. Also, an improvement in both metabolic (significant decrease in triglycerides and total cholesterol; p?=?0.0139) and hormonal (significant increase in testosterone/oestradiol ratio; p?=?0.0139) blood profiles was observed after following the lifestyle program. In seminal plasma, the amount of SOD2 has significantly increased (p?=?0.0139) while in parallel carbonylated proteins have decreased. Furthermore, all spouses got pregnant. All pregnancies were brought to term. Conclusion This study shows specifically that sperm DNA fragmentation among men in subfertile couples could be affected by abdominal fat, but improvement of lifestyle factor may correct this alteration. The effect of specific abdominal fat loss on sperm quality needs further investigation. The reduction of oxidative stress may be a contributing factor. PMID:24520319

Faure, Celine; Dupont, Charlotte; Baraibar, Martin A.; Ladouce, Romain; Cedrin-Durnerin, Isabelle; Wolf, Jean Philippe; Levy, Rachel



A case of spontaneous tubal pregnancy with caesarean scar pregnancy  

PubMed Central

Tubal pregnancy with caesarean scar pregnancy is rare. Early, accurate diagnosis and treatment for this kind of ectopic pregnancy can lead to a decrease of maternal morbidity and mortality. Here, we report a rare case of spontaneous tubal pregnancy co-existing with caesarean scar pregnancy. After timely emergency laparoscopy and curettage, the patient was cured. PMID:25356166

Zhu, Jie; Shen, Yue-Ying; Zhao, Yu-Qing; Lin, Ru; Fang, Fang



Heterotopic Pregnancy after Natural Conception: A Case Report  

PubMed Central

Heterotopic pregnancy (HP), i.e. the simultaneous development of an intrauterine and an ectopic pregnancy, is rare with a reported incidence of between 1?:?2600 and 1?:?30?000. Only a few cases have been described in the literature. We report here on an extremely rare case of HP after natural conception with cardiac activity noted on sonography in both the intrauterine and the ectopic foetus. Examination excluded appendicitis. Vaginal sonography (VS) was performed and revealed a second, extrauterine foetus with cardiac activity. The differential diagnosis included twin pregnancy in a bicornuate uterus, but HP could not be excluded. Diagnostic laparoscopy was scheduled due to progressive abdominal pain. Shortly before surgery the patient became acutely hypotensive. Laparoscopy confirmed a heterotopic pregnancy in the right tube. Due to acute rupture of the extrauterine pregnancy with intraabdominal bleeding, the procedure was converted to a laparotomy with right-sided salpingectomy. Subsequently, the intrauterine pregnancy continued without complications. The intrauterine pregnancy was uneventful with spontaneous delivery at term.

Kratschla-Apochal, A.; Nauer, C.; Bolla, D.





... each trimester are described below. 1 First Trimester (Week 1 to Week 12) The events that lead to pregnancy begin ... and oxygen to the fetus. 2 Second Trimester (Week 13 to Week 28) At 16 weeks, and ...


Ectopic gallbladder revisited, laparoscopically: a case report  

PubMed Central

A case of the rare congenital anomaly ectopic gallbladder is presented. A 16-year-old girl suffered attacks of epigastric pain unrelated to eating. On abdominal ultrasonography, the gallbladder could not be found in its usual position. Endoscopic retrograde cholangiography demonstrated the gallbladder on the left side of the common duct and the cystic duct arising from the right hepatic duct. Laparoscopic cholecystectomy was done without complication. This appears to be the first reported case of laparoscopic removal of an ectopic gallbladder. The importance of preoperative cholangiography is emphasized for accurate diagnosis and preoperative location of the gallbladder. PMID:9416258

Chung, C.C.; Leung, K.L.; Lau, W.Y.; Li, Arthur K.C.



A randomized study of fetal abdominal diameter and fetal weight estimation for detection of light-for-gestation infants in low-risk pregnancies.  


A total of 2771 pregnant women with gestational age estimated by ultrasound measurement of the fetal biparietal diameter (BPD) before the 22nd week of gestation were re-examined by ultrasound in the 32nd and 37th week of pregnancy at which time the fetal BPD and abdominal diameter (AD) were measured. An additional examination was performed at 34 weeks if the fetal weight in the 32nd week was estimated to be less than 95% of the expected mean weight. Light-for-gestational age (LGA) was suspected if the estimated birth-weight was less than 85% of the expected mean birthweight. This applied to 186 uncomplicated pregnancies in which there was no clinical suspicion of poor intrauterine growth. These pregnancies were randomly allocated to a treatment group (AD and estimated weight reported) or to a control group (AD and estimated weight withheld). Induction of labour was significantly more common in the treatment group (41%) than in the control group (15%). No statistically significant difference was found in the use of instrumental vaginal delivery or caesarean section. There was a suggestion of marginal benefit in terms of neonatal morbidity but this was not statistically significant. PMID:3548803

Secher, N J; Kern Hansen, P; Lenstrup, C; Sindberg Eriksen, P; Morsing, G



Ischemic optic neuropathy after hemorrhage from a cornual ectopic gestation  

Microsoft Academic Search

A case of ischemic optic neuropathy resulting from uterine hemorrhage is reported in which a 37-year-old white woman, gravida 1, para 0, was diagnosed at 8 weeks' gestation with a ruptured ectopic pregnancy. After diagnostic laparoscopy the patient underwent a minilaparotomy, cornual wedge resection, and right salpingectomy with a total estimated blood loss of 3000 ml. Her postoperative course was

Deborah M. Chun; David K. Levin



[Diagnosis of extrauterine pregnancy].  


In pregnancies, the incidence of ectopic pregnancy varies from 1.2% to 1.4%. Diagnostic management of ectopic pregnancy is made by biochemical and ultrasonographic analysis. The evaluation of symptoms and anamnesis improves both comprehension and evaluation of technical data. This review analyzed the risk factors most commonly reported in women with ectopic pregnancy. According to the literature, the improvement of biochemical knowledge has determined the study of many substances: beta hCG, specific glycoproteins beta 1, creatine kinase, renine, progesterone. Transvaginal ultrasound examination presents different specificity and sensitivity. When ultrasonic imagining is not clear, it is useful to study uterine and adnexal vascularization by color Doppler and pulsed Doppler. The majority of authors consider laparoscopy as a gold standard for diagnosing an ectopic pregnancy. The endoscopic approach has multiple advantages: it could be in the same time diagnostic and therapeutic. The curettage of uterine cavity has been proposed as a diagnostic tool for analyzing by frozen section the presence or not of chorial villi. In personal opinion, an easy and simple diagnostic management should involve the clinical, biochemical and ultrasonographic procedures. Laparoscopy should be the last step in order to confirm a diagnosis and to establish the best therapeutical approach. PMID:10230240

Giambanco, V; Giambanco, L; Alaimo, D



The Anatomical Considerations of Ectopic Gestation  

E-print Network

l e a f t e r abortions, i s c e r t a i n l y an important f a c t o r . Of the 32 cases reported by H e i n i c h (21), a miscarriage had preceded the ectopic pregnancy i n 30$. H i r s t says that the majority of h i s cases have been preceded... i (19), 2 i n 107. Microscopic examination w i l l show the absence or v i l l i or s y n c y t i a l c e l l s . (B) S p e c i f i c Changes. What are the changes p e c u l i a r to t ubal pregnancy* The maternal orginism makes abortive 18...

Guffey, Don Carlos



Pregnancy Complications: HELLP Syndrome  


... pregnancy or suffer abdominal trauma. I had a miscarriage. How long should I wait to try again? ... or treatments to discover the cause of the miscarriage, it's usually OK for you to become pregnant ...


Pregnancy Complications: Placental Abruption  


... pregnancy or suffer abdominal trauma. I had a miscarriage. How long should I wait to try again? ... or treatments to discover the cause of the miscarriage, it's usually OK for you to become pregnant ...


Pregnancy Complications: Bacterial Vaginosis  


... pregnancy or suffer abdominal trauma. I had a miscarriage. How long should I wait to try again? ... or treatments to discover the cause of the miscarriage, it's usually OK for you to become pregnant ...


Pregnancy Complications: Placenta Previa  


... pregnancy or suffer abdominal trauma. I had a miscarriage. How long should I wait to try again? ... or treatments to discover the cause of the miscarriage, it's usually OK for you to become pregnant ...


Pregnancy Complications: Cervical Insufficiency  


... pregnancy or suffer abdominal trauma. I had a miscarriage. How long should I wait to try again? ... or treatments to discover the cause of the miscarriage, it's usually OK for you to become pregnant ...


Resolution of hormonal markers of ectopic gestation: a randomized trial comparing single-dose intramuscular methotrexate with salpingostomy  

Microsoft Academic Search

Objective: To evaluate resolution of serum hCG and progesterone in patients with ectopic pregnancy receiving single-dose intramuscular (IM) methotrexate as compared with those undergoing laparoscopic salpingostomy.Methods: In this prospective randomized clinical trial, 75 hemodynamically stable women with a diagnosis of ectopic pregnancy were randomized to treatment with single-dose IM methotrexate (1 mg\\/kg) or laparoscopic salpingostomy. All women had initial, day

Asma J Saraj; John G Wilcox; Sam Najmabadi; Sharon M Stein; Meade B Johnson; Richard J Paulson



Ectopic intracranial retinoblastoma in childhood.  

PubMed Central

Twelve out of a series of 630 children with retinoblastoma, treated in the ocular oncology units at St Bartholomew's and Moorfields Eye Hospitals during the past 30 years, have developed ectopic intracranial retinoblastoma. The ectopic tumour occurred in the pineal region in eight children and in the suprasellar region in four. Ten patients had bilateral retinoblastoma, one unilateral disease, and one child presented with an isolated suprasellar tumour but no evidence of retinal disease. The interval from the initial diagnosis of retinoblastoma to the development of ectopic intracranial disease ranged from 4 to 70 months, median 34 months. Methods of treatment for the ectopic tumour varied, but all 12 children died with a median survival of only 8 months following the diagnosis of ectopic retinoblastoma. Subsequent spread of tumour to other sites within the central nervous system proved to be the most frequent cause of death. Ectopic intracranial retinoblastoma is a potentially curable neoplasm, but it requires adequate therapy to the whole neuraxis as well as high dose equivalent radiotherapy to the primary tumour. Images PMID:4052359

Kingston, J E; Plowman, P N; Hungerford, J L



[Pregnancy following bilateral salpingectomy].  


This report presents a rare case of spontaneous pregnancy following bilateral salpingectomy. A woman with a history of bilateral salpingectomy was admitted to hospital because of abdominal pain and positive urine HCG. Surprisingly, ultrasound confirmed a live intrauterine fetus. The pregnancy was unwanted, and the woman decided to terminate the pregnancy. She was offered diagnostic examination to localise a potential fistula, but she declined. In a MEDLINE search of English literature this is only the second case of spontaneous pregnancy following bilateral salpingectomy. PMID:18462619

Bang, Anne



Laparoscopy-Assisted Billroth I Gastrectomy for Ectopic Pancreas in the Prepyloric Region  

PubMed Central

Ectopic pancreatic tissue is an uncommon developmental anomaly. The condition mostly occurs in the gastrointestinal tract and is usually asymptomatic. It rarely causes symptoms of inflammation, bleeding and perforation, and has potential for malignant change. Though it is an uncommon condition, cases of ectopic pancreas have been reported worldwide. Preoperative diagnosis of ectopic pancreas is challenging because of its nonspecific symptoms and signs. Owing to the revolution of minimally invasive surgery, submucosal tumors of the stomach can be resected by laparoscopic techniques. We have earlier reported on a case of ectopic pancreas in the stomach treated by robotics-assisted laparoscopic wedge resection. Herein, we report a case of ectopic pancreas in the prepyloric region of the stomach. A 44-year-old female presented with a two-week history of epigastralgia with radiation to the back. She received endoscopy check-up which disclosed a mass in the stomach. By endoscopic findings, a submucosal lesion in the prepyloric region with umbilical folding on the mucosa was identified. The umbilical folding on the mucosa hint the orifice of the duct of ectopic pancreas into the gastric mucosa suggestive of ectopic pancreas. Contrast-enhanced abdominal computed tomography showed a 5 cm cystic mass with heterogeneous content. To sum it up, the patient was diagnosed as ectopic pancreas in the stomach. She underwent laparoscopy-assisted antrectomy with Billroth I anastomosis (excision of the antrum and prepyloric region with reconstruction of gastrointestinal continuity by gastroduodenostomy) and had an uneventful hospitalization course. The histopathology of the resected tumor demonstrated ectopic pancreatic tissue in the gastric wall. To the best of our knowledge, excision of gastric ectopic pancreas using laparoscopy-assisted antrectomy with Billroth I anastomosis has never been reported in the literature. PMID:23185154

Lee, Yueh-Tsung; Lin, Ho; Guo, Jen-Chang; Yan, Sheng-Lei; Hou, Hsiang-Jen; Lai, Yih-Shyong; Liu, Yi-Hsiang; Wu, Hurng-Sheng; Hwang, Min-Ho



Heterotopic Triplet Pregnancy after In Vitro Fertilization with Favorable Outcome of the Intrauterine Twin Pregnancy Subsequent to Surgical Treatment of the Tubal Pregnancy  

PubMed Central

Heterotopic triplet pregnancy is an exceptionally rare medical condition. The broad use of assisted reproductive technologies has contributed to the increase of ectopic and subsequently heterotopic pregnancy rate, masking a life-threatening condition for the gravid and the intrauterine pregnancy. We describe a case of a woman with heterotopic triplets at 9+4 gestational week following transfer of three embryos obtained by in vitro fertilization techniques. The ectopic tubal pregnancy was ruptured and salpingectomy was performed by laparotomy. The intrauterine pregnancy progressed to the delivery by cesarean section of two healthy twins at 36+2 gestational age. Heterotopic triplets with tubal ectopic are a special diagnostic and therapeutic challenge for the obstetrician. High index of suspicion and timely treatment by laparotomy or laparoscopy can preserve the intrauterine gestation with a successful outcome of the pregnancy. PMID:24527252

Akrivis, Christodoulos; Tsirkas, Panagiotis; Korkontzelos, Ioannis



Ectopic spleen: An easily identifiable but commonly undiagnosed entity until manifestation of complications  

PubMed Central

INTRODUCTION Ectopic spleen is an uncommon clinical entity as splenectomy for treatment of ectopic spleens accounts for less than 0.25% of splenectomies. The most common age of presentation is childhood especially under 1 year of age followed by the third decade of life. PRESENTATION OF CASE The present report refers to a patient with torsion of a pelvic spleen treated with splenectomy. The patient exhibited a period of vague intermittent lower abdominal pain lasted 65 days followed by a period of constant left lower quadrant pain of increasing severity lasted 6 days. On the first 65 days, vague pain was attributed to progressive torsion of the spleen which resulted in venous congestion. On the last 6 days, exacerbation of pain was attributed to irreducible torsion, infraction of the arterial supply, acute ischemia, strangulation and rupture of the gangrenous spleen. Diagnosis was made by CT which revealed absence of the spleen in its normal position, a homogeneous pelvic mass with no contrast enhancement, free blood in the peritoneal cavity, and confirmed by laparotomy. DISCUSSION Clinical manifestations of ectopic spleen vary from asymptomatic to abdominal emergency. Symptoms are most commonly attributed to complications related to torsion. Operative management, including splenopexy or splenectomy, is the treatment of choice in uncomplicated and complicated cases because conservative treatment of an asymptomatic ectopic spleen is associated with a complication rate of 65%. CONCLUSION Although an ectopic spleen can be easily identified on clinical examination, it is commonly misdiagnosed until the manifestation of complications in adulthood. PMID:24973525

Blouhos, Konstantinos; Boulas, Konstantinos A.; Salpigktidis, Ilias; Barettas, Nikolaos; Hatzigeorgiadis, Anestis



Relation between time to pregnancy and pregnancy outcome  

PubMed Central

Background: Studies have shown significant correlation between time to pregnancy (TTP) and pregnancy outcomes. But understanding of these mechanisms may not be facilitated. The aim of this study was to determine the relation between TTP and pregnancy outcome. Materials and Methods: This study was a case cohort study that was done in Shahid Beheshti Educational Hospital during 2006-2007. Women aged 18-35 years, who had only one pregnancy without using any contraception method before pregnancy and delivered their first child, were enrolled in this study. Thus, 801 women were selected and followed up for pregnancy outcome and TTP until the end of pregnancy. All the participants filled in a special questionnaire. Finally the collected data were entered into computer and analyzed by SPSS ver. 20 software. Results: The frequency distribution of TTP-based pregnancy outcome showed that TTP >48 weeks was higher in normal delivery than in abnormal delivery (5.6% vs. 19.4%). According to Chi-square test, the frequency distribution of pregnancy outcome was related to TTP (P < 0.001). Conclusion: According to the results of this study, there is a significant relationship between TTP and pregnancy outcome, and TTP may lead to unwanted complications such as ectopic pregnancy, preterm labor, and abortion. Thus, all women with a long time of contraception, especially in the rural areas, mast be controlled. PMID:25250289

Tehrani, Hatave Ghasemi; Allameh, Zahra Sadat; Mehrabi, Ali Koushki



Body art and pregnancy  

Microsoft Academic Search

Body art has gained tremendously in popularity over the past 20 years, and a substantial number of pregnant women may have tattoos or piercings. In most cases, pregnancy will be uneventful. However, on rare occasions, body art may become an issue or cause complications. Navel and abdominal surface piercing and microdermal implants may cause unsightly stretch marks from gravid distension.

Nicolas Kluger



Laparoscopic surgery in pregnancy  

Microsoft Academic Search

A 32-year-old white lady suffering from tubal infertility was referred to our institution in November 1992 because of low abdominal pain due to a heterotopic pregnancy (one intrauterine sac and the other in the right tube). The patient had undergone, 8 weeks before, her second successful attempt at in vitro fertilization and embryo transfer. We decided to perform a laparoscopic

V. Remorgida; C. Carrer; A. Ferraiolo; M. Natucci; P. Anserini



Pregnancy Complications  


... Emergency Preparedness and Response Pregnant Women and Flu Pregnancy Complications On this Page Before Pregnancy During Pregnancy ... to decrease the risk of pregnancy complications. Before Pregnancy Make sure to talk to your doctor about ...


Intraoperative molar pregnancy crisis.  


Molar pregnancy is a gestation in which the ovum is transformed into a fleshy tumor mass or mole. Of all gynecologic tumors, it is one of the most feared. It is characterized by first trimester bleeding, hyperemesis, and toxemia and can be diagnosed using pelvic ultrasound. Suction currettage is the treatment of choice for molar pregnancy when a patient desires to have more children; however, hysterectomy may be necessary. Abdominal hysterectomy reduces the risk of malignant sequelae. Complications associated with molar pregnancy usually are a result of suction curettage and include pulmonary insufficiency syndrome, choriocarcinoma, hyperthyroidism, theca lutein cysts, and disseminated intravascular coagulation. The perioperative nurse can be instrumental in assessing, planning, organizing, and directing intervention for potential complications associated with the management of a molar pregnancy crisis. The perioperative nurse is encouraged to review all aspects of molar pregnancy to understand the ramifications of the surgical procedures. PMID:7944318

Robinson, B J



Abdominal rectovaginopexy  

Microsoft Academic Search

PURPOSE: We noted the combination of obstructed defecation or constipation and fecal incontinence, the poor results of abdominal rectopexy for constipation, and the well-known risk of postoperative induction of constipation after rectopexy. We developed a new operation to treat patients with constipation or fecal incontinence (with a concomitant rectocele, internal rectal intussusception, enterocele at dynamic defecography, or all three) or

R. Silvis; H. G. Gooszen; A. van Essen; A. Th. C. M. Kruif; L. W. M. Janssen



Abdominal intrauterine vacuum aspiration.  


Evaluating and "cleaning" of the uterine cavity is probably the most performed operation in women. It is done for several reasons: abortion, evaluation of irregular bleeding in premenopausal period, and postmenopausal bleeding. Abortion is undoubtedly the number one procedure with more than 44 million pregnancies terminated every year. This procedure should not be underestimated and a careful preoperative evaluation is needed. Ideally a sensitive pregnancy test should be done together with an ultrasound in order to confirm a uterine pregnancy, excluding extra-uterine pregnancy, and to detect genital and/or uterine malformations. Three out of four abortions are performed by surgical methods. Surgical methods include a sharp, blunt, and suction curettage. Suction curettage or vacuum aspiration is the preferred method. Despite the fact that it is a relative safe procedure with major complications in less than one percent of cases, it is still responsible for 13% of all maternal deaths. All the figures have not declined in the last decade. Trauma, perforation, and bleeding are a danger triage. When there is a perforation, a laparoscopy should be performed immediately, in order to detect intra-abdominal lacerations and bleeding. The bleeding should be stopped as soon as possible in order to not destabilize the patient. When there is a perforation in the uterus, this "entrance" can be used to perform the curettage. This is particularly useful if there is trauma of the isthmus and uterine wall, and it is difficult to identify the uterine canal. A curettage is a frequent performed procedure, which should not be underestimated. If there is a perforation in the uterus, then this opening can safely be used for vacuum aspiration. PMID:25134300

Tjalma, W A A



Abdominal Aortic Aneurysms: Treatments  


... Minimally Invasive Treatments Snapshots Multimedia Multimedia Archive Abdominal Aortic Aneurysms Interventional Radiologists Treat Abdominal Aneurysms Nonsurgically Interventional radiologists ...


Ectopic lymphoid tissues and local immunity  

PubMed Central

Ectopic or tertiary lymphoid tissues develop at sites of inflammation or infection in peripheral, non-lymphoid organs. These tissues are architecturally similar to conventional secondary lymphoid organs, with separated B and T cell areas, specialized populations of dendritic cells, well-differentiated stromal cells and high endothelial venules. Ectopic lymphoid tissues are often associated with the local pathology that results from chronic infection or chronic inflammation. However, there are also examples in which ectopic lymphoid tissues appear to contribute to local protective immune responses. Here we review how ectopic lymphoid structures develop and function in the context of local immunity and pathology. PMID:18243731

Carragher, Damian M.; Rangel-Moreno, Javier; Randall, Troy D.



Pregnancy-related mortality in the United States due to hemorrhage: 1979–1992  

Microsoft Academic Search

Objective: To study trends and examine risk factors for pregnancy-related mortality due to hemorrhage.Methods: We analyzed pregnancy-related deaths from 1979–1992 from the National Pregnancy Mortality Surveillance System of the Centers for Disease Control and Prevention. Live-birth data used to calculate mortality ratios were obtained from published vital statistics. Deaths due to ectopic pregnancies were excluded.Results: There were 763 pregnancy-related deaths

Lina O Chichakli; Hani K Atrash; Andrea P MacKay; Altaf S Musani; Cynthia J Berg



Conception, complicated pregnancy, and labour of gods and heroes in Greek mythology  

Microsoft Academic Search

Pregnancy and labour are holy moments in a woman's life. Even in Greek mythology we can find descriptions of them. We searched in the Greek myths to find descriptions of labours of ancient heroes and gods. We identified descriptions of extracorporeal fertilization, superfecundation, ectopic pregnancy, preterm labour, prolonged pregnancy and Caesarean section. The use of imagination could help the reader

Christos Iavazzo; Constantinos Trompoukis; Thalia Sardi; Matthew E Falagas



Successful Management of Intrauterine Twin and Concomitant Cervical Pregnancy: A Case Report  

Microsoft Academic Search

Use of in vitro fertilization techniques increases the frequency of pathological implantation. However, simultaneous pregnancies are a rarity. Ectopic implantation of the embryo may occur in the cervical canal. This is the first case report, which describes successful management of an intrauterine twin pregnancy which occurred simultaneously with a cervical pregnancy. Diagnostic and therapeutic options are discussed along with the

E. Ujvari; F. Krizsa; A. Sebestyen; S. Varbiro; F. Paulin



Pregnancy Complications: Placental Accreta, Increta and Percreta  


... pregnancy or suffer abdominal trauma. I had a miscarriage. How long should I wait to try again? ... or treatments to discover the cause of the miscarriage, it's usually OK for you to become pregnant ...


Pregnancy Complications: Group B Strep Infection  


... pregnancy or suffer abdominal trauma. I had a miscarriage. How long should I wait to try again? ... or treatments to discover the cause of the miscarriage, it's usually OK for you to become pregnant ...


Glucocorticoid-Remediable Aldosteronism and Pregnancy  

Microsoft Academic Search

Glucocorticoid-remediable aldosteronism (GRA) is a hereditary form of primary hyperaldosteronism that presents with hypokalemia and hypertension from childhood onward. GRA is characterized by the ectopic production of aldosterone in the cortisol-producing zona fasciculata under the regulation of adrenocorticotrophic hormone. Despite the early age of onset, no previous reports of pregnancy and GRA exist. Therefore, we set out to describe the

Jennifer A. Wyckoff; Ellen W. Seely; Shelley Hurwitz; Bruce F. Anderson; Richard P. Lifton; Robert G. Dluhy


Explaining Pregnancy Loss: Parents' and Physicians' Attributions.  

ERIC Educational Resources Information Center

Asked 138 females and 56 of their male partners to explain why they believed their spontaneous abortion, fetal or neonatal death, or ectopic pregnancy occurred. Explanations for loss included blaming mother, physical problems with mother or fetus, fate, or no explanation. Physicians' explanations related to gestational age of fetus, although…

Dunn, Dana S.; And Others



Ectopic mediastinal parathyroid carcinoma presenting as acute pancreatitis.  


Parathyroid carcinoma is a rare cause of hyperparathyroidism, accounting for fewer than 1% of cases. The incidence of acute pancreatitis in patients with hyperparathyroidism was reported to be only 1.5%. We report a very rare case of ectopic mediastinal parathyroid carcinoma presenting as acute pancreatitis. A 72-year-old man presented with acute pancreatitis and hypercalcemia. During the work-up for hypercalcemia, a mediastinal parathyroid tumor was identified by (99m)Tc-sestamibi scintigraphy and magnetic resonance imaging. The tumor was completely removed via a lower cervical collar incision. The histopathology revealed parathyroid carcinoma. There was no tumor recurrence or abdominal symptoms at 3-year follow-up. PMID:23351422

Tseng, Chih-Wei; Lin, Shan-Zu; Sun, Chih-Hao; Chen, Chun-Chia; Yang, An-Hang; Chang, Full-Young; Lin, Han-Chieh; Lee, Shou-Dong



Hum Reprod . Author manuscript Fertility and pregnancy outcomes following conservative treatment for  

E-print Network

-trimester­ % [ % ­ %] deliveries, one ectopic pregnancy, two elective abortions, and 10 miscarriages) with a mean time weeks of gestation. Placenta accreta recurred in 6 of 21 cases­ (28.6 95 CI, 11.3 52

Paris-Sud XI, Université de


Abdominal wall surgery  


Abdominal wall surgery is surgery that improves the appearance of flabby, stretched-out abdominal (belly) muscles and skin. It ... tummy tuck" to more complicated, extensive surgery. Abdominal wall surgery is not the same as liposuction, which ...


Formation of ectopic osteogenesis in weightlessness  

NASA Technical Reports Server (NTRS)

An ectopic osteogenesis experiment aboard the Cosmos-936 biosatellite is described. Decalcified, lyophilized femur and tibia were implanted under the fascia or in the anterior wall of the abdomen in rats. Bone formation before and after the tests is described and illustrated. The extent of formation of ectopic bone in weightlessness did not differ significantly from that in the ground controls, but the bone marrow of the ectopic bone of the flight rats consisted exclusively of fat cells. The deficit of support-muscle loading was considered to cause the disturbance in skeletal bone tissue development.



Abdominal Aortic Aneurysm  


Abdominal Aortic Aneurysm Surgery Introduction Aorta Common Iliac Arteries Ballooning of the aorta, also known as an "abdominal aortic aneurysm," can lead to life threatening bleeding. Doctors may ...


Clinical management of pregnancy in cats.  


Average gestation length in domestic cats is 65.6 days, with a range of 52-74 days. Average reported litter size is 4.0 kittens per litter; litter size is not correlated with number of matings in a given estrus. Superfecundation is common in domestic cats; superfetation never has been definitively proven to occur. Eclampsia may occur during pregnancy in queens, with non-specific clinical signs. Ectopic pregnancy and uterine torsion have been reported. Pregnancy loss may be due to infectious causes, including bacteria, viruses or protozoa, or non-infectious causes, such as hypoluteoidism and chromosome errors. PMID:16620942

Root Kustritz, Margaret V



Pregnancy after hydrosalpinx treatment with Essure.  


We present a case of a 29-year-old woman, with a history of ectopic pregnancy, which required left salpingectomy, and with a tortuous and impermeable right fallopian tube, compatible with hydrosalpinx. As hydrosalpinx itself can compromise a future pregnancy, treatment with Essure was proposed before passing to medically assisted procreation techniques. Five months after placement of Essure in the right fallopian tube, an in vitro fertilisation cycle was successfully completed and the woman had a singleton pregnancy and vaginal delivery without intercurrences. PMID:23536627

Inocêncio, Gonçalo; Coutinho, Lúcia; Maciel, Raquel; Barreiro, Márcia



Ectopic Varices in the Gastrointestinal Tract: Short- and Long-Term Outcomes of Percutaneous Therapy  

SciTech Connect

To evaluate the results of percutaneous management of ectopic varices, a retrospective review was carried out of 14 patients (9 men, 5 women; mean age 58 years) who between 1992 and 2001 underwent interventional radiological techniques for management of bleeding ectopic varices. A history of prior abdominal surgery was present in 12 of 14 patients. The interval between the surgery and percutaneous intervention ranged from 2 to 38 years. Transhepatic portal venography confirmed ectopic varices to be the source of portal hypertension-related gastrointestinal bleeding. Embolization of the ectopic varices was performed by a transhepatic approach with coil embolization of the veins draining into the ectopic varices. Transjugular intrahepatic portosystemic shunt (TIPS) was performed in the standard fashion. Eighteen procedures (12 primary coil embolizations, 1 primary TIPS, 2 re-embolizations, 3 secondary TIPS) were performed in 13 patients. One patient was not a candidate for percutaneous treatment. All interventions but one (re-embolization) were technically successful. In 2 of 18 interventions, re-bleeding occurred within 72 hr (both embolization patients). Recurrent bleeding (23 days to 27 months after initial intervention) was identified in 9 procedures (8 coil embolizations, 1 TIPS due to biliary fistula). One patient had TIPS revision because of ultrasound surveillance findings. New encephalopathy developed in 2 of 4 TIPS patients. Percutaneous coil embolization is a simple and safe treatment for bleeding ectopic varices; however, recurrent bleeding is frequent and reintervention often required. TIPS can offer good control of bleeding at the expense of a more complex procedure and associated risk of encephalopathy.

Macedo, Thanila A., E-mail:; Andrews, James C. [Mayo Clinic and Foundation, Department of Radiology (United States); Kamath, Patrick S. [Mayo Clinic and Foundation, Division of Gastroenterology and Hepatology (United States)



Teenage pregnancy  


... find a health care provider who specializes in teenage pregnancies. At your first prenatal visit , your health care ... Yes. Teenage pregnancies are riskier than pregnancies in women who are older. This is partly because a teenager’s body is ...


Gallbladder-associated ectopic liver: A rare finding during a laparoscopic cholecystectomy  

PubMed Central

INTRODUCTION Ectopic hepatic tissue is due to an uncommon failure of embryological liver development that is rarely described in the world medical literature. The incidence of ectopic liver (EL) has been reported to be anywhere from 0.24% to 0.47% as diagnosed at laparotomy or laparoscopy. We describe a case of EL adherent to the gallbladder, removed at laparoscopic cholecystectomy. PRESENTATION OF CASE A 37-year-old female was admitted for elective cholecystectomy having had an episode of acute cholecystitis provoked by gallstones. During the procedure, a 30 mm × 10 mm × 5 mm section of EL tissue attached to the anterior wall of the gallbladder was identified and removed by en-bloc excision during laparoscopic cholecystectomy. Histological examination confirmed the absence of malignant degeneration of the hepatic tissue. The patient recovered well postoperatively and was discharged the day after the operation. She was well when seen six months later. DISCUSSION EL has been reported in several sites, such as the gallbladder, gastrohepatic ligament, adrenal glands, esophagus, and thoracic cavity. EL is often clinically silent and discovered incidentally during abdominal surgical procedures or autopsies. Because patients with ectopic liver may suffer complications such as torsion, peritoneal bleeding, fatty change, and evolution to cirrhosis or malignant degeneration to hepatocellular carcinoma, any ectopic liver tissue needs to be correctly identified and removed. CONCLUSION Despite the rare occurrence of EL, it should be recognized and removed by the surgeon to prevent a higher risk of complications and malignant transformation. PMID:23399516

Martinez, Carlos Augusto Real; de Resende, Herminio Cabral; Rodrigues, Murilo Rocha; Sato, Daniela Tiemi; Brunialti, Cyntia Viegas; Palma, Rogerio Tadeu



Cervical pregnancy: a report of four cases.  


Various conservative treatments for cervical pregnancy have been reported. However, unlike tubal ectopic pregnancy, the treatment of cervical pregnancy has not been well established. For patients who desire fertility preservation, treatment with methotrexate chemotherapy carries a high success rate for preservation of the uterus. When methotrexate is injected i.v. or i.m., expulsion of pregnant tissue occasionally takes up to 1 month. In this report, we present four cases of cervical pregnancy which were successfully managed by methotrexate injection into the bilateral uterine arteries. In cases presenting with massive bleeding, embolization of the bilateral uterine arteries was performed. Cervical pregnancy was aborted within 8 days safely, and fertility could be preserved without harmful side-effects. PMID:24118279

Kochi, Keiko; Hidaka, Takao; Yasoshima, Kuniaki; Yoneda, Kenji; Arai, Kazunori; Arai, Takashi



[Voluminous ectopic polycystic ovaries in Mayer-Rokitansky-Küster-Hauser syndrome].  


We report the case of a 20-year-old woman with primary amenorrhea, normally developed sexual characteristics, infantile external genitals and absence of vaginal orifice. Blood chemistry studies showed elevated serum levels of gonadotropin, estrogens, testosterone, 17OH-progesterone, prolactin and TSH and low concentrations of FT(3) and FT(4). Cytogenetic karyotyping and in situ fluorescence hybridization revealed a 46,XX karyotype and the presence of Barr chromatin body. Laparoscopy disclosed absence of a vagina, apparently normal, enlarged tubes, multifolicular ectopic gonads and symmetric bilateral uterine buds. Diagnostic work-up included skeletal radiography, renal ultrasonography, intravenous pyelography, pelvic echography, pelvic phlebography and magnetic resonance imaging studies to demonstrate possible associations between the genitourinary and skeletal anomalies. Based on the clinical and laboratory findings, a diagnosis of Mayer-Rokitansky-Küster-Hauser syndrome was established, associated with the presence of enlarged ectopic polycystic ovaries in the abdominal cavity. PMID:16306871

Pellicano, M; Penner, I; Connola, D; Cascone, D; Sorrentino, V; Gargano, V; Masucci, A; Stella, N; Nappi, C



Acute Ectopic Pancreatitis Occurring after Endoscopic Biopsy in a Gastric Ectopic Pancreas  

PubMed Central

Ectopic pancreas is a congenital anomaly and the most common type of ectopic tissue in the gastrointestinal tract. Most patients with an ectopic pancreas are asymptomatic and rarely have complications. Ectopic pancreatitis after an endoscopic biopsy has not been reported. We report a patient who developed acute ectopic pancreatitis in the stomach after an endoscopic biopsy. A 71-year-old male patient presented with a subepithelial tumor (SET) in the stomach and had no symptoms. Endoscopic ultrasonography demonstrated a 30-mm hypoechoic mural mass, lobulated margins, and anechoic duct-like lesions. To obtain proper tissue specimen, endoscopic biopsy was performed through the opening on the surface of the mass. The pathologic results confirmed an ectopic pancreas. One day after the endoscopic biopsy, he developed persistent epigastric pain. His serum amylase and lipase elevated. Computed tomography of the abdomen showed swelling of the SET and diffuse edema of the gastric wall. His condition was diagnosed as acute ectopic pancreatitis occurring after endoscopic biopsy. PMID:25325008

Lee, Seong Jun; Park, Do Youn; Choi, Sang A; Lee, Sang Hee; Choi, Yu Yi; Jeon, Moo Song; Song, Geun Am



A prospective evaluation of a single-visit strategy to manage pregnancies of unknown location  

Microsoft Academic Search

BACKGROUND: The aim was to assess whether women with a pregnancy of unknown location (PUL) can be safely excluded from potentially unnecessary multiple clinic visits. METHODS: A single-visit protocol was devel- oped based upon data from 200 consecutive PULs. PULs were divided into groups according to the probable risk of ectopic pregnancy. Those PULs with an initial serum progesterone #10

G. Condous; E. Okaro; A. Khalid; C. Lu; S. Van Huffel; D. Timmerman; T. Bourne



Misdiagnosis of bilateral tubal pregnancy: a case report  

PubMed Central

Introduction The incidence of bilateral tubal pregnancy is rising due to the increase of pelvic inflammatory disease and assisted reproductive techniques. Because the clinical manifestations of bilateral tubal pregnancy are not specific, we often ignore inspection of the other fallopian tube when focusing on the lesions, which may cause misdiagnosis. Case presentation A 33-year-old Chinese woman presented with vaginal bleeding after menopause and with an abnormality found by transvaginal ultrasound scan for which she underwent laparoscopy and salpingectomy. Unfortunately, she had to undergo a repetitive laparoscopic salpingotomy for the other tubal pregnancy due to misdiagnosis of her bilateral tubal pregnancy. Conclusions The incidence of unusual presentations of ectopic pregnancies has risen. Surgeons should always keep in mind the possibility of bilateral tubal pregnancy. An attentive examination of the pelvis, especially the two fallopian tubes, is necessary to avoid missing bilateral tubal pregnancy. PMID:25312677



Ectopic muscle in the middle ear  

Microsoft Academic Search

An ectopic muscle was found in the hypotympanum of a 31-year-old Japanese male. The muscle produced symptoms quite similar to those seen in cases of glomus jugulare tumor: a red mass visible through the ear drum, conductive deafness, a compressed jugular bulb demonstrable by retrograde jugulography, and VIIth and IXth nerve paresis. However, the audible pulsating tinnitus of glomus jugulare

Kiyotaka Murata; Haruo Saito; Manabi Hinoki



Ectopic gestation following emergency contraceptive pill administration  

Microsoft Academic Search

Emergency contraceptive pill prescription following rape is common. We report a case of ectopic gestation after emergency contraceptive pill failure and review the literature on this rare complication. A 26-year-old woman with a normal menstrual period 2 weeks before was administered an emergency contraceptive pill 8 hours after a single sexual assault. The assault was her only sexual activity before

Carin L. Nielsen; Leslie Miller



[Dilated cardiomyopathy induced by ectopic atrial tachycardia].  


The deleterious effect of chronic or incessant supraventricular tachycardia on ventricular function is well-known and it has been demonstrated than can ultimately lead to dilated cardiomyopathy if unrecognized. Any variety of supraventricular tachycardia with chronic evolution may lead to left ventricular dysfunction, ectopic atrial tachycardia because of its persistent nature, often incessant and poorly responsive to antiarrhythmic drugs is a frequent cause of reversible congestive heart failure in patients without other demonstrable organic heart disease. Five patients (aged 14 to 52 years) were referred with symptoms of heart failure, NYHA functional class II (one patient), class III (one patient) and class IV (3 patients) associated with an incessant ectopic atrial tachycardia. Four patients underwent radiofrequency catheter ablation of the ectopic focus and one patient was treated with amiodarone. All patients were successfully treated and the echocardiographic assessment of left ventricular function indicated regression of the cardiomyopathy picture with recovery of systolic function, (mean left ventricular ejection fraction 39.2 +/- 6.1% before vs mean 62.4 +/- 4.8% after (p < 0.01). The clinical and echocardiographic picture of cardiomyopathy induced by incessant ectopic atrial tachycardia is reversible after successful treatment. This stresses the necessity of recognizing such arrhythmia as cause of primary heart failure. PMID:10959459

Velázquez Rodríguez, E; Martínez Enríquez, A



Pregnancy Discrimination  


... Civil Rights Act of 1964. Discrimination on the basis of pregnancy, childbirth, or related medical conditions constitutes ... expenses for pregnancy related conditions on the same basis as expenses for other medical conditions. The PDA ...


Teenage Pregnancy  


... plan to get pregnant, but many do. Teen pregnancies carry extra health risks to both the mother ... later on. They have a higher risk for pregnancy-related high blood pressure and its complications. Risks ...


Cervical pregnancy complicated with group B streptococcal meningitis.  


Maternal group B streptococcal infection is an uncommon entity. Herein we describe a case of a 27-year-old-woman who presented life-threateniing group B streptococcus meningitis with an ectopic cervical pregnancy. No other infectious focus have been found. To our knowledge this is the first time that this association has been reported. PMID:17674249

Sabadell, Jordi; Sanchez-Iglesias, Jose Luis; Ferrer, Raquel; Higueras, Teresa; Alijotas, Jaume; Cabero, Luis



Unintended pregnancy  

Microsoft Academic Search

Unintended pregnancy is a worldwide problem that affects women, their families, and society. Unintended pregnancy can result from contraceptive failure, non-use of contraceptive services, and, less commonly, rape. Abortion is a frequent consequence of unintended pregnancy and, in the developing world, can result in serious, long-term negative health effects including infertility and maternal death. In many developing countries, poverty, malnutrition,

Carrie S Klima



Ectopic fetuses in two cottontail rabbits.  


Mummified fetuses were discovered in the abdominal cavities of two cottontail rabbits (Sylvilagus floridanus) collected during separate years from the same geographical location in Virginia. One of these rabbits had a patent opening through the vaginal wall to the abdominal cavity. The uterus and vagina of the second rabbit appeared normal. PMID:1195499

Jacobson, H A; Kibbe, D P; Kirkpatrick, R L



Pregnancy and liver disease.  


Liver disease in pregnancy should be considered in 3 categories: pre-existing disease, disease peculiar to pregnancy and coincident acute liver or gall-stone disease. In addition the time of onset of diagnosis in terms of the trimester of gestation must be verified, as the diseases peculiar to pregancy have a characteristic time of onset. In the last trimester closes obstetric management is required for the constellation of abnormal liver function tests, nausea and/or vomiting and abdominal pain. This may be due to severe pre-eclampsia, HELLP (haemolysis, elevated liver enzymes and low platelets) syndrome or acute fatty liver of pregnancy with or without sub-capsular hepatic haematomas, amongst which there is an overlap. Early delivery is curative. A molecular basis consisting of long chain 3-hydroxyl CoA dehydroxegenase deficiency in heterozygote mothers underlies this clinical syndrome. Ursodeoxycholic acid is now established treatment for intra-hepatic cholestasis of pregnancy and appears to improve foetal outcome. Hepatitis B vaccination and immunoglobulin at birth prevents chronic hepatitis B in children of HBsAg (hepatitis B surface antigen) positive carrier mothers. PMID:9514993

Burroughs, A K



Mirror image artifact mimicking heterotopic pregnancy on transvaginal ultrasound: case series.  


Vaginal bleeding in early pregnancy is a common emergency department complaint. Point-of-care ultrasound is a useful tool to evaluate for intrauterine ectopic pregnancy. Emergency physicians performing these studies need to be cognizant of artifacts produced by ultrasound technology, as they can lead to misdiagnosis. We present two cases where mirror-image artifacts initially led to a concern for heterotopic pregnancies but were excluded on further imaging. PMID:25247050

Malhotra, Radhika; Bramante, Robert M; Radomski, Marek; Nelson, Mathew



Mirror Image Artifact Mimicking Heterotopic Pregnancy on Transvaginal Ultrasound: Case Series  

PubMed Central

Vaginal bleeding in early pregnancy is a common emergency department complaint. Point-of-care ultrasound is a useful tool to evaluate for intrauterine ectopic pregnancy. Emergency physicians performing these studies need to be cognizant of artifacts produced by ultrasound technology, as they can lead to misdiagnosis. We present two cases where mirror-image artifacts initially led to a concern for heterotopic pregnancies but were excluded on further imaging.

Malhotra, Radhika; Bramante, Robert M.; Radomski, Marek; Nelson, Mathew



Pregnancy Complications: Genital Herpes  


... Home > Pregnancy > Pregnancy Complications > Genital herpes and pregnancy Pregnancy complications Pregnancy complications may need special medical care. ... been added to your dashboard . Genital herpes and pregnancy Genital herpes is a sexually transmitted disease (also ...


Cystic Fibrosis and Pregnancy  


... Home > Pregnancy > Pregnancy Complications > Cystic fibrosis and pregnancy Pregnancy complications Pregnancy complications may need special medical care. ... been added to your dashboard . Cystic fibrosis and pregnancy Cystic fibrosis (CF) is a condition that affects ...


Parietal abdominal endometriosis following Cesarean section.  


Endometriosis is a pathological feature induced by the presence and ectopic development of islets of endometrial active cells. The most common site of occurrence is the genital system, causing specific gynecological pathology. The extragenital localization of endometriosis is rare, but it is more severe and it may have a malignant local evolution, although its structures remain benign. The endometrial inclusions in the abdominal wall scar are iatrogenic "implants", created at the same time with the surgical operation, performed on patients with genital endometriosis. The only curable treatment of this topography of endometriosis is the surgical removal of all the pathological tissue, through a large excision. The hormonal therapy is adjuvant. Our study presents three cases treated in our clinic; the most important objective was to establish the etiological diagnosis and, subsequently, the large excision of the lesions. PMID:21424102

Pa?alega, M; Mirea, C; Vîlcea, I D; Vasile, I; Ple?ea, I E; Calot?, F; Me?in?, C; Pârv?nescu, H; Baluta, M



Unilateral duplex horseshoe kidney with ectopic ureterocele  

SciTech Connect

Horseshoe kidney results from mesial fusion of the two nephrogenic blastemas during the fourth to seventh weeks of gestation. Associated genitourinary anomalies occur in approximately 25% of patients with horseshoe kidney. The authors report a case of a horseshoe kidney with unilateral pelvis and ureteral duplication with an ectopic ureterocele obstructing its upper moiety diagnosed by intravenous urography and real-time sonography. 13 references, 2 figures.

Sumner, T.E.; Volberg, F.M.; Munitz, A.; Harrison, L.H.; Mashburn, A.M.



Abdominal vacuum lift as an aid to diagnosing abdominal adhesions  

E-print Network

The internal organs are designed to move freely and slide over one another during normal body movement. The abdominal organs, however, have a tendency to adhere to the abdominal cavity (peritoneum) and other abdominal ...

Strauss, Julius (Julius Y.)



Embarazo ectópico bilateral con embrión vivo en la trompa izquierda  

Microsoft Academic Search

Bilateral ectopic pregnancy with a live embryo is a rare occurrence. We report a case of bilateral ectopic pregnancy with live embryo in one tube and an interrupted gestation in the other tube, in a patient with no risk factors. When there is a unilateral ectopic pregnancy, even without risk factors, the other adnexal area and abdominal cavity should also

Aitziber Elvira Urdampilleta; Amaia Oyarzabal Urkiola; M. José Larraza Zandueta; Olatz Lizartza; Borja Rivero Torrejón; Juan Mari Landa Aranzabal; Miguel Ángel Giribet



Repeated pregnancy in a woman with uterine prolapse from a rural area in Nepal  

Microsoft Academic Search

Pelvic organ prolapse is common in rural women in Nepal. Pregnancy in a woman with pelvic organ prolapse is uncommon and rarely continues beyond the second trimester. If it proceeds after that, the uterus usually ascends with progression of pregnancy and becomes abdominal, leaving little trace of prolapse. Pregnancy continuing to term with uterine prolapse is very rare. The case

Sandesh Pantha



Abdominal Wall Endometriomas  

Microsoft Academic Search

Endometriosis is a condition in which uterine mucosal tissue is located outside the uterus. Endometriosis may be pelvic or extrapelvic. The term endometrioma is used when endometriosis appears as a circumscribed mass. Abdominal wall endometriomas are usually a secondary process in scars after surgical procedures. A retrospective study of abdominal wall endometrioma, from March 1992 through April 1999 at our

Amit J. Dwivedi; Sunita N. Agrawal; Yvan J. Silva



The role of routine post-natal abdominal ultrasound for newborns in a resource-poor setting: a longitudinal study  

PubMed Central

Background- Neonatal abdominal ultrasound is usually performed in Nigeria to investigate neonatal symptoms rather than as a follow up to evaluate fetal abnormalities which were detected on prenatal ultrasound. The role of routine obstetric ultrasonography in the monitoring of pregnancy and identification of fetal malformations has partly contributed to lowering of fetal mortality rates. In Nigeria which has a high maternal and fetal mortality rate, many pregnant women do not have ante-natal care and not infrequently, women also deliver their babies at home and only bring the newborns to the clinics for immunization. Even when performed, most routine obstetric scans are not targeted towards the detection of fetal abnormalities. The aim of the present study is to evaluate the benefit of routinely performing abdominal scans on newborns with a view to detecting possible abnormalities which may have been missed ante-natally. Methods- This was a longitudinal study of 202 consecutive, apparently normal newborns. Routine clinical examination and abdominal ultrasound scans were performed on the babies by their mother's bedside, before discharge. Neonates with abnormal initial scans had follow-up scans. Results- There were 108 males and 94 females. There were 12 (5.9%) abnormal scans seen in five male and seven female neonates. Eleven of the twelve abnormalities were in the kidneys, six on the left and five on the right. Three of the four major renal anomalies- absent kidney, ectopic/pelvic kidney and two cases of severe hydronephrosis were however on the left side. There was one suprarenal abnormality on the right suspected to be a possible infected adrenal haemorrage. Nine of the abnormal cases reported for follow- up and of these, two cases had persistent severe abnormalities. Conclusions- This study demonstrated a 5.9% incidence of genito urinary anomalies on routine neonatal abdominal ultrasound in this small population. Routine obstetric USS is very useful but inadequate availability of skilled personnel and cost implications create great challenges in poor resource settings like Nigeria. However, awareness should be created so that parents who can afford such investigations can make informed decisions. PMID:21749724



Abdominal hernias: Radiological features  

PubMed Central

Abdominal wall hernias are common diseases of the abdomen with a global incidence approximately 4%-5%. They are distinguished in external, diaphragmatic and internal hernias on the basis of their localisation. Groin hernias are the most common with a prevalence of 75%, followed by femoral (15%) and umbilical (8%). There is a higher prevalence in males (M:F, 8:1). Diagnosis is usually made on physical examination. However, clinical diagnosis may be difficult, especially in patients with obesity, pain or abdominal wall scarring. In these cases, abdominal imaging may be the first clue to the correct diagnosis and to confirm suspected complications. Different imaging modalities are used: conventional radiographs or barium studies, ultrasonography and Computed Tomography. Imaging modalities can aid in the differential diagnosis of palpable abdominal wall masses and can help to define hernial contents such as fatty tissue, bowel, other organs or fluid. This work focuses on the main radiological findings of abdominal herniations. PMID:21860678

Lassandro, Francesco; Iasiello, Francesca; Pizza, Nunzia Luisa; Valente, Tullio; Stefano, Maria Luisa Mangoni di Santo; Grassi, Roberto; Muto, Roberto



Portal Cavernoma during Pregnancy  

PubMed Central

Portal vein thrombosis (PVT) is characterized by the obstruction of the portal venous system. The venous obstruction can be partial or complete and it is caused by thrombogenic conditions (acquired or hereditary) or nonthrombotic factors. The acquired conditions include abdominal inflammation, infections, surgery, myeloproliferative disorders, obesity, oral contraceptive intake, pregnancy, and postpartum period. Occasionally, it is not possible to recognize any overt cause of PVT. During pregnancy there is an increased venous thromboembolism risk mainly in the systemic venous system and the PVT can occur, but there are no data about its exact prevalence, etiology, and outcome. The portal cavernoma is the cavernomatous transformation of the portal vein. It is a consequence of chronic PVT and occurs when myriads of collateral channels develop to bypass the occlusion. The clinical presentation includes hematemesis due to variceal bleeding, ascites or anaemia, and splenomegaly. The cavernous transformation of the portal vein is easily diagnosed by sonography. We report our case of a 32-year-old, gravida 3 para 2, pregnant woman admitted to our hospital at 13 weeks and 1 day of gestation, clinically asymptomatic. Laboratory test, ultrasound, and endoscopic evaluation were negative. After a detailed counseling, the patient decided on termination of pregnancy at 15 weeks and 1 day of gestation. PMID:24392231

Ferrara, Cinzia; Sansone, Anna; Bifulco, Giuseppe; Nappi, Carmine; Di Carlo, Costantino



Diagnosis of chronic ectopic gestation by hysterosalpingography  

Microsoft Academic Search

.   Pelvic ultrasound and human chorionic gonadotropin assays are currently the standard methodology to detect tubal pregnancy.\\u000a We report a case of infertility investigated by hysterosalpingography in which a clinically unsuspected chronic tubal pregnancy\\u000a was identified with the predisposing factor of bilateral salpingitis isthmica nodosa. The radiographic findings of this very\\u000a rare cause of tubal filling defect are shown.\\u000a RID=\\

N. S. Curry; G. A. Blackwood; C. C. Tsai



Treatment of Ectopic Mandibular Second Permanent Molar with Elastic Separators  

PubMed Central

Ectopic eruption is a developmental disturbance in which the tooth fails to follow its normal eruption pathway. Ectopic eruption of the second molar is relatively rare. This paper presents the case of thirteen-year-old male with an ectopic mandibular second permanent molar. The condition was corrected with surgical exposure and placement of elastic separators. This case report lays emphasis on the practice of basic methods to obtain acceptable results rather than extensive surgical or orthodontic corrections. It is advised that ectopic teeth should not be neglected especially when it concerns developing caries and malocclusion. PMID:25050182

Rajesh, R.; Naveen, V.; Amit, S.; Baroudi, Kusai; Sampath Reddy, C.; Namineni, Srinivas



Teenage Pregnancy.  

ERIC Educational Resources Information Center

Reviews the problems of teenage pregnancy, including the costs to society, the challenge to educators, and the types of preventive programs developing across the country. Programs dealing strictly with reproduction and contraception are the least effective deterrents to teenage pregnancy. (MD)

McClellan, Mary C.



Pregnancy and Liver Function  


... Liver Function Liver Fast Facts: Pregnancy and Liver Function | Pregnancy and Liver Function How does pregnancy affect the liver? Pregnancy has ... liver. There are no significant changes in liver function during pregnancy, but some markers of liver function ...


Pregnancy Complications: Chlamydia  


... in the community. Home > Pregnancy > Pregnancy Complications > Chlamydia Pregnancy complications Pregnancy complications may need special medical care. ... younger than 25. Can chlamydia cause problems during pregnancy? Yes. If you get it before or during ...


Pregnancy Complications: Syphilis  


... in the community. Home > Pregnancy > Pregnancy Complications > Syphilis Pregnancy complications Pregnancy complications may need special medical care. ... syphilis each year. Can syphilis cause problems during pregnancy and for your baby? Yes. You can pass ...


Pregnancy Complications: Gonorrhea  


... in the community. Home > Pregnancy > Pregnancy Complications > Gonorrhea Pregnancy complications Pregnancy complications may need special medical care. ... the United States. Can gonorrhea cause complications during pregnancy and for your baby? Yes. Gonorrhea can lead ...


Pregnancy Complications: Preeclampsia  


... in the community. Home > Pregnancy > Pregnancy Complications > Preeclampsia Pregnancy complications Pregnancy complications may need special medical care. ... health care provider right away. What health and pregnancy complications can preeclampsia cause? Without treatment, preeclampsia can ...


Pregnancy and IC  


Pregnancy & IC How Pregnancy Affects IC Unfortunately, there is limited scientific data on the subject of interstitial cystitis (IC) and pregnancy. In 1989, ... 2009 issue of the ICA Update . Planning Your Pregnancy Planning ahead for your pregnancy will let you: ...


Abdominal Pain Syndrome  


... most helpful information that a doctor uses to determine the cause of abdominal pain. The characteristics of the pain (sharp, dull, cramping, burning, twisting, tearing, penetrating), its location and relation to eating or to having a bowel movement are important ...


Abdominal ultrasound (image)  


Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X- ... use high frequency sound waves to produce an image and do not expose the individual to radiation. ...


Abdominal CT scan  


... care provider if you take the diabetes medication metformin(Glucophage). People taking this medicine may have to ... be used to look for: Cause of abdominal pain or swelling Hernia Cause of a fever Masses ...


Intra-abdominal abscess  


... abscess requires antibiotics (given by an IV) and drainage. Drainage involves placing a needle through the skin in ... abscess and how bad the infection is. Generally, drainage is successful in treating intra-abdominal abscesses that ...


Postpartum Lower Abdominal Pain  

Microsoft Academic Search

Pains after labor can be as severe as those experienced during labor, particularly the commonly occurring lower abdominal\\u000a “after-pains” that are associated with prolonged uterine contractions during breast feeding. Other causes of lower abdominal\\u000a pain may not be physiologically based but are either direct complications of parturition, such as genital infection, or fortuitous,\\u000a such as appendicitis. Although the focus of

Anita Holdcroft



Heterotopic cesarean scar pregnancy: diagnosis, treatment, and prognosis.  


Heterotopic cesarean scar pregnancy is a rare, life-threatening form of ectopic pregnancy. To provide information regarding the clinical manifestations, diagnosis, management, and prognosis of this condition, we reviewed all cases reported in the English literature. All literature on heterotopic cesarean scar pregnancy was retrieved by searching the PubMed database and tracking references of the relevant literature. Full texts were reviewed, and clinical manifestations, diagnostic methods, and the relationship between the treatment and prognosis were summarized. A total of 14 patients with heterotopic cesarean scar pregnancies were identified, including 6 spontaneous pregnancies and 8 following in vitro fertilization-embryo transfer. Gestational ages at diagnosis ranged from 5 weeks to 8 weeks 4 days. Only 5 cases presented with vaginal bleeding, and the others were asymptomatic. All 14 cases were diagnosed by transvaginal sonography. One patient with no future fertility requirements underwent pregnancy termination by methotrexate. Of the remaining 13 patients who desired to preserve their intrauterine gestations, 10 were treated by sonographically guided selective embryo reduction in situ (by embryo aspiration, drug injection, or both); 2 underwent laparoscopic and hysteroscopic excision of the ectopic pregnancy masses; and 1 was treated by expectant management. All operations were successful and maintained a living intrauterine gestation. Twelve cases resulted in live births by cesarean delivery (3 at term and 9 preterm). One patient underwent pregnancy termination at 12 weeks because of a fetal malformation confirmed by sonography. The possibility of heterotopic cesarean scar pregnancy after cesarean delivery should be considered, especially when pregnancy follows assisted reproductive technology. Transvaginal sonography is an important tool for diagnosis and management. Despite the many options, the best treatment for this condition remains unclear. Selective embryo reduction in situ with sonographic guidance is the main treatment modality and can result in a successful intrauterine gestation, albeit at high risk. PMID:25154932

OuYang, Zhenbo; Yin, Qian; Xu, Yujing; Ma, Yunyan; Zhang, Qiushi; Yu, Yanhong



Long segment jejuno-ileal duplication cyst with ectopic gastric mucosa detected on 99mTc-pertechnetate scintigraphy  

PubMed Central

Enteric duplication cysts (EDC) are uncommon congenital anomalies that may occur anywhere along the digestive tract. Ectopic gastric mucosa (EGM), another rare condition, is usually present as short segments in the small intestine and may be associated with EDC. Abdominal scintigraphy with 99mTc pertechnetate may be useful in the diagnosis, since the radiotracer is concentrated by functioning gastric mucosa. In this case report, the authors describe a child with a 150 cm long jejuno-ileal duplication cyst containing EGM identified by intense 99mTc pertechnetate uptake on scintigraphy without any pharmacological intervention. PMID:24163514

Bhattacharya, Anish; Samujh, Ram; Rao, Katragadda Lakshmi Narasimha; Mittal, Bhagwant Rai



Medullary Thyroid Carcinoma with Ectopic Adrenocorticotropic Hormone Syndrome  

PubMed Central

Ectopic adrenocorticotropic hormone (ACTH) syndrome is caused most frequently by a bronchial carcinoid tumor or by small cell lung cancer. Medullary thyroid carcinoma (MTC) is a rare etiology of ectopic ACTH syndrome. We describe a case of Cushing syndrome due to ectopic ACTH production from MTC in a 48-year-old male. He was diagnosed with MTC 14 years ago and underwent total thyroidectomy, cervical lymph node dissection and a series of metastasectomies. MTC was confirmed by the pathological examination of the thyroid and metastatic mediastinal lymph node tissues. Two years after his last surgery, he developed Cushingoid features, such as moon face and central obesity, accompanied by uncontrolled hypertension and new-onset diabetes. The laboratory results were compatible with ectopic ACTH syndrome. A bilateral adrenalectomy improved the clinical and laboratory findings that were associated with Cushing syndrome. This is the first confirmed case of ectopic ACTH syndrome caused by MTC in Korea. PMID:24741461

Choi, Hong Seok; Kim, Min Joo; Moon, Chae Ho; Yoon, Jong Ho; Ku, Ha Ra; Kang, Geon Wook; Na, Im Il; Lee, Seung-Sook; Lee, Byung-Chul; Park, Young Joo; Kim, Hong Il



Pregnancy Tumor  


... Pregnancy tumors are not dangerous. Causes include: Poor oral hygiene (not enough brushing, flossing or cleanings to remove food or plaque) Irritation of the area (caused by the mouth's inflammatory response to the food or plaque) Trauma ...


Adolescent Pregnancy  

Microsoft Academic Search

Adolescent pregnancy and childbearing remain at high levels and are problems in the United States even though rates have declined\\u000a substantially since the early 1990s (Manlove et al., 2002). Teen pregnancy and birth rates in the United States still are\\u000a about one-third higher than those in England and Wales, and are more than twice the rates in Canada (Singh &

Brent C. Miller; Rayna Sage; Bryan Winward


Multiple Extrauterine Pregnancy with Early and Near Full-Term Mummified Fetuses in a New Zealand White Rabbit (Oryctolagus cuniculus)  

PubMed Central

Extrauterine pregnancy (EP) is infrequent in mammalian species and occurs when fertilized ova implant and develop outside the uterus. A common outcome is abdominal pregnancy resulting in mummified fetuses (lithopedia). Here we describe an unusual case of abdominal pregnancy with early and near full-term lithopedia. Macroscopic findings supported the diagnosis of lithopedia with distinct age differences and facilitated further characterization of primary ectopia and risk factors leading to this occurrence. PMID:24602549

Tena-Betancourt, Eduardo; Tena-Betancourt, Carlos A; Zuniga-Munoz, Alejandra M; Hernandez-Godinez, Braulio; Ibanez-Contreras, Alejandra; Graullera-Rivera, Veronica



Body art and pregnancy.  


Body art has gained tremendously in popularity over the past 20 years, and a substantial number of pregnant women may have tattoos or piercings. In most cases, pregnancy will be uneventful. However, on rare occasions, body art may become an issue or cause complications. Navel and abdominal surface piercing and microdermal implants may cause unsightly stretch marks from gravid distension. Nipple piercing could impair breastfeeding. In emergency situations, oral piercing may interfere with airway management and nasal jewelry can be inhaled or swallowed during orotracheal intubation. Tattoos may become distorted if placed on a distended area or they may cover surgical incision lines. The risk of introducing tattoo pigments during epidural analgesia, with the potential for tumor growth, is currently under debate, although the arguments are highly speculative and without solid basis. PMID:20557995

Kluger, Nicolas



Predicting Pregnancy and Pregnancy Attrition.  

National Technical Information Service (NTIS)

Because pregnancy accounts for a large proportion of the attrition among enlisted Marine Corps women, an investigation was conducted of the effects of traditional family/career orientation, feelings of isolation, and feelings of dissatisfaction with the M...

G. Meg, M. H. Royle



[A rare cause of peritoneal fistula].  


The abdominal pregnancy is an extremely rare variety of the ectopic pregnancy. The symptoms are atypical, which causes a delay in putting the diagnosis, which is established most of the times when complications appear, which are always severe, and endanger the patients lives. This paper presents a rare complication of the abdominal pregnancy, at about 6 months old, stopped in evolution, complicated by an abscess, generalised peritonitis and peritoneal fistula. The diagnosis and treatment of the abdominal ectopic pregnancy are discussed. PMID:17278649

Vasile, I; Cheie, Mihaela; Persu, B; Tenea, T; Vîlcea, I D; Pa?alega, M; Calot?, F; Me?in?, C; Dumitrescu, T; Scurtu, S; M?nescu, N



Abdominal Inflammatory Myofibroblastic Tumor  

PubMed Central

A 28-year-old woman was referred to our hospital because of abdominal pain, weight loss and a palpable intra-abdominal mass. A CT scan revealed a tumor with a diameter of 7 cm with sharp margins, intra-tumoral fatty components and enhancing soft tissue. After initial workup, which suggested an inflammatory myofibroblastic tumor (IMT), she underwent laparotomy with complete resection. Pathological examination indeed revealed IMT. IMT is a rare benign neoplasm and has been described in nearly the entire body. It presents with nonspecific symptoms. The therapy of abdominal IMT consists of radical surgery because of high local recurrence rates. In this case report clinical, surgical, radiological and histological features with a review of the relevant literature are described. PMID:24707245

Groenveld, Roosmarijn L.; Raber, Menno H.; Oosterhof-Berktas, Richard; Eijken, Erik; Klaase, Joost M.



Pregnancy and Rheumatic Disease  


... outcome than others. What are the effects of pregnancy on rheumatic diseases? During pregnancy, the effects of ... scans during pregnancy. Use of rheumatic drugs during pregnancy and lactation Information regarding the safety of many ...


About Teen Pregnancy  


... . Teen Pregnancy Share Compartir About Teen Pregnancy On this Page Teen Pregnancy in the United ... and Promoting Health Equity Among Youth Resources Teen Pregnancy in the United States In 2012, a total ...


Sertraline (Zoloft) and Pregnancy  


Sertraline (Zoloft) and Pregnancy This sheet talks about the risks that exposure to sertraline can have during pregnancy. With each pregnancy, all women ... taking the medication. Can taking sertraline during my pregnancy cause birth defects? Sertraline is one of the ...


Postterm pregnancy  

PubMed Central

Postterm pregnancy is a pregnancy that extends to 42 weeks of gestation or beyond. Fetal, neonatal and maternal complications associated with this condition have always been underestimated. It is not well understood why some women become postterm although in obesity, hormonal and genetic factors have been implicated. The management of postterm pregnancy constitutes a challenge to clinicians; knowing who to induce, who will respond to induction and who will require a caesarean section (CS). The current definition and management of postterm pregnancy have been challenged in several studies as the emerging evidence demonstrates that the incidence of complications associated with postterm pregnancy also increase prior to 42 weeks of gestation. For example the incidence of stillbirth increases from 39 weeks onwards with a sharp rise after 40 weeks of gestation. Induction of labour before 42 weeks of gestation has the potential to prevent these complications; however, both patients and clinicians alike are concerned about risks associated with induction of labour such as failure of induction and increases in CS rates. There is a strong body of evidence however that demonstrates that induction of labour at term and prior to 42 weeks of gestation (particularly between 40 & 42 weeks) is associated with a reduction in perinatal complications without an associated increase in CS rates. It seems therefore that a policy of induction of labour at 41 weeks in postterm women could be beneficial with potential improvement in perinatal outcome and a reduction in maternal complications. PMID:24753906

Galal, M.; Symonds, I.; Murray, H.; Petraglia, F.; Smith, R.



Papillary carcinoma in ectopic thyroid detected by Tl-201 scintigraphy  

SciTech Connect

A 37-year-old man with papillary carcinoma in an ectopic thyroid is presented. Excisional biopsy revealed the cervical mass to be a metastasis from thyroid cancer. X-ray, ultrasonography, and computed tomography, however, failed to identify the primary tumor in the thyroid. Incidental TI-201 uptake was noted in the midline of the anterior neck, and a palpable nodule was discovered in this area. Fine needle aspiration cytology demonstrated Class V papillary adenocarcinoma, and subsequent surgery confirmed a papillary carcinoma in the ectopic thyroid. This case suggests the usefulness of TI-201 scintigraphy for the detection of ectopic thyroid malignancy.

Michigishi, T.; Mizukami, Y.; Mura, T.; Nomura, T.; Watanabe, K.; Tonami, N.; Hisada, K. (Kanazawa Univ. Hospital (Japan))



Papillary Carcinoma in Median Aberrant Thyroid (Ectopic) - Case Report  

PubMed Central

Median ectopic thyroid may be encountered anywhere from the foramen caecum to the diaphragm. Non lingual median aberrant thyroid (incomplete descent) usually found in the infrahyoid region and malignant transformation in this ectopic thyroid tissue is very rare. We report an extremely rare case of papillary carcinoma in non lingual median aberrant thyroid in a 25-year-old female. The differentiation between a carcinoma arising in the median ectopic thyroid tissue and a metastatic papillary carcinoma from an occult primary in the main thyroid gland is also discussed. PMID:25121039

K, Shashidhar; Deshmane, Vijaya Laxmi; Kumar, Veerendra; Arjunan, Ravi



Uterine torsion in second trimester of pregnancy followed by a successful-term pregnancy.  


Uterine torsion is defined as rotation of the uterus of more than 45° on its long axis. It is an unusual complication of pregnancy and for most obstetricians it probably represents a 'once-in-a-lifetime' diagnosis. Fetal mortality up to 12% and occasional maternal mortality are reported. A 22-year-old second gravida presented at 22+ weeks gestation with severe abdominal pain and shock. Laparotomy was done for suspected abruptio placenta, when torsion of the uterus to 180° was diagnosed. Posterior hysterotomy was performed. She conceived the next year and was delivered at term by caesarean section. Uterine torsion is a rare complication of pregnancy and obstetricians should have this complication in mind when performing a caesarean section for undiagnosed severe abdominal pain in pregnancy. Anatomical landmarks should be defined if possible, prior to uterine incision during a caesarean section, to avoid posterior hysterotomy. PMID:22914233

Fatih, Farah Farouq; Gowri, Vaidyanathan; Rao, Kuntal



Appendicitis During Pregnancy with a Normal MRI  

PubMed Central

Abdominal pain frequently represents a diagnostic challenge in the acute setting. In pregnant patients, the gravid abdomen and concern for ionizing radiation exposure further limit evaluation. If undiagnosed, appendicitis may cause disastrous consequences for the mother and fetus. We present the case of a pregnant female who was admitted for right lower quadrant abdominal pain. Advanced imaging of the abdomen and pelvis was interpreted to be either indeterminate or normal and a diagnosis of acute appendicitis was made on purely clinical grounds. This patient’s management and a literature review of diagnostic techniques for acute appendicitis during pregnancy are discussed. PMID:25247035

Thompson, Matthew M.; Kudla, Alexei U.; Chisholm, Chris B.



Laparoscopic total abdominal colectomy  

Microsoft Academic Search

The aim of this study was to prospectively assess the impact of laparoscopy upon the outcome of total abdominal colectomy (TAC). Specifically, patients underwent standard laparotomy with TAC and ileoproctostomy (TAC + IP), TAC and ileoanal reservoir (TAC + IAR), laparoscopically assisted TAC + IP (L-TAC + IP), or laparoscopically assisted TAC + IAR (L-TAC + IAR). Parameters studied included

Steven D. Wexner; Olaf B. Johansen; Juan J. Nogueras; David G. Jagelman



Abdominal Aortic Aneurysm (AAA) Screening  


... covered? Search for covered items Abdominal aortic aneurysm screening How often is it covered? Medicare Part B (Medical Insurance) covers a one-time abdominal aortic aneurysm ultrasound. You must get a referral for it ...


Ureteral triplication, contralateral duplication and bilateral extravesical ectopic ureter.  


A case of ureteral triplication associated with contralateral ureteral duplication and bilateral extravesical ectopic ureter is reported. The child presented with urinary incontinence. The incidence, classification and embryology of triplication are reviewed. PMID:4032556

Youngson, G G



A challenging case of an ectopic parathyroid adenoma  

PubMed Central

The occurrence of ectopic parathyroid adenomas is not uncommon (3-4% of all parathyroid adenomas). A 42-year-old female diagnosed as having GH secreting pituitary adenoma presented with an ectopic mediastinal parathyroid adenoma located between left (Lt) pulmonary artery and Lt main bronchus. The aim of presenting this case is not to appreciate the rarity of the condition but to rather discuss some of the vital practical problems faced during its management. Patient presenting in endocrine OPD with nausea, vomiting, drowsiness and chronic constipation was investigated biochemically and with various imaging modalities and accordingly managed. Patient was also investigated from the perspective of MEN 1 syndrome. Results: Baseline routine investigations revealed hypercalcemia (corrected S. Ca- 16.9 mg/dl) due to primary hyperparathyroidism (PHP, PTH-1190 ng/L) with adenoma located between Lt main bronchus and Lt pulmonary artery. Patient was medically managed and after proper preoperative preparation, surgical excision by open thoracotomy was planned but two days before surgery she developed pulmonary embolism and was shifted to ICU where she died after 20 days. An accurate preoperative localization by various imaging procedures plays a decisive role in case of ectopic adenomas in the chest. Ectopic parathyroid adenomas are frequent cause of failed initial surgery. The best surgical approach to these ectopic adenomas is still controversial. Equally effective newer medical treatment modalities are also required in patients who are awaiting or are unfit for surgery. Lastly combination of MEN 1 with ectopic parathyroid adenoma is rare. PMID:23565445

Panchani, Roopal; Varma, Tarun; Goyal, Ashutosh; Gupta, Nitinranjan; Saini, Ashish; Tripathi, Sudhir



Endosonographic Features of Histologically Proven Gastric Ectopic Pancreas  

PubMed Central

Gastric ectopic pancreas is an uncommon developmental anomaly and its histological diagnosis is usually difficult by using a conventional biopsy forceps. In the literature, most cases of gastric ectopic pancreas were usually diagnosed by gross pattern during endoscopic examination or features of endoscopic ultrasound. In contrast, this disease was seldom diagnosed by histology in clinical practice. Although the typical endoscopic ultrasonographic features of ectopic pancreas include heterogeneous echogenicity, indistinct borders, and a location within 2 or more layers, it can also exhibit hypoechoic homogeneous echogenicity and a distinct border within the fourth sonographic layer (muscularis propria) similar to the endoscopic ultrasonographic features of gastrointestinal stromal tumors. In our study, we found that 53% of gastric ectopic pancreas originated within the fourth sonographic layer, demonstrating hypoechoic, homogeneous echogenicity, and distinct borders. Therefore, recognizing endoscopic ultrasonographic features, combining with deep biopsy, endoscopic ultrasound-guided fine needle aspiration/core needle biopsy can prevent conducting unnecessary resection. Surgical resection is the mainstay treatment for symptomatic gastric ectopic pancreas, but endoscopic resection using endoscopic mucosal resection or endoscopic submucosal dissection technique provides an alternative method of removing superficial-type and deep-type gastric ectopic pancreas. PMID:25371670

Cheng, Ken-Sheng; Ting, Chun-Fu; Feng, Chun-Lung; Huang, Wen-Hsin



[Blunt abdominal trauma].  


Serious intraabdominal injury due to intraabdominal hemorrhage, gastro-intestinal laceration with peritonitis or incarceration of abdominal organs. The most important question in the management is to ascertain a laparotomy or the diagnostic of a specific organ injury is needed. The peritoneal lavage is a great help in making this decision. The x-ray examinations of thorax, abdomen and bones are required. Adjunctive diagnostic modalities for subtile examination of organs are ultrasound, computed tomography and angiography. These examinations have a limited application. Exploratory laparotomy should be done if there are signs of peritoneal irritation with an increased tendency. 168 patients with blunt abdominal trauma where treated in Charity-hospital of Berlin. The laparotomy was necessary in 78 patients. In 70 cases we found organ injuries. It was pointed to splenic repair, the management of liver injury especially the packing of the laceration and the treatment of the injuries of gastro-intestinal tract, pancreas- and diaphragmatic rupture. PMID:3281391

Wolff, H; Lippert, H



Functional Abdominal Pain  

Microsoft Academic Search

\\u000a Functional abdominal pain (FAP) is a frequent complaint seen in the pediatric primary care setting. Current diagnostic criteria\\u000a for functional gastrointestinal disorders (FGIDs) are defi ned in the Rome III criteria, which outline a positive symptom\\u000a profi le for diagnosis. In addition, clinicians should be aware of specifi c “red fl ag ” rule-out symptoms that may suggest\\u000a organic disease

Lisa Scharff; Laura E. Simons


Successful delivery after IVF-ET in an abdominal cocoon patient: case report and literature review  

PubMed Central

Abdominal cocoon (AC) is a rare condition of uncertain etiology. We report the case of a 29-year-old infertile Chinese woman with AC, who successfully got twin pregnancy and delivery through in vitro fertilization (IVF) and embryo transfer (ET). And this review discusses the current concepts of its pathogenesis, diagnosis and treatments. AC might lead to tubal infertility and IVF-ET would be the most effective remedy for the patients desiring pregnancy. PMID:23638238

Hu, Dan; Wang, Rui; Xiong, Ting; Zhang, Han Wang



[Abdominal catastrophe--surgeon's view].  


Abdominal catastrophe is a serious clinical condition, usually being a complication arising during treatment of intraabdominal nontraumatic disorders or abdominal injuries. Most commonly, inflamation- secondary peritonitis, is concerned. Abdominal catastrophe also includes secondary signs of sepsis, abdominal compartment syndrome and enterocutaneous fistules. Most septic abdominal disorders which show signs of abdominal catastrophy, require surgical intervention and reinterventions--planned or "on demand" laparotomies. During the postoperative period, the patient requires intensive care management, including steps taken to stabilize his/hers condition, management of sepsis and metabolic and nutritional support measures, as well as adequate indication for reoperations. New technologies aimed at prevention of complications in laparostomies and to improve conditions for final laparotomy closure are used in phase procedures for surgical management of intraabdominal infections. Despite the new technologies, abdominal catastrophe has higher morbidity and lethality risk rates. PMID:20731313

Vyhnánek, F



Obesity-Associated Abdominal Elephantiasis  

PubMed Central

Abdominal elephantiasis is a rare entity. Abdominal elephantiasis is an uncommon, but deformative and progressive cutaneous disease caused by chronic lymphedema and recurrent streptococcal or Staphylococcus infections of the abdominal wall. We present 3 cases of patients with morbid obesity who presented to our hospital with abdominal wall swelling, thickening, erythema, and pain. The abdominal wall and legs were edematous, with cobblestone-like, thickened, hyperpigmented, and fissured plaques on the abdomen. Two patients had localised areas of skin erythema, tenderness, and increased warmth. There was purulent drainage from the abdominal wall in one patient. They were managed with antibiotics with some initial improvement. Meticulous skin care and local keratolytic treatment for the lesions were initiated with limited success due to their late presentation. All three patients refused surgical therapy. Conclusion. Early diagnosis is important for the treatment of abdominal elephantiasis and prevention of complications. PMID:23606857

Kohli, Ritesh; Argento, Vivian; Amoateng-Adjepong, Yaw



Conservative treatment for interstitial monochorionic twin pregnancy: case report and review of the published work.  


Interstitial pregnancy is considered one of the most hazardous types of ectopic pregnancies, with a mortality rate of 2-2.5%. We describe a case of a viable monochorionic twin pregnancy in a 35-year-old woman successfully treated with systemic methotrexate associated with bilateral uterine arteries' embolization. ?-hCG was undetectable 67 days after the first administration of methotrexate and the ultrasonography performed on day 67 showed the remnant of the gestational sac in the right uterine horn, a thin endometrium and a normal myometrial vascularization. Conservative treatment allowed us to avoid surgical treatment and to preserve the patient's fertility. PMID:24319991

Berretta, Roberto; Merisio, Carla; Dall'Asta, Andrea; Verrotti, Carla; Rolla, Martino; Bruni, Stefano; Bacchi Modena, Alberto



The hemorheological basis of transfusion therapy in the case of extrauterine pregnancy  

NASA Astrophysics Data System (ADS)

The authors have studied 122 medical histories of extrauterine pregnancies from archives and directly followed up 122 patients who underwent emergency surgery for extrauterine pregnancy. Particular disturbances of rheological properties of blood in patients with ectopic pregnancy are revealed. The authors prove the necessity of rheologically active infusion-transfusion therapy, which normalizes rheological properties of blood, its acidic and basic conditions, and protein composition both during the operation and in the postoperational period. The following solutions were used: acesol, Haemodesum, rheopolyglucine, rheoglumane, gelatinol, 10% albumin solution, and fresh frozen plasma.

Smirnova, T. A.; Gerasimovich, G. I.; Kostin, G. M.



Conception, complicated pregnancy, and labour of gods and heroes in Greek mythology.  


Pregnancy and labour are holy moments in a woman's life. Even in Greek mythology we can find descriptions of them. We searched in the Greek myths to find descriptions of labours of ancient heroes and gods. We identified descriptions of extracorporeal fertilization, superfecundation, ectopic pregnancy, preterm labour, prolonged pregnancy and Caesarean section. The use of imagination could help the reader to find similarities in present or future developments in the field of obstetrics. It could be concluded that various aspects of modern obstetrical practice are described in Greek mythology. PMID:18644217

Iavazzo, Christos; Trompoukis, Constantinos; Sardi, Thalia; Falagas, Matthew E



Anemia and Pregnancy  


... For Patients / Blood Disorders / Anemia / Anemia and Pregnancy Anemia & Pregnancy Your body goes through significant changes when ... becoming anemic. back to top Is Pregnancy-Related Anemia Preventable? Good nutrition is the best way to ...


Formoterol and Pregnancy  


... us online at: . Formoterol and Pregnancy In every pregnancy, a woman starts out with ... to be small. Can taking formoterol during my pregnancy cause a birth defect? Limited data do not ...


Abuse during Pregnancy  


... It's been added to your dashboard . Abuse during pregnancy Abuse, whether emotional or physical, is never okay. ... or physical injuries. What can trigger abuse during pregnancy? For many families, pregnancy can bring about feelings ...


Caffeine in Pregnancy  


... It's been added to your dashboard . Caffeine in pregnancy Caffeine is a drug found in many foods, ... than someone who’s not pregnant. Does caffeine during pregnancy affect your baby? Yes. During pregnancy, caffeine passes ...


Stress and Pregnancy  


... It's been added to your dashboard . Stress and pregnancy Pregnancy is a time of many changes. Your ... risk for health problems. What causes stress during pregnancy? The causes of stress are different for every ...


Pregnancy and Reproductive Issues  


Pregnancy - National Multiple Sclerosis Society Skip to navigation Skip to content Menu Navigation National Multiple Sclerosis Society ... Living Well with MS Family and Relationships Pregnancy Pregnancy and Reproductive Issues Tahirah Diagnosed in 2003 Share ...


Smoking during Pregnancy  


... It's been added to your dashboard . Smoking during pregnancy Smoking is bad for you. It can cause ... your baby’s life. How can smoking affect your pregnancy? Women who smoke during pregnancy are more likely ...


Psoriasis: Pregnancy and Nursing  


... Info Kit Find Us Online YouTube Twitter Facebook Pregnancy and Nursing In general, psoriasis does not affect ... for pregnancy and nursing. How psoriasis changes during pregnancy Some women see an improvement in the severity ...


Abdominal imaging: An introduction  

SciTech Connect

This nine-chapter book gives an overview of the integrated approach to abdominal imaging. Chapter 1 provides an introduction to the physics used in medical imaging; chapter 2 is on the selection of imaging modalities. These are followed by four chapters that deal, respectively, with plain radiography, computed tomographic scanning, sonography, and nuclear imaging, as applied to the abdomen. Two chapters then cover contrast material-enhanced studies of the gastrointestinal (GI) tract: one focusing on technical considerations; the other, on radiologic study of disease processes. The final chapter is a brief account of different interventional procedures.

Frick, M.P.; Feinberg, S.B.



Blunt abdominal aortic trauma.  


Due to its well protected position within the abdomen, blunt injuries to the abdominal aorta are uncommon. A review of previous reports in the literature, together with four new cases, are presented here. Motor car accidents are the most common cause of this injury, especially if seat belts are worn. Associated gastrointestinal injuries did not lead to any increased mortality; however, delay in the diagnosis was a significant factor in the deaths of several patients. Prompt recognition and early surgical management are essential in the treatment of this problem. PMID:2334357

Frydenberg, M; Royle, J P; Hoare, M



[Ectopic sebaceous glands in the esophagus. Report of three cases].  


Sebaceous glands typically are located in the pilosebaceous unit located in the superficial layers of the skin. Thus, ectopic sebaceous glands in the esophagus are a very unusual condition. Since 1962 when De la Pava and Pickren described that sebaceous glands could be ectopically located in the esophagus, no more than 30 cases have been reported in the literature. Macroscopically, single or multiple nodular yellowish lesions are found, and most of the times are overlooked. In this paper, we describe 3 cases (2 female and one male) of ectopic sebaceous glands in the esophagus incidentally detected during routine upper gastrointestinal tract endoscopic examination. Histopathology diagnoses were supported using immunohistochemestry for AE1/AE3 citokeratins and epithelial membrane antigen. PMID:21339017

Grube-Pagola, Peter; Vicuña-González, Rosa M; Rivera-Salgado, Irene; Alderete-Vázquez, Georgia; Remes-Troche, José María; Valencia-Romero, Armando M



Ectopic papilla of Vater in the pylorus  

PubMed Central

The major papilla of Vater is usually located in the second portion of the duodenum, to the posterior medial wall. Sometimes the mouth of the biliary duct is located in other areas. Drainage of the common bile duct into the pylorus is extremely rare. A 73-year old man, with a history of duodenal ulcer, was admitted to hospital with the diagnosis of cholangitis. Dilatation of the extrahepatic biliary duct was observed by abdominal ultrasonography, and endoscopic retrograde cholangiopancreatography (ERCP) was performed. No area suggesting the presence of the papilla of Vater was found within the second duodenal portion. Finally the major papilla was located in the theoretical pyloric duct. Cholangiography was performed and choledocholithiasis was found in the biliary tree. The patient underwent dilatation of the papilla with a balloon tyre and removal of a 7 mm stone using a Dormia basket, which solved the problem without further complications. This anomaly increased the difficulty of performing therapeutic interventions during ERCP. This alteration in anatomy may increase the risk of complications during papillotomy, with a theoretically higher risk of perforation. Dilatation using a balloon was the chosen therapeutic technique both in our case and in the literature, due to its low rate of complications. PMID:19891024

Guerra, Ivan; Rabago, Luis Ramon; Bermejo, Fernando; Quintanilla, Elvira; Garcia-Garzon, Silvia



Embarazo ectópico ovárico  

Microsoft Academic Search

Ectopic pregnancy is defined as a gestation out of the endometrial cavity. The most frecuent implantation is the ampular portion of the tube, next to abdominal, ovarian and cervical location. The incidence of ectopic pregnancy is increasing in the last years, but the frecuency of ovarian pregnancies has remained stable. The clinical diagnosis is based in sonography and serum concentrations

A. Ferrero; S. Argüelles; B. Suárez; V. Orille; J. S. Salas; C. González-García



Embarazo ectópico recurrente ipsolateral  

Microsoft Academic Search

An ectopic pregnancy is a common pathology in the first trimester, with an increasing incidence due to several factors. Ruptured ectopic pregnancy is one of the most dangerous emergencies in the obstetric patient, since this is a condition responsible for most pregnancy-related deaths in the first trimester. Any woman in fertile age with vaginal bleeding and\\/or abdominal pain can have

Virginia Sánchez Millán; Laura de Mingo Romanillos; Vicente Manuel Patiño Maraver; Sonia Redondo Escudero; Ana de Motta Rodríguez



Hypnosis for functional abdominal pain.  


Chronic abdominal pain is a common pediatric condition affecting 20% of the pediatric population worldwide. Most children with this disorder are found to have no specific organic etiology and are given the diagnosis of functional abdominal pain. Well-designed clinical trials have found hypnotherapy and guided imagery to be the most efficacious treatments for this condition. Hypnotic techniques used for other somatic symptoms are easily adaptable for use with functional abdominal pain. The author discusses 2 contrasting hypnotic approaches to functional abdominal pain and provides implications for further research. These approaches may provide new insights into this common and complex disorder. PMID:21922712

Gottsegen, David



Abdominal MR Elastography  

PubMed Central

MR Elastography (MRE) is an MRI-based technique for quantitatively assessing the mechanical properties of tissues, based on the propagation of shear waves. Multiple studies have described many potential applications of MRE, from characterizing tumors to detecting diffuse disease processes. Studies have shown that MRE can be successfully implemented to assess abdominal organs. The first clinical application MRE to be well documented is the detection and characterization of hepatic fibrosis, which systematically increases the stiffness of liver tissue. In this diagnostic role, offers a safer, and less expensive, and potentially more accurate alternative to invasive liver biopsy. Emerging results suggest that measurements of liver and spleen stiffness may provide an indirect way to assess portal hypertension. Preliminary studies have demonstrated that is possible to use MRE to evaluate the mechanical properties of other abdominal structures, such as the pancreas and kidneys. Steady technical progress in developing practical protocols for applying MRE in the abdomen and pelvis provides opportunities to explore many other potential applications of this emerging technology. PMID:20010062

Yin, Meng; Chen, Jun; Glaser, Kevin J.; Talwalkar, Jayant A.; Ehman, Richard L.



Abdominal aortic aneurysms.  


Key Clinical Points Abdominal Aortic Aneurysms Abdominal aortic aneurysms are usually asymptomatic until they rupture, with an ensuing mortality of 85 to 90%. Symptomatic patients require urgent repair. U.S. Preventive Services Task Force recommendations support screening in men 65 to 75 years of age with a history of smoking and selective screening in men 65 to 75 years of age without a smoking history, although the optimal cohort to be screened remains controversial. The usual threshold for elective repair is an aortic diameter of 5.5 cm in men and 5.0 cm in women. Endovascular repair results in lower perioperative morbidity and mortality than open repair, but the two methods are associated with similar mortality in the long term (8 to 10 years). Patients treated with endovascular repair require long-term surveillance owing to a small risk of aneurysm sac reperfusion and late rupture. Decisions regarding prophylactic repair - whether to pursue it and, if so, what type of repair to perform - must take into account anatomy (not all patients have anatomy amenable to endovascular repair), operative risk, and patient preference. PMID:25427112

Kent, K Craig



Renal lymphangiomatosis during pregnancy: management with percutaneous drainage.  


We report a unique case of exacerbation of renal lymphangiomatosis during pregnancy which was managed percutaneously until delivery. Renal lymphangiomatosis is a very rare benign disorder that might cause abdominal pain and rarely hypertension and hematuria. Surgical treatment options may result in nephrectomy. Percutaneous drainage of symptomatic renal lymphangiomas should be viewed as an efficient therapeutic option particularly when surgery is contraindicated. PMID:11194914

Ozmen, M; Deren, O; Akata, D; Akhan, O; Ozen, H; Durukan, T



Gene Duplication and Ectopic Gene Conversion in Drosophila  

PubMed Central

The evolutionary impact of gene duplication events has been a theme of Drosophila genetics dating back to the Morgan School. While considerable attention has been placed on the genetic novelties that duplicates are capable of introducing, and the role that positive selection plays in their early stages of duplicate evolution, much less attention has been given to the potential consequences of ectopic (non-allelic) gene conversion on these evolutionary processes. In this paper we consider the historical origins of ectopic gene conversion models and present a synthesis of the current Drosophila data in light of several primary questions in the field. PMID:24710141

Arguello, J. Roman; Connallon, Tim



Evidence for ectopic neurotransmission at a neuronal synapse.  


Neurotransmitter release is well known to occur at specialized synaptic regions that include presynaptic active zones and postsynaptic densities. At cholinergic synapses in the chick ciliary ganglion, however, membrane formations and physiological measurements suggest that release distant from postsynaptic densities can activate the predominantly extrasynaptic alpha7 nicotinic receptor subtype. We explored such ectopic neurotransmission with a novel model synapse that combines Monte Carlo simulations with high-resolution serial electron microscopic tomography. Simulated synaptic activity is consistent with experimental recordings of miniature excitatory postsynaptic currents only when ectopic transmission is included in the model, broadening the possibilities for mechanisms of neuronal communication. PMID:16020730

Coggan, Jay S; Bartol, Thomas M; Esquenazi, Eduardo; Stiles, Joel R; Lamont, Stephan; Martone, Maryann E; Berg, Darwin K; Ellisman, Mark H; Sejnowski, Terrence J



Pelvic Nephroureterectomy for Renal Cell Carcinoma in an Ectopic Kidney  

PubMed Central

We present a case of an ectopic renal tumor in a 61-year-old morbidly obese man with a pelvic kidney found after presenting with hematuria and irritative voiding symptoms. The mass, along with the ectopic kidney and ureter, was radically resected through an open operation that involved removing both them and the renal vessels from the underlying iliac vessels. Pathological analysis demonstrated an 8.3?cm papillary renal cell carcinoma (RCC) with oncocytic features, Fuhrman nuclear grade 3, with angiolymphatic invasion and negative margins. The patient has been recurrence-free for over four years since tumor resection. PMID:23150838

Baldie, Kevin G.; Al-Qassab, Usama A.; Ritenour, Chad W.; Issa, Muta M.; Osunkoya, Adeboye O.; Petros, John A.



CASE REPORT Laparoscopic Management of Gallbladder-Associated Ectopic Liver  

E-print Network

Ectopic liver is a rare entity discussed infrequently in the surgical literature. Liver ectopia develops due to rests of liver parenchyma retained at various intraperitoneal or intrathoracic locations during migration of the liver proper during embryologic development. It is usually found during exploration for other diagnoses, commonly diseases of the biliary tree. We report a case in which a 3.7-cm mass associated with the fundus of the gallbladder was visualized preoperatively by computed tomography and identified histologically as ectopic liver after diagnostic laparoscopy and cholecystectomy with en bloc resection of the associated mass.

unknown authors


Ectopic lacrimal gland tissue of the orbit and sclerosing dacryoadenitis.  


A 28-year-old man with unilateral proptosis was found to have sclerosing dacryoadenitis and ectopic lacrimal gland tissue of the orbit. The unusual combination simulated invasive adenocarcinoma of the lacrimal gland both clinically and histopathologically. Based on clinical and experimental observations, we propose that the acinar gland atrophy and fibrous replacement of the lacrimal gland and of the heterotopic tissue was the result of a primary developmental abnormality associated with obstruction to normal gland outflow. Physician awareness that ectopic lacrimal gland tissue in the orbit can be affected by sclerosing dacryoadenitis is probably the most critical factor in establishing the correct diagnosis. PMID:3991115

Margo, C E; Naugle, T C; Karcioglu, Z A



Teenage pregnancy.  


The pediatrician's role in teenage pregnancy is multifaceted. The problem is a sociologic phenomenon with medical consequences. The pregnant teenager actually represents three patients: the mother, the baby, and the adolescent herself. Prepregnancy nutrition can be improved through pediatric education and advice. Sex education can be improved through the advocacy of pediatricians, who can discuss postponing parenthood until the end of adolescence with many of their patients. Services to prevent pregnancy can be offered by pediatricians. Unfortunately, in Oklahoma it is illegal to dispense contraceptives to minors without parental consent. Pediatricians should work to gain acceptance of laws modeled after the American Academy of Pediatrics' health care for minors policy. Lastly, support services to promote proper parenthood and establishment of families can be developed with pediatric input. The entire problem must be viewed in the context of current social patterns, an understanding of adolescent development, the significance of peer pressures, and the biological changes that make it possible for children to bear children. PMID:7041565

Block, R W; Saltzman, S; Block, S A



JAMA Patient Page: Abdominal Hernia  


... movement • Cystic fibrosis and chronic lung infections • Previous abdominal surgery COMPLICATIONS A hernia may result in entrapment of other organs (such as the bladder or colon) or nerves, producing constipation or problems with ... of the abdominal cavity) needing surgical removal of part of the ...


Hypnosis for Functional Abdominal Pain  

Microsoft Academic Search

Chronic abdominal pain is a common pediatric condition affecting 20% of the pediatric population worldwide. Most children with this disorder are found to have no specific organic etiology and are given the diagnosis of functional abdominal pain. Well-designed clinical trials have found hypnotherapy and guided imagery to be the most efficacious treatments for this condition. Hypnotic techniques used for other

David Gottsegen



Simulated spaceflight effects on mating and pregnancy of rats  

NASA Technical Reports Server (NTRS)

The mating of rats was studied to determine the effects of: simulated reentry stresses at known stages of pregnancy, and full flight simulation, consisting of sequential launch stresses, group housing, mating opportunity, diet, simulated reentry, and postreentry isolation of male and female rats. Uterine contents, adrenal mass and abdominal fat as a proportion of body mass, duration of pregnancy, and number and sex of offspring were studied. It is found that: (1) parturition following full flight simulation was delayed relative to that of controls; (2) litter size was reduced and resorptions increased compared with previous matings in the same group of animals; and (3) abdominal fat was highly elevated in animals that were fed the Soviet paste diet. It is suggested that the combined effects of diet, stress, spacecraft environment, and weightlessness decreased the probability of mating or of viable pregnancies in the Cosmos 1129 flight and control animals.

Sabelman, E. E.; Chetirkin, P. V.; Howard, R. M.



Nutrition and Multifetal Pregnancy  

Microsoft Academic Search

Largely because of assisted reproduction, the rate of multifetal pregnancy is rising rapidly in the United States. Accordingly, dietitians are increasingly being called upon to provide nutrition services for these high-risk pregnancies. This article gives an overview of the incidence of and risks associated with multifetal pregnancy and reviews studies that contribute to our knowledge of nutrition and multifetal pregnancy.




Type ii ureteral triplication associated with ectopic ureter  

Microsoft Academic Search

We report a case of type II ureteral triplication associated with ectopic ureter. The ureter, draining the upper renal segment, entered the vagina, and the other two ureters, draining the middle and lower renal segments, had joined and entered the bladder. The anatomic findings are compatible with those predicted by the Weigert-Meyer law. A thorough evaluation of such an anomaly

Dov Engelstein; Pinhas M. Livne; Maya Cohen; Ciro Servadio



Ectopic Production of Human Chorionic Gonadotrophin by Human Breast Tumours  

PubMed Central

The incidence of tumours ectopically producing the human chorionic gonadotrophins was studied in patients with breast cancer. Specific radioimmunoassay of subunits of HCG was utilized. Nine out of 65 patients with carcinoma of breast showed the presence of circulating HCG. Patients with other pathological conditions of breast tissue did not show any evidence of circulating HCG. PMID:4374964

Sheth, N. A.; Saruiya, J. N.; Ranadive, K. J.; Sheth, A. R.



Phyllodes Tumor in Ectopic Breast Tissue of the Vulva  

Microsoft Academic Search

Phyllodes tumor arising from ectopic breast tissue of the vulva is an extremely rare occurrence. A case is reported in a 34-year-old nulligravida woman, presenting as a nodule on the left labium majus. A simple excision was carried out, and no recurrence has been detected after 18 months of follow-up.

M. T. Chulia; A. Paya; M. Niveiro; S. Ceballos; F. I. Aranda



Redefining anatomy in a case of midline subhyoid ectopic thyroid.  


Ectopic thyroid is an uncommon embryological aberration of the thyroid descent. Subhyoid median ectopic thyroid gland is a result of incomplete descent of the thyroid anlage and is characterized by a cosmetically unacceptable ovoid mass of thyroid tissue in the midline overlying the thyroid cartilage and thyrohyoid membrane. A normally placed thyroid gland is not detectable and in most cases all functioning thyroid tissue is located within the mass. Most of the ectopic thyroids are usually mistaken for a thyroglossal cyst and excised. Severe myxedema follows removal. Many cases have been reported in the literature, none of which was recognized prior to operation. All patients were operated upon for removal of a thyroglossal duct cyst. The diagnosis was missed at operation and in these cases severe myxedema was universal. The cause of the myxedema was not always immediately recognized. Therefore, many diagnostic tests including thyroid function test, ultrasound of the neck, and thyroid scanning had been recommended in the preoperative evaluation of a thyroglossal cyst. Here, we present a case of ectopic thyroid mass which was the only thyroid tissue present in the neck. So, division and repositioning of the thyroid mass thereby redefining the anatomy was done with good cosmetic results. PMID:25278663

Naik, Kiran



Hemorrhagic ascites from spontaneous ectopic mesenteric varices rupture in NASH induced cirrhosis and successful outcome: A case report  

PubMed Central

Bleeding from gastro-esophageal varices can often present as the first decompensating event in patients with cirrhosis. This can be a potentially life threatening event associated with a 15%-20% early mortality. We present a rare case of new onset ascites due to intra-abdominal hemorrhage from ruptured mesenteric varices; in a 37 years old male with newly diagnosed nonalcoholic steatohepatitis induced cirrhosis as the first decompensating event. The patient was successfully resuscitated with emergent evacuation of ascites for diagnosis, identification and control of bleeding mesenteric varices and eventually orthotopic liver transplantation with successful outcome. Various clinical presentations, available treatment options and outcomes of ectopic variceal bleeding are discussed in this report. PMID:25009406

Edula, Raja GR; Qureshi, Kamran; Khallafi, Hicham



Hemorrhagic ascites from spontaneous ectopic mesenteric varices rupture in NASH induced cirrhosis and successful outcome: a case report.  


Bleeding from gastro-esophageal varices can often present as the first decompensating event in patients with cirrhosis. This can be a potentially life threatening event associated with a 15%-20% early mortality. We present a rare case of new onset ascites due to intra-abdominal hemorrhage from ruptured mesenteric varices; in a 37 years old male with newly diagnosed nonalcoholic steatohepatitis induced cirrhosis as the first decompensating event. The patient was successfully resuscitated with emergent evacuation of ascites for diagnosis, identification and control of bleeding mesenteric varices and eventually orthotopic liver transplantation with successful outcome. Various clinical presentations, available treatment options and outcomes of ectopic variceal bleeding are discussed in this report. PMID:25009406

Edula, Raja G R; Qureshi, Kamran; Khallafi, Hicham




Microsoft Academic Search

Mummified fetuses were discovered in the abdominal cavities of two cot- tontail rabbits (Syls'ilagus floridanus) collected during separate years from the same geographical location in Virginia. One of these rabbits had a patent opening through the vaginal wall to the abdominal cavity. The uterus and vagina of the second rabbit appeared normal. During separate research projectson free-livingcottontail rabbits (Sylvilagus floridanus)



Natural expansion of artificial dermal template by successful full-term pregnancy.  


Extensive postburn scars of the trunk may cause breathing difficulty and, in female patients of reproductive age, render future pregnancy a serious reconstructive goal. Scar excision and skin grafting with or without artificial dermal templates is the current preferred management. A patient who underwent staged extensive grafting of the abdominal wall by dermal regeneration template and completed a full-term successful pregnancy is presented here. Although tissue expanders have been used to expand artificial dermal templates, natural expansion by pregnancy has not been previously documented. A 30-year-old woman with extensive chest and abdominal wall, bilateral gluteal and breast scars after burns sustained at childhood presented with difficulty in deep breathing. Abdominal scar tissue was excised and the abdominal wall was reconstructed by dermal regeneration template and autologous thin split-thickness skin graft in two stages. Six months postoperatively, spirometric values were improved by 15%, while 1 year later the patient completed successfully a full-term pregnancy. Reconstruction of extensive abdominal postburn scars by dermal regeneration template improves breathing by increasing elasticity and compliance of the reconstructed area. In female patients, the template can be extensively and naturally expanded by the gradually growing uterus, allowing for full-term pregnancy. PMID:22210074

Kakagia, Despoina; Kyriopoulos, Eugenia; Zapandioti, Polyxeni; Tsoutsos, Dimosthenis



Splenic artery aneurysm presenting with abdominal discomfort and weight loss.  


Splenic artery aneurysm (SAA) is uncommon, but it is the most frequent visceral artery aneurysm. It is more common in women, especially during pregnancy. SAA is usually asymptomatic, but abdominal pain and rupture may develop. At present, computerized tomography (CT) angiogram is the best diagnostic test but not the only. Surgical or endovascular treatment may be considered both in symptomatic or asymptomatic aneurysms greater then 2 cm in diameter. We present the case of an elderly woman with an SAA and review the literature. PMID:25092196

Rodríguez-Cordero, M; González-Quintela, A; Díaz-Peromingo, J A



Abdominal aortic feminism.  


A 79-year-old woman presented to a private medical practice 2?years previously for an elective ultrasound screening scan. This imaging provided the evidence for a diagnosis of an abdominal aortic aneurysm (AAA) to be made. Despite having a number of recognised risk factors for an AAA, her general practitioner at the time did not follow the guidance set out by the private medical professional, that is, to refer the patient to a vascular specialist to be entered into a surveillance programme and surgically evaluated. The patient became symptomatic with her AAA, was admitted to hospital and found to have a tender, symptomatic, 6?cm leaking AAA. She consented for an emergency open AAA repair within a few hours of being admitted to hospital, despite the 50% perioperative mortality risk. The patient spent 4?days in intensive care where she recovered well. She was discharged after a 12?day hospital stay but unfortunately passed away shortly after her discharge from a previously undiagnosed gastric cancer. PMID:25398912

Mortimer, Alice Emily



[Management options of caesarean scar pregnancy].  


Cesarean scar pregnancy is an uncommon ectopic gestation. Without timely and proper management,it may cause major bleeding,uterine rupture,and other life-threatening complications. The causes of this condition remain unclear,and no standardized management has been available,although some medical and surgical treatment modalities have been suggested. The main treatment objectives include preventing massive blood loss,preserving the uterus function,and maintain the women's health and quality of life. Current data do not support expectant management. After early diagnosis,single or combined medical and surgical treatment options should be provided to avoid uterine rupture and haemorrhage,so as to preserve the uterus and thus the fertility. PMID:24791804

Li, Jin-jin; Liu, Xin-yan



Induction of acute ectopic pancreatitis by endoscopic ultrasound with fine-needle aspiration.  


Ectopic pancreas rarely causes symptoms or complications. We analyzed 2 atypical cases of ectopic pancreas associated with acute ectopic pancreatitis, 1 of which was induced by endoscopic ultrasound with fine-needle aspiration (EUS-FNA). The patients were seen at a tertiary medical center where they had undergone computed tomography, esophagogastroduodenoscopy, and EUS-FNA analyses. They initially received conservative medical treatment and were later treated by surgery. Both patients were diagnosed with ectopic pancreas of the stomach on the basis of computed tomography, esophagogastroduodenoscopy, or EUS-FNA. Surgical resection cured both patients and confirmed the diagnosis of ectopic pancreas. Acute ectopic pancreatitis is an unusual complication of ectopic pancreas that can be induced by EUS-FNA and diagnosed and cured with surgery. PMID:24361413

Attwell, Augustin; Sams, Sharon; Fukami, Norio



JAMA Patient Page: Abdominal Paracentesis  


... organs), severe bowel or bladder distention, and previous abdominal-pelvic surgery may increase the risk of the procedure. In those situations, an ultrasound-guided paracentesis should be considered. Procedural complications are rare but can include ANALYSIS OF ASCITIC ...


Adolescent pregnancy and contraception.  


7% of US teen women became pregnant in 2008, totaling 750,000 pregnancies nationwide. For women ages 15 to 19, 82% of pregnancies are unintended. Adolescents have a disproportionate risk of medical complications in pregnancy. Furthermore, adolescent parents and their infants both tend to suffer poor psychosocial outcomes. Preventing unintended and adolescent pregnancies are key public health objectives for Healthy People 2020. Screening for sexual activity and pregnancy risk should be a routine part of all adolescent visits. Proven reductions in unintended pregnancy in teens are attained by providing access to contraception at no cost and promoting the most-effective methods. PMID:25124209

Dalby, Jessica; Hayon, Ronni; Carlson, Jensena



Embarazo ectópico cervical: diagnóstico y tratamiento  

Microsoft Academic Search

We report a case of cervical ectopic pregnancy treated with methotrexate and abdominal hysterectomy.A 34-year-old woman with three previous cesarean sections was diagnosed with a cervical ectopic pregnancy through transvaginal ultrasound at 7 weeks of amenorrhea.Cervical ectopic pregnancy is an uncommon event that usually presents as irregular bleeding in the first trimester. Diagnosis is based on ?-human chorionic gonadotrophin and

Clara Crespo Ferrer; Arantxa Jaca Navarro; Noelia Juárez Sabater; Regina Aliaga Parreño; Yousef Mahmoud Jaddou; Mariano Sanz Martínez



Abdominal ultrasonography, 2nd Ed  

SciTech Connect

This volume is a new and updated edition of an extensively illustrated text and reference on the capabilities and imaging of gray scale ultrasonography for each major abdominal organ. Each major organ system is treated separately, including liver, gallbladder and bile ducts, pancreas, kidney, retroperitoneum, abdominal vasculature, and more. There are over 500 illustrations and ten pages of full color plates for cross sectional anatomy.

Goldberg, B.B.



[Laparoscopy in an abdominal emergency: the diagnosis and therapy in 3 clinical cases of acute abdomen].  


Authors report three cases of acute abdomen due a probable appendicitis and submit to laparoscopic procedure. In the first case acute abdomen was due to a bowel obstruction secondary to an ectopic pregnancy; in the second case acute appendicitis was associated with a rare congenital malformation (atresia of uterus); in third case acute abdomen was due to a rare case of torsion of accessory spleen in an adult. In all the cases laparoscopy demonstrated the elective procedure in urgency, permitting the diagnosis and the surgical treatment of acute abdomen with the post-operatory advantage of the technique. PMID:10434461

Catani, M; De Milito, R; Rattà, G; Abati, G; Chiaretti, M; Rengo, M



[Congenital hepatic fibrosis in pregnancy].  


The purpose of this study was to analyse the course of pregnancy of a 20-year-old woman suffering from congenital hepatic fibrosis (CHF), a genetic disease with recessive autosomic transmission, attributed to the group of hepato-nephro-pancreatic fibropolycystic familial diseases. This was the only time such a case had ever been encountered in a pregnancy in the history of Turin University's Obstetrics and Gynaecological Clinic. The case of a 20-year-old woman is considered. She was admitted to our observation at the Obstetrics and Gynaecological Department of Faculty "B" of the University of Turin, suffering from CHF, a primigravid in the eighth week of gestation. Haematochemical tests carried out on the patient showed a platelet deficiency without evident changes in liver and renal function. Objective examination revealed a slight hepatosplenomegaly confirmed by abdominal echotomography. The haematochemical examinations subsequently carried out confirmed thrombocytopenia due to hepatosplenic hyperhaemocataresis. In agreement with the will of the patient and her family, and after having heard the opinion of our hospital's anaesthetists and internists, a conservative approach was decided on and close monitoring of maternal and foetal conditions was planned, with hospitalisations scheduled for every fortnight. Together with the internists and anaesthetists, it was decided to allow the pregnancy to proceed as far as foetal maturity but not to term, to avoid problems relating to the excessive increase in uterine volume which would have led to pressure on the portal tree and so favoured haemorrhaging due to rupture of the oesophageal varices. Caesarean delivery was planned for the 37th week of gestation. The birth went according to plan and the foetus was a live, vital male with Apgar index of 9/9. The placenta presented normal characteristics and a weight of 590 g. No haemorrhagic complications were observed either in the course of surgery or in the postoperative phase, notwithstanding the preoperative finding of a platelet count of 64,000 platelets/ mm3. Although in our case neither the pregnancy nor the delivery constituted a serious danger for the life of the mother, possible obstetric complications are among the most serious encountered in obstetric pathology and can lead both to maternal death and to the intrauterine death of the foetus. For these reasons we believe it essential to provide correct, clear and adequate information about the risks involved for patients suffering from congenital hepatic fibrosis, especially if they are associated with renal polycystic disease, and who are admitted to our wards with the desire to programme a pregnancy. PMID:12432335

Grio, R; D'Addato, F; Nicolosi, M G; Barbini, V; Colla, F; Attini, R; Leotta, E; Lanza, A



The other lipids: Ectopic lipids with emphasis on skeletal muscle  

Microsoft Academic Search

The obesity pandemic has intensified research into the multifaceted functions of adipose tissues. Recent studies are revealing\\u000a an intricate intercellular and intracellular system of lipid signaling between adipose tissue and other major peripheral organs\\u000a to control energy flux. If not controlled, minor disturbances can lead to deleterious ectopic lipids deposition with unwanted\\u000a health consequences. The pathophysiology of obesity is associated

Lan Chi T. Luu; Eric Ravussin



Ectopic Overexpression of Asparagine Synthetase in Transgenic Tobacco  

Microsoft Academic Search

Here, we monitor the effects of ectopic overexpression of genes for pea asparagine synthetase (AS1) in transgenic tobacco (Nico- tiana tabacum). lhe AS genes of pea and tobacco are normally expressed only during the dark phase of the diurna1 growth cycle and specifically in phloem cells. A hybrid gene was construded in which a pea AS1 cDNA was fused to

Timothy Brears; Christopher Liu; Thomas J Knight; Gloria M. Coruzzi


Type II ureteral triplication associated with ectopic ureter.  


We report a case of type II ureteral triplication associated with ectopic ureter. The ureter, draining the upper renal segment, entered the vagina, and the other two ureters, draining the middle and lower renal segments, had joined and entered the bladder. The anatomic findings are compatible with those predicted by the Weigert-Meyer law. A thorough evaluation of such an anomaly is essential for effective management. PMID:8911529

Engelstein, D; Livne, P M; Cohen, M; Servadio, C



Transcriptome, Methylome and Genomic Variations Analysis of Ectopic Thyroid Glands  

Microsoft Academic Search

BackgroundCongenital hypothyroidism from thyroid dysgenesis (CHTD) is predominantly a sporadic disease characterized by defects in the differentiation, migration or growth of thyroid tissue. Of these defects, incomplete migration resulting in ectopic thyroid tissue is the most common (up to 80%). Germinal mutations in the thyroid-related transcription factors NKX2.1, FOXE1, PAX-8, and NKX2.5 have been identified in only 3% of patients

Rasha Abu-Khudir; Jean Paquette; Anne Lefort; Frederick Libert; Jean-Pierre Chanoine; Gilbert Vassart; Johnny Deladoëy



Ectopic uterine tissue as a chronic pain generator  

PubMed Central

While chronic pain is a main symptom in endometriosis, the underlying mechanisms and effective therapy remain elusive. We developed an animal model enabling exploration of ectopic endometrium as a source of endometriosis pain. Rats were surgically implanted with autologous uterus in the gastrocnemius muscle. Within two weeks, visual inspection revealed the presence of a reddish-brown fluid filled cystic structure at the implant site. Histology demonstrated cystic glandular structures with stromal invasion of the muscle. Immunohistochemical studies of these lesions revealed the presence of markers for nociceptor nerve fibers and neuronal sprouting. Fourteen days after surgery rats exhibited persistent mechanical hyperalgesia at the site of the ectopic endometrial lesion. Intralesional, but not contralateral, injection of progesterone was dose-dependently antihyperalgesic. Systemic administration of leuprolide also produced antihyperalgesia. In vivo electrophysiological recordings from sensory neurons innervating the lesion revealed a significant increase in their response to sustained mechanical stimulation. These results are consistent with clinical and pathologic findings observed in patients with endometriosis, compatible with the ectopic endometrium as a source of pain. This model of endometriosis allows mechanistic exploration at the lesion site facilitating our understanding of endometriosis pain. PMID:22922120

Alvarez, Pedro; Chen, Xiaojie; Hendrich, Jan; Irwin, Juan C.; Green, Paul G.; Giudice, Linda C.; Levine, Jon D.



Management Strategies for Aggressive Cushing's Syndrome: From Macroadenomas to Ectopics  

PubMed Central

Cushing's syndrome (CS) is a rare but severe clinical condition represented by an excessive endogenous cortisol secretion and hence excess circulating free cortisol, characterized by loss of the normal feedback regulation and circadian rhythm of the hypothalamic-pituitary axis due to inappropriate secretion of ACTH from a pituitary tumor (Cushing's disease, CD) or an ectopic source (ectopic ACTH secretion, EAS). The remaining causes (20%) are ACTH independent. As soon as the diagnosis is established, the therapeutic goal is the removal of the tumor. Whenever surgery is not curative, management of patients with CS requires a major effort to control hypercortisolemia and associated symptoms. A multidisciplinary approach that includes endocrinologists, neurosurgeons, oncologists, and radiotherapists should be adopted. This paper will focus on traditional and novel medical therapy for aggressive ACTH-dependent CS. Several drugs are able to reduce cortisol levels. Their mechanism of action involves blocking adrenal steroidogenesis (ketoconazole, metyrapone, aminoglutethimide, mitotane, etomidate) or inhibiting the peripheral action of cortisol through blocking its receptors (mifepristone “RU-486”). Other drugs include centrally acting agents (dopamine agonists, somatostatin receptor agonists, retinoic acid, peroxisome proliferator-activated receptor ? “PPAR-?” ligands) and novel chemotherapeutic agents (temozolomide and tyrosine kinase inhibitors) which have a significant activity against aggressive pituitary or ectopic tumors. PMID:22934113

Pozza, Carlotta; Graziadio, Chiara; Giannetta, Elisa; Lenzi, Andrea; Isidori, Andrea M.



Ectopic uterine tissue as a chronic pain generator.  


While chronic pain is a main symptom in endometriosis, the underlying mechanisms and effective therapy remain elusive. We developed an animal model enabling the exploration of ectopic endometrium as a source of endometriosis pain. Rats were surgically implanted with autologous uterus in the gastrocnemius muscle. Within two weeks, visual inspection revealed the presence of a reddish-brown fluid-filled cystic structure at the implant site. Histology demonstrated cystic glandular structures with stromal invasion of the muscle. Immunohistochemical studies of these lesions revealed the presence of markers for nociceptor nerve fibers and neuronal sprouting. Fourteen days after surgery rats exhibited persistent mechanical hyperalgesia at the site of the ectopic endometrial lesion. Intralesional, but not contralateral, injection of progesterone was dose-dependently antihyperalgesic. Systemic administration of leuprolide also produced antihyperalgesia. In vivo electrophysiological recordings from sensory neurons innervating the lesion revealed a significant increase in their response to sustained mechanical stimulation. These results are consistent with clinical and pathological findings observed in patients with endometriosis, compatible with the ectopic endometrium as a source of pain. This model of endometriosis allows mechanistic exploration at the lesion site facilitating our understanding of endometriosis pain. PMID:22922120

Alvarez, P; Chen, X; Hendrich, J; Irwin, J C; Green, P G; Giudice, L C; Levine, J D



A Challenging Case of an Ectopic Cushing Syndrome  

PubMed Central

Bronchopulmonary carcinoids are rare pulmonary neoplasms although they account for most cases of ectopic ACTH syndromes. When feasible, the mainstay treatment is surgical resection of the tumor. We report the case of a 52-year-old woman with signs and symptoms suggestive of hypercortisolism for 12 months, admitted to our department because of community acquired pneumonia. Blood hormone analysis showed increased levels of ACTH and urinary free cortisol and nonsuppressibility to high- and low-dose dexamethasone tests. Pituitary MRI showed no lesion and no central-to-peripheral ACTH gradient was present in bilateral inferior petrosal sinus sampling. CRH stimulation test suggested an ectopic ACTH source. Thoracic CT scan revealed a nodular region measuring 12?mm located in the inferior lingular lobule of the left superior lung with negative uptake by 18-FDG-PET scan and negative SRS. The patient was successfully treated with an atypical lung resection and histology revealed an atypical bronchial carcinoid tumor with positive ACTH immunoreactivity. This was an interesting case because the patient was admitted due to pneumonia that may have been associated with her untreated and chronic hypercortisolism and a challenging case of ectopic ACTH syndrome due to conflicting results on the diagnostic exams.

Menezes Nunes, Joana; Camões, Isabel; Maciel, João; Cabral Bastos, Pedro; Souto de Moura, Conceição; Bettencourt, Paulo



Nitric oxide signaling contributes to ectopic orofacial neuropathic pain.  


Inferior alveolar nerve (IAN) injury induces persistent ectopic pain which spreads to a wide area in the orofacial region. Its exact mechanism remains unclear. We investigated the involvement of nitric oxide (NO) in relation to ectopic orofacial pain caused by IAN transection (IANX). We assessed the changes in mechanical sensitivity of the whisker pad skin following IANX, neuronal nitric oxide synthase (nNOS) expression in the trigeminal ganglion (TG), and the functional significance of NO in relation to the mechanical allodynia following intra-TG administration of a chemical precursor to NO and selective nNOS inhibitors. IANX induced mechanical allodynia, which was diminished by intra-TG administration of selective nNOS inhibitors. NO metabolites and nNOS immunoreactive neurons innervating the lower lip were also increased in the TG. Intra-TG administration of nNOS substrate induced the mechanical allodynia. The present findings suggest that NO released from TG neurons regulates the excitability of TG neurons innervating the whisker pad skin, and the enhancement of TG neuronal excitability may underlie ectopic mechanical allodynia. PMID:24130220

Sugiyama, T; Shinoda, M; Watase, T; Honda, K; Ito, R; Kaji, K; Urata, K; Lee, J; Ohara, K; Takahashi, O; Echizenya, S; Iwata, K



Immunization and Pregnancy  


Immunization & Pregnancy Vaccines help keep a pregnant woman and her growing family healthy. Vaccine Before pregnancy During ... 232-4636) • English or Spanish National Center for Immunization and Respiratory Diseases Immunization Services Division CS238938B 03/ ...


Pregnancy Risks for Teens  


... than 10 movements in a 12-hour period Preeclampsia Preeclampsia (also called toxemia or pregnancy-related hypertension) is ... Pregnant teens have a greater chance of developing preeclampsia during their pregnancy. Symptoms include: Swelling of the ...


Ibuprofen and Pregnancy  


... or visit us online at: . Ibuprofen and Pregnancy In every pregnancy, a woman starts ... advice from your health care professional. What is ibuprofen? Ibuprofen is a nonsteroidal anti- inflammatory drug (NSAID) ...


Pregnancy Loss and Miscarriage  


... Share this: Page Content What is pregnancy loss/miscarriage? A miscarriage, also called pregnancy loss or spontaneous abortion, is ... D.A.M. Medical Encyclopedia. (2010, November 21). Miscarriage . Retrieved May 21, 2012, from http://www.ncbi. ...


Metronidazole (Flagyl) and Pregnancy  


... metronidazole during early pregnancy increase the risk for miscarriage? It’s unlikely. There is one large study that ... and did not find an increased risk for miscarriage. Can taking metronidazole during pregnancy cause birth defects ...


Familiy Planning and Pregnancy  


... Storage Pool Deficiencies Home About Bleeding Disorders Family planning and pregnancy Carriers should receive genetic counselling about ... Diagnosis When to Test for Carrier Status Family Planning and Pregnancy Conception Options Prenatal Diagnosis Fetal Sex ...


Medicine and Pregnancy  


... New Moms Registries Help Moms Measure Medication Risks Medicine and Pregnancy Print and Share (PDF 201KB) En Español Get the facts before you take any medicines during pregnancy. Many pregnant women take prescription medicines ...


Etanercept (Enbrel) and Pregnancy  


... or visit us online at: . Etanercept (Enbrel ? ) and Pregnancy In every pregnancy, a woman ... advice from your health care professional. What is etanercept? Etanercept is a prescription medication used to treat ...


Depression and Pregnancy  


... on a pregnancy. I’ve had problems with substance abuse in the past. Should this influence my ... during pregnancy is associated with legal and illegal substance abuse. It is believed that some women turn ...


Alcohol during Pregnancy  


... Smoking, alcohol and drugs > Alcohol during pregnancy Smoking, alcohol and drugs Don’t smoke, drink alcohol or ... this page It's been added to your dashboard . Alcohol during pregnancy Drinking alcohol when you're pregnant ...


Pregnancy-Induced Hypertension  


... Pregnancy-induced hypertension (PIH), also called toxemia or preeclampsia: This condition can cause serious problems for both ... delivery for my baby? Source NHBPEP Report on High Blood Pressure in Pregnancy: A Summary for Family Physicians by MA Zamorski, ...


Eating Right during Pregnancy  


... outlines essential information for people diagnosed with Celiac disease. Eating Right During Pregnancy The 40 weeks of pregnancy ... range of topics including careers in dietetics, healthy eating, the Academy membership benefits, media interviewing skills and the professional role of the ...


Asthma Medications and Pregnancy  


... Director, Health Initiatives View full profile Asthma and Pregnancy: Asthma Medications We would like to avoid all ... mother and child. Making Decisions about Medication During Pregnancy It is important that your asthma be controlled ...


Pregnancy and Fifth Disease  


... Cheek Rash Parvovirus B19 and Other Illnesses References Pregnancy and Fifth Disease On this Page Testing for ... with fifth disease. Testing for Parvovirus B19 During Pregnancy A blood test for parvovirus B19 can show ...


Medication Use during Pregnancy  


... this? Submit Button CDC Features Medication Use During Pregnancy Language: English Español (Spanish) Share Compartir The safety ... Information About the Effects of Medication Use During Pregnancy? The U.S. Food and Drug Administration (FDA) regulates ...


Pregnancy and Nutrition  


... calcium, and folic acid than you did before pregnancy. You also need more calories. But "eating for ... baby. You should gain weight gradually during your pregnancy, with most of the weight gained in the ...


Tumors and Pregnancy  


Tumors during pregnancy are rare, but they can happen. Tumors can be either benign or malignant. Benign tumors aren't cancer. Malignant ones are. The most common cancers in pregnancy are breast cancer, cervical cancer, lymphoma, and melanoma. ...


Pregnancy and Your Vision  


Pregnancy and your vision Pregnancy brings an increase in hormones that may cause changes in vision. In most cases, these are temporary eye conditions ... an expectant mother, you should: be aware of vision changes during pregnancy and know what symptoms indicate ...


Liver disease in pregnancy  

PubMed Central

Liver diseases in pregnancy may be categorized into liver disorders that occur only in the setting of pregnancy and liver diseases that occur coincidentally with pregnancy. Hyperemesis gravidarum, preeclampsia/eclampsia, syndrome of hemolysis, elevated liver tests and low platelets (HELLP), acute fatty liver of pregnancy, and intrahepatic cholestasis of pregnancy are pregnancy-specific disorders that may cause elevations in liver tests and hepatic dysfunction. Chronic liver diseases, including cholestatic liver disease, autoimmune hepatitis, Wilson disease, and viral hepatitis may also be seen in pregnancy. Management of liver disease in pregnancy requires collaboration between obstetricians and gastroenterologists/hepatologists. Treatment of pregnancy-specific liver disorders usually involves delivery of the fetus and supportive care, whereas management of chronic liver disease in pregnancy is directed toward optimizing control of the liver disorder. Cirrhosis in the setting of pregnancy is less commonly observed but offers unique challenges for patients and practitioners. This article reviews the epidemiology, pathophysiology, diagnosis, and management of liver diseases seen in pregnancy. PMID:19248187

Lee, Noel M; Brady, Carla W



Certolizumab Pegol and Pregnancy  


... Disease. It is called a tumor necrosis factor (TNF) inhibitor because it binds and blocks TNF, a substance in the body that causes inflammation ... pregnancy? Recent information on the use of other TNF inhibitors in pregnancy suggest that as the pregnancy ...


Addiction in Pregnancy  

Microsoft Academic Search

Substance abuse in pregnancy has increased over the past three decades in the United States, resulting in approximately 225,000 infants yearly with prenatal exposure to illicit substances. Routine screening and the education of women of child bearing age remain the most important ways to reduce addiction in pregnancy. Legal and illegal substances and their effect on pregnancy discussed in this

Joan Keegan; Mehdi Parva; Mark Finnegan; Andrew Gerson; Michael Belden



Hyperthermia and Pregnancy  


... fever in pregnancy. I have been using the hot tub and sauna. Is this a risk during my pregnancy? Hot tub or sauna use during pregnancy should be ... take only 10 to 20 minutes in a hot tub or sauna to raise your body temperature ...


Rheumatic diseases in pregnancy.  


The effects of pregnancy on the clinical course of the rheumatic diseases is not only variable but often unpredictable. Disease activity at the onset of pregnancy will have great bearing on fetal outcome. Thus the use of potentially harmful drug combinations in pregnancy has to be weighed against theoretical teratogenic effects. This review outlines some of these dilemmas. PMID:3258776

Nicholas, N S



Vaccinations during Pregnancy  


... couldn't see my baby at my 7 week ultrasound. Why? At the 7th week of pregnancy, your baby is about ½ an ... 1 in 120 pregnancies at 15 to 20 weeks gestation. Most disappear during pregnancy or within several ...


Adolescent pregnancy options.  


The range of pregnancy options available to adolescents each have significant ramifications for future educational and economic achievement. The changing societal context of adolescent pregnancy decision-making are described, and the characteristics of adolescents who choose to terminate their pregnancy, parent their child, or place for adoption are examined. The role of significant others in decision-making and the implications of mandatory parental involvement in pregnancy decision-making is discussed, as well as the roles of schools in promoting the well-being and potential of adolescents considering pregnancy decisions. PMID:1434557

Resnick, M D



Thrombophilia and pregnancy  

PubMed Central

Pregnancy is hypercoagulable state. The field of thrombophilia; the tendency to thrombosis, has been developed rapidly and has been linked to many aspects of pregnancy. It is recently that severe pregnancy complications such as severe preeclampsia intrauterine growth retardation abruptio placentae and stillbirth has been shown to be associated with thrombophilia. Recurrent miscarriage and has also been associated with thrombophilia. Finally, thromboembolism in pregnancy as in the non-pregnant state is linked to thrombophilia. In this review all aspects of thrombophilia in pregnancy are discussed, and also all prophylactic and therapeutic implications. PMID:14617365

Kupferminc, Michael J



Characterization of abdominal adiposity and its relationship to adipokines and the adaptive immune response  

E-print Network

women [108], a phenomenon also observed in obese women with 12 T a b le 1 .1 P h y si o lo g ic E ff ec ts o f A d ip o k in es R o le s in P re g n a n cy C o m p li ca ti o n s ? m ac ro so m ia [ 1 09 ], ? I U G R [ 11 0... 2 II. Methods to Body Composition: Problems and Considerations in Pregnancy 4 III. Abdominal Adiposity: Measuring Its Impact 7 IV. Adipokines Role in Obese Pregnancy 10 A. Leptin 11 B. Resistin...

Ozias, Marlies



Role of fetal abdominal circumference as a prognostic parameter of perinatal complications  

Microsoft Academic Search

Objective  To evaluate the potential of fetal abdominal circumference (AC) measurement as predictor of perinatal complications in term\\u000a newborns.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods  This prospective study included 324 consecutive term pregnancies within a 6-month period between February and August 2009.\\u000a Inclusion criteria were a singleton pregnancy with at least 37 weeks of gestation, vertex presentation, absence of structural\\u000a or chromosomal disorders and complete ultrasound

Sven Kehl; Joachim Brade; Ulrike Schmidt; Sebastian Berlit; Michael K. Bohlmann; Marc Sütterlin; Jörn Siemer; Amadeus Hornemann


Abdominal radiation causes bacterial translocation  

SciTech Connect

The purpose of this study was to determine if a single dose of radiation to the rat abdomen leads to bacterial translocation into the mesenteric lymph nodes (MLN). A second issue addressed was whether translocation correlates with anatomic damage to the mucosa. The radiated group (1100 cGy) which received anesthesia also was compared with a control group and a third group which received anesthesia alone but no abdominal radiation. Abdominal radiation lead to 100% positive cultures of MLN between 12 hr and 4 days postradiation. Bacterial translocation was almost nonexistent in the control and anesthesia group. Signs of inflammation and ulceration of the intestinal mucosa were not seen until Day 3 postradiation. Mucosal damage was maximal by Day 4. Bacterial translocation onto the MLN after a single dose of abdominal radiation was not apparently dependent on anatomical, histologic damage of the mucosa.

Guzman-Stein, G.; Bonsack, M.; Liberty, J.; Delaney, J.P.



Ultrastructural observations on the biogenic amines in the carotid and aortic-abdominal bodies of the human fetus  

Microsoft Academic Search

The carotid and aortic-abdominal bodies of two human fetus at fifth month of pregnancy have been studied with the light and electron microscope. A personal variation of the glutaraldehyde ammoniacal silver (GA\\/S) method has been used, which consists in performing the silver reaction on the ultramicrotomical sections of the tissues, first fixed by glutaraldehyde perfusion and then included in Epikote

Gabriele Battaglia



Aorta pathology and pregnancy.  


In addition to the haemodynamic changes in pregnancy, hormones also induce changes in the aortic wall. Women with diseases like Marfan syndrome, Ehlers-Danlo syndrome, or other aortic abnormalities, have an increased risk of complications during pregnancy. Counselling and risk assessment before pregnancy is mandatory for all women with known aortic disease. Proper information should be provided about the risks of morbidity and mortality during pregnancy and information on the risks for the fetus, including the potential recurrence of disease in the offspring. Evaluation of past medical and family history, the aortic size before conception, and any increase in size before and during pregnancy, is essential to try and estimate the risk of aortic dissection. If the aorta is dilated, prophylactic repair before pregnancy may be indicated. In some cases, elective surgery during pregnancy may be warranted. In women with a severely dilated ascending aorta, caesarean section is, at present, the advised mode of delivery. PMID:24726851

van Hagen, Iris M; Roos-Hesselink, Jolien W



Early pregnancy disorders: expert knowledge based consultation.  


The study presents a part of the knowledge-based consultation system for use in a gynecological primary health service to assist doctors who might not be highly experienced, such as junior gynecologists or general practitioners working in small centers, rural areas, developing countries, etc. Aiding the prompt detection of early pregnancy disorders has been considered to reduce complications in these cases, including the life-threatening ones. Although imminent abortion or ectopic pregnancy is usually assumed, all 17 diagnostic hypotheses manifested through similar symptoms are provided. A special experts' knowledge base including 12,000 rules formulated according to the ELSA-method (Experts Lattice Structured Acquirements) principles has been completed for this purpose. The following pattern serves for obtaining experts acquirements: IF (diagnostic problem) AND (manifestation) THEN (diagnostic hypothesis A) R (diagnostic hypothesis B) where R denotes one of the following relations: ... "preferred rather than"..., ... "preferred strongly to" ..., ... "equivalent to" ... A special procedure has been developed for processing these experts judgements to aid the medical reasoning in complex situations. The consultation system offers its assistance in: --differentiation within any given group of diagnostic hypotheses through setting them in order dependent on the patient's manifestations presented, --selection of the most efficient diagnostic steps for differentiating within the diagnostic hypotheses assumed. A consultation in the case of the patient with irregular vaginal bleeding has been included. The system operates on IBM PC/XT, equipped with 256 RAM, 360 kB floppy and a printer. PMID:3065471

Ruszkowski, J



Fibrolipomas masquerading as abdominal hernias.  


A 15-year-old Caucasian girl presented to her general practitioner with a tender, irreducible mass in the paraumbilical region. On examination, two small masses could be felt. She was referred to general surgery. Ultrasound imaging and MRI were unremarkable. However, clinical suspicion suggested multiple areas of abdominal wall herniation. The patient was admitted for elective surgery to exclude herniation. At operation, three subcutaneous masses were found but with no evidence of abdominal wall herniation. Histopathology results from the specimens showed mature adipose tissue mixed with fibrous deposits. There was no evidence of malignancy. A diagnosis of fibrolipoma was given. PMID:24343803

Watson, Hannah Isabella; Saunders, Andrew John



CT appearances of abdominal tuberculosis.  


The purpose of this article is to review and illustrate the spectrum of computed tomography (CT) appearances of abdominal tuberculosis. Tuberculosis can affect any organ or tissue in the abdomen, and can be mistaken for other inflammatory or neoplastic conditions. The most common sites of tuberculosis in the abdomen include lymph nodes, genitourinary tract, peritoneal cavity and gastrointestinal tract. The liver, spleen, biliary tract, pancreas and adrenals are rarely affected, but are more likely in HIV-seropositive patients and in miliary tuberculosis. This article should alert the radiologist to consider abdominal tuberculosis in the correct clinical setting to ensure timely diagnosis and enable appropriate treatment. PMID:22212637

Lee, W-K; Van Tonder, F; Tartaglia, C J; Dagia, C; Cazzato, R L; Duddalwar, V A; Chang, S D



Abdominal imaging in child abuse  

Microsoft Academic Search

Introduction  Abdominal injuries in abused children are less common than musculoskeletal and craniocerebral injuries; however they carry\\u000a high mortality and morbidity rates. In every case of trauma, regardless of aetiology, radiologists are responsible for the\\u000a documentation and evaluation of injuries.\\u000a \\u000a \\u000a \\u000a \\u000a Injuries  Any abdominal injury pattern maybe observed following physical abuse and none is specific for abuse. However, a high index\\u000a of suspicion

Maria Raissaki; Corinne Veyrac; Eleonore Blondiaux; Christiana Hadjigeorgi



Recurrent abdominal pain in children.  


Eighty five children with recurrent abdominal pain(RAP) were studied. Organic cause was noticed in 70 cases and non-organic in 15 cases. Giardiasis was the commonest organic cause in 57 (67.0 percent), either alone or with other parasitic infestations. Other organic causes include gallstones (4.7 percent), urinary infections (4.7 percent), esophagitis/gastritis (3.5 percent) and abdominal tuberculosis (2.3 percent). Single parent, school phobia, sibling rivalry, RAP in other family members and nocturnal enuresis are significant factors associated with nonorganic causes PMID:12368527

Buch, Niyaz A; Ahmad, Sheikh Mushtaq; Ahmed, S Zubair; Ali, Syed Wazid; Charoo, B A; Hassan, Masood Ul



Penetrating abdominal injuries: management controversies  

PubMed Central

Penetrating abdominal injuries have been traditionally managed by routine laparotomy. New understanding of trajectories, potential for organ injury, and correlation with advanced radiographic imaging has allowed a shift towards non-operative management of appropriate cases. Although a selective approach has been established for stab wounds, the management of abdominal gunshot wounds remains a matter of controversy. In this chapter we describe the rationale and methodology of selecting patients for non-operative management. We also discuss additional controversial issues, as related to antibiotic prophylaxis, management of asymptomatic thoracoabdominal injuries, and the use of colostomy vs. primary repair for colon injuries. PMID:19374761

Butt, Muhammad U; Zacharias, Nikolaos; Velmahos, George C



Surgical management of colonic perforation due to ulcerative colitis during pregnancy: Report of a case.  


This report describes a young female in her second trimester of pregnancy with known ulcerative colitis on maintenance medical therapy. She was admitted for abdominal pain, and workup revealed a colonic stricture and ulceration with contained perforation. After multidisciplinary discussion she was managed with colectomy and end ileostomy. She delivered a healthy newborn 18 wk after surgery. Only a few prior reports described surgical management of inflammatory bowel disease during pregnancy, with recent results indicating low risk of adverse outcomes. PMID:25346802

Overbey, Douglas; Govekar, Henry; Gajdos, Csaba



Surgical management of colonic perforation due to ulcerative colitis during pregnancy: Report of a case  

PubMed Central

This report describes a young female in her second trimester of pregnancy with known ulcerative colitis on maintenance medical therapy. She was admitted for abdominal pain, and workup revealed a colonic stricture and ulceration with contained perforation. After multidisciplinary discussion she was managed with colectomy and end ileostomy. She delivered a healthy newborn 18 wk after surgery. Only a few prior reports described surgical management of inflammatory bowel disease during pregnancy, with recent results indicating low risk of adverse outcomes.

Overbey, Douglas; Govekar, Henry; Gajdos, Csaba



An Ectopic Case of Tunga spp. Infection in Peru  

PubMed Central

Tungiasis is a neglected ectoparasitism of impoverished areas in South America and sub-Saharan Africa. The sand flea Tunga spp. preferably infests the soles and the periungueal and interdigital regions of the feet. Ectopic tungiasis is rare, even in highly endemic areas. We describe a case of an indigenous patient in Peru who presented with a nodular lesion in the extensor aspect of the knee and whose biopsy was compatible with Tunga spp. This is the first documented case of knee tungiasis in an endemic country. The historical, clinical, histological, and current epidemiological aspects of tungiasis in Peru are discussed here. PMID:20519602

Maco, Vicente; Maco, Vicente P.; Gotuzzo, Eduardo



Case report: nocardia infection associated with ectopic cushings  

PubMed Central

Background Cushing’s syndrome results from exposure to excess glucocorticoids. Ectopic Cushings is endogenous ACTH dependant form of Cushing’s associated with markedly raised ACTH and cortisol levels. This leads to an impaired immune response, setting the stage for occurrence of opportunistic infections. Nocardiosis is a gram positive bacterial infection caused by aerobic actinomycetes in genus Nocardia. We report a series of patients diagnosed with ectopic Cushings, having pneumonia with Nocardia spp. In one of these cases, the manifestations of Cushing’s disappeared with treatment for Nocardia. Case presentation Two middle aged men of Asian descent presented to the Endocrine clinic: the first with history of exertional shortness of breath, and weight loss for 1 year, the other with facial swelling, disturbed sleep and lethargy for a month. The third case was a young Asian male who presented with progressive weakness & weight loss for 2 months. All three patients had uncontrolled hypertension, high blood sugars & were hypokalemic (K: 2.52, 2.9, 1.5 mmol/l); 24 hour urine cortisol was elevated at 2000, 27216 and 9088 (32-243 ug/24 hours); ACTH 68.5, 159, 255 [0–48 pg/ml), respectively. Their MRI pituitary was normal, inferior petrosal sinus sampling revealed no central peripheral gradient. CT chest of these subjects demonstrated cavitatory lung lesions; microscopic analysis of respiratory samples was suggestive of infection with Nocardia spp. Histopathology of bronchoscopic-guided biopsy revealed no malignancy. Antihypertensives, insulin, potassium replacement, ketoconazole & trimethoprim-sulphamethoxazole (TS) were initiated. The patients’ symptomatology improved & cavitatory lesions resolved with treatment. The primary source for the ectopic cushings remained unknown. The first case required bilateral adrenalectomy. The second case followed a progressively downhill course leading to death. In the third case, we were able to completely taper off ketoconazole, potassium, insulin & antihypertensives, after starting TS. Conclusion Opportunistic infections are known to be associated with Cushing’s syndrome, and higher levels of glucocorticoid secretion are found in patients with ectopically produced ACTH. Pulmonary nocardiosis is important differential to consider. This series includes the first case reported in which signs and symptoms of cushings subsided after treatment of Nocardia. PMID:24950706



Abdominal pain - children under age 12  


Stomach pain in children; Pain - abdomen - children; Abdominal cramps in children; Belly ache in children ... When your child complains of abdominal pain, see if s/he can describe it to you. Here are different kinds of pain: ...


Hematological Problems of Pregnancy  

PubMed Central

Hematologic complications are relatively common in pregnancy. Furthermore, many chronic hematologic disorders require special surveillance and intervention in pregnancy. In this brief review, the author discusses common nutritional anemias in pregnancy. She reviews the disorders of hemoglobin synthesis and the need for early genetic counselling and prenatal diagnosis, as well as the special requirements and problems affected patients encounter in pregnancy. An overview of the frequent causes of thrombocytopenia in pregnancy is given and an approach suggested to the management of both the mother and the fetus. An approach is also presented to the management of women at risk for thrombosis in pregnancy, a particularly vexing and controversial problem. The risks of the various forms of anticoagulation are reviewed. Finally, a brief review of obstetrical hemorrhage is presented along with some guidelines useful in its management. PMID:21253125

Ballem, P.J.



Gynecologic malignancy in pregnancy  

PubMed Central

Gynecologic malignancy during pregnancy is a stressful problem. For the diagnosis and treatment of malignancy during pregnancy, a multidisciplinary approach is needed. Patients should be advised about the benefits and risk of treatment. When selecting a treatment for malignancy during pregnancy, the physiologic changes that occur with the pregnancy should be considered. Various diagnostic procedures that do not harm the fetus can be used. Laparoscopic surgery or laparotomy may be safely performed. The staging approach and treatment should be standard. Systemic chemotherapy during the first trimester should be delayed if possible. Radiation therapy should preferably start postpartum. Although delivery should be delayed preferably until after 35 weeks of gestation, termination of pregnancy may be considered when immediate treatment is required. Subsequent pregnancies do not increase the risk of malignancy recurrence. PMID:24328018

Ji, Yong Il



Warfarin Accelerates Ectopic Mineralization in Abcc6?/? Mice  

PubMed Central

Pseudoxanthoma elasticum (PXE) is a multisystem ectopic mineralization disorder caused by mutations in the ABCC6 gene. Warfarin, a commonly used anticoagulant, is associated with increased mineralization of the arterial blood vessels and cardiac valves. We hypothesized that warfarin may accelerate ectopic tissue mineralization in PXE, with clinical consequences. To test this hypothesis, we developed a model in which Abcc6?/? mice, which recapitulate features of PXE, were fed a diet supplemented with warfarin and vitamin K1. Warfarin action was confirmed by significantly increased serum levels of oxidized vitamin K. For mice placed on a warfarin-containing diet, quantitative chemical and morphometric analyses revealed massive accumulation of mineral deposits in a number of tissues. Mice fed a warfarin-containing diet were also shown to have abundant uncarboxylated form of matrix Gla protein, which allowed progressive tissue mineralization to ensue. To explore the clinical relevance of these findings, 1747 patients with PXE from the approximately 4000 patients in the PXE International database were surveyed about the use of warfarin. Of the 539 respondents, 2.6% reported past or present use of warfarin. Based on the prevalence of PXE (approximately 1:50,000), thousands of patients with PXE worldwide may be at risk for worsening of PXE as a result of warfarin therapy. PMID:23415960

Li, Qiaoli; Guo, Haitao; Chou, David W.; Harrington, Dominic J.; Schurgers, Leon J.; Terry, Sharon F.; Uitto, Jouni



Pregnancy in essential thrombocythaemia: experience with 40 pregnancies.  


In this study, the course of 40 pregnancies in 16 women with essential thrombocythaemia (ET) was analysed retrospectively. Of the pregnancies, 45% were complicated, 55% uncomplicated, and 62% resulted in live birth. The most common complication was spontaneous abortion during the first trimester seen in 33% of all pregnancies and comprising 72% of all complications. Two intrauterine foetal deaths occurred at weeks 22 and 28. Three pregnancies were complicated by eclampsia or pre-eclampsia. Nine of 16 women with 29 pregnancies had at least one complicated pregnancy. In seven of 16 women, all 11 pregnancies were uneventful. The non-pregnancy-related symptoms of ET or the platelet count before conception or during pregnancy did not correlate with the risk of pregnancy complications. Treatment with low-dose acetylsalicylic acid (ASA) alone during pregnancy or platelet-lowering drugs before or during pregnancy reduced the risk of complications. PMID:15522066

Niittyvuopio, Riitta; Juvonen, Eeva; Kaaja, Risto; Oksanen, Kalevi; Hallman, Heikki; Timonen, Timo; Ruutu, Tapani



Asthma in Pregnancy  

Microsoft Academic Search

The prevalence of asthma among pregnant women is increasing and for many women with asthma, pregnancy leads to a worsening\\u000a of their disease. This chapter will examine the complications which may occur during pregnancy, particularly focussing on\\u000a exacerbations of asthma. A summary of the clinical guidelines for the management of asthma during pregnancy will be presented,\\u000a along with a discussion

Vanessa E. Murphy; Peter G. Gibson


Insomnia During Pregnancy  

Microsoft Academic Search

\\u000a Pregnancy is a time of extensive physiologic, physical, and hormonal changes. These changes can significantly disrupt a woman’s\\u000a sleep and can result in symptoms of daytime sleepiness and fatigue. Understanding how sleep is altered during pregnancy and\\u000a recognizing sleep disorders that commonly develop during pregnancy may enable healthcare professionals to identify and treat\\u000a sleep problems. Sleep is vital to the

Beth Ann Ward


Pregnancy and Portal Hypertension  

Microsoft Academic Search

Pregnancy is a normal physiological state characterized by numerous hemodynamic changes. These hemodynamic changes, although\\u000a necessary for a normal pregnancy, pose a special problem in the presence of portal hypertension. In North America, cirrhosis\\u000a of the liver is the most common cause of portal hypertension. Although rare, the occurrence of pregnancy is not altogether\\u000a unknown in this population. This is

Bimaljit Sandhu; Arun J. Sanyal


Abdominal cocoon secondary to disseminated tuberculosis.  


Abdominal cocoon, also known as sclerosing encapsulating peritonitis, represents a rare entity where a variable length of the small bowel is enveloped by a fibrocollagenous membrane giving the appearance of a cocoon. It may be asymptomatic and is often diagnosed incidentally at laparotomy. We present a rare case of abdominal cocoon due to abdominal tuberculosis. PMID:25239980

Puppala, Radha; Sripathi, Smiti; Kadavigere, Rajagopal; Koteshwar, Prakashini; Singh, Jyoti



Abdominal Aortic Aneurysm and Diastasis Recti  

Microsoft Academic Search

Midline abdominal incisional hernias are common following open repair of abdominal aortic aneurysms. These may be caused by the weakness of connective tissue. This study sought to determine the prevalence of diastasis recti among unoperated Caucasian males with abdominal aortic aneurysm compared to a control group with atherosclerotic lower extremity peripheral arterial disease. Forty-two consecutive white males referred for evaluation

Ian McPhail



Intrahepatic cholestasis of pregnancy.  


Intrahepatic cholestasis of pregnancy is the most common pregnancy-specific liver disease that typically presents in the third trimester. The clinical features are maternal pruritus in the absence of a rash and deranged liver function tests, including raised serum bile acids. Intrahepatic cholestasis of pregnancy is associated with an increased risk of adverse perinatal outcomes, including spontaneous preterm delivery, meconium staining of the amniotic fluid, and stillbirth. It is commonly treated with ursodeoxycholic acid. There is accumulating evidence to suggest that intrahepatic cholestasis of pregnancy has a lasting influence on both maternal and fetal health. We review the etiology, diagnosis, and management of this intriguing condition. PMID:24901263

Williamson, Catherine; Geenes, Victoria



Fertility, pregnancy and cancer.  


Results of clinical and experimental research into various aspects of cancer and pregnancy are reported. These investigations have been proceeding for many years. 845 cases of pregnancy with concomitant malignant tumor at various localization are reported here. Diagnostic methods and results of treating cervical and breast cancer during pregnancy are described. Also discussed is the influence of pregnancy on the clinical course of cancer and survival. Fertility after recovery from cancer accomplished by means of organ-preserving surgery is commented on. PMID:9225628

Bokhman, J V; Bakidoze, E V; Ourmancheeva, A F



Tissue-Autonomous Function of Drosophila Seipin in Preventing Ectopic Lipid Droplet Formation  

Microsoft Academic Search

Obesity is characterized by accumulation of excess body fat, while lipodystrophy is characterized by loss or absence of body fat. Despite their opposite phenotypes, these two conditions both cause ectopic lipid storage in non-adipose tissues, leading to lipotoxicity, which has health-threatening consequences. The exact mechanisms underlying ectopic lipid storage remain elusive. Here we report the analysis of a Drosophila model

Yuan Tian; Junfeng Bi; Guanghou Shui; Zhonghua Liu; Yanhui Xiang; Yuan Liu; Markus R. Wenk; Hongyuan Yang; Xun Huang



Ectopic thoracic kidney: evaluation using 99mTc dimercaptosuccinic acid SPECT-CT.  


Ectopic thoracic kidney is a very rare congenital defect and is usually diagnosed incidentally. 99mTc-dimercaptosuccinic acid SPECT-CT images of a 7-year-old boy with left ectopic thoracic kidney are presented here. PMID:22691527

Singh, Harmandeep; Sharma, Punit; Nazar, Aftab Hasan; Das, Kalpajyoti; Naswa, Niraj; Singla, Suhas; Kumar, Rakesh



MRI Findings of Coexistence of Ectopic Neurohypophysis, Corpus Callosum Dysgenesis, and Periventricular Neuronal Heterotopia  

PubMed Central

Ectopic neurohypophysis is a pituitary gland abnormality, which can accompany growth hormone deficiency associated with dwarfism. Here we present magnetic resonance imaging (MRI) findings of a rare case of ectopic neurohypophysis, corpus callosum dysgenesis, and periventricular neuronal heterotopia coexisting, with a review of the literature. PMID:24987569

Arslan, Harun; Sayl?k, Metin; Akdeniz, Huseyin



Overweight and Obesity during Pregnancy  


... It's been added to your dashboard . Overweight and obesity during pregnancy Being overweight or obese during pregnancy ... What kinds of pregnancy complications can overweight and obesity cause? If you’re overweight or obese, you’ ...


Understanding Pregnancy and Birth Issues  


... Navigation Bar Home Current Issue Past Issues Understanding Pregnancy and Birth Issues Past Issues / Winter 2008 Table ... turn Javascript on. What is a High-Risk Pregnancy? All pregnancies involve a certain degree of risk ...


Maternal-neonatal outcome in pregnancies with non-obstetric laparotomy during pregnancy.  


In this study maternal and neonatal outcome evaluated in each trimester of pregnancies with non obstetric laparotomies. In this descriptive-analytic study, 100 pregnant women operated during pregnancy were evaluated. Based on available data a questionnaire comprising general information, kind of surgery as well as the maternal-neonatal outcome was fulfilled. These outcomes were compared in the different gestational ages. In this study, 28 (28%), 48 (48%) and 24 (24%) patients had been operated in the first, second and third trimester, respectively. The patients of these three groups were matched for general characters. Sixty one patients had appendectomy, 30 adnexal mass or torsion, 6% cholecystectomy, 3% abdominal mass. Maternal complications were recorded in 6, 3 and 9% patient in 3rd, 2nd and 1st trimester of pregnancy, respectively. Abortion in first trimester was 8.2%. Low apgar in fifth minute and asphyxia were higher in third trimester. Appendectomy was the most common surgery in the pregnancy. Maternal and fetal complications were higher in third and first trimester. Besides obstetric and pediatric consultation before surgery are necessary for optimal safety of the woman and the fetus. PMID:24783811

Fardiazar, Zahra; Derakhshan, Iraj; Torab, Reza; Vahedi, Amir; Goldust, Mohamad



[Denial of pregnancy and neonaticide: psychopathological and clinical features].  


Pregnancy denial and neonaticide have recently received media coverage following a series of French cases of neonatal killing. Although it has been known for a long time that some women deny their pregnancy and may kill their newborns, there is still no consensus on the etiopathogenic factors involved in the denial of pregnancy occurrence. Even though neonaticide is often committed by young, poor, unmarried women with little or no prenatal care, it appears that denial of pregnancy is a heterogeneous condition associated with different psychological features. Societies are ambivalent with regard to mothers who killed their children and tend to lay the entire blame on them. Furthermore, there is a widespread lack of understanding among the public on these affairs, when birth control techniques and methods are widely available. The purpose of this article is to describe the different types of pregnancy denial and neonaticide and to review the still debated etiopathogenic hypotheses. The absence of the physical changes of pregnancy at the time of the denial such as cessation of menstruation, abdominal swelling or perception of foetal movements is also discussed. PMID:22939654

Seigneurie, A-S; Limosin, F



[Abdominal cystic tumor revealing lymphangioleiomyomatosis].  


We report the case of a 39 year-old woman with many years of intermittent abdominal pain who was found to have cystic masses evocative of cystic lymphangioma involving the posterior mediastinal and retroperitoneum. Worsening abdominal pain led to a recommendation for laparoscopic unroofing and decompression of the cysts. During the postoperative period, hemorrhagic shock required reintervention with excision of the tumoral mass. Pathologic examination revealed lymphangioleiomyomatosis (LAM). On the 15th postoperative day, the patient developed a chylopneumothorax which required prolonged chest tube drainage. The presence of multiple polycystic lesions in the pulmonary parenchyma supported the diagnosis of diffuse LAM with primary extrapulmonary presentation. This diagnosis should be considered preoperatively since it modifies the treatment: a complete excision of the cystic lesions seems to be necessary in order to prevent bleeding and lymphatic extravasation. PMID:19446700

Barbier, L; Ebbo, M; Andrac-Meyer, L; Schneilitz, N; Le Treut, Y-P; Reynaud-Gaubert, M; Hardwigsen, J



Ciprofloxacin and Pregnancy  


... 346:307-308. Leung D, et al. 1995. Treatment of typhoid in pregnancy. The Lancet 346:648. Loebstein R, et al. 1998. Pregnancy outcome following gestational exposure to fluoroquinolones: ... 2013 Prophylaxis and treatment of anthrax in pregnant women. Obstet Gynecol. 122( ...


Diagnosing rhinitis during pregnancy.  


Chronic rhinitis is a common medical condition to affect pregnant women. Uncontrolled rhinitis during pregnancy may have a significant adverse effect on quality of life and may have an effect on coexisting asthma. This article reviews the most common causes of rhinitis to occur during pregnancy as well as treatment options for pregnant women. PMID:25086578

Namazy, Jennifer A; Schatz, Michael



Losing weight after pregnancy  


... able to return to your exact pre-pregnancy weight or shape. For many women, pregnancy causes changes in the body that stay. You may have a softer belly, wider hips, and a larger waistline. Make your goals about your new body realistic.


Pregnancy: A social stigma?  

Microsoft Academic Search

Experimental evidence is presented which explores the social stimulus value of pregnancy. It was found that, for men especially, the pregnant woman elicits avoidance and staring and that these responses occur primarily because pregnancy is a novel visual stimulus. For women, avoidance seems to be tied less to the stimulus aspects of the pregnant woman than to role expectations about

Shelley E. Taylor; Ellen J. Langer



Teenage Pregnancy in Perspective  

Microsoft Academic Search

In an effort to provide the clinician with suggestions for preventive and remedial approaches to adolescent pregnancy, the nature, medical, social, eco nomic, and psychological aspects of the problem are reviewed and discussed. While the rate of adolescent pregnancy is declining, there are more than 560,000 deliveries to teenagers annually. Medical risks are significantly diminished by early and comprehensive prenatal

Robert Wm. Blum; Jeffrey Goldhagen



Phentermine and Pregnancy  


... Milk, 13 th ed. Amarillo, TX: Hale Publishing. Johnson KA, et al. 1998. Pregnancy outcome of women exposed to Fen/Phen [abstract]. Organization of Teratology Information Specialists Annual Meeting, June 1998. Jones KL, et al. 2002. Pregnancy outcomes after first trimester exposure to phentermine/ ...


Costs of triplet pregnancy  

Microsoft Academic Search

OBJECTIVE: Our purpose was to describe the total costs involved in the delivery, prenatal, and neonatal care for triplet pregnancies.STUDY DESIGN: Twenty triplet pregnancies were born at our institution over the 1-year period between July 1, 1992, and June 30, 1993. Total charges for prenatal care, physician fees, antepartum admissions, delivery, postpartum inpatient and outpatient care, and neonatal inpatient and

David Chelmow; Alan S. Penzias; Gary Kaufman; Curtis Cetrulu



Adolescent pregnancy: A review  

Microsoft Academic Search

Adolescent pregnancy represents a critical social and health problemfor our society today. This article examines the effects of pregnancy on the teenagers’ health, educational attainment, vocational opportunities and marriage status. The health risks and developmental consequences of infants born to teenage mothers are also examined. A review of intervention programs shows that adequate prenatal care for the pregnant adolescent can

Phyllis R. Magrab



Hepatitis E in pregnancy  

Microsoft Academic Search

Objectives: To study the spectrum and the clinical and biochemical course of viral hepatitis E during pregnancy. Methods: In this prospective study, sera of 62 pregnant women having jaundice in the third trimester of pregnancy were analyzed for markers of hepatitis A, B, C and E viruses. The cord blood samples of hepatitis E virus (HEV)-positive pregnant women at the

A. Kumar; M. Beniwal; P. Kar; J. B. Sharma; N. S. Murthy



Diabetes in pregnancy  

Microsoft Academic Search

Diabetes is the most common medical condition to complicate pregnancy and includes pregestational type 1 and type 2 diabetes and gestational diabetes, defined as glucose intolerance first diagnosed during pregnancy. Risks for the fetus include malformation, spontaneous abortion, stillbirth, neonatal death, macrosomia and intrauterine growth retardation. Risks for the mother include severe hypoglycaemia, diabetic ketoacidosis, progression of eye or renal

Rosemary Temple



Parity and pregnancy outcomes  

Microsoft Academic Search

Objective: The issue of parity and risk of pregnancy outcomes has been controversial for many decades. We conducted a study to evaluate the association between parity and pregnancy outcomes and to clarify the basis of the classification of risk based on parity. Study Design: The study is a cross-sectional analysis on a large routinely collected data set of singleton births

Jun Bai; Felix W. S. Wong; Adrian Bauman; Mohammed Mohsin



Hot yoga and pregnancy  

PubMed Central

Abstract Question One of my pregnant patients wishes to continue her hot yoga exercises during pregnancy. Is this practice safe? Answer With the increased risk of neural tube defects and possibly of other malformations among fetuses exposed to excessive heat, pregnant women should avoid practising hot yoga during pregnancy. PMID:24452558

Chan, Justin; Natekar, Aniket; Koren, Gideon



Combined laparoscopy and hysteroscopy vs. uterine curettage in the uterine artery embolization-based management of cesarean scar pregnancy: a cohort study  

PubMed Central

Aim: To evaluate the efficacy of combined laparoscopy and hysteroscopy compared with traditional uterine curettage in removing the ectopic conceptus and repairing the tissue defect following uterine artery embolization (UAE) management of cesarean scar pregnancy (CSP). Design: A prospective cohort study. Setting: Three large obstetrics and gynecology centers in Shanghai, China. Sample: CSP patients diagnosed between March 2009 and August 2010 who had received no prior treatments, were hemodynamically stable, and had no contraindications for UAE were enrolled. Methods: Patients were divided into two cohorts to undergo the intra-arterial methotrexate (MTX), UAE, and one of the following treatments: combined laparoscopy and hysteroscopy (research group, 25 cases) and uterine curettage (control group, 33 cases). Main Outcome Measures: The conceptus removal rate, the severity of intra- and postoperative complications, surgical time, and duration of hospital stay. Results: The single-surgery conceptus removal rate reached 100% in the research group, which was significantly higher than the 82% (P=0.024) observed in the control group (with one hysterectomy). The average volume of intraoperative blood loss was 78.0 mL in the research group, which was much less than the 258.5 mL (P=0.004) in the control group. Moreover, the research group had significantly shorter hospital stays and ?-hCG regression times, as well as lower rates of postoperative abdominal pain, uterine bleeding and menstruation abnormalities. Conclusions: Combined laparoscopy and hysteroscopy is much safer and more effective than uterine curettage as a supplementary measure following UAE. PMID:25356141

Wu, Xin; Xue, Xiaohong; Wu, Xuezhe; Lin, Ru; Yuan, Ying; Wang, Qing; Xu, Congjian; He, Yifeng; Hu, Weiguo



Neurology of pregnancy.  


Pregnancy creates alterations in maternal physiology which predispose to unique neurologic disorders. Pre-eclampsia, eclampsia, certain types of ischemic and hemorrhagic stroke, reversible cerebral vasoconstriction syndrome, posterior reversible encephalopathy syndrome, and thunderclap headache all appear to share a common origin from vascular endothelial dysfunction, with overlapping clinical presentations. Multiple sclerosis often improves during pregnancy. Compression mononeuropathies may occur in the extremities. Myasthenia gravis may affect second stage labor. Various inflammatory peripheral neuropathies, dystrophies, myopathies may occur during pregnancy. The safety of specific immune suppressants is reviewed. Epilepsy does not have a significant effect upon the course of pregnancy, albeit there is a modest increase in the need for cesarean section. Certain antiepileptic drugs may produce fetal malformations, most notably valproic acid. Brain tumors are rare during pregnancy, but may increase in size due to activation of hormonal receptors on tumor cells surfaces, water retention, and engorged blood vessels. PMID:24365437

Block, H Steven; Biller, José



Thrombophilia in pregnancy  

PubMed Central

Thrombophilia can be defined as a predisposition to thrombosis. Abnormalities in haemostasis that are associated with clinical thrombophilia include heritable defects, such as mutations in the genes encoding the natural anticoagulants antithrombin, protein C, and protein S, or clotting factors prothrombin and factor V, and acquired defects, such as antiphospholipids. Women with thrombophilic defects have been shown to be at increased risk, not only of pregnancy associated thromboembolism, but also of other vascular complications of pregnancy, including pre-eclampsia and fetal loss. Routine thrombophilia screening of all women attending antenatal clinics is not recommended. Because some thrombophilic defects—for example, type 1 antithrombin deficiency and antiphospholipids—are associated with a high risk of recurrent thrombosis or other pregnancy complications, it is suggested that selected women (those with a personal or confirmed family history of venous thromboembolism or with a history of recurrent fetal loss) are screened for these defects to allow pregnancy management planning. Key Words: thrombophilia • pregnancy PMID:11002758

Walker, I.



Hypertension in pregnancy.  


Hypertensive disorders of pregnancy represent the second commonest cause of direct maternal death and complicate an estimated 5-10 % of pregnancies. Classification systems aim to separate hypertension similar to that seen outside pregnancy (chronic and gestational hypertension) from the potentially fatal pregnancy-specific conditions. Preeclampsia, HELLP syndrome, and eclampsia represent increasing severities of this disease spectrum. The American College of Obstetricians and Gynecologists' 2013 guidelines no longer require proteinuria as a diagnostic criterion, because of its variable appearance in the disease spectrum. The cause involves inadequate cytotrophoblastic invasion of the myometrium, resulting in placental hypoperfusion and diffuse maternal endothelial dysfunction. Changes in angiogenic and antiangiogentic peptide profiles precede the onset of clinical preeclampsia. Women with preeclampsia should be closely monitored and receive magnesium sulfate intravenously if severe features, HELLP syndrome, or eclampsia occur. Definitive therapy is delivery of the fetus. Hypertension in pregnancy increases future maternal risk of hypertension and cardiovascular disorders. PMID:24477794

Vest, Amanda R; Cho, Leslie S



Ectopic Expression Reveals a Conserved PHYB Homolog in Soybean  

PubMed Central

Phytochromes sense red/far-red light and trigger a cascade of physiological responses in plant. Here, a phytochrome B homolog, GmPHYB1, was amplified from the soybean genome, and its expression profiles were obtained for various parts of the plant and at various developmental stages. The gene was ectopically expressed in Arabidopsis thaliana, driven by CaMV 35S promoter, to study the physiological functions of the gene product. The overexpressors of GmPHYB1 behaved similarly to those of AtPHYB, but with some subtle differences with respect to the acceleration of flowering under short day conditions and the growth of the hypocotyl under certain light fluence rate. The results suggested that this soybean PHYB homolog was well conserved both at the level of sequence and physiological function. PMID:22110748

Wu, Fa-Qiang; Zhang, Xiao-Mei; Li, Dong-Mei; Fu, Yong-Fu



Ectopic functioning adrenocortical oncocytic adenoma (oncocytoma) with myelolipoma causing virilization.  


Functioning adrenal adenomas are well-described entities that can rarely occur outside the adrenal gland in the ectopic adrenal tissue. Similarly, myelolipoma is an another benign lesion of the adrenal tissue which can rarely occur outside the adrenal gland. We report the first case of a testosterone producing an extra-adrenal adrenocortical oncocytoma accompanied by a myelolipoma. The patient presented with virilization and elevated androgen levels. Imaging revealed a retroperitoneal mass, which histologically consisted of oncocytes and intermingled myelolipoma. Postoperative androgen levels decreased to normal. The tumor cells were strongly positive for inhibin and Melan-A, supporting the adrenal origin. This case demonstrates a diagnostic challenge in which correlation with histology, immunohistochemistry, and serum endocrine studies led to the final diagnosis. PMID:23094172

Surrey, Lea F; Thaker, Ashesh A; Zhang, Paul J; Karakousis, Giorgos; Feldman, Michael D



Ectopic Functioning Adrenocortical Oncocytic Adenoma (Oncocytoma) with Myelolipoma Causing Virilization  

PubMed Central

Functioning adrenal adenomas are well-described entities that can rarely occur outside the adrenal gland in the ectopic adrenal tissue. Similarly, myelolipoma is an another benign lesion of the adrenal tissue which can rarely occur outside the adrenal gland. We report the first case of a testosterone producing an extra-adrenal adrenocortical oncocytoma accompanied by a myelolipoma. The patient presented with virilization and elevated androgen levels. Imaging revealed a retroperitoneal mass, which histologically consisted of oncocytes and intermingled myelolipoma. Postoperative androgen levels decreased to normal. The tumor cells were strongly positive for inhibin and Melan-A, supporting the adrenal origin. This case demonstrates a diagnostic challenge in which correlation with histology, immunohistochemistry, and serum endocrine studies led to the final diagnosis. PMID:23094172

Surrey, Lea F.; Thaker, Ashesh A.; Zhang, Paul J.; Karakousis, Giorgos; Feldman, Michael D.



Ectopic Overexpression of Asparagine Synthetase in Transgenic Tobacco.  


Here, we monitor the effects of ectopic overexpression of genes for pea asparagine synthetase (AS1) in transgenic tobacco (Nicotiana tabacum). The AS genes of pea and tobacco are normally expressed only during the dark phase of the diurnal growth cycle and specifically in phloem cells. A hybrid gene was constructed in which a pea AS1 cDNA was fused to the cauliflower mosaic virus 35S promoter. The 35S-AS1 gene was therefore ectopically expressed in all cell types in transgenic tobacco and constitutively expressed at high levels in both the light and the dark. Northern analysis demonstrated that the 35S-AS1 transgene was constitutively expressed at high levels in leaves of several independent transformants. Furthermore, amino acid analysis revealed a 10- to 100-fold increase in free asparagine in leaves of transgenic 35S-AS1 plants (construct z127) compared with controls. Plant growth analyses showed increases (although statistically insignificant) in growth phenotype during the vegetative stage of growth in 35S-AS1 transgenic lines. The 35S-AS1 construct was further modified by deletion of the glutamine-binding domain of the enzyme (gln[delta]AS1; construct z167). By analogy to animal AS, we reasoned that inhibition of glutamine-dependent AS activity might enhance the ammonia-dependent AS activity. The 3- to 19-fold increase in asparagine levels in the transgenic plants expressing gln[delta]AS1 compared with wild type suggests that the novel AS holoenzyme present in the transgenic plants (gln[delta]AS1 homodimer) has enhanced ammonia-dependent activity. These data indicate that manipulation of AS expression in transgenic plants causes an increase in nitrogen assimilation into asparagine, which in turn produces effects on plant growth and asparagine biosynthesis. PMID:12232020

Brears, T.; Liu, C.; Knight, T. J.; Coruzzi, G. M.



Expression Profile of Ectopic Olfactory Receptors Determined by Deep Sequencing  

PubMed Central

Olfactory receptors (ORs) provide the molecular basis for the detection of volatile odorant molecules by olfactory sensory neurons. The OR supergene family encodes G-protein coupled proteins that belong to the seven-transmembrane-domain receptor family. It was initially postulated that ORs are exclusively expressed in the olfactory epithelium. However, recent studies have demonstrated ectopic expression of some ORs in a variety of other tissues. In the present study, we conducted a comprehensive expression analysis of ORs using an extended panel of human tissues. This analysis made use of recent dramatic technical developments of the so-called Next Generation Sequencing (NGS) technique, which encouraged us to use open access data for the first comprehensive RNA-Seq expression analysis of ectopically expressed ORs in multiple human tissues. We analyzed mRNA-Seq data obtained by Illumina sequencing of 16 human tissues available from Illumina Body Map project 2.0 and from an additional study of OR expression in testis. At least some ORs were expressed in all the tissues analyzed. In several tissues, we could detect broadly expressed ORs such as OR2W3 and OR51E1. We also identified ORs that showed exclusive expression in one investigated tissue, such as OR4N4 in testis. For some ORs, the coding exon was found to be part of a transcript of upstream genes. In total, 111 of 400 OR genes were expressed with an FPKM (fragments per kilobase of exon per million fragments mapped) higher than 0.1 in at least one tissue. For several ORs, mRNA expression was verified by RT-PCR. Our results support the idea that ORs are broadly expressed in a variety of tissues and provide the basis for further functional studies. PMID:23405139

Flegel, Caroline; Manteniotis, Stavros; Osthold, Sandra; Hatt, Hanns; Gisselmann, Gunter



Hepatitis C and pregnancy  

PubMed Central

Acute hepatitis C is a rare event in pregnancy. The most common scenario is chronic hepatitis C virus (HCV) infection in pregnancy. During pregnancy in women with chronic HCV infection a significant reduction in mean alanine aminotransferase levels has been reported, with a rebound during the postpartum period. In few cases exacerbation of chronic hepatitis C has been reported in pregnancy. A cofactor that might play a role in the reduction of liver damage is the release of endogenous interferon from the placenta. Observations regarding serum HCV-RNA concentration have been variable. In some women HCV-RNA levels rise toward the end of pregnancy. In general, pregnancy does not have a negative effect on HCV infection. Conversely, chronic hepatitis does not appear to have an adverse effect on the course of pregnancy, or the birth weight of the newborn infant. The role of spontaneous abortion is approximately the same as in the general population. The overall rate of mother-to-child transmission for HCV is 3%-5% if the mother is known to be anti-HCV positive. Co-infection with human immunodeficiency virus (HIV) increases the rate of mother-to-child transmission up to 19.4%. Numerous risk factors for vertical transmission have been studied. In general, high viral load defined as at least 2.5 × 106 viral RNA copies/mL, HIV co-infection, and invasive procedures are the most important factors. Both interferon and ribavirin are contraindicated during pregnancy. Viral clearance prior to pregnancy increases the likelihood that a woman remains non-viremic in pregnancy with a consequent reduced risk of vertical transmission. PMID:24187446

Floreani, Annarosa



Extraction of fetal heart rate from maternal surface ECG with provisions for multiple pregnancies.  


Twin pregnancies carry an inherently higher risk than singleton pregnancies due to the increased chances of uterine growth restriction. It is thus desirable to monitor the wellbeing of the fetuses during gestation to detect potentially harmful conditions. The detection of fetal heart rate from the maternal abdominal ECG represents one possible approach for noninvasive and continuous fetal monitoring. Here, we propose a new algorithm for the extraction of twin fetal heart rate signals from maternal abdominal ECG recordings. The algorithm detects the fetal QRS complexes and converts the QRS onset series into a binary signal that is then recursively scanned to separate the contributions from the two fetuses. The algorithm was tested on synthetic singleton and twin abdominal recordings. It achieved an average sensitivity and accuracy for QRS complex detection of 97.5% and 93.6%, respectively. PMID:23367336

Fanelli, A; Signorini, M G; Heldt, T



Adolescent pregnancy intentions and pregnancy outcomes: A longitudinal examination  

Microsoft Academic Search

Purpose(a) To examine different methods of assessing pregnancy intention; (b) to identify psychosocial differences between those who indicate pregnancy intentions and those who do not; and (c) to examine the relationship between pregnancy intentions and subsequent pregnancy at 6-month follow-up in nonpregnant (at baseline), sexually experienced adolescent females.

Cynthia Rosengard; Maureen G. Phipps; Nancy E. Adler; Jonathan M. Ellen



Perineal Distensibility Using Epi-no in Twin Pregnancies: Comparative Study with Singleton Pregnancies  

PubMed Central

The aims of this study were to compare perineal distensibility between women with twin and singleton pregnancies and to correlate these women's perineal distensibility with anthropometric data. This prospective cross-sectional case-control study was conducted among nulliparous women, of whom 20 were pregnant with twins and 23 with a single fetus. Perineal distensibility was evaluated in the third trimester by means of Epi-no, which was introduced into the vagina and inflated up to the maximum tolerable limit. It was then withdrawn while inflated and its circumference was measured. The unpaired Student's t-test was used to compare perineal distensibility in the two groups and Pearson's correlation coefficient (r) was used to correlate the pregnant women's perineal distensibility with their anthropometric data. There was no difference in perineal distensibility between the twin group (16.51 ± 2.05?cm) and singleton group (16.13 ± 1.67?cm) (P = 0.50). There was a positive correlation between perineal distensibility and abdominal circumference (r = 0.36; P = 0.01). The greater the abdominal circumference was, the greater the perineal distensibility was, regardless of whether the pregnancy was twin or singleton. PMID:25006476

Kubotani, Juliana Sayuri; Moron, Antonio Fernandes; Zanetti, Miriam Raquel Diniz; Soares, Vanessa Cardoso Marques; Elito Junior, Julio



Ectopic thyroid mass in the left lateral neck and anterior mediastinum: a case report  

PubMed Central

Introduction Ectopic thyroid is characterized by the presence of thyroid tissue in a site other than in its usual pretracheal region. It is a rare condition among the thyroid diseases. Dural ectopic thyroid present in the cervical and anterior mediastinal has not been reported. Case presentation A 45-year-old Chinese woman presented with a nonfunctional ectopic thyroid located both in the cervical and anterior mediastinum. The ectopic thyroid was removed under video-assisted thoracoscopic surgery using a transverse neck incision and her postoperative period has been uneventful thus far. Conclusions Ectopic thyroid is a rare condition among the thyroid diseases, and its location in the anterior mediastinum is even more uncommon. Less than 15 cases have been reported in the last four decades. This is the first case of ectopic thyroid to appear in both the cervical and anterior mediastinum at same time. Masses in the anterior mediastinal are usually thymoma, lymphoma, pheochromocytoma and germ cell tumors. Ectopic thyroid in this area is quite rare so this case enhances our understanding of the diagnosis of mediastinal masses. PMID:25335650



Primary aldosteronism in pregnancy.  


We describe a case of primary aldosteronism secondary to bilateral adrenal hyperplasia in three subsequent pregnancies. The disease was diagnosed soon after the first pregnancy, which ended in a miscarriage, and was treated pharmacologically with spironolactone. Because spironolactone is contraindicated in pregnancy, while the hypotensive effects of methyldopa, hydralazine, labetalol, diazoxide and nifedipine were unsatisfactory, in the second (since week 14) and third (since week 6) pregnancy, she received amiloride. This agent, administered at a daily dose of 10-15 mg, effectively controlled blood pressure, reversed hypokalaemia, and led to an increase in plasma renin activity. The course of both pregnancies was uneventful and ultrasonography performed during each visit revealed normal foetal development without growth retardation. Both pregnancies ended in giving birth to healthy children. Our report shows that each case of treatment-resistant hypertension in pregnancy requires assessment for the presence of primary aldosteronism, and that amiloride seems to be a safe and effective agent in the non-surgical treatment of this disorder in pregnant women with primary aldosteronism. PMID:22712170

Krysiak, R; Samborek, M; Stojko, R



FACT SHEETS HIV and Pregnancy  

E-print Network

. In areas with opt-out testing, HIV testing is automatically included as part of rou tine prenatal careFACT SHEETS HIV and Pregnancy HIV Testing and Pregnancy Mother-to-Child Transmission of HIV Anti in managing HIV dur ing pregnancy. Table of Contents 1. HIV Testing and Pregnancy 2. Mother

Levin, Judith G.


Taking bisphosphonates during pregnancy.  

PubMed Central

QUESTION: Several of my female patients take bisphosphonates for low bone mineral density (BMD). Two of them are of reproductive age. Are these drugs safe during pregnancy? ANSWER: Very little is currently known about the effects of bisphosphonates on human pregnancy. There have been only two reports of bisphosphonate use during late pregnancy. Animal studies suggest that biphosphonates cross the placenta and that the effect is an extension of the expected pharmacologic effect of bisphosphonates on both fetus and mother. Risks and benefits should be carefully weighed. PMID:14594094

French, Amy E.; Kaplan, Nikolay; Lishner, Michael; Koren, Gideon



Sleep disorders in pregnancy.  


Sleep disturbances are common in pregnancy and may be influenced by a multitude of factors. Pregnancy physiology may predispose to sleep disruption but may also result in worsening of some underlying sleep disorders, and the de novo development of others. Apart from sleep disordered breathing, the impact of sleep disorders on pregnancy, fetal, and neonatal outcomes is poorly understood. In this article, we review the literature and discuss available data pertaining to the most common sleep disorders in perinatal women. These include restless legs syndrome, insomnia, circadian pattern disturbances, narcolepsy, and sleep-disordered breathing. PMID:25156772

Oyiengo, Dennis; Louis, Mariam; Hott, Beth; Bourjeily, Ghada



Endovascular abdominal aortic aneurysm repair  

PubMed Central

The operative mortality following conventional abdominal aortic aneurysm (AAA) repair has not fallen significantly over the past two decades. Since its inception in 1991, endovascular aneurysm repair (EVAR) has provided an alternative to open AAA repair and perhaps an opportunity to improve operative mortality. Two recent large randomised trials have demonstrated the short and medium term benefit of EVAR over open AAA repair, although data on the long term efficacy of the technique are still lacking. This review aimed at providing an overview of EVAR and a discussion of the potential benefits and current limitations of the technique. PMID:17267674

Norwood, M G A; Lloyd, G M; Bown, M J; Fishwick, G; London, N J; Sayers, R D



Pathology Case Study: Abdominal Pain  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 65-year-old man is complaining of abdominal pain. Visitors are given the radiology, gross and microscopic descriptions, flow cytometry, and molecular diagnostics, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in hematopathology.

Latulippe, Steven; Ohori, N. P.



Pathology Case Study: Abdominal Pain  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 72-year-old man has abdominal pain, anorexia, and weight loss but no significant past medical history. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in autopsy pathology.

Nine, Jeff S.; Weir, Ed



Management of an iatrogenic injury in a crossed ectopic kidney without fusion.  


Crossed renal ectopia is a condition in which a kidney is located on the side opposite of its ureteral insertion. Ninety percent of crossed ectopic kidneys are fused to their ipsilateral uncrossed renal unit. Crossed renal ectopia without fusion is rare, with only 62 patients reported in the literature to date. These kidneys may suffer iatrogenic injury during an unrelated surgical intervention. The injury, unless self-limiting, may necessitate the removal of the ectopic kidney. We present a unique case of a dual injury, renal as well as ureteric, in a crossed ectopic kidney without fusion that was successfully managed without surgical excision. PMID:25132952

Jindal, Tarun; Kamal, Mir Reza; Mukherjee, Satyadip; Mandal, Soumendra Nath; Karmakar, Dilip



Ectopic anus with barrel gun perineum rare type of anorectal anomaly  

PubMed Central

Perineal ectopic anus in female infants is not a very uncommon congenital anorectal anomaly with opening into the low vaginal or vulvar region. However, ectopic anus with barrel gun perineum is a less common variety. Patients generally present with frequent history of constipation, but may seek medical help for just aesthetic reasons. We present here one such case of an asymptomatic seven years old female with the rare form of anterior ectopic anus with barrel gun perineum without any fistulous communications with an innovative method of demonstration of the anomaly by using ultrasound gel as rectal contrast in MRI pelvis. PMID:24421941

Chamaria, Komal; shetty, Roshan



Management of an Iatrogenic Injury in a Crossed Ectopic Kidney Without Fusion  

PubMed Central

Crossed renal ectopia is a condition in which a kidney is located on the side opposite of its ureteral insertion. Ninety percent of crossed ectopic kidneys are fused to their ipsilateral uncrossed renal unit. Crossed renal ectopia without fusion is rare, with only 62 patients reported in the literature to date. These kidneys may suffer iatrogenic injury during an unrelated surgical intervention. The injury, unless self-limiting, may necessitate the removal of the ectopic kidney. We present a unique case of a dual injury, renal as well as ureteric, in a crossed ectopic kidney without fusion that was successfully managed without surgical excision. PMID:25132952

Kamal, Mir Reza; Mukherjee, Satyadip; Mandal, Soumendra Nath; Karmakar, Dilip



Non-traumatic lateral abdominal wall hernia  

Microsoft Academic Search

A rare lateral abdominal wall hernia is described in an adult patient. This was diagnosed in a patient with a prominent right\\u000a lateral abdominal wall deformity. The patient had been experiencing pain that increased progressively in severity over time.\\u000a A computerized tomography (CT) scan of the abdomen revealed the location of the lateral abdominal wall defect. The hernia\\u000a defect was

M. Castillo-Sang; B. Gociman; B. Almaroof; J. Fath; F. Cason



Abdominal aortic aneurysm and diastasis recti.  


Midline abdominal incisional hernias are common following open repair of abdominal aortic aneurysms. These may be caused by the weakness of connective tissue. This study sought to determine the prevalence of diastasis recti among unoperated Caucasian males with abdominal aortic aneurysm compared to a control group with atherosclerotic lower extremity peripheral arterial disease. Forty-two consecutive white males referred for evaluation of abdominal aortic aneurysm (n = 18) or peripheral arterial disease (n = 24) were examined by a single examiner at the Mayo Clinic. Both groups were similar in terms of age and smoking history, 2 major risk factors for both abdominal aortic aneurysm and peripheral arterial disease. Abdominal aortic aneurysm patients ranged in age from 59 to 89 (mean, 73.2) years. Seventeen of 18 (94.4%) had a history of smoking. Peripheral arterial disease patients ranged in age from 52 to 93 (mean, 70.8) years. Twenty-one of 24 (87.5%) had a history of smoking. Diastasis recti were present in 12 of 18 (66.7%) subjects with abdominal aortic aneurysm versus 4 of 24 (16.7%) subjects with peripheral arterial disease (P = .001, 2-tailed Fisher exact test). Diastasis recti are significantly more common in males with abdominal aortic aneurysm than peripheral arterial disease and may provide an important clue to screen for abdominal aortic aneurysm in those at risk. PMID:18550558

McPhail, Ian


Predicting Teenage Pregnancy.  

National Technical Information Service (NTIS)

To develop preventive intervention strategies to address the serious social problem of adolescent pregnancy in the United States, it is important that its antecedents be understood and that those adolescents at risk for early childbearing be identified. T...

J. Ager



Anesthesia during Pregnancy  


Anesthesia During Pregnancy Local Anesthetics Sedation General Anesthesia If you are pregnant or think you might be pregnant, tell your dentist during your visit. During the first trimester (three months), it ...


Health Problems in Pregnancy  


... a chronic condition, you should talk to your health care provider about how to minimize your risk before you get pregnant. Once you are pregnant, you may need a health care team to monitor your pregnancy. Examples of ...


American Pregnancy Association  


... Chiropractic Care During Pregnancy Chiropractic care is health maintenance of the spinal column, discs, related nerves and bone geometry without drugs or surgery. It involves the art and science of adjusting ...


Pregnancy Complications: Shoulder Dystocia  


... In the NICU Home after the NICU Your premature baby Birth Defects Loss and grief Pregnancy loss Newborn loss ... and the baby do well and have no permanent damage. But there may be some complications. For ...


Cancer during Pregnancy  


... Types of Cancer Navigating Cancer Care Coping and Emotions Research and Advocacy Survivorship Blog About Us s You are here Home > Coping and Emotions > Sexual and Reproductive Health > Cancer During Pregnancy Request ...


Pregnancy and Thyroid Disease  


... every 500 pregnancies. 1 Graves’ disease is an autoimmune disorder. Normally, the immune system protects people from infection ... gland. Like Graves’ disease, Hashimoto’s disease is an autoimmune disorder. In Hashimoto’s disease, the immune system attacks the ...


Skin Conditions during Pregnancy  


... the body. It is thought to be an autoimmune disorder . There is a slightly increased risk of pregnancy ... A drug that treats certain types of infections. Autoimmune Disorder: A condition in which the body attacks its ...


Sertraline (Zoloft) and Pregnancy  


... Saf 18(3):246-252. Bonari L, et al. 2004. Perinatal risks of untreated depression during pregnancy. Can J Psychiatry 49(11):726-735. Casper R, et al. 2003. Follow-up of children of depressed mothers ...


Stillbirth in diabetic pregnancies.  


Pregnancy in women with pregestational diabetes is associated with high perinatal morbidity and mortality. Stillbirth accounts for the majority of cases with perinatal death. Intrauterine growth restriction, pre-eclampsia, foetal hypoxia and congenital malformations may be contributing factors, but more than 50% of stillbirths are unexplained. Majority of stillbirths are characterised by suboptimal glycaemic control during pregnancy. Foetal hypoxia and cardiac dysfunction secondary to poor glycaemic control are probably the most important pathogenic factors in stillbirths among pregnant diabetic women. There is thus a need for new strategies for improving glycaemic control to near-normal levels throughout pregnancy and for preventing and treating hypertensive disorders in pregnancy. Antenatal surveillance tests including ultrasound examinations of the foetal growth rate, kick counting and non-stress testing of foetal cardiac function are widely used. However, future research should establish better antenatal surveillance tests to identify the infants susceptible to stillbirth before it happens. PMID:21256813

Mathiesen, Elisabeth R; Ringholm, Lene; Damm, Peter



Paroxetine (Paxil) and Pregnancy  


... to become pregnant. Can taking paroxetine cause a miscarriage? There have been some studies suggesting exposure to ... et al. 2009. Rates of spontaneous and therapeutic abortions following use of antidepressants in pregnancy: results from ...


Iodine and Pregnancy  


... iodine in my system increase my risk of miscarriage? Possibly. If you do not have enough iodine ... levels during pregnancy have an increased risk for miscarriage. Can low levels of iodine in my system ...


Lupus and Pregnancy  


... pregnant. Do I have a higher chance of miscarriage because of my medical condition? Lupus appears to increase the chance of miscarriage early in pregnancy. While studies vary, miscarriage rates ...


Bleeding during Pregnancy  


... who is born too small, or having a miscarriage . How is bleeding during early pregnancy checked? If ... Sometimes the cause is not found. When does miscarriage happen? Miscarriage can occur any time in the ...


Alcohol and pregnancy  


Drinking alcohol during pregnancy ... When a pregnant woman drinks alcohol, the alcohol travels through her blood and into the baby's blood, tissues, and organs. Alcohol breaks down much more slowly in ...


Stages of Pregnancy  


... your baby in these three stages. First trimester (week 1-week 12) First trimester See how your baby is ... is each pregnancy. Return to top Second trimester (week 13-week 28) Second trimester See how your ...


STDs and Pregnancy  


... are pregnant can become infected with the same sexually transmitted diseases (STDs) as women who are not pregnant. Pregnant ... are pregnant can become infected with the same sexually-transmitted diseases (STDs) as women who are not pregnant. Pregnancy ...


Pregnancy and Healthy Weight  


... and during pregnancy can reduce the likelihood of negative effects for mothers and babies We’ve heard ... health. Now women of childbearing age have another motivation for watching their weight: studies show that prepregnancy ...


Mechanical ventilation in abdominal surgery.  


One of the key challenges in perioperative care is to reduce postoperative morbidity and mortality. Patients who develop postoperative morbidity but survive to leave hospital have often reduced functional independence and long-term survival. Mechanical ventilation provides a specific example that may help us to shift thinking from treatment to prevention of postoperative complications. Mechanical ventilation in patients undergoing surgery has long been considered only as a modality to ensure gas exchange while allowing maintenance of anesthesia with delivery of inhaled anesthetics. Evidence is accumulating, however, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary function and clinical outcome in patients undergoing abdominal surgery. Non-protective ventilator settings, especially high tidal volume (VT) (>10-12mL/kg) and the use of very low level of positive end-expiratory pressure (PEEP) (PEEP<5cmH2O) or no PEEP, may cause alveolar overdistension and repetitive tidal recruitment leading to ventilator-associated lung injury in patients with healthy lungs. Stimulated by previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung protective mechanical ventilation. In this review, we aimed at providing the most recent and relevant clinical evidence regarding the use of mechanical ventilation in patients undergoing abdominal surgery. PMID:25153670

Futier, E; Godet, T; Millot, A; Constantin, J-M; Jaber, S



Primary hyperparathyroidism and pregnancy  

PubMed Central

Primary hyperparathyroidism is the third most common endocrine disorder after diabetes and thyroid disease, and women are affected twice as often as men. Hyperparathyroidism in pregnancy was first reported in 1931. Maternal complications in patients with hyperparathyroidism can be as high as 67%. We present a case of a pregnant patient with chronic hypertension that was exacerbated throughout the course of her pregnancy with a concomitant diagnosis of primary hyperparathyroidism and its sequelae for both the mother and fetus. PMID:21738295

Som, Mousumi



Screening in Pregnancy  

PubMed Central

Over the past 20 years, traditional elements of antenatal care have been supplemented by complex biochemical and biophysical investigations. With his/her knowledge of the patient and awareness of the principles of screening, the family physician is ideally placed to assess potential problems in pregnancy. This article reviews the rationale for screening for certain disorders in pregnancy. Genetic disorders, infectious diseases, and other specific conditions are considered. Some of the more recent controversies in prenatal screening are highlighted. PMID:21253226

Biringer, Anne



Hay fever in pregnancy.  


Spring and summer can bring misery to millions who suffer from allergic reactions to pollen. Hay fever can cause runny noses, streaming eyes and sore throats. Sadly, many treatments for this distressing condition are not recommended during pregnancy because of fears surrounding the effect on the unborn child. This article presents the causes and treatments of hay fever and explores the alternatives for use during pregnancy which may be able to relieve or minimise the unpleasant symptoms without harming the baby. PMID:24873116

Wiseberg, Max



Cardiac arrest during pregnancy.  


Cardiac arrest is a rare event during pregnancy. The pregnant population represents a unique subset of cardiac arrest victims. Not only are there unique causes of circulatory collapse during the pregnant state, but the physiological modifications to the maternal physiology during pregnancy require specific modifications to the standard management of the arrest. Lastly, the pregnant victim presents herself with the challenges of a second patient who needs to be considered in the decision-making process. PMID:25314090

Montufar-Rueda, Carlos; Gei, Alfredo



Depression during pregnancy  

PubMed Central

OBJECTIVE To review existing literature on depression during pregnancy and to provide information for family physicians in order to promote early detection and treatment. QUALITY OF EVIDENCE MEDLINE was searched from January 1989 through August 2004 using the key words depression, pregnancy, prenatal, and antenatal. Articles focusing on depression during pregnancy were chosen for review; these articles were based on expert opinion (level III evidence) and prospective studies (level II evidence). MAIN MESSAGE Pregnancy does not safeguard women against depressive illness. The Edinburgh Postnatal Depression Scale is an effective screening tool for identifying women with depressive symptoms during pregnancy. Once diagnosed with major depression, these patients need to be monitored closely for up to a year after delivery. Patients with mild-to-moderate illness should be referred for psychotherapy. More severely ill patients might require additional treatment with antidepressants. The most commonly used antidepressants are selective serotonin reuptake inhibitors and the serotonin and norepinephrine reuptake inhibitor, venlafaxine. For each patient, risk of treatment with an antidepressant needs to be compared with risk of not treating her depressive illness. CONCLUSION Early detection of depression during pregnancy is critical because depression can adversely affect birth outcomes and neonatal health and, if left untreated, can persist after the birth. Untreated postpartum depression can impair mother-infant attachments and have cognitive, emotional, and behavioural consequences for children. PMID:16121830

Ryan, Deirdre; Milis, Lisa; Misri, Nicholas



[Air travel in pregnancy].  


Women who fly during pregnancy, whether as passengers or crew, continue to fuel the debate over the potential impact on pregnancy outcome and fetal development, the two risk factors most commonly invoked being relative hypoxaemia due to the decreased cabin pressure and, more recently, cosmic radiation. On both theoretical and experimental grounds (altitude physiology and studies in pregnant women during flight), commercial flight poses no threat to the fetal oxygen supply in a normal pregnancy. As for cosmic radiation, only theoretical estimates are available of flight crew exposure: if annual doses approximate to background at ground level (3-5 mSv), the dose received during an individual pregnancy can be estimated from the fraction of annual flight time spent while pregnant. It is doubtful whether any epidemiological study could ever confirm or refute this theoretical estimate of a low increase in risk. Many airlines have opted to allow pregnant crew to continue flying. There is thus little if any ground for advising against passenger flight in pregnancy. Flying is probably the safest and most comfortable way to travel long-distance in pregnancy. The few relative contraindications include flying close to term, a history of miscarriage and premature delivery, heavy smoking, severe anemia, cardiopulmonary disease, and a serious fear of flying. PMID:10568251

Huch, R



Diabetes mellitus and pregnancy  

PubMed Central

Diabetes mellitus is the most common medical complication of pregnancy and it carries a significant risk to the foetus and the mother. Congenital malformations and perinatal morbidity remain common compared with the offspring of non diabetic pregnancies. Diabetic mothers are at risk of progression of microvascular diabetic complications as well as early pregnancy loss, pre-eclampsia, polyhydramnios and premature labour. Glycaemic control before and during pregnancy is critical and the benefit may result in a viable, healthy off spring. Gestational diabetes mellitus (GDM) which manifests for the first time during pregnancy is common and on the increase, its proper management will reduce the risk of neonatal macrosomia and hypoglycaemia. Post-partum evaluation of glucose tolerance and appropriate counselling in women with GDM may help decrease the high risk of subsequent type 2 diabetes in the longterm. This article will briefly review the changes in the carbohydrate metabolism that characterise normal pregnancy and will focus on a practical approach to the care of patients with pre-existing diabetes as well as GDM. PMID:21526019

Abourawi, Fathi I



Herlyn-Weber-Wunderlich syndrome with ectopic ureter in prepubertal female  

PubMed Central

We report a rare case of uterovaginal duplication in a prepubertal female. The patient also had a permeable ureter (ureter with urine passing through it) subtending a poorly functioning kidney with ectopic insertion in the obstructed hemivagina. PMID:24741215

Garge, Saurabh; Bagga, Deepak; Acharya, Sameer Kant; Yadav, Devendra Kumar; Khan, Tanvir Roshan; Kumar, Ram; Kumar, Vinod; Kumar, Srinivas; Gupta, Divya; Prasad, Ashish



National clinical guidelines for management of the palatally ectopic maxillary canine.  


This review summarises updated clinical guidelines produced by the Clinical Standards Committee of the Faculty of Dental Surgery, Royal College of Surgeons of England (FDSRCS). This guideline on the management of the palatally ectopic maxillary canine illustrates the information contained in the recently updated online version. The timely recognition of ectopic canines is important for the overall management of the dentition. This review illustrates five management strategies for ectopic permanent canines: interceptive treatment by extraction of the deciduous canine, surgical exposure and orthodontic alignment, surgical removal of the palatally ectopic permanent canine, auto-transplantation and no active treatment/leave and observe. The current available evidence for each of these management options has been evaluated and awarded a grade used by the Scottish Intercollegiate Guidelines Network. PMID:22918345

Husain, J; Burden, D; McSherry, P; Morris, D; Allen, M



Embolization of bronchial artery-supplied ectopic parathyroid adenomas located in the aortopulmonary window.  


Ectopic parathyroid adenomas in the aortopulmonary window (APW) are extremely rare, constituting only 1% of ectopic mediastinal adenomas and 0.24% of all parathyroid adenomas. The authors have encountered three patients with ectopic adenomas in the APW. In each case, the primary arterial supply to the APW adenoma arose from the bronchial artery. In addition, there was a small anastomotic arterial channel connecting the bronchial artery supplying the adenoma to the left inferior thyroid. All three adenomas were treated with transcatheter embolization, with control of hyperparathyroidism in two of three patients. One patient required thoracoscopic removal of the adenoma. It is critical that the interventionalist be aware of this arterial supply pattern to allow successful embolization of an APW ectopic adenoma. PMID:24365508

Ali, Mujtaba; Kumpe, David A



Abdominal atlas mapping in CT and MR volume images using a normalized abdominal coordinate system  

Microsoft Academic Search

In this paper, a normalized abdominal coordinate system is defined for abdominal atlas mapping in CT and MR volume images. This coordinate system is independent of both the abdomen size and the respiratory motion. A real-time atlas mapping algorithm based on this coordinate system is also proposed. The purpose of this algorithm is to provide initial positions for abdominal organ

Hongkai Wang; Jing Bai; Yongxin Zhou; Yonghong Zhang



Tissue regeneration mesh reinforcement during abdominoplasty for severe myoaponeurotic laxity after pregnancy.  


A 28-year-old woman who was 6 months postpartum following her second pregnancy presented with a history of painful protrusion and weakness of her abdominal wall musculature. Despite having had physiotherapy there was no improvement in muscle strength. MRI scan of her abdominal wall was performed which showed significant diastasis of the recti but no herniae were seen. The effect of this on the patient's quality of life was marked, and therefore abdominoplasty with mesh reinforcement was planned. In order to limit the consequences of infection, a Strattice mesh (a tissue regeneration mesh) was selected. Standard panniculectomy and plication of the rectus sheath using non-absorbable sutures was performed, and the mesh sutured to the anterior abdominal wall using an on-lay technique. The patient recovered well from the procedure, with a significant return of functionality to her abdominal wall, enabling her to return to work some3 months later. PMID:23833094

Uzair, Sheikh; Babar, Zaheer; Sutton, Paul A



Nephrocalcinosis in a child with autosomal dominant polycystic kidney disease and a prolapsing ectopic ureterocele.  


Although autosomal dominant polycystic kidney disease commonly presents in adults, it can occur in children. Usually, renal calcification in patients with autosomal dominant polycystic kidney disease is manifested as calculi or as hemorrhage into a renal cyst. An ectopic ureterocele is a well-known finding in patients with renal duplication. To our knowledge, this is the first case report of a child who had combined findings of autosomal dominant polycystic kidney disease, nephrocalcinosis, and an obstructing ectopic ureterocele. PMID:7491203

Burton, E M; Hanna, J D; Mercado-Deane, M G



Ectopic Posterior Pituitary Lobe and Periventricular Heterotopia: Cerebral Malformations with the Same Underlying Mechanism?  

Microsoft Academic Search

BACKGROUND AND PURPOSE: Ectopic posterior pituitary lobe often occurs in children with growth hormone deficiency and is part of the spectrum associated with septo-optic dysplasia. Some cases of septo-optic dysplasia are caused by homozygous mutations in the homeobox gene HESX1, whereas heterozygous mutations are associated with milder pheno- types. To date, HESX1 is the only gene associated with ectopic posterior

L. Anne Mitchell; Paul Q. Thomas; Margaret R. Zacharin; Ingrid E. Scheffer


Ectopic fat assessment focusing on cardiometabolic and renal risk.  


It is well known that people with high levels of body fat are at higher risk for developing diabetes mellitus, kidney disease, and cardiovascular disorders. Since individuals who are slightly overweight, or even individuals of normal weight, can vary in body fat distribution, their metabolic profiles and the degree of association of these profiles with cardiometabolic risk factors may differ. Fat distribution might be more of a predictive factor for cardiorenometabolic risk than obesity itself, which has led researchers to investigate whether ectopic fat accumulation may partially account for the development of cardiorenometabolic disorders. In addition to visceral obesity, fat can accumulate in the liver and muscle, and these intrahepatic and intramuscular lipid stores are associated with insulin resistance and adverse metabolic phenotypes. More recently, pericardial fat, perivascular fat, and perirenal fat were found to be associated with coronary atherosclerosis, cardiovascular diseases, and kidney damage, respectively. Thus, regional fat distribution may play a key role in understanding the development of cardiorenometabolic diseases in nonobese people. PMID:24741447

Lim, Soo



Ectopically tethered CP190 induces large-scale chromatin decondensation  

PubMed Central

Insulator mediated alteration in higher-order chromatin and/or nucleosome organization is an important aspect of epigenetic gene regulation. Recent studies have suggested a key role for CP190 in such processes. In this study, we analysed the effects of ectopically tethered insulator factors on chromatin structure and found that CP190 induces large-scale decondensation when targeted to a condensed lacO array in mammalian and Drosophila cells. In contrast, dCTCF alone, is unable to cause such a decondensation, however, when CP190 is present, dCTCF recruits it to the lacO array and mediates chromatin unfolding. The CP190 induced opening of chromatin may not be correlated with transcriptional activation, as binding of CP190 does not enhance luciferase activity in reporter assays. We propose that CP190 may mediate histone modification and chromatin remodelling activity to induce an open chromatin state by its direct recruitment or targeting by a DNA binding factor such as dCTCF. PMID:24472778

Ahanger, Sajad H.; Gunther, Katharina; Weth, Oliver; Bartkuhn, Marek; Bhonde, Ramesh R.; Shouche, Yogesh S.; Renkawitz, Rainer



Biochemical and immunological characterization of ectopic tumoral renin  

SciTech Connect

Biochemical and immunological characteristics of renin secreted by two malignant renin-secreting tumors (pulmonary (PT) and paraovarian (POT)) were studied. They both contain inactive renin (IR), as renin activity of tumoral extracts was able to be increased after acid activation or trypsin treatment (10.1 to 20.8 Goldblatt units/g tissue for PT and 1.4 to 3.71 for POT). Renin activity after activation reached the value obtained by direct RIA of human renin (23 and 3.4, respectively), as both forms are recognized by renin antiserum. Both enzymatic activities could be completely inhibited by renin antiserum. Displacement curves for the two tumoral renins paralleled the MRC renin in the direct RIA. After chromatography on affigel blue, active renin was not bound to the gel, and inactive renin eluted only with 1 M NaCl. On pepstatin A Sepharose and CBL-pepstatin Sepharose (an N-modified-pepstatin), a separation of the two forms of pulmonary renin was obtained; inactive renin eluted with breakthrough proteins, whereas active renin was strongly bound to the gel. After this affinity chromatography, the molecular weights of inactive and active renin, determined on Ultrogel, were very close (46,000 and 42,500). We conclude that 1) ectopic renin in these cases is similar to the renal enzyme; 2) renin can be secreted in an inactive form, supporting the hypothesis of an inactive initial state of renin; and 3) molecular weight differences between the two forms are very slight.

Soubrier, F. (INSERM U36, Paris, France); Devaux, C.; Galen, F.X.; Skinner, S.L.; Aurell, M.; Genest, J.; Menard, J.; Corvol, P.



[Thyroid dysfunction in pregnancy].  


Thyroid dysfunction may impair fertility, course of pregnancy and fetal development. Physiological alterations of thyroid function parameters, that occur during pregnancy need to be distinguished from pathophysiological states of hypo- and hyperthyroidism. We performed a literature search (PubMed 1990-2013) and review relevant publications as well as consensus and practice guidelines of international thyroid/endocrine societies. Interpretation of thyroid function values in pregnancy must be based on trimester-specific TSH and T4 ranges. Alterations in thyroid function are present in up to 15% of pregnancies (0.4% overt hypothyroidism, 0.1-0.4% hyperthyroidism) and may lead to preventable complications in the pregnant woman and the fetus. Hypothyroidism is associated with an increased risk for abortion, premature delivery and stillbirth, besides impairment of neurocognitive development. The latter has also been shown in situations of grave iodine deficiency. In addition to new-born screening directed at early recognition of congenital hypothyroidism (incidence 0.03%), universal screening of all pregnant women should be implemented in health care guidelines. Newly diagnosed overt hypothyroidism in a pregnant woman requires immediate levothyroxine substitution at adequate doses. In subclinical hypothyroidism thyroid hormone replacement should be considered. Iodine supplementation is strongly recommended in all pregnant and breast-feeding women. Pregnancy causes a number of, that need to be of thyroid dysfunction. Both hypothyroidism and thyrotoxicosis may impair the course of pregnancy and may negatively affect the fetus. In particular, maternal hypothyroidism may lead to irreparable and detrimental deficits in the neurocognitive development of the fetus. Autoimmune thyroid disease is the most common cause of thyroid dysfunction in pregnancy. Hashimoto's thyroiditis is associated with impaired fertility and miscarriage, and may first manifest in pregnancy due to the increased thyroid hormone requirement. Graves' disease often shows a characteristic course in pregnancy with amelioration of thyrotoxicosis in the second half of pregnancy and exacerbation after delivery. In addition transplacental passage of maternal TSH receptor antibodies may lead to thyrotoxicosis in the fetus and/or newborn. PMID:25289925

Führer, D; Mann, K; Feldkamp, J; Krude, H; Spitzweg, C; Kratzsch, J; Schott, M



Tissue-Autonomous Function of Drosophila Seipin in Preventing Ectopic Lipid Droplet Formation  

PubMed Central

Obesity is characterized by accumulation of excess body fat, while lipodystrophy is characterized by loss or absence of body fat. Despite their opposite phenotypes, these two conditions both cause ectopic lipid storage in non-adipose tissues, leading to lipotoxicity, which has health-threatening consequences. The exact mechanisms underlying ectopic lipid storage remain elusive. Here we report the analysis of a Drosophila model of the most severe form of human lipodystrophy, Berardinelli-Seip Congenital Lipodystrophy 2, which is caused by mutations in the BSCL2/Seipin gene. In addition to reduced lipid storage in the fat body, dSeipin mutant flies accumulate ectopic lipid droplets in the salivary gland, a non-adipose tissue. This phenotype was suppressed by expressing dSeipin specifically within the salivary gland. dSeipin mutants display synergistic genetic interactions with lipogenic genes in the formation of ectopic lipid droplets. Our data suggest that dSeipin may participate in phosphatidic acid metabolism and subsequently down-regulate lipogenesis to prevent ectopic lipid droplet formation. In summary, we have demonstrated a tissue-autonomous role of dSeipin in ectopic lipid storage in lipodystrophy. PMID:21533227

Shui, Guanghou; Liu, Zhonghua; Xiang, Yanhui; Liu, Yuan; Wenk, Markus R.; Yang, Hongyuan; Huang, Xun



Respiration-related control of abdominal motoneurons.  


The abdominal muscles form part of the expiratory pump in cooperation with the other expiratory muscles, primarily the internal intercostal and triangularis sterni muscles. The discharge of abdominal muscles is divided into four main patterns: augmenting, plateau, spindle and decrementing. The patterns tend to be species-specific and dependent on the state of the central nervous system. Recent studies suggest that the abdominal muscles are more active than classically thought, even under resting conditions. Expiratory bulbospinal neurons (EBSN) in the caudal ventral respiratory group are the final output pathway to abdominal motoneurons in the spinal cord. Electrophysiological and anatomical studies indicated the excitatory monosynaptic inputs from EBSN to the abdominal motoneurons, although inputs from the propriospinal neurons seemed to be necessary to produce useful motor outputs. Respiration-related sensory modulation of expiratory neurons by vagal afferents that monitor the rate of change of lung volume and the end-expiratory lung volume (EELV) play a crucial role in modulating the drive to the abdominal musculature. Studies using in vitro and in situ preparations of neonatal and juvenile rats show bi-phasic abdominal activity, characterized by bursting at the end of expiration, a silent period during the inspiratory period, and another burst that occurs abruptly after inspiratory termination. Since the abdominal muscles rarely show these post-inspiratory bursts in the adult rat, the organization of the expiratory output pathway must undergo significant development alterations. PMID:21255690

Iizuka, Makito



Infected abdominal sacrocolpopexies: diagnosis and treatment  

Microsoft Academic Search

The abdominal sacrocolpopexy is an excellent procedure to surgically treat vaginal vault prolapse. A synthetic graft is often used to support the vaginal apex, but has the potential to become infected or erode, requiring its removal or revision. The purpose of this paper is to report our experience in the management of patients with infected synthetic grafts after abdominal sacrocolpopexy.

T. Fleming Mattox; Edward J. Stanford; E. Varner



Endografts, Pressure, and the Abdominal Aortic Aneurysm  

E-print Network

Abdominal aortic aneurysms (AAA) are an expansion in diameter of the abdominal aorta and their rupture is a leading cause of mortality. One of the treatments for AAA is the implantation of an endograft (also called a stent graft), a combination...

Meyer, Clark A.



Pathology Case Study: Abdominal Distention  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology, which describes a 60-year-old woman who presented with a history of marked abdominal distention lasted for several months with associated progressive fatigue, progressive weight loss and fever. Visitors are given patient history along with gross and microscopic descriptions, including images, and are given the opportunity to diagnose the patient. A "Final Diagnosis" section provides a discussion of the findings as well as references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in soft tissue pathology.

Rao, Uma N.; Sepulveda, Antonia; Yu, Hongbo



Ruptured heterotopic pregnancy in a natural conception cycle: a case report at the Yaounde central Hospital (Cameroon)  

PubMed Central

Heterotopic pregnancy is very rare under natural circumstances. We report the case of a 28 year old Gravida2 Para1001 woman at 9 weeks of pregnancy who consulted in emergency for acute pelvic pain following metrorrhagia. Physical exam revealed hemoperitoneum without shock. An emergency ultrasonography revealed two gestational sacs, one intra-uterine and the other extra-uterine. Laparotomy was done and the findings were: a ruptured right tubal pregnancy with 1,300 milliliters of hemoperitoneum, type B left utero-adnexal adhesions and an increased uterus consistent with a 9 weeks pregnancy. Right total salpingectomy was done and the patient did well postoperatively. That intrauterine pregnancy evolved normally under progesterone supply and the woman delivered a termed live female baby weighing 3.1 kilogrammes. In our context where ultrasound is not always available, practitioners carrying out salpingectomy for ruptured ectopic pregnancies should bear in mind the plausibleness of heterotopic pregnancy in order to properly handle the uterus. PMID:24876895

Fouedjio, Jeanne Hortence; Fouelifack, Florent Ymele; Fouogue, Jovanny Tsuala; Sando, Zacharie



Abdominal tuberculosis of the gastrointestinal tract: Revisited  

PubMed Central

Abdominal tuberculosis is an increasingly common disease that poses diagnostic challenge, as the nonspecific features of the disease which may lead to diagnostic delays and development of complications. This condition is regarded as a great mimicker of other abdominal pathology. A high index of suspicion is an important factor in early diagnosis. Abdominal involvement may occur in the gastrointestinal tract, peritoneum, lymphnodes or solid viscera. Various investigative methods have been used to aid in the diagnosis of abdominal tuberculosis. Early diagnosis and initiation of antituberculous therapy and surgical treatment are essential to prevent morbidity and mortality. Most of the patients respond very well to standard antitubercular therapy and surgery is required only in a minority of cases. Imaging plays an important role in diagnosis of abdominal tuberculosis because early recognition of this condition is important. We reviewed our experience with the findings on various imaging modalities for diagnosis of this potentially treatable disease.

Debi, Uma; Ravisankar, Vasudevan; Prasad, Kaushal Kishor; Sinha, Saroj Kant; Sharma, Arun Kumar



The role of routine post-natal abdominal ultrasound for newborns in a resource-poor setting: a longitudinal study  

Microsoft Academic Search

Background-  Neonatal abdominal ultrasound is usually performed in Nigeria to investigate neonatal symptoms rather than as a follow up\\u000a to evaluate fetal abnormalities which were detected on prenatal ultrasound. The role of routine obstetric ultrasonography\\u000a in the monitoring of pregnancy and identification of fetal malformations has partly contributed to lowering of fetal mortality\\u000a rates. In Nigeria which has a high maternal

Atinuke M Agunloye; Adejumoke I Ayede; Samuel I Omokhodion



Pregnancy feelings among adolescents awaiting pregnancy test results.  

PubMed Central

OBJECTIVE: The authors surveyed adolescent girls about their feelings regarding pregnancy. METHODS: A survey was administered to 117 13- to 18-year-olds who obtained pregnancy tests at nine clinics in Minneapolis and St. Paul, Minnesota, in 1998. The survey included four measures of pregnancy feelings. The authors used bivariate and multivariate logistic regression analyses to examine the associations of these measures with engagement with school, future expectations, social and environmental characteristics, and perceived partner desire for pregnancy. RESULTS: The four measures of pregnancy feelings were highly correlated (P = 0.0001). Participants reported a range of positive, negative, and ambivalent feelings on all measures. Perceived partner desire for pregnancy, limited future expectations, and lack of school engagement were significantly associated with positive pregnancy feelings for the four measures. CONCLUSIONS: Successful adolescent pregnancy prevention interventions may include the involvement of partners and key adults as well as strategies to enhance the educational or employment aspirations of girls and adolescents. PMID:11889284

Hellerstedt, W. L.; Fee, R. M.; McNeely, C. A.; Sieving, R. E.; Shew, M. L.; Resnick, M. D.



[Pregnancy and vaccinoprevention].  


Vaccinations protect woman and her fetus against different infectious diseases, but their application on pregnant should be extremely responsible. In this review I present information about some infectious diseases and vaccines during pregnancy. Women, planning to get pregnant should be advised to do serological tests in order to find out their immune status against some infections, leading to fetal congenital malformations (rubella, chicken pox, hepatitis B) and if necessary to get vaccinated at least a month before pregnancy. Despite the lack of vaccines against Cytomegalovirus (CMV), parvovirus 19 and Toxoplasma gondii it is good to know woman's immune status against these infections in order to clarify the clinical approach in case of future contact with sick or carriers. Parvovirus 19 could cause fetal death, while CMV could be transmitted to the child. Immune women wouldn't get sick and wouldn't transmit Toxoplasmagondii to the fetus during pregnancy. Recommended vaccines before pregnancy include vaccines against flu, human papilloma virus, MMR (morbilli, measles, rubella), Tdap (tetanus, diphtheria, whooping cough), chicken pox. CDC-Atlanta recommends during pregnancy two vaccines--against flu, in case it wasn't done before pregnancy, and Tdap during every pregnancy between 27-th and 36-th gestation week. Whooping cough is very dangerous for the baby during the first two months after birth, while it is not yet vaccinated. From this point of view it is of best interest of the mother to have strong immunity in order to transfer antibodies during breastfeeding, as well as for the father and the rest who will take care for the newborn child to be vaccinated against whooping cough. During pregnancy vaccinations against tuberculosis, morbilli, measles, rubella, meningococcal disease, typhoid fever and chicken pox are contraindicated. In case of contact vaccinations against rabies, anthrax, small pox, poliomyelitis and yellow fever should be taken into consideration. Immediately after birth, if the vaccination against whooping cough is missed young mother vaccination is recommended. The vaccination is one of the greatest achievements of the modern medicine, but it is still an object of vigorous attacks, concerning used products safety. One of the most spreading fears is about sterility after vaccination. Over a period of three years (2009-2012) 563 women were vaccinated by SACMEH against HPV. Forty two of them (13.40%) interrupt vaccination due to pregnancy (18 of them after the first shot and 24 after the second shot). Our observations show, that this vaccine is carried out good by the patients, tit is safe and does not cause sterility. PMID:24919344

Galev, A; Nacheva, A



Thinking about Pregnancy After Premature Birth  


... about pregnancy after premature birth Get ready for pregnancy Having a healthy baby starts well before pregnancy. ... It's been added to your dashboard . Thinking about pregnancy after premature birth Even if you do everything ...


Kala azar in Pregnancy.  


Kala azar (KA) is one of the most important tropical diseases. More so is the issue of KA in pregnancy. In this retrospective study we tried to find out the out come of pregnant patient treated with Sodium Antimony Gluconate (SAG) for KA in one of the most endemic area of Bangladesh, Fulbaria. SAG is the available and registered drug for treatment of KA patient with pregnancy in Bangladesh. A total of 16 pregnant women presented with KA during the study period of 2005 to 2009. Out of the 16 patients 11 had abortion and they were all with in the 16 to 22nd week of pregnancy. The abortion took place mostly on the 22nd to 24th day of treatment when the patient had become afebrile. Rest of the 5 patients was in their 30 to 34th week of pregnancy and had good obstetric outcome. All the 16 patients were clinically cured at the end of treatment. No follow up records were available and there was no data regarding the 5 children. It is of our opinion that the abortions were induced by SAG and therefore we recommend that SAG should not be used in early or mid pregnancy for treating KA. PMID:20956894

Miah, M T; Ayaz, F M; Maniruzzaman, M; Ahasan, M N; Bari, S; Mawla, S M; Mahbub, M S; Khan, A I



Morphometry of Hilar Ectopic Granule Cells in the Rat  

PubMed Central

Granule cell (GC) neurogenesis in the dentate gyrus (DG) does not always proceed normally. After severe seizures (e.g., status epilepticus [SE]) and some other conditions, newborn GCs appear in the hilus. Hilar ectopic GCs (EGCs) can potentially provide insight into the effects of abnormal location and seizures on GC development. Additionally, hilar EGCs that develop after SE may contribute to epileptogenesis and cognitive impairments that follow SE. Thus, it is critical to understand how EGCs differ from normal GCs. Relatively little morphometric information is available on EGCs, especially those restricted to the hilus. This study quantitatively analyzed the structural morphology of hilar EGCs from adult male rats several months after pilocarpineinduced SE, when they are considered to have chronic epilepsy. Hilar EGCs were physiologically identified in slices, intracellularly labeled, processed for light microscopic reconstruction, and compared to GC layer GCs, from both the same post-SE tissue and the NeuroMorpho database (normal GCs). Consistently, hilar EGC and GC layer GCs had similar dendritic lengths and field sizes, and identifiable apical dendrites. However, hilar EGC dendrites were topologically more complex, with more branch points and tortuous dendritic paths. Three-dimensional analysis revealed that, remarkably, hilar EGC dendrites often extended along the longitudinal DG axis, suggesting increased capacity for septotemporal integration. Axonal reconstruction demonstrated that hilar EGCs contributed to mossy fiber sprouting. This combination of preserved and aberrant morphological features, potentially supporting convergent afferent input to EGCs and broad, divergent efferent output, could help explain why the hilar EGC population could impair DG function. PMID:21344409

Pierce, Joseph P.; McCloskey, Daniel P.; Scharfman, Helen E.



Junctional ectopic tachycardia after infant heart surgery: incidence and outcomes.  


Junctional ectopic tachycardia (JET) is an arrhythmia observed almost exclusively after open heart surgery in children. Current literature on JET has not focused on patients at the highest risk of both developing and being negatively impacted by JET. The purpose of this study was to determine the overall incidence of JET in an infant patient cohort undergoing open cardiac surgery, to identify patient- and procedure-related factors associated with developing JET, and to assess the clinical impact of JET on patient outcomes. We performed a nested case-control study from the complete cohort of patients at our institution younger than 1 year of age who underwent open heart surgery between 2005 and 2010. JET patients were compared with an age matched control group undergoing open heart surgery without JET regarding potential risk factors and outcomes. The overall incidence of JET in infants after open cardiac surgery was 14.3 %. From multivariate analyses, complete repair of tetralogy of Fallot [adjusted odds ratio (AOR) 2.0, 95 % CI 1.12-3.57] and longer aortic cross clamp times (AOR 1.02, 95 % CI 1.01-1.03) increased the risk of developing JET. Patients with JET had longer length of intubation, intensive care unit stays, and total length of hospitalization, and were more likely to require extracorporeal membrane oxygenation support (13 vs. 4.3 %). JET is a common postoperative arrhythmia in infants after open heart operations. Both anatomic substrate and surgical procedure contribute to the overall risk of developing JET. Developing JET is associated with worse clinical outcomes. PMID:22585344

Zampi, Jeffrey D; Hirsch, Jennifer C; Gurney, James G; Donohue, Janet E; Yu, Sunkyung; LaPage, Martin J; Hanauer, David A; Charpie, John R



Valve disease in pregnancy.  


Maternal cardiac disease is a major cause of non-obstetric morbidity and accounts for 10-25% of maternal mortality. Valvular heart disease may result from congenital abnormalities or acquired lesions, some of which may involve more than one valve. Maternal and fetal risks in pregnant patients with valve disease vary according to the type and severity of the valve lesion along with resulting abnormalities of functional capacity, left ventricular function, and pulmonary artery pressure. Certain high-risk conditions are considered contraindications to pregnancy, while others may be successfully managed with observation, medications, and, in refractory cases, surgical intervention. Communication between the patient?s obstetrician, maternal-fetal medicine specialist, obstetrical anesthesiologist, and cardiologist is critical in managing a pregnancy with underlying maternal cardiac disease. The management of the various types of valve diseases in pregnancy will be reviewed here, along with a discussion of related complications including mechanical prosthetic valves and infective endocarditis. PMID:25037517

Pessel, Cara; Bonanno, Clarissa



Isaacs' syndrome in pregnancy.  


Isaacs' syndrome is a rare neuromuscular disorder of continuous muscle fibre activity resulting from peripheral nerve hyperexcitability. Symptoms commonly include myokymia (muscle twitching at rest), pseudomyotonia (delayed muscle relaxation), muscle cramps and stiffness. It is caused by voltage-gated potassium channel dysfunction and may be inherited or acquired. Treatment commonly includes anticonvulsants, immunosuppressive therapy and plasma exchange. To date only two cases of Isaacs' syndrome in pregnancy have been reported. We present a case of maternal Isaacs' along with a review of the literature. There are few reports of Isaacs' syndrome in pregnancy, but all are associated with favourable outcomes. Given the autosomal dominant inheritance pattern, genetic counselling of the gravida is recommended. Anticonvulsant may have to be used in pregnancy, and given the potential teratogenicity with several of these agents; preference should be given to newer drugs such as lamotrigine. PMID:25301428

Lide, Brianna; Singh, Jasbir; Haeri, Sina



Successful direct bipolar resection of 6th week cesarean scar pregnancy: case report and literature review.  


Cesarean scar pregnancy is a specific ectopic pregnancy implanted in the scar tissue of a previous cesarean section. To date, no clear consensus exists regarding its management and treatment. Timely diagnosis of this condition is fundamental, owing to the high rate of life-threatening complications and massive hemorrhage. The use of high-definition transvaginal ultrasound is strongly recommended as a first-line diagnostic approach. A wide range of medical and surgical strategies has been described in the literature, including methotrexate administration, local injection of embryocides, uterine curettage, and laparoscopic surgery. The treatment goal should be complete and efficient without compromising the chance of future pregnancies. Recently, many cases were successfully treated through the hysteroscopic route. Illustrating the case of an early detected cesarean scar pregnancy originally treated in our institution with direct bipolar resection, we reviewed the literature regarding the advantages and efficacy of the hysteroscopic approach in terms of fertility preservation, rapid recovery, and safety. In conclusion, the use of a direct hysteroscopic approach could represent a valuable strategy in the first stage of cesarean scar pregnancy. PMID:24835813

Mollo, Antonio; Conforti, Alessandro; Alviggi, Carlo; De Placido, Giuseppe



Tobacco, Alcohol, Drugs, and Pregnancy  


... College of Obstetricians and Gynecologists f AQ Tobacco, Alcohol, Drugs, and Pregnancy • Why is smoking dangerous during ... pregnancy dangerous for my baby? • What are fetal alcohol spectrum disorders? • What is fetal alcohol syndrome? • What ...


Prednisone/Prednisolone and Pregnancy  


... or visit us online at: . Prednisone/Prednisolone and Pregnancy In every pregnancy, a woman ... advice from your health care professional. What are prednisone and prednisolone? Prednisone/prednisolone are part of a ...


High Blood Pressure in Pregnancy  


... of the baby. Controlling your blood pressure during pregnancy and getting regular prenatal care are important for ... your baby. Treatments for high blood pressure in pregnancy may include close monitoring of the baby, lifestyle ...


Microfollicular adenoma of ectopic thyroid gland masquerading as salivary gland tumor - a diagnostic and therapeutic challenge: a case report  

PubMed Central

Introduction Ectopic thyroid tissue may appear in any location along the trajectory of the thyroglossal duct from the foramen cecum to the mediastinum. Rarely, there is incomplete descent of the gland where the final resting point may be high resulting in sublingual ectopic thyroid tissue. Ectopic thyroid tissue carries a low risk of malignancy. Most recently reported neoplasms in ectopic thyroid tissue have been papillary carcinoma of thyroid. Individual case reports of clear cell type of follicular adenoma within the ectopic thyroid tissue have been described in the literature. Case presentation We present a rare case of microfollicular follicular adenoma in an ectopic sublingual thyroid tissue presenting as submental swelling in a euthyroid 24-year-old Dravidian woman. Conclusion Findings in this case emphasize that when confronted with a submental/sublingual mass lesion, the evaluation of thyroid function tests and ultrasonography of the neck should be included in a pre-operative workup. PMID:25103611



Intra-abdominal pressure during swimming.  


The present study aimed to determine the intra-abdominal pressure during front crawl swimming at different velocities in competitive swimmers and to clarify the relationships between stroke indices and changes in intra-abdominal pressure. The subjects were 7 highly trained competitive collegiate male swimmers. Intra-abdominal pressure was measured during front crawl swimming at 1.0, 1.2 and 1.4?m?·?s(-1) and during the Valsalva maneuver. Intra-abdominal pressure was taken as the difference between minimum and maximum values, and the mean of 6 stable front crawl stroke cycles was used. Stroke rate and stroke length were also measured as stroke indices. There were significant differences in stroke rate among all velocities (P < 0.05). However, there was no significant difference in stroke length by velocity. Significant within-subject correlations between intra-abdominal pressure and stroke rate or stroke length (P < 0.01) were observed, although there were no significant correlations between intra-abdominal pressure and stroke indices when controlling for swimming velocity. These findings do not appear to support the effectiveness of trunk training performed by competitive swimmers aimed at increasing intra-abdominal pressure. PMID:23868677

Moriyama, S; Ogita, F; Huang, Z; Kurobe, K; Nagira, A; Tanaka, T; Takahashi, H; Hirano, Y



Sipple syndrome and pregnancy.  


Sipple syndrome is an unusual entity during pregnancy. To our knowledge, this is the second case report of a pregnant patient with signs of Sipple syndrome. During pregnancy, this syndrome may present unusual complications, which require informed physician expertise for appropriate management. Our patient had a strong family history for Sipple syndrome, which is considered to be transmitted as an autosomal dominant. Thus, other family members, including the patient's offspring must be assessed frequently during their lifetime for any of the developing manifestations of this entity. Genetic counseling should be included in the management of all patients with Sipple syndrome. PMID:946212

Harris, R E; Gilstrap, L C; Brekken, A L



Intrahepatic cholestasis of pregnancy  

PubMed Central

Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver disorder characterized by maternal pruritus in the third trimester, raised serum bile acids and increased rates of adverse fetal outcomes. The etiology of ICP is complex and not fully understood, but it is likely to result from the cholestatic effects of reproductive hormones and their metabolites in genetically susceptible women. Equally unclear are the mechanisms by which the fetal complications occur. This article reviews the epidemiology, clinical features, diagnosis, etiology and management of ICP. PMID:19418576

Geenes, Victoria; Williamson, Catherine



Thyroid screening in pregnancy.  


The adverse impact of overt hypothyroidism that complicates pregnancy outcomes is well-established and not debated. For more than a decade, however, endocrinologists and obstetricians have been debating whether screening for subclinical thyroid disorders during pregnancy should be routine or should continue to be based on symptoms and risk factors. Several observational studies have suggested that offspring of women with asymptomatic thyroid dysfunction were at increased risk for impaired neurodevelopment. Other studies have suggested that pregnant women with subclinical thyroid disease, particularly those identified with an elevated thyroid-stimulating hormone (TSH) level may be at increased risk for pregnancy complications such as fetal death, preterm birth, or placental abruption. These data have prompted both obstetric and endocrinologic professional societies to draft recommendations regarding screening for thyroid disease during pregnancy, some of which are not entirely based on available evidence. The prevalence of overt thyroid disease is estimated to be 1-2 per 1000 pregnancies and historically has not been considered high enough to justify routine screening. Lower TSH thresholds (>2.5 mU/L) for the diagnosis of hypothyroidism have been promoted, and women with subclinical thyroid dysfunction commonly are included in estimates of thyroid disease during pregnancy, both of which exaggerate prevalence rates. The most compelling recent evidence on this issue has come from the Controlled Antenatal Thyroid Screening trial. After almost 22,000 pregnant women were screened for either isolated high TSH or isolated low free thyroxine level, 390 children of treated women with either diagnosis were compared with 404 children of similar women who were not treated during pregnancy. Treatment had no effect on mean offspring IQ at age 3 years or the number of children with an IQ <85. Authors of this landmark study concluded that antenatal screening and maternal treatment for women with subclinical thyroid dysfunction did not result in improved cognitive function. An ongoing intervention trial conducted by the Eunice Kennedy-Shriver National Institute of Child Health and Human Development's Maternal-Fetal Medicine Units Network will provide further clarity to this important question. In the interim, the debating authors have concluded, after careful review of the currently published literature, that routine screening for subclinical thyroid dysfunction during pregnancy is not currently warranted at this time. PMID:25139139

Casey, Brian; de Veciana, Margarita



Management of intra-abdominal hypertension and abdominal compartment syndrome: a review  

PubMed Central

Patients in the intensive care unit (ICU) are at risk of developing of intra abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Aim: This review seeks to define IAH and ACS, identify the aetiology and presentation of IAH and ACS, identify IAP measurement techniques, identify current management and discuss the implications of IAH and ACS for nursing practice. A search of the electronic databases was supervised by a health librarian. The electronic data bases Cumulative Index of Nursing and Allied Health Literature (CINAHL); Medline, EMBASE, and the World Wide Web was undertaken from 1996- January 2011 using MeSH and key words which included but not limited to: abdominal compartment syndrome, intra -abdominal hypertension, intra-abdominal pressure in adult populations met the search criteria and were reviewed by three authors using a critical appraisal tool. Data derived from the retrieved material are discussed under the following themes: (1) etiology of intra-abdominal hypertension; (2) strategies for measuring intra-abdominal pressure (3) the manifestation of abdominal compartment syndrome; and (4) the importance of nursing assessment, observation and interventions. Intra-abdominal pressure (IAP) and abdominal compartment syndrome (ACS) have the potential to alter organ perfusion and compromise organ function. PMID:24499574



Use of Antimicrobials during Pregnancy  

PubMed Central

The use of any drug during pregnancy is complicated by concerns of adverse effects, not only on the pregnant woman, but also on the fetus. This paper provides an overview of the use of antimicrobials in pregnancy, based on current knowledge of fetal development and on available documented experience. The author also discusses the use of specific antimicrobial agents during pregnancy. PMID:21263935

Nicolle, L.E.



An Advanced Rudimentary Horn Pregnancy  

Microsoft Academic Search

SUMMARY AN ADVANCED RUDIMENTARY HORN PREGNANCY (A Case Report) In this case report we presented a 29 th week intact rudimentary horn pregnancy that is not communicating with uterus and discussed under literature review. Rudimentary horn pregnancy has ever sufficient interest because of its very rarity, mode of fertilization, and its life threa- tening potency, high mortality rate of both

Ahmet GÜL; Cemal ARK


Acute fatty liver of pregnancy.  

PubMed Central

Six further cases of acute fatty liver of pregnancy are presented and discussed in relation to the world literature on this rare disease of pregnancy, the aetiology of which is still unknown. The importance of vomiting in late pregnancy is emphasized. A common feature seems to be a metabolic stress, possibly related to infection, which tips a susceptible liver into metabolic failure. PMID:6887187

Hague, W M; Fenton, D W; Duncan, S L; Slater, D N



Obesity, Leanness and Pregnancy Outcome.  

National Technical Information Service (NTIS)

Weight control during pregnancy is an important aspect of any prenatal care program. It is less widely known that weight control before pregnancy can also play an important role in achieving a successful pregnancy and delivery. This paper focuses on this ...

W. F. Schramm



Traumatic mesenteric cyst after blunt abdominal trauma  

PubMed Central

Mesenteric cysts are rare abdominal tumors of unclear histologic origin, usually asymptomatic. Post-traumatic mesenteric cyst usually results as a consequence of a mesenteric lymphangitic rupture or a hematoma followed by absorption and cystic degeneration. The preoperative histological and radiological diagnosis is difficult. We present the case of a 45-year-old male patient with sizable, palpable abdominal tumor, the gradual swelling of which the patient himself combined with the blunt abdominal trauma he acquired from an opponent's knee in a football game 5 months ago. PMID:22096714

Falidas, Evangelos; Mathioulakis, Stavros; Vlachos, Konstantinos; Pavlakis, Emmanouil; Anyfantakis, Georgios; Villias, Constantinos



[Abdominal tuberculosis: clinical and therapeutic evaluation].  


In this paper we present our experience concerning abdominal tuberculosis. The aim of this study is to evaluate various methods and to establish therapeutic approach to patients with abdominal tuberculosis. There were six patients (3 males and 3 females), aged between 22 and 67 years old, such as: 2 patients developed peritoneal tuberculosis, 3 patients developed intestinal tuberculosis and one patient developed mesenteric lymph node tuberculosis. We concluded that early diagnosis is often impossible and laboratory report was non-specific. Because surgical treatment in abdominal tuberculosis was made in complicate forms, we concluded that enterostomy "a minima" is the best therapeutic method. PMID:15675286

Me?in?, C; Pa?alega, M; Vâlcea, D; Vasile, I



Localization and Significance of Urokinase Plasminogen Activator and its Receptor in Placental Tissue from Intrauterine, Ectopic and Molar Pregnancies  

Microsoft Academic Search

Urokinase plasminogen activator receptor (uPAR) is a membrane-anchored protein with urokinase plasminogen activator (uPA) as the ligand. This complex induces proteolysis and remodelling of maternal decidua during placental implantation. The presence of uPAR on trophoblasts is supposed to promote adhesion, migration and invasion. In cancer tissue, high levels of uPAR are correlated with a poor prognosis. This immunohistochemical study shows

C Floridon; O Nielsen; B Hølund; L Sunde; J. G Westergaard; S. G Thomsen; B Teisner



Abdominal surgery. [Radiology, screening techniques  

SciTech Connect

A new art of ''interventional radiology'' has been developed in the past few years. Major applications include postoperative instrumentation of the biliary tract, percutaneous biliary drainage, tumor biopsy, abscess drainage, and intestinal-intubation procedures. Intervention by angiography encompasses injection of such substances as Pitressin (vasopressin), and embolization. These procedures have been of immense value. Fortunately, complications, such as sepsis and bleeding, have been infrequent. Computerized body tomography has also proved extremely important, particularly in the diagnosis of subphrenic abscess and pancreatic and pelvic pathology. /sup 99m/Tc-labeled-erythrocyte scans can be used to detect gastrointestinal bleeding sites. Scans can also identify hepatobiliary disease and splenic injury or differentiate the cause of jaundice. /sup 111/Indium-labeled autologous leukocytes may be useful in differentiating a pancreatic abscess from a pseudocyst. The advantage of indium scans over /sup 67/Ga scans is that a shorter time is required for maximum resolution: gallium requires 48 hours, indium 4. Another advantage is that indium is cleared through the liver and spleen and is not secreted into the bowel. /sup 67/Ga is absorbed by lymphomas and hepatocarcinomas. Nuclear magnetic resonance has many possible uses in abdominal surgery, but so far little information is available. This technique has been used to detect an empyema of the gallbladder that was not diagnosed by ultrasound. Among hepatic lesions, it can easily differentiate tumors from cysts and in that regard is superior to both ultrasound and scan. (JMT)

Welch, C.E.; Malt, R.A.



A Case of Colorectal Cancer during Pregnancy: A Brief Review of the Literature  

PubMed Central

The incidence of colorectal cancer (CRC) during pregnancy is so rare. Herein we present a case of colorectal cancer that was missed by pregnancy all over the pregnancy period. The patient was a 37-year-old woman (gravid 4, para 2) referred with the complaints of vaginal discharge and suspicious rupture of membrane (ROM). The patient was pale and the initial physical examination revealed dilation of two fingers, effacement about 30%. She underwent emergent cesarean section which showed adhesions surrounding the uterus, the bladder, and the abdominal wall. Forty days postoperatively, the patient presented with abdominal pain in the left upper quadrant (LUQ). Imaging confirmed a mass in LUQ. Partial colectomy of transverse colon (20?cm) was performed. Postoperative histopathologic study revealed a 7 ? 6 ? 5?cm mass in transverse colon compatible to stage IIa of the Duck class (T3, N0, Mx). Adjuvant chemotherapy was applied and the patient showed improvements during 7 months followup after surgery. Colorectal cancer in pregnancy is associated with diagnostic and therapeutic challenges which mostly lead to late diagnosis in advanced stages and poor prognosis. A targeted program to improve the general population knowledge and the establishment of a national consultant and screening program particularly for women with a planned pregnancy in the high risk group might be beneficial. PMID:23401815

Khodaverdi, Sepideh; Kord Valeshabad, Ali; Khodaverdi, Maryam



Ectopic eyes outside the head in Xenopus tadpoles provide sensory data for light-mediated learning  

PubMed Central

SUMMARY A major roadblock in the biomedical treatment of human sensory disorders, including blindness, has been an incomplete understanding of the nervous system and its ability to adapt to changes in sensory modality. Likewise, fundamental insight into the evolvability of complex functional anatomies requires understanding brain plasticity and the interaction between the nervous system and body architecture. While advances have been made in the generation of artificial and biological replacement components, the brain's ability to interpret sensory information arising from ectopic locations is not well understood. We report the use of eye primordia grafts to create ectopic eyes along the body axis of Xenopus tadpoles. These eyes are morphologically identical to native eyes and can be induced at caudal locations. Cell labeling studies reveal that eyes created in the tail send projections to the stomach and trunk. To assess function we performed light-mediated learning assays using an automated machine vision and environmental control system. The results demonstrate that ectopic eyes in the tail of Xenopus tadpoles could confer vision to the host. Thus ectopic visual organs were functional even when present at posterior locations. These data and protocols demonstrate the ability of vertebrate brains to interpret sensory input from ectopic structures and incorporate them into adaptive behavioral programs. This tractable new model for understanding the robust plasticity of the central nervous system has significant implications for regenerative medicine and sensory augmentation technology. PMID:23447666

Blackiston, Douglas J.; Levin, Michael



Risperidone and Pregnancy  


... prolactin can prevent ovulation, which prevents pregnancy. Your health care provider can test your levels of prolactin, if there is concern. I am currently taking risperidone and I am already pregnant. Should I stop taking ... first talking with your health care provider. Studies have shown that women with untreated ...


Renal physiology of pregnancy.  


Pregnancy involves remarkable orchestration of physiologic changes. The kidneys are central players in the evolving hormonal milieu of pregnancy, responding and contributing to the changes in the environment for the pregnant woman and fetus. The functional impact of pregnancy on kidney physiology is widespread, involving practically all aspects of kidney function. The glomerular filtration rate increases 50% with subsequent decrease in serum creatinine, urea, and uric acid values. The threshold for thirst and antidiuretic hormone secretion are depressed, resulting in lower osmolality and serum sodium levels. Blood pressure drops approximately 10 mmHg by the second trimester despite a gain in intravascular volume of 30% to 50%. The drop in systemic vascular resistance is multifactorial, attributed in part to insensitivity to vasoactive hormones, and leads to activation of the renin-aldosterone-angiostensin system. A rise in serum aldosterone results in a net gain of approximately 1000 mg of sodium. A parallel rise in progesterone protects the pregnant woman from hypokalemia. The kidneys increase in length and volume, and physiologic hydronephrosis occurs in up to 80% of women. This review will provide an understanding of these important changes in kidney physiology during pregnancy, which is fundamental in caring for the pregnant patient. PMID:23928384

Cheung, Katharine L; Lafayette, Richard A



Viral Hepatitis and Pregnancy  

Microsoft Academic Search

An acute hepatitis can have an onset during any trimester; it does not represent a risk for malformation in the baby, nor for the mother (with very rare exceptions). In fact, only hepatitis E virus poses a significantly increased risk to pregnant women. The most common scenario is a pregnancy in a women chronically infected with a hepatotropic virus. As

Annarosa Floreani



Gastrointestinal endoscopy in pregnancy  

PubMed Central

Gastrointestinal endoscopy has a major diagnostic and therapeutic role in most gastrointestinal disorders; however, limited information is available about clinical efficacy and safety in pregnant patients. The major risks of endoscopy during pregnancy include potential harm to the fetus because of hypoxia, premature labor, trauma and teratogenesis. In some cases, endoscopic procedures may be postponed until after delivery. When emergency or urgent indications are present, endoscopic procedures may be considered with some precautions. United States Food and Drug Administration category B drugs may be used in low doses. Endoscopic procedures during pregnancy may include upper gastrointestinal endoscopy, percutaneous endoscopic gastrostomy, sigmoidoscopy, colonoscopy, enteroscopy of the small bowel or video capsule endoscopy, endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography. All gastrointestinal endoscopic procedures in pregnant patients should be performed in hospitals by expert endoscopists and an obstetrician should be informed about all endoscopic procedures. The endoscopy and flexible sigmoidoscopy may be safe for the fetus and pregnant patient, and may be performed during pregnancy when strong indications are present. Colonoscopy for pregnant patients may be considered for strong indications during the second trimester. Although therapeutic endoscopic retrograde cholangiopancreatography may be considered during pregnancy, this procedure should be performed only for strong indications and attempts should be made to minimize radiation exposure. PMID:25386072

Savas, Nurten



[Kidney cancer and pregnancy].  


Renal cancer is rare in pregnant women. Through a study of two cases, the authors underline diagnostic, therapeutic and pathogenic aspects of this association. Two female patients, 26 and 34 years old, were admitted for renal tumor, discovered respectively at the first and the second trimester of pregnancy. Investigation's exams for tumor extension were negative. They were based on ultrasound exam (2 cases), CT scan (1 case) and chest X ray (2 cases). The histological examination concluded to a bright cell carcinoma. In the former case, evolution was marked by spontaneous abortion at the fifth post-operative day, and the absence of metastasis after 16 months. In the second case, the evolution was worse because of metastasis occurrence four months after normal delivery. Pregnancy represents a privileged period for the discovery of renal tumor. Exams of tumor extension must consider pregnancy age. The treatment is similar to that of usual renal cancer and is associated to a simultaneous supervision of the pregnancy. PMID:11859663

Dakir, M; Aboutaieb, R; Dahami, Z; Meziane, F; Ghazli, M; Benjelloun, S



Leflunomide and Pregnancy  


... humans. Concern has been raised about leflunomide because pregnancy studies in animals showed an increased risk of birth defects. A small study on 109 women (64 women in the main study and 45 in the case- series study) who became pregnant while taking leflunomide ...


Cardiac disease in pregnancy.  


Cardiac disease complicates approximately 1% to 3% of pregnancies and is responsible for 10% to 15% of maternal mortality. The number of women of childbearing age with congenital disease is increasing as advances in diagnosis and treatment improve survival rates and overall health, allowing successful pregnancy. Pregnant women with severe cardiac disease or women who experience a cardiac event during pregnancy will require admission and stabilization in an adult critical care unit. This group of patients can prove challenging for the obstetrical staff and the critical care staff because they require blending of the knowledge and skills of 2 highly specialized areas of healthcare. The key component to a comprehensive and organized approach to management that ensures the best possible outcome for the woman is a multidisciplinary team that devises a plan on the basis of the most current information, communicates with each other and the patient effectively, and assumes responsibility for implementation of the plan. The purpose of this article is to review management of the woman with cardiac disease throughout pregnancy. PMID:16456361

Arafeh, Julie M R; Baird, Suzanne McMurtry



Genital herpes complicating pregnancy.  


Approximately 22% of pregnant women are infected with herpes simplex virus (HSV)-2, and 2% of women will acquire HSV during pregnancy. Remarkably, up to 90% of these women are undiagnosed because they are asymptomatic or have subtle symptoms attributed to other vulvovaginal disorders. Diagnosis of genital herpes relies on laboratory confirmation with culture or polymerase chain reaction assay of genital lesions and type-specific glycoprotein G-based serologic testing. Neonatal herpes is the most severe complication of genital HSV infection and is caused by contact with infected genital secretions at the time of labor. Maternal acquisition of HSV in the third trimester of pregnancy carries the highest risk of neonatal transmission. Despite advances in the diagnosis and treatment of neonatal herpes, little change in the incidence or serious sequelae from this infection has occurred. As such, prevention of the initial neonatal infection is critically important. Obstetricians are in a unique position to prevent vertical HSV transmission by identifying women with genital lesions at the time of labor for cesarean delivery, prescribing antiviral suppressive therapy as appropriate, and avoiding unnecessary invasive intrapartum procedures in women with genital herpes. Enhanced prevention strategies include identification of women at risk for HSV acquisition during pregnancy by testing women and possibly their partners for HSV antibodies and providing counseling to prevent transmission to women in late pregnancy. PMID:16199646

Brown, Zane A; Gardella, Carolyn; Wald, Anna; Morrow, Rhoda Ashley; Corey, Lawrence



Parathyroid carcinoma in pregnancy.  


A 24-year-old female patient with parathyroid carcinoma, the rarest endocrine malignancy, had two pregnancies. In the first pregnancy, she had severe nausea and fatigue. Hypercalcemia and hyperparathyroidism were diagnosed in the postpartum period. Hyperemesis gravidarum masked a diagnosis of hypercalcemia. Neck ultrasound and Tc-99m sestamibi found an enlarged lower right parathyroid gland. The gland was surgically removed, and an initial pathology report described atypical adenoma. Shortly afterward, she became pregnant again. During the second pregnancy, her calcium level was frequently controlled but was always in the normal range. Normocalcemia is explained by the specific physiology of pregnancy accompanied by hemodilution, hypoalbuminemia and maternal hypercalciuria (mediated by increased glomerular filtration). During lactation, calcium levels rose, and a new neck ultrasound showed a solitary mass in the area of prior surgery and an enlarged pretracheal lymph node. Fine needle aspiration of the solitary mass and node showed parathyroid carcinoma cells. The tumor mass was resected en bloc with the contiguous tissues and surrounding lymph nodes (pathology report; parathyroid carcinoma with metastases). Over the next five years, four consecutive surgeries were performed to remove malignant parathyroid tissue, lymph nodes and local metastases. Following the surgical procedures, no hypocalcemia was observed. More serious hypercalcemia recurred; the calcium level was difficult to control with a combination of pamidronate, cinacalcet and loop diuretic. No elements of multiple endocrine neoplasia were present. PMID:24868516

Bareti?, Maja; Tomi? Brzac, Hrvojka; Dobreni?, Margareta; Jakov?evi?, Antonia



Multiple sclerosis and pregnancy  

PubMed Central

Multiple sclerosis causes disability in young adults and, like most autoimmune diseases, affects women more commonly than men. The disease can therefore present at a time when many have, or are considering, starting a family. The effect of pregnancy on the outcome of multiple sclerosis is reviewed and the management of pregnant women who have multiple sclerosis is discussed. PMID:12185217

Lorenzi, A; Ford, H



Kidney angiomyolipoma in pregnancy  

PubMed Central

Neoplasms are rare in pregnant women, however they are always a challenging diagnostic and curative problem. We present a case of a benign kidney tumor (angiomyolipoma) imitating nephroblastoma on magnetic resonance diagnosed in pregnancy. Cesarean section was performed in 29. gestotic week followed immediately by right radical nephrectomy. PMID:24757536

Bialy, Aleksander; Dembowski, Janusz; Zlotkiewicz, Monika; Guzinski, Maciej; Kolodziej, Anna Karina; Zdrojowy, Romuald



Nutrition in pregnancy  

Microsoft Academic Search

Epidemiological evidence shows that women living in affluent circumstances have bigger babies with a lower mortality than underpriviliged women. How much of that effect is due to nutrition alone is not known but supplementary feeding in pregnancy of chronically ill nourished women does appear to increase mean birth weight, and famine conditions in a basically well nourished community reduce the

F. E. Hytten



Bed rest in pregnancy.  


The use of bed rest in medicine dates back to Hippocrates, who first recommended bed rest as a restorative measure for pain. With the formalization of prenatal care in the early 1900s, maternal bed rest became a standard of care, especially toward the end of pregnancy. Antepartum bed rest is a common obstetric management tool, with up to 95% of obstetricians utilizing maternal activity restriction in some way in their practice. Bed rest is prescribed for a variety of complications of pregnancy, from threatened abortion and multiple gestations to preeclampsia and preterm labor. Although the use of bed rest is pervasive, there is a paucity of data to support its use. Additionally, many well-documented adverse physical, psychological, familial, societal, and financial effects have been discussed in the literature. There have been no complications of pregnancy for which the literature consistently demonstrates a benefit to antepartum bed rest. Given the well-documented adverse effects of bed rest, disruption of social relationships, and financial implications of this intervention, there is a real need for scientific investigation to establish whether this is an appropriate therapeutic modality. Well-designed randomized, controlled trials of bed rest versus normal activity for various complications of pregnancy are required to lay this debate to rest once and for all. PMID:21425272

Bigelow, Catherine; Stone, Joanne



[Radiodiagnosis and irradiated pregnancies].  


An X-ray examination can sometimes be performed during the first few days of pregnancy. To prevent these accidental irradiations of the fetus, women must receive specific information about radiation effects, the ten Day Rule must be respected, and the physician must choose a non irradiating technique. X-ray examination may be performed in an emergency, especially if the examination is far from the pelvis. The radiologist must optimize the constants and decrease the number of films. The dose received depends on mAs, but other parameters are necessary for calculation (film source distance, kV, filtration...). For computed tomography, slice thickness, and interval between slices are taken in account. The dose received reaches a maximum after three axial sections, but is higher for a given area, than with conventional radiography. The irradiation effects depend on the fetal dose and the stage of pregnancy. Before implantation, the fetal dose is either ineffective or induces a miscarriage. During organogenesis, between the second and 16th week, doses exceeding 500 mGy can cause death of the fetus, malformations or growth retardation. We consider that when the dose is less than 100 mGy, they are no reasons to terminate the pregnancy. MRI does not seem to be dangerous for the course of pregnancy. No studies have demonstrated any teratogenic effects with intense magnetic fields. PMID:9846441

Foulquier, J N; Le Breton, C



Albuterol and Pregnancy  


... 4):383-388. Lin S, et al. 2012. National Birth Defects Prevention Study. Maternal asthma medication use and the risk ... Albuterol and Pregnancy Lin S, et al. 2012. National Birth Defects Prevention Study. Maternal asthma medication use and the risk ...


[Epilepsy and pregnancy].  


Course and outcome of 200 pregnancies, deliveries and post-partum periods of 127 women with the onset of epilepsy before or during pregnancy were compared to clinical form of the disease, frequency of seizures and antiepileptic therapy. In addition, 104 children born to 97 mothers with epilepsy, 85 children--from the moment of birth to 1 year old and others from 1 to 16 years old, were studied. The particular attention was focused on the early neonatal adaptation. It was shown that, along with the last weeks of pregnancy, the first 7 days period after the delivery was critical for epilepsy severity. The development of seizures at this period was related to sleep deprivation and marked hormonal changes. There were no significant changes between the body mass of newborns of mothers with epilepsy and those of healthy mothers. The period of neonatal adaptation in children of affected mothers was favorable in 46% of cases. Some peculiarities of a child's state (withdrawal syndrome, hepatitis A etc.) were mostly related to the treatment of a mother with high dosages of antiepileptic preparations, i.e. valproic acid. These disturbances vanished to the age of 1-3 years. In summary, the active supervision of women by an epileptologist during the pregnancy period allows to optimize the prognosis of the child's health and better course of epilepsy in the mother. PMID:19621485

Poverennova, I E; Iakunina, A V; Postnova, E N; Kalinin, V A; Kordonskaia, I S; Chueva, L E



The Tribolium homeotic gene Abdominal is homologous to abdominal-A of the Drosophila bithorax complex  

NASA Technical Reports Server (NTRS)

The Abdominal gene is a member of the single homeotic complex of the beetle, Tribolium castaneum. An integrated developmental genetic and molecular analysis shows that Abdominal is homologous to the abdominal-A gene of the bithorax complex of Drosophila. abdominal-A mutant embryos display strong homeotic transformations of the anterior abdomen (parasegments 7-9) to PS6, whereas developmental commitments in the posterior abdomen depend primarily on Abdominal-B. In beetle embryos lacking Abdominal function, parasegments throughout the abdomen are transformed to PS6. This observation demonstrates the general functional significance of parasegmental expression among insects and shows that the control of determinative decisions in the posterior abdomen by homeotic selector genes has undergone considerable evolutionary modification.

Stuart, J. J.; Brown, S. J.; Beeman, R. W.; Denell, R. E.; Spooner, B. S. (Principal Investigator)



ADHD treatment and pregnancy.  


There is increasing recognition that ADHD is a common condition, not only in children and teenagers but also in adults. This has led to a rapid rise in the number of women of childbearing age who are being treated for this condition. Against the background of concerns about the use of medication of any kind during pregnancy and breastfeeding, it is remarkable that there is so little information available on the effects of ADHD medication on the fetus and newborn. The impulsivity associated with ADHD might lead to an increased rate of unplanned pregnancy. Although treating ADHD during pregnancy and lactation might have negative effects on the baby, suspension of treatment or inadequate treatment could also place both mother and baby at risk. Pharmacodynamic and pharmacokinetic changes during pregnancy could affect both the efficacy and the concentration of medication. Again, there is almost no guidance available. The US Food and Drug Administration has classified ADHD medications as being "pregnancy category C", implying that there is insufficient information to confirm either harm or lack of harm. From the limited information that has been published, it would appear that the risk of fetal malformation, at least with methylphenidate, is very low and that the amounts of medication excreted in breast milk and consumed by the infant are very small. Three questions that both clinicians and patients are likely to ask are the following. Should ADHD medication be stopped before, during or after pregnancy, or should it be continued throughout? Should ADHD medication doses be adjusted during the course of the pregnancy or after delivery? Should breastfeeding be encouraged or discouraged? Discontinuing ADHD treatment could put both mother and baby at risk. This has to be balanced against the possible risks to the baby of continuing treatment. Although the data remain inadequate, the risk of the latter appears to be quite small, at least for methylphenidate. However, there is recent evidence that the rates of fetal loss both through abortion and through miscarriage are increased with methylphenidate. Discussions about ADHD treatment with women of childbearing age should be balanced, open and honest, acknowledging the lack of information on the possible risks to the offspring of continuing treatment, while also drawing attention to the possible risks to both mother and child of discontinuing treatment. PMID:24794209

Besag, Frank M C



Abdominal imaging in zinc phosphide poisoning.  


Radiography has been proved to be a good diagnostic tool in visualization of many radiopaque xenobiotics in clinical toxicology. Zinc is a potentially radiopaque material which is a constituent of the zinc phosphide (ZN2P3) rodenticide. We report two cases of zinc phosphide poisoning with positive abdominal X-rays in whom the diagnosis was confirmed by abdominal imaging. Positive abdominal imaging was an indication for aggressive management; however, aggressive treatment was not lifesaving in one of them. We aim to emphasize the diagnostic value of abdominal X-rays in zinc phosphide-poisoned patients. We also would like to suggest that zinc phosphide (ZP)-poisoned patients with positive X-rays have more chance to become unstable even if they are symptom free on presentation and should be more aggressively managed. PMID:24477450

Hassanian-Moghaddam, Hossein; Shahnazi, Makhtoom; Zamani, Nasim; Bahrami-Motlagh, Hooman



Intra-abdominal actinomycetoma in a cat.  


A 5-year-old, female Ragdoll cat was diagnosed with an intra-abdominal mycetoma involving the ileocaecal region. Diagnosis was obtained via histopathological examination following surgical resection of the mass and an ileocolic anastomosis. The initial surgery was complicated by lymphangiectasia, chylous abdominal effusion and mild bacterial leakage from the anastomosis site. A second, exploratory laparotomy was performed to augment the anastomosis with serosal patching and omentalisation and to investigate a cystic structure observed on follow-up abdominal ultrasound. Initial amoxycillin clavulanate (Clavulox; Pfizer Animal Health) therapy was ineffective, but clindamycin (Antirobe; Pfizer Animal Health) proved successful in resolving the infection. Abdominal actinomycetoma in the cat ma