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1

Ectopic Pregnancy  

MedlinePLUS

... enough. The rest will require surgery to treat. Laparoscopy Laparoscopy is the most common surgery for ectopic pregnancies. ... be able to remove the ectopic pregnancy using laparoscopy. In these cases, a larger abdominal incision called ...

2

Primary abdominal ectopic pregnancy: a case report  

PubMed Central

Introduction We present a case of a 13-week abdominal pregnancy evaluated with ultrasound and magnetic resonance imaging. Case presentation A 34-year-old woman, (gravida 2, para 1) suffering from lower abdominal pain and slight vaginal bleeding was transferred to our hospital. A transabdominal ultrasound and magnetic resonance imaging were performed. The diagnosis of primary abdominal pregnancy was confirmed according to Studdiford’s criteria. A laparatomy was carried out. The placenta was attached to the mesentery of sigmoid colon and to the left abdominal sidewall. The placenta was dissected away completely and safely. No postoperative complications were observed. Conclusion Ultrasound examination is the usual diagnostic procedure of choice. In addition magnetic resonance imaging can be useful to show the localization of the placenta preoperatively. PMID:19918376

Kolusari, Ali; Adali, Fulya; Adali, Ertan; Kurdoglu, Mertihan; Ozgokce, Cagdas; Cim, Numan

2009-01-01

3

Ectopic Pregnancy  

MedlinePLUS

... tubes, and nearby pelvic structures) • Previous ectopic pregnancy • Infertility • Pelvic or abdominal surgery • Endometriosis • Sexually transmitted diseases • ... body to control the functions of various organs. Infertility: A condition in which a couple has been ...

4

Ectopic Pregnancy  

MedlinePLUS

... 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 ...

5

Ectopic Pregnancy  

MedlinePLUS

... 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. ...

6

Ectopic pregnancy  

MedlinePLUS

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 ...

7

Diagnosis and management of ectopic pregnancy.  

PubMed

Ectopic pregnancy affects 1% to 2% of all pregnancies and is responsible for 9% of pregnancy-related deaths in the United States. When a pregnant patient presents with first-trimester bleeding or abdominal pain, physicians should consider ectopic pregnancy as a possible cause. The patient history, physical examination, and imaging with transvaginal ultrasonography can usually confirm the diagnosis. When ultrasonography does not clearly identify the pregnancy location, the physician must determine whether the pregnancy is intrauterine (either viable or failing) or ectopic. Use of the beta subunit of human chorionic gonadotropin (ß-hCG) discriminatory level, the ß-hCG value above which an intrauterine pregnancy should be visualized by transvaginal ultrasonography, may be helpful. Failure to visualize an intrauterine pregnancy when ß-hCG is above the discriminatory level suggests ectopic pregnancy. In addition to single measurements of ß-hCG levels, serial levels can be monitored to detect changes. ß-hCG values in approximately 99% of viable intrauterine pregnancies increase by about 50% in 48 hours. The remaining 1% of patients have a slower rate of increase; these patients may have pregnancies that are misdiagnosed as nonviable intrauterine or ectopic. After an ectopic pregnancy has been confirmed, treatment options include medical, surgical, or expectant management. For patients who are medically unstable or experiencing life-threatening hemorrhage, a surgical approach is indicated. For others, management should be based on patient preference after discussion of the risks, benefits, and monitoring requirements of all approaches. PMID:25077500

Barash, Joshua H; Buchanan, Edward M; Hillson, Christina

2014-07-01

8

Laparoscopic Treatment of Cesarean Scar Ectopic Pregnancy.  

PubMed

Background: An ectopic pregnancy within a Cesarean scar represents a rare type of extrauterine pregnancy in which the fertilized egg nidates in the myometrium of the uterine wall within a scar left from a previous Cesarean delivery. An unrecognized growing Cesarian scar pregnancy may result in uterine rupture, uncontrollable metrorrhagia, and bleeding into the abdominal cavity; therefore, early diagnosis and therapy are necessary to prevent the development of severe complications. Case: A 34-year-old woman after a previous Cesarean delivery presented with amenorrhoa of 7 weeks' duration. Transvaginal ultrasonography revealed an ectopic pregnancy in the Cesarean scar, and a laparoscopic removal of the gestational sac was performed with no complications. Results: Three months later, another laparoscopy with chromopertubation showed no signs of penetration in the suture, both the Fallopian tubes being bilaterally passable. The patient was advised that she could try to achieve pregnancy through spontaneous conception, after which monitoring of the gestational development and a careful assessment of the nidation site would be needed. Conclusions: Laparoscopic surgical management of a viable ectopic pregnancy is technically simple, and is followed by a good recovery. (J GYNECOL SURG 30:309). PMID:25336858

Hude?ek, Robert; Felsingerová, Zuzana; Felsinger, Michal; Jandakova, Eva

2014-10-01

9

Heterochronic bilateral ectopic pregnancy after ovulation induction*  

PubMed Central

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

2014-01-01

10

Ruptured ectopic pregnancy presenting 3 years after supracervical hysterectomy.  

PubMed

An ectopic pregnancy after a hysterectomy is a rare event, with about 40 reported cases since it was first identified by Wendeler in 1895. There are even fewer cases reported of an ectopic pregnancy occurring years after a hysterectomy has been performed. This case illustrates the sonographic and computed tomographic (CT) findings in the setting of abdominal pain in a woman of childbearing age and highlights the need to obtain a urine pregnancy test as part of the workup for abdominal pain in women, even if a history of a hysterectomy has been given. Many providers may automatically exclude an ectopic pregnancy as a possibility in the aforementioned clinical scenario if the patient has a history of a hysterectomy. Such automatic exclusion may result in life-threatening consequences. PMID:18577674

Babikian, Sarkis; Thoma, David C; Berkey, Bryan D

2008-07-01

11

Laparoscopic Management of an Abdominal Pregnancy  

PubMed Central

Background. Ectopic pregnancy is one of the leading causes of significant maternal morbidity and mortality. Abdominal surgeries increase the risk of postoperative adhesions. We here present a case of omental ectopic pregnancy in a patient with a prior history of cesarean section. Case. A 20-year-old female presented with a two-day history of crampy lower abdominal pain. Patient was hemodynamically stable with a beta HCG of 1057?mI/mL. Transvaginal ultrasound did not show an intrauterine pregnancy but revealed an ill-defined mass in the midline pelvis extending to the right of the midline. Diagnostic laparoscopy revealed large clots in the pelvis with normal uterus and adnexa. Intra-abdominal survey revealed an omental adhesion close to the right adnexa with a hematoma. Partial omentectomy was completed and the portion of the omentum with the hematoma was sent to pathology for confirmation. Final pathology confirmed the presence of chorionic villi consistent with products of conception. Conclusion. Omental ectopic pregnancy is a rare diagnosis and often missed. We recommend careful intra-abdominal survey for an ectopic pregnancy in the presence of hemoperitoneum with normal uterus and adnexa. This can be safely achieved using laparoscopy in early gestational ages when the patient is hemodynamically stable. PMID:25478262

2014-01-01

12

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

2012-01-01

13

Hydatidiform mole presentation as a tubal ectopic pregnancy.  

PubMed

Presentation of hydatidiform mole as tubal ectopic pregnancy is very rare. These patients usually present with ectopic pregnancy and are later diagnosed with hydatidiform mole on the basis of histological examination following surgery. We present the case of a 32-year-old female who presented with abdominal pain and vaginal bleed since 2 days of presentation. She was vitally stable. There was mild tenderness in hypogastrium and left iliac fossa. Pelvic examination showed mild bleeding per vaginum and fullness in both fornices. The patient was suspected of having an ectopic pregnancy. Ultrasonography of pelvis revealed fluid in cul-de-sac and a sac like mass of 1.8 cm attached to the left ovary. On laparotomy, there was a left sided tubal ectopic pregnancy and subsequently left salpingectomy was done. Histopathology of the tissue sample showed features of partial hydatidiform mole. Ectopic pregnancy can present as hydatidiform mole in rare cases for which histological examination of the tissue is required to establish the diagnosis. PMID:24906283

Nakeer, Tabassum; Shahid, Muhammad; Ansari, Muhammad Asad; Nakeer, Rooham

2014-05-01

14

Ectopic pregnancy in Conakry, Guinea.  

PubMed Central

OBJECTIVE: To assess the incidence of ectopic pregnancy (EP) in hospitals in Conakry, the capital of Guinea, West Africa. Data on EP incidence in developing countries are rare and often out of date, particularly in Africa. METHODS: A retrospective study was carried out, examining all cases of EP registered in the medical files of two referral maternity units at the Donka and Ignace Deen university hospitals between 1995 and 1999. FINDINGS: The EP incidence at the two maternity units increased from 0.41% to 1.5% of annual deliveries over this period. Haemoperitoneum was observed in most women, with tubal rupture in 93%; only 6 women received conservative treatment. CONCLUSION: The results suggest that the hospital-based incidence of EP per delivery has increased over the last decade in this West African capital, and that health professionals and public health officials in developing countries, especially those in Africa, should consider EP as a major obstetric problem for maternal morbidity. PMID:12077611

Thonneau, Patrick; Hijazi, Yolande; Goyaux, Nathalie; Calvez, Thierry; Keita, Namory

2002-01-01

15

Ectopic Pregnancy: Prospective Study With Improved Diagnostic Accuracy  

Microsoft Academic Search

Study objective: To assess the utility of ultrasonography, quantitative serum ?-human chorionic gonadotropin (?-hCG) level, history, and physical examination in the diagnosis of ectopic pregnancy (EP) in the emergency department. Methods: We prospectively studied 481 consecutive pregnant patients who presented to an urban ED with first-trimester abdominal pain or vaginal bleeding. History, physical examination findings, quantitative ?-hCG values, sonography findings,

Beth C Kaplan; Robert G Dart; Margo Moskos; Ewa Kuligowska; Byungyol Chun; M. Adel Hamid; Katherine Northern; Joseph Schmidt; Ashlesha Kharwadkar

1996-01-01

16

Main Risk Factors for Ectopic Pregnancy: A Case-Control Study in A Sample of Iranian Women  

PubMed Central

Background Although the risk factors of ectopic pregnancy have been determined in previous studies, the main risk factors of ectopic pregnancy are different in various countries due to different cultural and social characteristics. Determination of main risk factors of ectopic pregnancy leads to a rapid diagnosis and an improvement in strategies for its prevention. The purpose of this study was to determine the main risk factors of ectopic pregnancy in a sample of Iranian women. Materials and Methods We designed a case-control study to include 150 cases and 300 controls and to compare them by the following factors: socio-demographic characteristics, contraceptive methods, prior tubal surgery, tubal pathology, prior ectopic pregnancy, prior caesarean section, prior abortion, prior infertility, and prior abdominal/pelvic surgery. Results The case and control groups were significantly similar in term of education and parity. There was an association between ectopic pregnancy and age which was disappeared after controlling for the main risk factors (adjusted OR=2.45, 95% CI: 0.86-6.97). There was no statistically significant relation between ectopic pregnancy and prior tubal surgery, tubal pathology, prior abortion, prior infertility, assisted reproductive technology, and oral contraceptive method (p>0.05). However, there was a significant association between prior ectopic pregnancy, prior tubal ligation, use of intrauterine device, and prior abdominal/pelvic surgery with ectopic pregnancy (p<0.05). The risk of ectopic pregnancy increased with the use of intrauterine device and tubal ligation, whereas decreased with use of oral contraception. Conclusion This study identified prior ectopic pregnancy, prior tubal ligation, use of intrauterine device, and prior pelvic/abdominal surgery as the main risk factors for ectopic pregnancy in a sample of Iranian women. Our findings can be useful for early diagnosis of ectopic pregnancy and for improvement in strategies of its prevention through medical therapy instead of unnecessarily surgical treatment. PMID:25083179

Parashi, Shayesteh; Moukhah, Somayeh; Ashrafi, Mahnaz

2014-01-01

17

Ectopic pregnancy in an apparently healthy bitch.  

PubMed

This case describes an extrauterine fetus that was discovered in an apparently healthy bitch 5 mo after whelping. The extrauterine fetus was surgically removed, and the bitch made a complete recovery. The topic of canine ectopic pregnancy is discussed, and a review of previously reported cases is presented. PMID:22474049

Eddey, Philip D

2012-01-01

18

Isolated fluid in the cul-de-sac: How well does it predict ectopic pregnancy?  

Microsoft Academic Search

We examined the risk of ectopic pregnancy among patients with isolated abnormal cul-de-sac fluid at transvaginal ultrasound. We conducted a retrospective cohort study of all ED patients presenting January 1995 to August 1999 with abdominal pain or vaginal bleeding and a positive [beta ]-hCG test. The risk of ectopic pregnancy in patients with a moderate volume of anechoic fluid was

Robert Dart; Samuel A. McLean; Linda Dart

2002-01-01

19

Treatment of ectopic pregnancy with methotrexate.  

PubMed

The aim of the present study was to analyze retrospectively the safety and success rates of single- and two-dose methotrexate (MTX) protocols for the treatment of hemodynamically stable cases of ectopic pregnancy at University Department of Gynecology and Obstetrics, Zagreb University Hospital Center, during a five-year period. The study evaluated MTX treatment efficacy in 35 women with ectopic pregnancies in relation to the initial levels of human chorionic gonadotropin (hCG) and progesterone. Successful treatment was recorded in 32/35 women, 24/25 on single dose MTX and 8/10 on double dose MTX, whereas 3/35 patients underwent laparoscopy. The mean initial hCG level in all 35 patients on day 0 was 657.54 +/- 592.4 IU/L; 572.99 +/- 488.10 IU/L in those successfully treated with MTX and 1560.30 +/- 890.70 IU/L in those requiring additional laparoscopy (p < 0.005). The mean initial hCG level was 393.10 +/- 305.9 IU/L in patients successfully treated with a single dose of MTX and 973.5 +/- 722.40 IU/L in those with an additional dose of MTX (p < 0.002). The mean initial progesterone level was 16.36 +/-10.70 nmol/L in 35 MTX-treated ectopic pregnancy patients, 13.64 +/- 8.89 nmol/L in those with treatment success and 28.45 +/- 11.32 nmol/L in cases of treatment failure (p < 0.05). The mean level of progesterone on day 0 was 12.74 +/- 830 nmol/L in patients successfully treated with a single dose of MTX and 26.10 +/- 18.80 nmol/L in patients treated with double-dose MTX (p < 0.006). It is concluded that pretreatment values of hCG and progesterone are inversely related to medicamentous treatment success in selected cases ofhemodynamically stable patients, thus they may be used as an important predictor in the management of ectopic pregnancy treated with MTX. PMID:23540161

Kasum, Miro; Oreskovi?, Slavko; Simuni?, Velimir; Jezek, Davor; Tomi?, Vlatka; Tomi?, Jozo; Gall, Vesna; Mihaljevi?, Slobodan

2012-12-01

20

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

2014-01-01

21

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

PubMed

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

2014-01-01

22

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.

1985-02-01

23

Successful laparoscopic management of concomitant ectopic pregnancy and acute appendicitis in a patient of failed tubal ligation – case report with a review of the literature  

PubMed Central

Background The incidence of failed abdominal bilateral tubal ligation (BTL) is quite low. Most often the pregnancy following BTL is ectopic in location. The association of concurrent acute appendicitis with ectopic pregnancy is also very rare. From 1960 till 2008 only 23 such cases of ectopic pregnancy with appendicitis managed by open surgery have been reported in the medical literature. Case presentation We present a case in which the patient had concurrent ectopic pregnancy of the right fallopian tube with acute appendicitis after failed BTL and which was managed successfully by laparoscopic approach. Conclusion Although the combination of ectopic pregnancy and acute appendicitis is quite rare, it is wise to rule out concurrent acute appendicitis in patients of ectopic pregnancy especially if it is on the right side due to an inter-etiological relationship. Laparoscopic management of both these pathologies can be accomplished quite successfully in properly selected cases. PMID:19102771

Mir, Iqbal Saleem; Mohsin, Mir; Malik, Anjum; Ahad, Basharat; Farooq, Syed Suraiya Arjumand

2008-01-01

24

Primary Abdominal Pregnancy in the Uterosacral Ligament with Haemoperitoneum: A Near Miss  

PubMed Central

Primary abdominal pregnancy has a higher mortality rate than other ectopic gestations. Delayed diagnosis can be associated with catastrophic haemorrhage. This report describes a spontaneous conception which occurred in the uterosacral ligament in a woman with no known risk factors for an ectopic pregnancy. Extrauterine pregnancy was diagnosed by ultrasound and laparoscopy was performed secondary to haemoperitoneum, which revealed a pregnancy implanted in the right uterosacral ligament. The rarity of this condition signifies the need for reporting all cases to facilitate future research and clinical management. PMID:24995221

Pochiraju, Manjula

2014-01-01

25

Primary abdominal pregnancy in the uterosacral ligament with haemoperitoneum: a near miss.  

PubMed

Primary abdominal pregnancy has a higher mortality rate than other ectopic gestations. Delayed diagnosis can be associated with catastrophic haemorrhage. This report describes a spontaneous conception which occurred in the uterosacral ligament in a woman with no known risk factors for an ectopic pregnancy. Extrauterine pregnancy was diagnosed by ultrasound and laparoscopy was performed secondary to haemoperitoneum, which revealed a pregnancy implanted in the right uterosacral ligament. The rarity of this condition signifies the need for reporting all cases to facilitate future research and clinical management. PMID:24995221

Gundabattula, Sirisha Rao; Pochiraju, Manjula

2014-05-01

26

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

2014-01-01

27

Ectopic pancreas: a rare cause of abdominal pain.  

PubMed

We present a case of recurrent abdominal pain due to an ectopic or heterotopic pancreas. Heterotopic pancreas (HP) is the presence of histologic pancreatic tissue outside its normal location without any anatomic or vascular continuity with the pancreas. The frequency of HP has been estimated as 0.6-13.7%. Most are found in the duodenum, stomach, andjejunum. The exact mechanism remains controversial but it has been theorized that it most likely arises congenitally during embryonic development. The elevations of amylase and lipase levels are modest due to the small volume of pancreatic tissue in the HP. Therefore, diagnostic modalities including barium swallow, upper-gastrointestinal series, CT, EUS, and MRCP can be used when suspecting HP. The need for treatment is based on symptoms and definitive diagnosis, especially when the possibility of malignancy exists. Asymptomatic causes need not require treatment. PMID:25314887

Habibi, Hamid; Devuni, Deepika; Rossi, Lisa

2014-09-01

28

42 CFR 136.55 - Drugs and devices and termination of ectopic pregnancies.  

Code of Federal Regulations, 2013 CFR

...devices and termination of ectopic pregnancies. Federal funds are available for drugs or devices to prevent implantation of the fertilized ovum, and for medical procedures necessary for the termination of an ectopic...

2013-10-01

29

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

Code of Federal Regulations, 2013 CFR

...and termination of ectopic pregnancies. FFP is available in expenditures for drugs or devices to prevent implantation of the fertilized ovum and for medical procedures necessary for the termination of an ectopic...

2013-10-01

30

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

...and termination of ectopic pregnancies. FFP is available in expenditures for drugs or devices to prevent implantation of the fertilized ovum and for medical procedures necessary for the termination of an ectopic...

2014-10-01

31

42 CFR 136a.55 - Drugs and devices and termination of ectopic pregnancies.  

Code of Federal Regulations, 2013 CFR

...devices and termination of ectopic pregnancies. Federal funds are available for drugs or devices to prevent implantation of the fertilized ovum, and for medical procedures necessary for the termination of an ectopic...

2013-10-01

32

Endometrial Gene Expression in Early Pregnancy: Lessons From Human Ectopic Pregnancy  

PubMed Central

Human endometrium undergoes modifications in preparation for embryonic implantation. This study investigated in vivo the endocrine effects of pregnancy on the endometrium, using the model of ectopic pregnancy. Endometrial biopsies from 9 subjects with ectopic pregnancy (Preg) were compared with 8 and 6 samples of mid and late secretory endometrium, respectively. After hybridizing with Affymetrix HGU133 Plus 2 chips, data were analyzed using GeneSpring GX and Ingenuity Pathways Analysis. From 54 675 genes, 3021 genes were significantly differentiated when mid-secretory endometrium was compared with the Preg (Volcano plot; P < .05, ?2-fold change). The complement and coagulation cascade, phospholid degradation, glycosphingolipid biosynthesis (globoseries), retinol metabolism, antigen presentation pathway, glycosphingolipid biosynthesis, and O-glycan biosynthesis were main significant canonical pathways found in Preg samples. Validation was done with reverse transcriptase polymerase chain reaction. In conclusion, the ectopic embryo has a significant impact, by an endocrine mechanism, on endometrium, when compared with the window of implantation. PMID:18591649

Savaris, Ricardo F.; Hamilton, Amy E.; Lessey, Bruce A.; Giudice, Linda C.

2010-01-01

33

Ectopic pregnancies associated with low dose progestagen-releasing IUDs.  

PubMed

Dimethyl-polysiloxane capsules containing pure progestagens were attached to Tatum's T IUDs and tested in 594 fertile women for contraceptive performance. The control group was represented by 71 women who received identical devices containing barium sulphate instead of steroid and 100 women who received a Copper T-200. The progestagens and the doses tested were megestrol acetate (4.8, 19.2, 26 and 32 micrograms/day; levonorgestrel (2.1, 3.4 and 8.5 micrograms/day); norethindrone (18 micrograms/day); R2323 (28.6 and 45 micrograms/day); and norgestrienone (26 micrograms/day). Twelve pregnancies were diagnosed during 5201 woman-months of exposure accumulated within the first year of use among users of the steroid-bearing IUDs. Five of these were ectopic gestations. Ten pregnancies, all uterine, were detected during 1701 woman-months of exposure in the control group. Intrauterine delivery of progestagens by means of a carrier IUD is effective in decreasing the pregnancy rate but it might effect postovulatory events in a way which increases the rate of tubal implantation. Because of this property, progestagen-releasing IUDs should be limited to doses that assure maximal effectiveness to avoid increasing the risk of ectopic pregnancy. PMID:7438753

Díaz, S; Croxatto, H B; Pavez, M; Quinteros, E; Carrillo, D; Simonetti, L; Croxatto, H D; Rosati, S

1980-09-01

34

Embryonic miRNA Profiles of Normal and Ectopic Pregnancies  

PubMed Central

Our objective was to investigate the miRNA profile of embryonic tissues in ectopic pregnancies (EPs) and controlled abortions (voluntary termination of pregnancy; VTOP). Twenty-three patients suffering from tubal EP and twenty-nine patients with a normal ongoing pregnancy scheduled for a VTOP were recruited. Embryonic tissue samples were analyzed by miRNA microarray and further validated by real time PCR. Microarray studies showed that four miRNAs were differentially downregulated (hsa-mir-196b, hsa-mir-30a, hsa-mir-873, and hsa-mir-337-3p) and three upregulated (hsa-mir-1288, hsa-mir-451, and hsa-mir-223) in EP compared to control tissue samples. Hsa-miR-196, hsa-miR-223, and hsa-miR-451 were further validated by real time PCR in a wider population of EP and control samples. We also performed a computational analysis to identify the gene targets and pathways which might be modulated by these three differentially expressed miRNAs. The most significant pathways found were the mucin type O-glycan biosynthesis and the ECM-receptor-interaction pathways. We also checked that the dysregulation of these three miRNAs was able to alter the expression of the gene targets in the embryonic tissues included in these pathways such as GALNT13 and ITGA2 genes. In conclusion, analysis of miRNAs in ectopic and eutopic embryonic tissues shows different expression patterns that could modify pathways which are critical for correct implantation, providing new insights into the understanding of ectopic implantation in humans. PMID:25013942

Dominguez, Francisco; Moreno-Moya, Juan Manuel; Lozoya, Teresa; Romero, Ainhoa; Martínez, Sebastian; Monterde, Mercedes; Gurrea, Marta; Ferri, Blanca; Núñez, Maria Jose; Simón, Carlos; Pellicer, Antonio

2014-01-01

35

Surgical Management of the Cesarean Scar Ectopic Pregnancy: A Case Report  

PubMed Central

Cesarean scar pregnancy is one of the rarest forms of ectopic pregnancy. Little is known about its incidence and natural history. The diagnosis and treatment of cesarean scar pregnancy (CSP) is challenging. The authors reported here a case of cesarean scar pregnancy (CSP) with hypovolemic shock that underwent emergency laparotomy with resection of ectopic mass. The patient was discharged from the hospital without any complications. PMID:24455350

Nankali, Anisodowleh; Ataee, Mina; Shahlazadeh, Haleh; Daeichin, Sara

2013-01-01

36

Ectopic pregnancy within a cesarean scar resulting in live birth: a case report.  

PubMed

Implantation of an embryo within the scar of a previous cesarean delivery is one of the rare forms of ectopic pregnancy (EP). There are two types of such pregnancies:   type 1, in which the embryo starts to progress towards the uterine cavity and may result in live birth despite the high risk of a hemorrhage occurring during birth, and type 2, which consists of pregnancies in which the embryo is embedded deep within the cesarean scar (CS) and grows towards the bladder and abdominal cavity, which is very dangerous and needs to be terminated immediately. There are very few cases in the literature reporting live birth as a result of such pregnancies. Here, we present a 41-year-old single gravid woman who had been treated for infertility at our institute and had eventually conceived through embryonic transfer freezing. At six weeks, a transvaginal scan showed the presence of an EP within the CS but despite this finding the pregnancy was continued to term. PMID:24206413

Ahmadi, Firoozeh; Moinian, Deena; Pooransari, Parichehr; Rashidi, Zohreh; Haghighi, Hadieh

2013-11-01

37

Right ampullary ectopic pregnancy following bilateral tubal ligation using spring clips.  

PubMed

Pregnancy is unlikely to occur in women who have undergone sterilization. However when it occurs, there is a substantial risk that it will be an ectopic pregnancy. We report a case of right unruptured ampullary ectopic gestation following tubal sterilization with spring clips 6 years prior to presentation. The likely aetiology may be spontaneous reanastomosis. PMID:25161421

Obajimi, G O; Balogun, F O; Nwose, U; Obajimi, O M

2013-12-01

38

Do Religious Restrictions Influence Ectopic Pregnancy Management? A National Qualitative Study  

Microsoft Academic Search

IntroductionIn the United States, ectopic pregnancies are relatively common and associated with significant maternal morbidity and mortality. The Ethical and Religious Directives for Catholic Health Care Services (the Directives) govern the provision of care in Catholic-affiliated hospitals and prohibit the provision of abortion in almost all circumstances. Although ectopic pregnancies are not viable, some Catholic ethicists have argued that the

Angel M. Foster; Amanda Dennis; Fiona Smith

2011-01-01

39

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

2014-01-01

40

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

2014-01-01

41

A Case of Fallopian Tube Adenofibroma: Difficulties Associated with Differentiation from Ectopic Pregnancy  

PubMed Central

Benign solid tumors of the fallopian tubes are extremely rare and often difficult to differentiate from tumors associated with adjacent organs or from various inflammatory diseases. Here, we present a patient who was diagnosed with ectopic pregnancy, based on preoperative tests and intraoperative macroscopic findings, but was later diagnosed with a fallopian tube adenofibroma, based on histopathological evidence, and intrauterine pregnancy. Although initial pregnancy test results were positive, no gestational sac (GS) was seen in the uterus and the patient was diagnosed with an ectopic pregnancy and underwent emergency laparoscopic surgery. A 20-mm, fetus-like solid mass was noted inside the GS-like cystic tumor of the left fallopian tube. From histopathological findings, the lesion was identified as a serous fallopian tube adenofibroma. The baby was born healthy with no problems. This case report suggests that fallopian tube adenofibroma should be considered in the differential diagnosis of suspected ectopic pregnancies. PMID:25525402

Fukushima, Akimune; Shoji, Tadahiro; Tanaka, Shino; Sugiyama, Toru

2014-01-01

42

The expression of IL-6R? and Gp130 in fallopian tubes bearing an ectopic pregnancy.  

PubMed

Women with tubal ectopic pregnancies have high levels of circulating interleukin 6 (IL-6). IL-6 treatment in vitro significantly reduces the ciliary activity of tubal epithelium. The effects of IL-6 on target cells occur via the formation of a high-affinity complex with its receptors IL-6R? and glycoprotein 130 (Gp130). IL-6R? is specifically expressed in the cilia of the epithelial cells. In this study, we performed a quantitative reverse transcriptase polymerase chain reaction to determine the mRNA expression of IL-6R? and Gp130 in the fallopian tubes obtained from 12 women with ectopic pregnancies, 12 women with normal pregnancies, and 12 healthy nonpregnant women in the luteal phase of their menstrual cycle. Fallopian tubes were evaluated from specimens taken during tubal ligation in normal pregnancies and nonpregnant fertile women or during tubal surgery in ectopic pregnancies. We observed that IL-6R? mRNA expression in fallopian tubes was increased in ectopic pregnancy compared with that in the midluteal phase. We also found that the Gp130 mRNA expression was significantly lower in fallopian tubes from ectopic pregnancies than in those from nonpregnant women during the midluteal phase of their menstrual cycle, although its expression was noticeably high in fallopian tubes in the midluteal phase, which suggests that high Gp130 levels may possibly contribute to embryo transport into the uterus. PMID:24179692

Yousefian, Elham; Novin, Marefat Ghaffari; Fathabadi, Fateme Fadaei; Farahani, Reza Mastery; Kachouei, Emadeddin Yazdani

2013-09-01

43

Risk factors for ectopic pregnancy: A case–control study  

PubMed Central

Background: Ectopic pregnancy (EP) is a condition presenting as a major health problem for women of childbearing age. This study aimed to identify potential risk factors for EP and to evaluate the contribution of the risk factors associated to EP. Materials and Methods: This retrospective nested case–control study was conducted from 2006 to 2011. In case group, there were a total of 83 women diagnosed with EP, while in the control group; there was a total of 340 women who gave birth. The basic recorded information included surgical, gynecological, obstetrics, sexual, contraceptive, and infectious histories; demographic characteristics; smoking habits; fertility markers; as well as reproductive outcome after EP. The association between EP and the factors studied was analyzed by logistic regression. Results: The findings reveal that the following factors were associated with increased risk of EP, including: Maternal age (odds ratio [OR] =1.11, confidence interval [CI] [1.06–1.16], P < 0.0001), spouse's cigarette smoking (OR = 1.73, CI [1.05–2.85], P = 0.02), gravidity (OR = 1.50, CI [1.25–1.80], P < 0.0001), prior spontaneous abortions (OR = 1.93, CI [1.11–3.36], P = 0.01), history of EP (OR = 17.16, CI [1.89–155.67], P = 0.01), tubal blockage (OR = 10.85, CI [2.02–58.08], P = 0.01), use of intrauterine device (IUD) (OR = 4.39, CI [1.78–10.81], P = 0.001), tubal damage (OR = 2.704, CI [1.26–5.78], P = 0.01), first pregnancy interval (OR = 1.01, CI [1.00–1.02], P < 0.0001) and history of infertility (OR = 6.13, CI [2.70–13.93], P < 0.0001). Conclusion: By identifying risk factors being amenable to modification, such as cigarette smoking and use of IUD and first pregnancy interval the effective risk-reduction strategies can be devised.

Moini, Ashraf; Hosseini, Reihaneh; Jahangiri, Nadia; Shiva, Marzieh; Akhoond, Mohammad Reza

2014-01-01

44

Bilateral septic knee arthritis after treatment of an ectopic pregnancy with methotrexate  

PubMed Central

We describe a case of bilateral septic knee arthritis that followed the administration of methotrexate for nonsurgical termination of an ectopic pregnancy. We believe that methotrexate is a relatively effective alternative to surgery in patients with early unruptured tubal pregnancies, but suggest that it be used with caution in view of possible septic events. PMID:25610005

Karaaslan, Fatih; Mermerkaya, Musa U?ur; Yurdakul, Emre; Tan?n, Özlem

2015-01-01

45

Long-term effects of cesarean sections: Ectopic pregnancies and placental problems  

Microsoft Academic Search

OBJECTIVE: Few studies on the long-term effects of cesarean sections exist. The purpose of this study was to investigate the occurrence of three long-term effects, ectopic pregnancy, placenta previa, and abruptio placentae, in the subsequent pregnancy. STUDY DESIGN: This retrospective cohort study was based on two nationwide registers in Finland: the birth register and the hospital inpatient register. Women (n

Elina Hemminki; Jouni Meriläinen

1996-01-01

46

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

1996-01-01

47

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

48

Is adverse pregnancy outcome predictable after blunt abdominal trauma?  

Microsoft Academic Search

Objective: The aim of the study was to evaluate the following: (1) pregnancy outcome after blunt abdominal trauma and (2) factors that may predict preterm birth and adverse peripartum outcomes. Study Design: All women who had noncatastrophic abdominal trauma and came to the labor and delivery suite July 1994-August 1997 were prospectively evaluated and admitted for continuous uterine and fetal

Lisa Leone Pak; E. Albert Reece; Linda Chan

1998-01-01

49

Rare association of ovarian implantation site for patients with heterotopic and with primary ectopic pregnancies after ICSI and blastocyst transfer  

Microsoft Academic Search

Two cases of patients with ruptured ovarian pregnancies (P1 ovarian heterotopic and P2 primary ovarian ectopic) after intracytoplasmic sperm injection and blastocyst transfer are presented. Laparoscopy was performed on day 40 and day 27 after transfer in cases P1 and P2 respectively. In both cases the ectopic pregnancies were located on the left ovary and were successfully removed by laparoscopy

Flavio Garcia Oliveira; Vicente Abdelmassih; AndreLuiz Eigenheer Costa; JosePedro Balmaceda; Soraya Abdelmassih; Roger Abdelmassih

50

Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases  

Microsoft Academic Search

BACKGROUND: Several risk factors for ectopic pregnancy (EP) have been identified, but the site of implantation of EP has been little studied. METHODS: A total of 1800 surgically treated EP was registered between January 1992 and December 2001 in the Auvergne EP register and the women concerned were followed up. In this large population-based sample, we studied the distribution of

J. Bouyer; J. Coste; H. Fernandez; J. L. Pouly; N. Job-Spira

2002-01-01

51

Rare association of ovarian implantation site for patients with heterotopic and with primary ectopic pregnancies after ICSI and blastocyst transfer.  

PubMed

Two cases of patients with ruptured ovarian pregnancies (P1 = ovarian heterotopic and P2 = primary ovarian ectopic) after intracytoplasmic sperm injection and blastocyst transfer are presented. Laparoscopy was performed on day 40 and day 27 after transfer in cases P1 and P2 respectively. In both cases the ectopic pregnancies were located on the left ovary and were successfully removed by laparoscopy preserving the ovaries. In case P1 the intrauterine pregnancy was not affected. A healthy boy was born after 37 weeks of pregnancy. In this way, potential fertility of the patients and the intrauterine pregnancy were maintained. These cases occurred during a series of blastocyst transfers in which 129 pregnancies were obtained. There were no cases of ovarian ectopic/heterotopic pregnancies from January 1996 to September 1999 in 814 pregnancies obtained from day 2 or day 3 embryo transfers. Because the ovarian ectopic pregnancies occurred in patients with day 5 embryo transfer who otherwise did not have any predisposing factors for ectopic pregnancy, it is advisable to conduct a large scale analysis of future data about the possible association between blastocyst-stage embryo transfer and the somewhat higher risk of unexpected complications of clinical outcome. PMID:11574520

Oliveira, F G; Abdelmassih, V; Costa, A L; Balmaceda, J P; Abdelmassih, S; Abdelmassih, R

2001-10-01

52

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

2014-01-01

53

Ectopic Pregnancy Among American Indian and Alaska Native Women, 2002-2009.  

PubMed

To examine rates of ectopic pregnancy (EP) among American Indian and Alaska Native (AI/AN) women aged 15-44 years seeking care at Indian Health Service (IHS), Tribal, and urban Indian health facilities during 2002-2009. We used 2002-2009 inpatient and outpatient data from the IHS National Patient Information Reporting System to identify EP-associated visits and obtain the number of pregnancies among AI/AN women. Repeat visits for the same EP were determined by calculating the interval between visits; if more than 90 days between visits, the visit was considered related to a new EP. We identified 229,986 pregnancies among AI/AN women 15-44 years receiving care at IHS-affiliated facilities during 2002-2009. Of these, 2,406 (1.05 %) were coded as EPs, corresponding to an average annual rate of 10.5 per 1,000 pregnancies. The EP rate among AI/AN women was lowest in the 15-19 years age group (5.5 EPs per 1,000 pregnancies) and highest among 35-39 year olds (18.7 EPs per 1,000 pregnancies). EP rates varied by geographic region, ranging between 6.9 and 24.4 per 1,000 pregnancies in the Northern Plains East and the East region, respectively. The percentage of ectopic pregnancies found among AI/AN women is within the national 1-2 % range. We found relatively stable annual rates of EP among AI/AN women receiving care at IHS-affiliated facilities during 2002-2009, but considerable variation by age group and geographic region. Coupling timely diagnosis and management with public health interventions focused on tobacco use and sexually transmitted diseases may provide opportunities for reducing EP and EP-associated complications among AI/AN women. PMID:25023759

de Ravello, Lori; Folkema, Arianne; Tulloch, Scott; Taylor, Melanie; Reilley, Brigg; Hoover, Karen; Holman, Robert; Creanga, Andreea

2014-07-15

54

A unique case of ruptured ectopic pregnancy in a patient with negative preg-nancy test - a case report and brief review of the literature  

PubMed Central

Introduction: Despite the major advances made in the diagnosis and management of ectopic pregnancies in the last two decades, an accurate diagnosis can sometimes still be quite challenging, since it relies on the combination of ultrasound findings and serial serum beta-human chorionic gonadotrophin (?-hCG) measurements. Case presentation: This paper describes the case of a 36-year-old woman of Caucasian origin who was admitted to the emergency department of our clinic with clinical symptoms of hemorrhagic shock in combination with two negative pregnancy tests done by her at home and a negative urine test which was performed on her admission to the hospital. Quantitative measurement of ?-hCG in the serum of the patient was 13 mIU/mL. On admission, right tubal pregnancy was diagnosed on ultrasound and she underwent an emergency laparotomy due to signs of hemodynamic shock. Conclusion: It is sometimes a considerable challenge to identify a patient with an ectopic pregnancy at risk of rupture. This case of ectopic pregnancy which was followed by a negative pregnancy test illustrates the magnitude of the difficulties involved in the diagnosis of ectopic pregnancy. It also demonstrates the need to maintain a high clinical index of suspicion and to undertake careful clinical examination of the patient on the basis of the clinician's diagnostic research. Hippokratia 2014; 18 (3): 282-284. PMID:25694767

Daniilidis, A; Pantelis, A; Makris, V; Balaouras, D; Vrachnis, N

2014-01-01

55

Life-threatening complications following multidose methotrexate for medical management of ectopic pregnancy.  

PubMed

A 25-year-old primigravida was diagnosed to be suffering from unruptured ectopic pregnancy. The serum ?-human chorionic gonadotropin levels were 2851 mIU/l and the ectopic gestational sac was 2.7×2.7 cm without any fetal pole. It was decided to manage her by expectant therapy. But she received medical therapy with multidose methotrexate because of misinterpretation of expectant therapy as medical therapy. She suffered from methotrexate toxicity, which manifested as high-grade fever, vomiting, melena, oral ulcerations, pneumonitis, subconjunctival haemorrhages and skin pigmentation. She developed severe third space fluid collection and shock, which was mistaken for rupture ectopic gestation. Her haematological picture showed severe neutropaenia and thrombocytopaenia which confirmed the clinical picture to be due to methotrexate toxicity. She also developed septicaemia and candidal infection secondary to immunosuppression. She was managed in intensive care unit with ventilatory support, high-dose leucovorin and injection filgastrim. She responded well to the therapy with dramatic recovery in 4 days. PMID:22922914

Dasari, Papa; Sagili, Haritha

2012-01-01

56

Ectopic Pregnancy  

MedlinePLUS

... transmitted diseases • Prior tubal surgery (such as tubal sterilization ) Other factors that increase a woman’s risk of ... eggs released at ovulation and produces hormones. Tubal Sterilization: A method of female sterilization in which the ...

57

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

2011-01-01

58

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

2012-01-01

59

The regulation of nitric oxide synthase isoform expression in mouse and human fallopian tubes: potential insights for ectopic pregnancy.  

PubMed

Nitric oxide (NO) is highly unstable and has a half-life of seconds in buffer solutions. It is synthesized by NO-synthase (NOS), which has been found to exist in the following three isoforms: neuro nitric oxide synthase (nNOS), inducible nitric oxide synthase (iNOS), and endothelial nitric oxide synthase (eNOS). NOS activity is localized in the reproductive tracts of many species, although direct evidence for NOS isoforms in the Fallopian tubes of mice is still lacking. In the present study, we investigated the expression and regulation of NOS isoforms in the mouse and human Fallopian tubes during the estrous and menstrual cycles, respectively. We also measured isoform expression in humans with ectopic pregnancy and in mice treated with lipopolysaccharide (LPS). Our results confirmed the presence of different NOS isoforms in the mouse and human Fallopian tubes during different stages of the estrous and menstrual cycles and showed that iNOS expression increased in the Fallopian tubes of women with ectopic pregnancy and in LPS-treated mice. Elevated iNOS activity might influence ovulation, cilia beats, contractility, and embryo transportation in such a manner as to increase the risk of ectopic pregnancy. This study has provided morphological and molecular evidence that NOS isoforms are present and active in the human and mouse Fallopian tubes and suggests that iNOS might play an important role in both the reproductive cycle and infection-induced ectopic pregnancies. PMID:25546387

Hu, Junting; Ma, Shulan; Zou, Sien; Li, Xin; Cui, Peng; Weijdegård, Birgitta; Wu, Gencheng; Shao, Ruijin; Billig, Håkan; Feng, Yi

2014-01-01

60

The Regulation of Nitric Oxide Synthase Isoform Expression in Mouse and Human Fallopian Tubes: Potential Insights for Ectopic Pregnancy  

PubMed Central

Nitric oxide (NO) is highly unstable and has a half-life of seconds in buffer solutions. It is synthesized by NO-synthase (NOS), which has been found to exist in the following three isoforms: neuro nitric oxide synthase (nNOS), inducible nitric oxide synthase (iNOS), and endothelial nitric oxide synthase (eNOS). NOS activity is localized in the reproductive tracts of many species, although direct evidence for NOS isoforms in the Fallopian tubes of mice is still lacking. In the present study, we investigated the expression and regulation of NOS isoforms in the mouse and human Fallopian tubes during the estrous and menstrual cycles, respectively. We also measured isoform expression in humans with ectopic pregnancy and in mice treated with lipopolysaccharide (LPS). Our results confirmed the presence of different NOS isoforms in the mouse and human Fallopian tubes during different stages of the estrous and menstrual cycles and showed that iNOS expression increased in the Fallopian tubes of women with ectopic pregnancy and in LPS-treated mice. Elevated iNOS activity might influence ovulation, cilia beats, contractility, and embryo transportation in such a manner as to increase the risk of ectopic pregnancy. This study has provided morphological and molecular evidence that NOS isoforms are present and active in the human and mouse Fallopian tubes and suggests that iNOS might play an important role in both the reproductive cycle and infection-induced ectopic pregnancies. PMID:25546387

Hu, Junting; Ma, Shulan; Zou, Sien; Li, Xin; Cui, Peng; Weijdegård, Birgitta; Wu, Gencheng; Shao, Ruijin; Billig, Håkan; Feng, Yi

2014-01-01

61

Intact removal of spontaneous twin ectopic Caesarean scar pregnancy by office hysteroscopy: case report and literature review.  

PubMed

Caesarean scar pregnancy is a dangerous condition that occurs when an embryo is implanted in a previous Caesarean scar. This condition has become more frequent as a direct consequence of the increased number of Caesarean sections reported worldwide. Timely diagnosis of this condition is fundamental, and allows a conservative approach to preserving fertility. A wide range of medical and surgical strategies has been described, with no consensus on preferred management. Recently, hysteroscopic surgery has been proposed as a conservative strategy, with interesting results in reproductive outcome, postoperative course and success rate. Most cases of Caesarean scar pregnancy reported worldwide involve a singleton pregnancy. A peculiar case of fully documented office hysteroscopic removal of twin Caesarean scar pregnancy is presented in this paper. This procedure took place in a tertiary care university hospital without cervix dilatation, under conscious sedation, after failure of systemic methotrexate administration. Complete removal of the ectopic pregnancy was obtained without intra- and postoperative complications. PMID:25246120

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

2014-11-01

62

Term extrauterine pregnancy in a Nigerian mother: a complication of uterine dehiscence.  

PubMed

Abdominal pregnancy is an uncommon but life-threatening form of ectopic pregnancy. It is associated with high maternal/fetal morbidity and mortality. We present a rare case of term abdominal pregnancy resulting from anterior uterine wall dehiscence, in a 36-year-old woman with three previous caesarean sections. The diagnosis was made at laparotomy for the fourth "caesarean section". PMID:18449557

Adesiyun, Adebiyi Gbadebo; Audu, Aveka Ishaq

2009-01-01

63

Transvaginal sonography as the ultimate diagnostic tool for the management of ectopic pregnancy: experience with 840 cases  

Microsoft Academic Search

Objective: To evaluate the efficacy of transvaginal sonography and serum?-hCG levels as diagnostic tools for deciding whether to perform operative laparoscopy in the treatment of presumed ectopic pregnancy (EP).Design: A prospective protocol for the evaluation and treatment of women with presumed EP.Setting: Department of Obstetrics and Gynecology, Haemek Medical Center, Afula, Israel.Patient(s): Eight hundred forty women with presumed EP who

Eliezer Shalev; Ilan Yarom; Moshe Bustan; Ehud Weiner; Izhar Ben-Shlomo

1998-01-01

64

Contraceptive Use and the Risk of Ectopic Pregnancy: A Multi-Center Case-Control Study  

PubMed Central

Objective To evaluate the association between the risk of ectopic pregnancy (EP) and the use of common contraceptives during the previous and current conception/menstrual cycle. Methods A multi-center case-control study was conducted in Shanghai. Women diagnosed with EP were recruited as the case group (n?=?2,411). Women with intrauterine pregnancy (IUP) (n?=?2,416) and non-pregnant women (n?=?2,419) were matched as controls at a ratio of 1?1. Information regarding the previous and current use of contraceptives was collected. Multivariate logistic regression analyses were performed to calculate odds ratios (ORs) and the corresponding 95% confidential intervals (CIs). Results Previous use of intrauterine devices (IUDs) was associated with a slight risk of ectopic pregnancy (AOR1?=?1.87 [95% CI: 1.48–2.37]; AOR2?=?1.84 [1.49–2.27]), and the risk increased with the duration of previous use (P1 for trend <10?4, P2 for trend <10?4). The current use of most contraceptives reduced the risk of both unwanted IUP (condom: AOR?=?0.04 [0.03–0.05]; withdrawal method: AOR?=?0.10 [0.07–0.13]; calendar rhythm method: AOR?=?0.54 [0.40–0.73]; oral contraceptive pills [OCPs]: AOR?=?0.03 [0.02–0.08]; levonorgestrel emergency contraception [LNG-EC]: AOR?=?0.22 [0.16–0.30]; IUDs: AOR?=?0.01 [0.005–0.012]; tubal sterilization: AOR?=?0.01 [0.001–0.022]) and unwanted EP (condom: AOR1?=?0.05 [0.04–0.06]; withdrawal method: AOR1?=?0.13 [0.09–0.19]; calendar rhythm method: AOR1?=?0.66 [0.48–0.91]; OCPs: AOR1?=?0.14 [0.07–0.26]; IUDs: AOR1?=?0.17 [0.13–0.22]; tubal sterilization: AOR1?=?0.04 [0.02–0.08]). However, when contraception failed and pregnancy occurred, current use of OCPs (AOR2?=?4.06 [1.64–10.07]), LNG-EC (AOR2?=?4.87 [3.88–6.10]), IUDs (AOR2?=?21.08 [13.44–33.07]), and tubal sterilization (AOR2?=?7.68 [1.69–34.80]) increased the risk of EP compared with the non-use of contraceptives. Conclusion Current use of most contraceptives reduce the risk of both IUP and EP. However, if the contraceptive method fails, the proportions of EP may be higher than those of non-users. In the case of contraceptive failure in the current cycle, EP cases should be differentiated according to current use of OCPs, LNG-EC, IUDs, and tubal sterilization. In addition, attention should be paid to women with previous long-term use of IUDs. PMID:25493939

Meng, Chun-Xia; Ping, Hua; Qin, Guo-Juan; Cao, Shu-Jun; Xi, Xiaowei; Zhu, Qian; Li, Xiao-Cui; Zhang, Jian

2014-01-01

65

Predictors of Success of Different Treatment Modalities for Management of Ectopic Pregnancy  

PubMed Central

Aim. The purpose of this study was to investigate factors affecting the success of different treatment modalities for the management of ectopic pregnancy (EP). Methods. One hundred and ninety-seven patients with EP, were included in the study. Patients were treated with either intramuscular methotrexate (Mtx) or surgical treatment. Results. Mtx was applied in 97 (49.2%) patients. In 67 patients (69.1%), a single dose of Mtx and in 30 patients (30.9%) a multiple dose of Mtx was applied. Forty-seven (70.14%) patients were successfully treated with a single-dose Mtx. In the multiple-dose group, the success rate was 70% (21/30 patients). The difference between the success rates was not statistically significant. When the initial serum ?hCG value was <1000?mIU/mL, the overall success rate of Mtx treatment was determined to be 86.11%; however, the rate decreased to 42.3% when the ?hCG value was >3000?mIU/mL. On the other hand, if the EP mass diameter was <25?mm, the success rate was 89.28% and decreased to 52.63% when it was ?25?mm. Conclusion. The results of the study showed that single-dose treatment with Mtx could be as successful as multiple doses. Overall success of Mtx treatment depended on initial ?hCG value and EP mass diameter. PMID:25580127

Avcio?lu, Sümeyra Nergiz; Altinkaya, Sündüz Özlem; Küçük, Mert; Yüksel, Hasan

2014-01-01

66

Low-back pain in pregnancy. Abdominal muscles, sit-up performance, and back pain.  

PubMed

An attempt was made to determine the effect of pregnancy on the abdominal muscles and to correlate changes in abdominal muscles strength with low-back pain during pregnancy. The study included 328 women. Group A consisted of 164 pregnant women; group B consisted of 164 non-pregnant women. The race, age, height, weight, parity, profession, time devoted to physical fitness per week, abdominal length, and relation between the abdominal length to height were recorded. A detailed history relating to backache prior to and during pregnancy was obtained. Each woman was asked to perform a single sit-up. The results of the study indicate that about 10% of pregnant women develop severe low-back pain that interferes with daily life activities. About 49% of the non-pregnant women complained of LBP. The pain did not interfere with activities of daily living. During pregnancy, due to overstretching of the abdominal muscles, the ability to perform a sit-up is significantly decreased. Whereas all non-pregnant women could perform a sit-up, 16.6% of pregnant women could not perform a single sit-up. There was no statistically significant correlation between the sit-up performance and backache. It may be concluded that during pregnancy the abdominal muscles become insufficient. PMID:2139238

Fast, A; Weiss, L; Ducommun, E J; Medina, E; Butler, J G

1990-01-01

67

Cesarean Section and Rate of Subsequent Stillbirth, Miscarriage, and Ectopic Pregnancy: A Danish Register-Based Cohort Study  

PubMed Central

Background With cesarean section rates increasing worldwide, clarity regarding negative effects is essential. This study aimed to investigate the rate of subsequent stillbirth, miscarriage, and ectopic pregnancy following primary cesarean section, controlling for confounding by indication. Methods and Findings We performed a population-based cohort study using Danish national registry data linking various registers. The cohort included primiparous women with a live birth between January 1, 1982, and December 31, 2010 (n?=?832,996), with follow-up until the next event (stillbirth, miscarriage, or ectopic pregnancy) or censoring by live birth, death, emigration, or study end. Cox regression models for all types of cesarean sections, sub-group analyses by type of cesarean, and competing risks analyses for the causes of stillbirth were performed. An increased rate of stillbirth (hazard ratio [HR] 1.14, 95% CI 1.01, 1.28) was found in women with primary cesarean section compared to spontaneous vaginal delivery, giving a theoretical absolute risk increase (ARI) of 0.03% for stillbirth, and a number needed to harm (NNH) of 3,333 women. Analyses by type of cesarean section showed similarly increased rates for emergency (HR 1.15, 95% CI 1.01, 1.31) and elective cesarean (HR 1.11, 95% CI 0.91, 1.35), although not statistically significant in the latter case. An increased rate of ectopic pregnancy was found among women with primary cesarean overall (HR 1.09, 95% CI 1.04, 1.15) and by type (emergency cesarean, HR 1.09, 95% CI 1.03, 1.15, and elective cesarean, HR 1.12, 95% CI 1.03, 1.21), yielding an ARI of 0.1% and a NNH of 1,000 women for ectopic pregnancy. No increased rate of miscarriage was found among women with primary cesarean, with maternally requested cesarean section associated with a decreased rate of miscarriage (HR 0.72, 95% CI 0.60, 0.85). Limitations include incomplete data on maternal body mass index, maternal smoking, fertility treatment, causes of stillbirth, and maternally requested cesarean section, as well as lack of data on antepartum/intrapartum stillbirth and gestational age for stillbirth and miscarriage. Conclusions This study found that cesarean section is associated with a small increased rate of subsequent stillbirth and ectopic pregnancy. Underlying medical conditions, however, and confounding by indication for the primary cesarean delivery account for at least part of this increased rate. These findings will assist women and health-care providers to reach more informed decisions regarding mode of delivery. Please see later in the article for the Editors' Summary PMID:24983970

O'Neill, Sinéad M.; Agerbo, Esben; Kenny, Louise C.; Henriksen, Tine B.; Kearney, Patricia M.; Greene, Richard A.; Mortensen, Preben Bo; Khashan, Ali S.

2014-01-01

68

Inflammation of ectopic pancreatic tissue in a Meckel's diverticulum causing acute abdominal symptoms: a case report and review of the literature.  

PubMed

An unusual case of acute abdomen was caused by the inflammation of ectopic pancreatic tissue in a Meckel's diverticulum. A 49-year-old man presented with acute abdominal pain, and the clinical diagnosis of acute appendicitis was established. During laparotomy, a normal appendix of unusual localization near the gallbladder and a Meckel's diverticulum with an inflamed tip were found. Histological examination showed acute inflammation of heterotopic pancreatic tissue along with normal ectopic gastric and duodenal mucosa within the wall of the diverticulum. Fat necrosis was also ascertained. The authors believe that this is the first report of acute inflammation of ectopic pancreatic tissue and the presence of normal ectopic gastric and duodenal tissue in the same Meckel's diverticulum. PMID:19223375

Zarand, Attila; Bajtai, Attila; Baranyai, Zsolt; Dede, Kristof; Jakab, Ferenc

2011-06-01

69

Secondary abdominal pregnancy and its associated diagnostic and operative dilemma: three case reports  

PubMed Central

Introduction Abdominal pregnancy is extremely rare and has historically been defined as an implantation in the peritoneal cavity, exclusive of tubal, ovarian or intraligamentary pregnancy. Case presentations Three cases are reported. All came from a lower middle-income group and all of them were subjected to surgery. The first patient was a 30-year-old woman, who was pregnant for the fourth time, who presented at 16 weeks with an abdominal pregnancy. She was admitted with constant abdominal pain and retention of urine. She was hemodynamically stable and was administered a pre-operative intramuscular injection of methotrexate. During laparotomy she had only minor blood loss, the major part of the placenta was removed easily and she did not require any blood transfusion. Serum beta human chorionic gonadotrophin values and ultrasound follow-up revealed a normal study four weeks after surgery. The second patient was a 26-year-old woman, pregnant for the third time, admitted at 14 weeks with an abdominal pregnancy with hemoperitoneum, and the third patient was a 24-year-old woman, pregnant for the first time, who presented at 36 weeks gestation. She was only diagnosed as having an abdominal pregnancy during surgery, experienced excessive blood loss and required a longer hospital stay. Conclusions We hypothesize that treatment with pre-operative systemic methotrexate with subsequent laparotomy for removal of the fetus and placenta may minimize potential blood loss, and would be a reasonable approach in the care of a patient with an abdominal pregnancy with placental implantation to the abdominal viscera and blood vessels. This treatment option should be considered in the management of this potentially life-threatening condition. During surgery, if the placenta is attached to vital organs it should be left behind. Early diagnosis can help in reducing associated maternal morbidity and mortality. PMID:19830195

2009-01-01

70

The value of a single combined measurement of VEGF, glycodelin, progesterone, PAPP-A, HPL and LIF for differentiating between ectopic and abnormal intrauterine pregnancy  

Microsoft Academic Search

BACKGROUND: To evaluate whether serum concentrations of the non-placental markers vascular endothelial growth factor (VEGF), glycodelin (GLY) and progesterone (P) and the novel placental markers pregnancy-associated plasmaprotein A (PAPP-A), human placental lactogen (HPL) and leukaemia inhibiting factor (LIF) differ in ectopic pregnancy (EP) when compared with abnormal intrauterine pregnancy (aIUP). METHODS: A prospective clinical study was conducted at the University

A. Daponte; S. Pournaras; E. Zintzaras; A. Kallitsaris; G. Lialios; A. N. Maniatis; I. E. Messinis

2005-01-01

71

Secondary abdominal pregnancy and its associated diagnostic and operative dilemma: three case reports  

Microsoft Academic Search

INTRODUCTION: Abdominal pregnancy is extremely rare and has historically been defined as an implantation in the peritoneal cavity, exclusive of tubal, ovarian or intraligamentary pregnancy. CASE PRESENTATIONS: Three cases are reported. All came from a lower middle-income group and all of them were subjected to surgery. The first patient was a 30-year-old woman, who was pregnant for the fourth time,

Pratiksha Gupta; Alka Sehgal; Anju Huria; Reeti Mehra

2009-01-01

72

42 CFR 50.308 - Drugs and devices and termination of ectopic pregnancies.  

Code of Federal Regulations, 2013 CFR

... Federal financial participation is available with respect to the cost of drugs or devices to prevent implantation of the fertilized ovum, and for medical procedures necessary for the termination of an ectopic...

2013-10-01

73

Localization and significance of urokinase plasminogen activator and its receptor in placental tissue from intrauterine, ectopic and molar pregnancies.  

PubMed

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 the localization of uPA and uPAR in a prospective design with stereological sampling of fetal and maternal tissue from normal, ectopic and hydatidiform molar (HM) pregnancies. Cytokeratin and Ki67 were used as markers for trophoblasts and proliferating cells. Membrane-bound uPAR was observed on villous non-proliferating intermediate trophoblasts (IT) within cell columns in intrauterine and ectopic pregnancies. The corresponding proliferating IT with cytological atypia sprouting from the chorionic villi in HM was uPAR-negative. uPA but not uPAR was observed in anchoring distal IT at the attachment-point to the basal plate. In the placental bed, extravillous interstitial trophoblasts were uPA-positive but uPAR-negative. The trophoblast giant cells were both uPA- and uPAR-negative. In relation to the maternal vessels, a focal distribution for uPA and uPAR was present in the endovascular and perivascular trophoblasts. The intraluminal trophoblasts overlying endothelial cells were uPAR-positive only. In maternal tissue from intrauterine and molar pregnancies, uPAR was seen in the decidual cells in a zone facing the anchoring villi and the fibrinoid lesions with embedded trophoblasts. In contrast, the stromal cells of the fallopian tube without a decidual reaction facing the implanted gestation were uPAR-negative. Non-invaded decidual, myometrial and muscular tissue of the pregnant uterus and fallopian tube was extensively positive for uPA whereas 'pseudodecidual' cells from the intrauterine evacuate in patients with an ectopic pregnancy only showed a focal and scanty reaction for uPA. When trophoblast invasion of the decidua was present, the decidual cells were uPA-negative. A semi-quantitative assessment of the receptor was estimated in villous IT within cell columns in normal and molar pregnancies but, in conclusion, quantitative evaluation of uPAR cannot be used to predict development of post-molar persistent trophoblastic disease (PTD). PMID:10527826

Floridon, C; Nielsen, O; Holund, B; Sunde, L; Westergaard, J G; Thomsen, S G; Teisner, B

1999-11-01

74

Abdominal visceral adiposity influences CD4(+) T cell cytokine production in pregnancy.  

PubMed

Women with pre-gravid obesity are at risk for pregnancy complications. While the macrophage response of obese pregnant women categorized by body mass index (BMI) has been documented, the relationship between the peripheral CD4(+) T cell cytokine profile and body fat compartments during pregnancy is unknown. In this study, third trimester peripheral CD4(+) T cell cytokine profiles were measured in healthy pregnant women [n=35; pre-pregnancy BMI: 18.5-40]. CD4(+) T cells were isolated from peripheral blood mononuclear cells and stimulated to examine their capacity to generate cytokines. Between 1 and 3weeks postpartum, total body fat was determined by dual-energy X-ray absorptiometry and abdominal subcutaneous and visceral fat masses were determined by magnetic resonance imaging. Pearson's correlation was performed to assess relationships between cytokines and fat mass. Results showed that greater abdominal visceral fat mass was associated with a decrease in stimulated CD4(+) T cell cytokine expression. IFN-gamma, TNF-alpha, IL-12p70, IL-10 and IL-17A were inversely related to visceral fat mass. Chemokines CCL3 and IL-8 and growth factors G-CSF and FLT-3L were also inversely correlated. Additionally, total body fat mass was inversely correlated with FGF-2 while abdominal subcutaneous fat mass and BMI were unrelated to any CD4(+) T cell cytokine. In conclusion, lower responsiveness of CD4(+) T cell cytokines associated with abdominal visceral fat mass is a novel finding late in gestation. PMID:25458969

Ozias, Marlies K; Li, Shengqi; Hull, Holly R; Brooks, William M; Petroff, Margaret G; Carlson, Susan E

2015-02-01

75

Rate of Change of Serial ?–Human Chorionic Gonadotropin Values as a Predictor of Ectopic Pregnancy in Patients With Indeterminate Transvaginal Ultrasound Findings  

Microsoft Academic Search

Study objective: To determine the predictive value of the rate of change of serial ?–human chorionic gonadotropin (hCG) values in patients with symptoms suggestive of ectopic pregnancy but who have indeterminate transvaginal ultrasound findings, and to determine whether the predictive value was enhanced depending on whether the endometrial cavity was empty at ultrasound examination. Methods: A retrospective study was performed

Robert G Dart; Julie Mitterando; Linda M Dart

1999-01-01

76

Ectopic Pregnancy as a Model to Identify Endometrial Genes and Signaling Pathways Important in Decidualization and Regulated by Local Trophoblast  

PubMed Central

The endometrium in early pregnancy undergoes decidualization and functional changes induced by local trophoblast, which are not fully understood. We hypothesized that endometrium from tubal ectopic pregnancy (EP) could be interrogated to identify novel genes and pathways involved in these processes. Gestation-matched endometrium was collected from women with EP (n?=?11) and intrauterine pregnancies (IUP) (n?=?13). RNA was extracted from the tissue. In addition, tissues were prepared for histological analysis for degree of decidualization. We compared a) the samples from EP that were decidualized (n?=?6) with non-decidualized samples (n?=?5), and b) the decidualized EP (n?=?6) with decidualization-matched IUP (n?=?6) samples using an Affymetrix gene array platform, with Ingenuity Pathway Analysis, combined with quantitative RT-PCR. Expression of PRL and IGFBP1 was used to confirm the degree of decidualization in each group. There were no differences in PRL or IGFBP1 expression in the decidualization-matched samples but a marked reduction (P<0.001) in the non-decidualized samples. Decidualization was associated with increased expression of 428 genes including SCARA5 (181-fold), DKK1 (71-fold) and PROK1 (32-fold), and decreased expression of 230 genes including MMP-7 (35-fold) and SFRP4 (21-fold). The top canonical pathways associated with these differentially expressed genes were Natural Killer Cell and Wnt/b-Catenin signaling. Local trophoblast was associated with much less alteration of endometrial gene expression with an increase in 56 genes, including CSH1 (8-fold), and a reduction in 29 genes including CRISP3 (8-fold). The top associated canonical pathway was Antigen Presentation. The study of endometrium from tubal EP may promote novel insights into genes involved in decidualization and those influenced by factors from neighboring trophoblast. This has afforded unique information not highlighted by previous studies and adds to our understanding of the endometrium in early pregnancy. PMID:21858178

Burgess, Stewart; McDonald, Sarah E.; Critchley, Hilary O. D.; Horne, Andrew W.

2011-01-01

77

MAIN RESEARCH ARTICLE Ectopic pregnancy: using the hCG ratio to select women  

E-print Network

pregnancy, expectant management, methotrexate, transvaginal ultrasound, serum human chorionic gonadotrophin, transvaginal ultrasound scan. Introduction Historically, histological confirmation after visualization and Gynaecological Ultrasound Unit, St George's, University of London, UK, 2 Department of Electrical Engineering

78

Abdominal delivery in the intact amniotic sac in twin pregnancy.  

PubMed

Abstract Objective: There has been an increasing trend for Caesarean deliveries in twin pregnancies over the last decades; preferred mode of delivery is still unclear. The article presents the mode of twin delivery within intact amniotic sac. Methods: The intrapartum courses in 70 matched twin pairs extracted by Caesarean section were analysed. Neonates were distributed to two groups - main (delivered "en caul") and control (delivered by conventional Caesarean section) groups, and subdivided according to gestational age at the time of delivery: 28-30 weeks, 31-33 weeks and 34-37 weeks. Neonates delivered first and second were matched by pairs. Results: The duration of Caesarean section was higher in the main group (delivered "en caul"). Apgar score at 5-th min depend on the gestational age at birth and was higher in main group. Mechanical ventilation term and length of hospital stay were lower in main group. Postnatal neurological examination showed lower incidence of brain damage in the main group. During the first year of life, neonates extracted within intact amniotic sac showed lower morbidity rate. This was correct also for pairs of neonates matched by delivery order. Conclusions: Presented method improves neonates' Apgar score, reduces the need for resuscitation and influence of intrapartum negative factors. The length of hospital stay and hospitalisation rate for the first year of life were also lower in neonates delivered "en caul", providing an economical benefit. PMID:25308206

Radzinsky, Viktor; Akhmadeev, Nariman; Fatkullin, Ildar; Fatkullin, Farid

2014-11-01

79

Association between increased expression of endothelial isoform of nitric oxide synthase in the human fallopian tube and tubal ectopic pregnancy  

PubMed Central

Background: Tubal ectopic pregnancy (tEP) is the most common type of extra-uterine pregnancy and the most common cause of maternal mortality. Nitric oxide (NO) is a molecule that incorporates in many physiological processes of female reproductive system. Recent studies have demonstrated the possible role of endothelial isoform of nitric oxide synthase (eNOS) enzyme in the regulation of many reproductive events that occur in the fallopian tube (FT). Objective: The aim of this study was to evaluate the expression of eNOS in the FTs of women with tEP. Materials and Methods: In this case-control study, a total number of 30FTs samples were obtained from three groups including: 10 FTs of women that bearing an EP, 10 FTs from the non-pregnant women at luteal phase of the menstrual cycle, and 10 FTs of healthy pregnant women (n=10). Samples were fixed in 10% buffered formalin and then were evaluated by immunohistochemistry. Results: Localization of eNOS was seen in secretory and ciliated luminal epithelium and vascular endothelium of all groups. However, we did not observed the expression of eNOS in smooth muscle cells of all groups. Expression of eNOS in luminal epithelium of women with EP compared to non-pregnant women at luteal phase of menstrual cycle and healthy pregnant group showed statistically significant increase (p=0.00). Significant difference in expression of eNOS was not observed in luminal epithelium of FTs of women at luteal phase compared to healthy pregnant groups (p=0.78). Conclusion: This study indicates that changes in expression of eNOS in luminal epithelium of FT may lead to development of EP. This article extracted from M.Sc. thesis. (Leyla Fath Bayati) PMID:24799858

Fath Bayati, Leyla; Ghaffari Novin, Marefat; Fadaei Fathabadi, Fatemeh; Piryaei, Abbas; Heidari, Mohammad Hasan; Bandehpour, Mozhgan; Norouzian, Mohsen; Alizadeh Parhizgar, Mahdi; Shakooriyan Fard, Mahmood

2014-01-01

80

Primary Omental Pregnancy With Secondary Implantation Into Posterior Cul-de-sac: Laparoscopic Treatment Using Hemostatic Matrix.  

PubMed

Primary omental pregnancy is a rare form of ectopic pregnancy. Only a few reported cases have been treated using laparoscopy. Hemostasis after trophoblast removal can be challenging. A 25-year-old primigravida in week 8 of pregnancy was admitted to our hospital with a diagnosis of missed abortion. An ultrasound scan showed an empty uterine cavity and a gestational sac with a 15-mm embryo dorsal to the uterus, indicative of an ectopic pregnancy. The preoperative serum concentration of human chorionic gonadotropin was 33 600 U/mL. Laparoscopy was performed, which revealed an omental pregnancy invading the peritoneum of the Douglas pouch. After laparoscopic removal of the ectopic pregnancy with partial omentectomy, diffuse bleeding from the crater between both sacrouterine ligaments was treated using the gelatin-thrombin matrix (FloSeal). The final histologic analysis confirmed the omentum as the primary site of the ectopic pregnancy (multiple chorionic villi and decidua within the omental fat). The postoperative period was uneventful. This case expands the classic Studdiford criteria. Secondary peritoneal ectopic pregnancy implantation can occur not only after tubal rupture or expulsion of tubal ectopic pregnancy but also after primary implantation at any other ectopic site. The laparoscopic approach to abdominal pregnancy is safe and feasible if there is sufficient intraoperative hemostasis. The hemostatic matrix facilitates quick and effective control of bleeding. PMID:24973638

Watrowski, Rafa?; Lange, Annabel; Möckel, Jochen

2014-06-25

81

Evaluation of Plasma Creatine Phosphokinase (CPK) Level Following a Single Injection of Methotrexate as a Predicator of Treatment Success in Ectopic Pregnancy  

PubMed Central

Objective To evaluate the plasma creatine phosphokinase (CPK) level after a single injection of methotrexate (MTX) as a predictor of treatment success in ectopic pregnancy (EP). Materials and methods In this prospective study, seventy nine women older than 18 years treated with methotrexate for ectopic pregnancy were evaluated for CPK and ?-subunit of human chorionic gonadotropin (?hCG) levels, while they received intramuscular MTX at a dose of 50 mg/m2. The day of injection was considered as day 1 (D1). CPK level on D1 was compared between the group 1(as treatment success group), treated by a single MTX injection, and the group 2, treated by two or three MTX injections or by surgery. Results The success rate of MTX treatment was 58 (73.3%). The mean of CPK was higher in treatment success group (group1) than failure group (group 2) (71.98 ± 15.711 vs. 64.43 ± 15.898), but the difference was not significant (p=0.06). The mean of ?hCG was significantly lower in treatment success group (group 1) than failure group (group 2) (1187.52±631.45 vs. 1663.87±1096.845; p=0.01). Ultrasonographic findings of EP were seen in 63 patients, while the means of ?HCG and CPK were higher in these patients than those with normal ultrasonography, but difference was not significant (p=0.37 and p=0.24, respectively). Conclusion The sample was not large enough to indicate a significant difference in the CPK level, which can be considered as an indicator for differentiating between the successful and unsuccessful treatment groups. Moreover, the present study did not show any relation between initial ?-hCG and CPK serum levels, so our findings indicate that they are not possibly considered as two independent biomarkers in ectopic pregnancy. PMID:24971118

Safdarian, Leila; Aghahosseini, Marzieh; Alleyassin, Ashraf

2013-01-01

82

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)

2010-03-01

83

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. PMID:25276159

Kö?ü?, Ayd?n; Turhan, Nilgün

2014-01-01

84

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

2007-04-01

85

Ectopic/Tubal Pregnancy  

MedlinePLUS

... Can a fertilized egg survive outside of the uterus? No. A fertilized egg cannot live outside of the uterus. It needs space to grow and a source ... egg attaches itself to the inside of the uterus. The sac develops, but since there is no ...

86

Intra-Abdominal Pressure Measurements in Term Pregnancy and Postpartum: An Observational Study  

PubMed Central

Objective To determine intra-abdominal pressure (IAP) and to evaluate the reproducibility of IAP-measurements using the Foley Manometer Low Volume (FMLV) in term uncomplicated pregnancies before and after caesarean section (CS), relative to two different reference points and to non-pregnant values. Design Observational cohort study. Setting Secondary level referral center for feto-maternal medicine. Population Term uncomplicated pregnant women as the case-group and non-pregnant patients undergoing a laparoscopic assisted vaginal hysterectomy (LAVH) as control group. Methods IAP was measured in 23 term pregnant patients, before and after CS and in 27 women immediately after and 1 day after LAVH. The midaxillary line was used as zero-reference (IAPMAL) in all patients and in 13 CS and 13 LAVH patients, the symphysis pubis (IAPSP) was evaluated as additional zero-reference. Intraobserver correlation (ICC) was calculated for each zero-reference. Paired student's t-tests were performed to compare IAP values and Pearson's correlation was used to assess correlations between IAP and gestational variables. Main outcome measures ICC before and after surgery, IAP before and after CS, IAP after CS and LAVH. Results The ICC for IAPMAL before CS was lower than after (0.71 versus 0.87). Both mean IAPMAL and IAPSP were significantly higher before CS than after: 14.0±2.6 mmHg versus 9.8±3.0 mmHg (p<0.0001) and 8.2±2.5 mmHg versus 3.5±1.9 mmHg (p?=?0.010), respectively. After CS, IAP was not different from values measured in the LAVH-group. Conclusion IAP-measurements using FMLV is reproducible in pregnant women. Before CS, IAP is increased in the range of intra-abdominal hypertension for non-pregnant individuals. IAP significantly decreases to normal values after delivery. PMID:25117778

Staelens, Anneleen S. E.; Van Cauwelaert, Stefan; Tomsin, Kathleen; Mesens, Tinne; Malbrain, Manu L. N.; Gyselaers, Wilfried

2014-01-01

87

Atypical presentation of pseudoxanthoma elasticum with abdominal cutis laxa: evidence for a spectrum of ectopic calcification disorders?  

PubMed

A patient is presented with severe cutis laxa of the abdomen. Molecular investigations, including sequencing of the fibulin-5 and elastin gene, failed to endorse the diagnosis of inherited cutis laxa. Ultrasonographical discovery of renal calcifications during his general work-up suggested a possible diagnosis of pseudo-xanthoma elasticum (PXE). A discrete yellowish reticular pattern in the anterior neck region was detected upon careful clinical examination. Clinically, the patient presented characteristics of both classic PXE (retinopathy, renal calcifications) and the PXE-like syndrome (cutis laxa beyond the flexural areas). Skin biopsy and ophthalmological examination confirmed the diagnosis of PXE. In addition, ultrastructural evaluation revealed calcium deposits in the periphery of elastic fibers, a typical observation in the PXE-like syndrome. Immunohistochemical experiments and ELISA tests for various inhibitors of calcification displayed results which were partly reminiscent of both PXE and the PXE-like syndrome. Molecular analysis revealed not only two ABCC6 mutations (related to PXE), but also a gain of function SNP in the GGCX gene, in which loss-of-function mutations cause the PXE-like syndrome. We conclude that the patients phenotype and--to a further extent--the PXE-like syndrome, are part of a spectrum of ectopic calcification disorders which are clinically and/or pathogenetically related to PXE. The molecular findings in this patient are however insufficient to explain the entire phenotype and suggest a role for multiple genetic factors in soft tissue mineralization. PMID:21964806

Vanakker, Olivier M; Leroy, Bart P; Schurgers, Leon J; Vermeer, Cees; Coucke, Paul J; De Paepe, Anne

2011-11-01

88

Topical tretinoin 0.1% for pregnancy-related abdominal striae: An open-label, multicenter, prospective study  

Microsoft Academic Search

In an open-label, multicenter, prospective study, 20 women applied tretinoin (retinoic acid) cream 0.1% daily for 3 months\\u000a to pregnancy-related stretch marks in the abdominal area. Efficacy was evaluated by analysis of one preselected target lesion,\\u000a which was rated on a six-point scale (?1 = worse to 4 = cleared). At week 12, significant global improvement was noted from\\u000a baseline

Onésimo Rangel; Isabel Arias; Edith García; Sergio Lopez-Padilla

2001-01-01

89

Implementation Study of Patient-Ready Syringes Containing 25?mg/mL Methotrexate Solution for Use in Treating Ectopic Pregnancy  

PubMed Central

Background. Ectopic pregnancy (EP) is a significant cause of morbidity and mortality during the first trimester of pregnancy. Small unruptured tubal pregnancies can be treated medically with a single dose of methotrexate (MTX). Objective. The aim of this study was to evaluate the stability of a 25?mg/mL solution of MTX to devise a secure delivery circuit for the preparation and use of this medication in the management of EP. Method. MTX solutions were packaged in polypropylene syringes, stored over an 84-day period, and protected from light either at +2 to +8°C or at 23°C. We assessed the physical and chemical stability of the solutions at various time points over the storage period. A pharmaceutical delivery circuit was implemented that involved the batch preparation of MTX syringes. Results. We show that 25?mg/mL MTX solutions remain stable over an 84-day period under the storage conditions tested. Standard doses were prepared, ranging from 50?mg to 100?mg. The results of this study suggest that MTX syringes can be prepared in advance by the pharmacy, ready to be dispensed at any time that a diagnosis of EP is made. Conclusion. The high stability of a 25?mg/mL MTX solution in polypropylene syringes makes it possible to implement a flexible and cost-effective delivery circuit for ready-to-use preparations of this drug, providing 24-hour access and preventing treatment delays. PMID:24900977

Respaud, R.; Gaudy, A. S.; Arlicot, C.; Tournamille, J. F.; Viaud-Massuard, M. C.; Elfakir, C.; Antier, D.

2014-01-01

90

Possible Early Warning of Pregnancy Abnormalities  

MedlinePLUS

... pregnancies are ectopic. Another condition, known as “blighted ovum,” the fertilized egg also fails to develop into ... genetic factors involved in ectopic pregnancy and blighted ovum. In healthy pregnancies, the fertilized egg develops into ...

91

Ectopic Kidney  

MedlinePLUS

... participate in body contact sports may want to wear protective gear. [ Top ] How is an ectopic kidney diagnosed? A health care provider may use one or more of the following imaging tests to diagnose an ectopic kidney: Ultrasound. An ultrasound ...

92

Topical tretinoin 0.1% for pregnancy-related abdominal striae: an open-label, multicenter, prospective study.  

PubMed

In an open-label, multicenter, prospective study, 20 women applied tretinoin (retinoic acid) cream 0.1% daily for 3 months to pregnancy-related stretch marks in the abdominal area. Efficacy was evaluated by analysis of one preselected target lesion, which was rated on a six-point scale (-1 = worse to 4 = cleared). At week 12, significant global improvement was noted from baseline in all stretch marks, and the target lesion decreased in length by 20% (P = .01). Erythema and scaling, the most common adverse events, occurred in 11 patients, decreased in severity after the first month of treatment, and were controlled with continued application of tretinoin and petroleum jelly ointment. In this small study, topical application of tretinoin significantly improved the clinical appearance of pregnancy-related stretch marks. PMID:11697021

Rangel, O; Arias, I; García, E; Lopez-Padilla, S

2001-01-01

93

ß-hCG and prediction of therapeutic success in ectopic pregnancies treated with methotrexate, results from a prospective observational study.  

PubMed

Abstract Objective: To evaluate the diagnostic accuracy of different beta-human chorionic gonadotrophin (ß-hCG) levels measurement, for predicting success of medical treatment in cases diagnosed as tubal ectopic pregnancy (TEP). Design: Five-year prospective observational study. Setting: Prenatal Diagnosis Unit, Vall d'Hebron University Hospital - Barcelona. Patients: TEP cases fulfilling criteria for medical treatment with Methotrexate. Interventions: ß-hCG levels were measured on d 0, 4 and 7 of treatment. Results were compared by non-parametrical tests. A ROC curve was plotted to define cut-off points. Diagnostic accuracy of the different measurements was evaluated. Main outcome measure: Failure of treatment defined as need for surgical treatment or persistence of high ß-HCG levels despite treatment. Results: 126 women were diagnosed as TEP, eligible for medical treatment. There were no differences in parity, age, previous TEP, or adnexal mass size. Success rate was 88%. ß-HCG decreased significantly more, between days 0-7 and 4-7, in the successful cases. LR for success prediction was 6.2 and 7.8 for ß-HCG levels at days 4 and 7 respectively, 4.02 and 2.47 for decrement between days 0-7 (25%) and 4-7 (20%), respectively. Conclusion: ß-hCG cutoff values have a potential for predicting a successful medical treatment of TEP. PMID:24871360

Orozco, Esteban Mauricio; Sánchez-Durán, Maria Angeles; Bello-Muñoz, Juan Carlos; Sagalá, Juan; Carreras, Elena; Roura, Lluis Cabero

2014-06-30

94

Decidual infiltration of FoxP3? regulatory T cells, CD3? T cells, CD56? decidual natural killer cells and Ki-67 trophoblast cells in hydatidiform mole compared to normal and ectopic pregnancies.  

PubMed

Hydatidiform moles are considered pre-cancerous lesions of gestational trophoblastic neoplasia and are associated with an aberrant immune response. This preliminary study aimed to evaluate the feasibility of measuring the presence of immune cells as potential prognostic markers for hydatidiform moles. Immunohistochemical staining of FoxP3? regulatory T cells, CD3? T cells, CD56? decidual natural killer cells and Ki-67? trophoblast cells was performed on 32 samples. Samples were from complete hydatidiform moles, partial hydatidiform moles, ectopic pregnancies, gestational age-matched normal elective pregnancy terminations (normal pregnancies) and gestational trophoblastic neoplasias. FoxP3? regulatory T-cell infiltration was highest in the complete hydatidiform moles and lowest in the normal pregnancy samples. The normal pregnancy cases showed significantly fewer FoxP3? regulatory T cells compared to the ectopic pregnancy cases (p=0.037) and compared to the combination of all of the other groups (p=0.044). Normal pregnancy samples also showed the lowest infiltration of CD3? T cells and the highest number of CD56? decidual natural killer cells; conversely, gestational trophoblastic neoplasias showed the highest infiltration of CD3? T cells and the lowest number of CD56? decidual natural killer cells. The numbers of Ki-67? trophoblast cells were highest in the gestational trophoblastic neoplasias (688/1,000 trophoblast cells) and lowest in the partial moles (87/1,000 trophoblast cells). Our results suggest that regulatory T cells may be involved in the progression of complete hydatidiform moles. A larger cohort study is required to assess whether immune cells are effective prognostic markers in gestational trophoblastic diseases. PMID:22002546

Sundara, Yayan T; Jordanova, Ekaterina S; Hernowo, Bethy S; Gandamihardja, Supriadi; Fleuren, Gert Jan

2012-01-01

95

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))

1989-02-10

96

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. PMID:25431713

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

2014-01-01

97

Ectopic Ureter  

MedlinePLUS

... the need for stitches. Frequently asked questions: Are boys or girls more likely to have an ectopic ureter? This condition is more common in girls than boys, but can occur in either sex. What is ...

98

Ectopic Kidneys  

MedlinePLUS

... the Ureter F no topics for this letter G no topics for this letter H Hematuria Horseshoe ... medical history, and analyzing any tests performed (e.g., blood tets, urine tests, brain scans, etc.). ectopic: ...

99

Pregnancy  

MedlinePLUS

... 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 ...

100

Advanced Extrauterine Pregnancy at 33 Weeks with a Healthy Newborn  

PubMed Central

Abdominal pregnancy is a very rare form of ectopic pregnancy, associated with high morbidity and mortality for both fetus and mother. It is, and often, seen in poor resource nations, where early diagnosis is often a major challenge due to poor prenatal care and lack of medical resources. An advanced abdominal pregnancy with a good fetal and maternal outcome is therefore a more extraordinary occurrence in the modern developed world. We present a case of an abdominal pregnancy at 33.4?weeks in an individual with no documented prenatal care, who arrived in a hospital in the Bronx, in June 25th 2014, with symptoms of generalized, severe lower abdominal pain. Upon examination it was found that due to category III fetal tracing an emergent cesarean section was performed. At the time of laparotomy the fetus was located in the pelvis covered by the uterine serosa, with distortion of the entire right adnexa and invasion to the right parametrium. The placenta invaded the pouch of Douglas and the lower part of the sigmoid colon. A massive hemorrhage followed, followed by a supracervical hysterectomy. A viable infant was delivered and mother discharged on postoperative day 4. PMID:25544940

Dabiri, Tajudeen; Marroquin, Guillermo A.; Bendek, Boleslaw; Agamasu, Enyonam; Mikhail, Magdy

2014-01-01

101

Heterotopic triplet pregnancy: report of a case with bilateral tubal pregnancy and an intrauterine pregnancy  

Microsoft Academic Search

The first report of an ectopic pregnancy following IVF was published in 1976, and since then heterotopic pregnancies (HPs) have been reported at an increasing rate. Although cases of the co-existence of a bilateral tubal and an intrauterine pregnancy following IVF-embryo transfer have been reported, a case of heterotopic triplet pregnancy caused by unilateral tubal embryo transfer has not yet

Hun-Shan Pan; Jesse Chuang; Su-Fang Chiu; Bih-Chwen Hsieh; Yu-Hung Lin; Yieh-Loong Tsai; Shih-Chia Huang; Mei-Ling Hsieh; Chin-Yu Chen; Jiann-Loung Hwang

102

Easing Back Pain During Pregnancy  

MedlinePLUS

What causes back pain during pregnancy? The following changes during pregnancy can lead to back pain: • Strain on your back muscles • Abdominal ... you exercise. How can pregnancy hormones contribute to back pain? To prepare for the passage of the baby ...

103

Ectopic pancreas presenting with pancreatitis and a mesenteric mass.  

PubMed

Ectopic pancreas is defined by the presence of abnormally situated pancreatic tissue that lacks contact with normal pancreas and possesses its own duct system and vascular supply. Ectopic pancreas in the gastrointestinal tract is not uncommon. Moreover, there are several reported cases of adult ectopic pancreatitis in the literature, but to date, only two cases of pediatric ectopic pancreatitis have been reported. We describe a 15-year-old female with acute right upper quadrant pain and elevated serum lipase and amylase, in whom the radiological diagnosis was mesenteric soft tissue mass with adjacent inflammatory changes. The surgical pathology diagnosis, however, was mesenteric ectopic pancreas complicated by pancreatitis. We advocate for ectopic pancreatitis to be considered in a pediatric patient with acute abdominal pain, laboratory findings consistent with pancreatitis, and imaging findings of a mesenteric mass and normal orthotopic pancreas. PMID:23331836

Ginsburg, Michael; Ahmed, Osman; Rana, Kuntal A; Boumendjel, Redouane; Dachman, Abraham H; Zaritzky, Mario

2013-01-01

104

[Intramural pregnancy: a case report].  

PubMed

Implantation into the muscle wall is one of the rarer forms of ectopic pregnancy. We report an uncomplicated case which was discovered during therapeutic termination of pregnancy at 10 weeks. We point out how valuable the use of ultrasound during the operation is for making the diagnosis when suction does not provide adequate quantities of products. PMID:1430910

Falfoul, A; Jadoui, A; Bellasfar, M; Kaabar, N; Hamdoun, L; Ben Zineb, N; Zouari, F; Kharouf, M

1992-01-01

105

Ectopic adrenal cortical adenoma in the gastric wall: case report.  

PubMed

Ectopic adrenal cortical neoplasms are extremely rare. Ectopic adrenocortical tissue can be found in locations such as the celiac axis, the broad ligament, the adnexa of the testes, and the spermatic cord; however, they rarely involve the stomach. We report an unusual case of a patient with an ectopic adrenal cortical adenoma in the gastric wall. The patient was a 72-year old female admitted to our hospital with upper abdominal discomfort. Physical examination revealed tenderness below the xiphoid process. Both computed tomography and fibergastroscopy revealed a mass on the lesser curvature side of the gastric antrum; it was initially diagnosed as a gastric stromal tumor. After adequate preparation, the patient underwent surgery. During the procedure, we found a 30 mm × 30 mm mass with medium density in the lesser curvature near the gastric antrum within the serosa. Following immunohistochemistry examination, we corrected the diagnosis to an ectopic adrenal cortical adenoma; the tumor was nonfunctional. PMID:23429246

Ren, Pei-Tu; Fu, Hong; He, Xiao-Wen

2013-02-01

106

Pregnancy Complications: Cervical Insufficiency  

MedlinePLUS

... It may take a few weeks before you fully recover. Can Rh factor affect my baby? The ... Symptoms of gallstones include nausea, vomiting and intense, continuous abdominal pain. Treatment during pregnancy may include surgery ...

107

Pregnancy Complications: Preeclampsia  

MedlinePLUS

... It may take a few weeks before you fully recover. Can Rh factor affect my baby? The ... Symptoms of gallstones include nausea, vomiting and intense, continuous abdominal pain. Treatment during pregnancy may include surgery ...

108

Primary ovarian pregnancy after interval tubal ligation: a case report.  

PubMed

We report a case of a woman presenting in a state of shock with classic symptoms of ruptured ectopic pregnancy. She had a history of tubal ligation done three years back. Exploratory laparotomy was done, and a diagnosis of ruptured ectopic ovarian pregnancy was made. PMID:24971124

Vahnu, Changsan; Rajlaxmi, Mundhra; Vandana, Raphael

2013-12-01

109

[Cervical ectopic thymus].  

PubMed

We present a case of ectopic thymus in an eight month old male baby, with a right lateral tumor of the neck. Ectopic thymus is a pathology rarely observed, its embryogenesis could explain its cervical localization. X Ray, ultrasonography, IRM, esophagoscophy and laryngoscophy may be helpful in the differential diagnosis with other tumors of the neck. Due to the fact that cystic lesions and neoplasis developments take place, the chosen treatment is the complete chirurgical extirpation. But at the absence of symptoms, no treatments is advisable because eventually the thymus spontaneously involutionates. PMID:10668274

Saracho Cornet, P L; Traversaro, M; Courel, J; Buteler, G; Moreno, P; Ferreo, G; Arias, M

1999-01-01

110

[Cervical ectopic thymus].  

PubMed

Two cases of cervical aberrant thymus in infants are reported; it's important to identify such ectopia because thymic tissue involutes spontaneously later on; neither surgery nor other treatment is needed. Ultrasonography is a method of choice for tissue characterization of ectopic thymus and differential diagnosis with other cervical masses. PMID:2695627

Rypens, F; Avni, F; Müller, F; Baran, D; Struyven, J

1989-12-01

111

Ectopic liver tissue in the kidney: case report and literature review.  

PubMed

The presence of ectopic liver tissue has been reported in various abdominal and extra-abdominal sites, most often in the gall bladder. Other rare sites include the retroperitoneum and the adrenal gland, which are anatomically closer to the kidney. However, our literature search did not reveal any reports of ectopic liver tissue within the kidney. We present such a case, detected incidentally during a fetal autopsy histologic examination, and we review the possible developmental aspects causing it. Ectopic liver is usually asymptomatic, although it can carry pathology similar to the orthotopic liver. It can be associated with other congenital anomalies and, rarely, can be the cause for clinical emergencies. The most significant implication, however, is development of hepatocellular carcinoma because of an increased predisposition compared with the native liver. Hence, we suggest that ectopic liver in the kidney should be considered by histopathologists, even in unsuspecting cases. PMID:24972298

Merve, Ashirwad; Scheimberg, Irene

2014-01-01

112

Successful Laparoscopically Assisted Transcervical Suction Evacuation of Interstitial Pregnancy following Failed Methotrexate Injection in a Community Hospital Setting  

PubMed Central

We report on a case of a patient with an early diagnosed cornual ectopic pregnancy following failed methotrexate treatment. The patient was subsequently taken to the operating room for a laparoscopic guided transcervical suction curettage of the cornual ectopic. The surgery was successful and the patient was followed up until her urine pregnancy test was negative. We conclude that in properly selected patients, cornual ectopic pregnancy may be treated with transcervical suction curettage. PMID:24649387

Fritz, Rani B.; Rosenblum, Neal; Gaither, Kecia; Sherman, Alonzo; McCalla, Alwyn

2014-01-01

113

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

2014-01-01

114

Maternal Serum Disintegrin and Metalloprotease Protein-12 in Early Pregnancy as a Potential Marker of Adverse Pregnancy Outcomes  

PubMed Central

Objectives The aim of this study was to determine whether the concentration of disintegrin and metalloprotease protein12 (ADAM12) in first trimester maternal serum can be used as a marker for first-trimester complete spontaneous abortions, missed abortions, ectopic pregnancies and hydatidiform moles. Methods The maternal serum concentrations of ADAM12 were measured in the range of 5–9+6 weeks of gestation using an automated AutoDelfia immunoassay platform in 9 cases of complete spontaneous abortion, 27 cases of missed abortions, 56 cases of ectopic pregnancies, 12 cases of hydatidiform moles, and 100 controls. Logistic regression analysis was used to determine significant factors for predicting adverse pregnancy outcomes in early pregnancy. Screening performance was assessed using receiver operating characteristic curves. Results Two hundred and four women were enrolled in the study. In the control group, the level of ADAM12 increased with gestational age. The median ADAM12 levels in the spontaneous abortion (0.430 MoM), ectopic pregnancy (0.460 MoM) and hydatidiform mole (0.037 MoM) groups were lower than that in the control group, while the median ADAM12 level in the missed abortion group (1.062 MoM) was not significant from the controls (1.002 MoM). Logistic regression analysis demonstrated that the level of ADAM12 in maternal serum facilitated the detection of ectopic pregnancies (OR?=?0.909; 95% CI?=?0.841?0.982) and complete spontaneous abortion (OR?=?0.863; 95% CI?=?0.787?0.946). Conclusions In complete spontaneous abortion and ectopic pregnancy, ADAM12 maintained at low levels in early pregnancies, and there were significant differences compared to normal pregnancies. ADAM12 is a promising marker for the diagnosis of complete spontaneous abortion and ectopic pregnancy in symptomatic women, and under certain conditions, ADAM12 can diagnose ectopic pregnancy and spontaneous abortion before an ultrasonographic detection of the conditions. PMID:24830297

Yang, Jiexia; Wu, Jing; Guo, Fangfang; Wang, Dongmei; Chen, Keyi; Li, Jie; Du, Li; Yin, Aihua

2014-01-01

115

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

2014-01-01

116

Severe acute pancreatitis in pregnancy.  

PubMed

This is a case of a pregnant lady at 8 weeks of gestation, who presented with acute abdomen. She was initially diagnosed with ruptured ectopic pregnancy and ruptured corpus luteal cyst as the differential diagnosis. However she then, was finally diagnosed as acute hemorrhagic pancreatitis with spontaneous complete miscarriage. This is followed by review of literature on this topic. Acute pancreatitis in pregnancy is not uncommon. The emphasis on high index of suspicion of acute pancreatitis in women who presented with acute abdomen in pregnancy is highlighted. Early diagnosis and good supportive care by multidisciplinary team are crucial to ensure good maternal and fetal outcomes. PMID:25628906

Abdullah, Bahiyah; Kathiresan Pillai, Thanikasalam; Cheen, Lim Huay; Ryan, Ray Joshua

2015-01-01

117

Severe Acute Pancreatitis in Pregnancy  

PubMed Central

This is a case of a pregnant lady at 8 weeks of gestation, who presented with acute abdomen. She was initially diagnosed with ruptured ectopic pregnancy and ruptured corpus luteal cyst as the differential diagnosis. However she then, was finally diagnosed as acute hemorrhagic pancreatitis with spontaneous complete miscarriage. This is followed by review of literature on this topic. Acute pancreatitis in pregnancy is not uncommon. The emphasis on high index of suspicion of acute pancreatitis in women who presented with acute abdomen in pregnancy is highlighted. Early diagnosis and good supportive care by multidisciplinary team are crucial to ensure good maternal and fetal outcomes. PMID:25628906

Abdullah, Bahiyah; Kathiresan Pillai, Thanikasalam; Cheen, Lim Huay; Ryan, Ray Joshua

2015-01-01

118

A Case of Successful Laparoscopic Surgery for Tubal Stump Pregnancy After Tubectomy  

PubMed Central

The incidence of ectopic pregnancy is approximately 1.3–2% of all pregnancies, and more than 90% of ectopic pregnancies are detected in the ampulla of the fallopian tube. Ectopic pregnancy occurring in tubal stump after tubectomy is extremely rare, and the frequency of tubal stump pregnancy is approximately 0.4% of all pregnancies. We report one of these rare cases of ectopic pregnancy in a 26-year-old Japanese woman, gravida 4, parity 1. She had undergone laparoscopic tubectomy because of a tubal pregnancy two years ago. She was presented to our hospital with a positive pregnancy test, but no gestational sac was detected in the uterus by echography, even though the level of human chorionic gonadotropin (hCG) in the blood was elevated to 8,900 mIU/mL. Laparoscopic surgery for ectopic pregnancy was performed. During surgery, the position of the pregnancy was found to be in the tubal stump, where tubectomy had already been performed, and the gestational sac was successfully removed. After the surgery, the condition of the patient uneventfully improved and she was discharged from the hospital three days after the surgery. The diagnosis of tubal stump pregnancy is more difficult than that of the more common positions of an ectopic pregnancy in the fallopian tube, and so it is more important to carefully examine the patients with suspected ectopic pregnancy. Laparoscopic surgery is one of the options for tubal stump pregnancy if diagnosed early and if the condition of the patient is stable.

Nishida, Masakazu; Miyamoto, Yuko; Kawano, Yasushi; Takebayashi, Kanetoshi; Narahara, Hisashi

2015-01-01

119

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

2010-01-01

120

The biological role of Treg cells in ectopic endometrium homeostasis.  

PubMed

Although retrograde menstruation is observed in up to 90% of women, endometriosis actually develops in only 15% of women. There is considerable evidence in the literature that ectopic endometrial cells are able to evade immune surveillance and that the immune response in the microenvironment of ectopic lesions is limited. Endometriosis develops when a deficiency in the local immune response has been generated, and progression of the disease is related to the intensity of this process. Over the last couple of decades it has been well known that T regulatory lymphocytes (Tregs) play a crucial role in controlling a variety of physiological and pathological immune responses. In this review we have focused on the physiological alteration of Treg cell infiltration into the endometrium during the reproductive processes of women. We discuss how a disturbance in Treg cell expansion is involved in generating such pathological processes as miscarriage and ectopic pregnancy development. We hypothesize about the role Treg cells might play in the survival of endometriosis foci in ectopic localization and in the evasion of such lesions from host immune surveillance. PMID:24831778

Basta, Pawel; Koper, Krzysztof; Kazmierczak, Wojciech; Wisniewski, Michal; Makarewicz, Adrianna; Dutsch-Wicherek, Magdalena; Kojs, Zbigniew; Popiela, Tadeusz J; Slusarz, Robert; Dubiel, Mariusz; Wicherek, Lukasz

2014-10-01

121

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

2012-01-01

122

Gastric Metastasis of Ectopic Breast Cancer Mimicking Axillary Metastasis of Primary Gastric Cancer  

PubMed Central

Ectopic breast tissue has the ability to undergo all the pathological changes of the normal breast, including breast cancer. Gastrointestinal metastasis of breast cancer is rarely observed and it is very difficult to differentiate gastric metastases from primary gastric cancer. We present a case of 52-year-old female, who suffered from abdominal pain. Physical examination showed a palpable mass in the left anterior axilla and computerized tomography revealed gastric wall thickening with linitis plastica. When gastroscopic biopsy showed no signs of malignancy, excisional biopsy was performed in the left axilla. Histological examination revealed invasive lobular carcinoma of the breast, consistent with ectopic breast cancer. Further gastroscopic submucosal biopsies and immunohistochemical studies revealed gastric metastases of invasive lobular carcinoma. Axillary ectopic breast tissue carcinomas can mimic axillary lymphadenopathies. Additionally, gastric metastasis of breast cancer is an uncommon but possible condition. To the best of our knowledge, this is the first report of ectopic breast cancer with gastric metastasis.

Kay?l?o?lu, Selami Ilgaz; Akyol, Cihangir; Esen, Ebru; Cans?z-Ersöz, Cevriye; Kocaay, Ak?n F?rat; Genç, Volkan; Kepenekçi, ?lknur; Demirer, Seher

2014-01-01

123

Synchronous Ectopic Pancreatoblastoma in a Child: A Case Report  

PubMed Central

Pancreatoblastoma is a rare primary pancreatic neoplasm of children that may arise in any portion of the pancreas. We report a case of a 3-yr-old boy who presented to with abdominal pain our hospital and a progressive bulge in his right abdomen. Biochemical evaluation and serum levels of tumoral markers were within reference limits. On the computed tomography, two tumors were found. One located in the head of the pancreas; however, a laparotomy revealed that the head of pancreas was compressed but normal. The other was in the left abdomen near the spleen and the tail of the pancreas. The diagnosis of two synchronous pancreatoblastoma originating from the omentum was confirmed by pathology. Therefore, a pancreatoblastoma should be considered when a large well-defined, lobulated, and heterogeneous mass is identified in the pancreas of children. In addition, an ectopic pancreatoblastoma should be considered when identified within or near the ectopic pancreatic tissue. PMID:21655073

Gao, Jian-Bo; Yue, Song-Wei; Yang, Xue-Hua; Guo, Hua

2011-01-01

124

Thoracoscopic treatment of recurrent pneumothorax in a pregnant woman: a case of ectopic deciduosis.  

PubMed

We report here on a case of recurrent pneumothorax during pregnancy, which was successfully treated with thoracoscopic surgery. This report describes the intraoperative and histopathological findings of diaphragmatic and pulmonary ectopic deciduosis. Our case highlights the need for all surgeons to explore the diaphragm when performing surgery to treat pneumothorax in a woman, even if she is pregnant. PMID:20922628

Kim, Y-D; Min, K-O; Moon, S-W

2010-10-01

125

Abdominal pain  

MedlinePLUS

Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps; Bellyache; Stomachache ... Almost everyone has pain in the abdomen at some point. Most of the time, it is not serious. How bad your pain is ...

126

Pregnancy Registries  

MedlinePLUS

... Healthcare Professionals Pregnancy and Lactation Labeling Final Rule Pregnancy Registries Many women need to take medicine while ... understand how medicines affect pregnant women. What are pregnancy registries? A pregnancy exposure registry is a study ...

127

Management of women presenting to the accident and emergency department with lower abdominal pain.  

PubMed Central

The diagnosis and management of lower abdominal pain is difficult, particularly for the inexperienced accident and emergency (A&E) or surgical trainee. In women, potential gynaecological causes may further confuse the picture. We analysed the incidence, spectrum of presentation and immediate management of 322 women presenting consecutively to an inner city A&E department over a 6-month period with lower abdominal pain. A standard questionnaire relating to history, examination, immediate investigations and preliminary diagnosis was completed by the attending A&E doctor. The cause of abdominal pain, according to the A&E doctor's diagnosis, was gynaecological in 61%, gastroenterological in 23%, urological in 7% and non-specific in 9% of cases. Of the women, 39% (124/322) were referred to a duty specialist, of whom 86% (107/124) required admission for investigation and/or treatment. Women initially diagnosed as having pain of gynaecological origin formed the largest group of patients to be referred. In 69% (67/97) of these cases, the A&E doctor's initial diagnosis was confirmed by the gynaecologist. This study shows that pain of gynaecological origin was the largest single cause of lower abdominal pain in women presenting to our A&E department and that, in the majority of cases, these women needed to be referred to the duty gynaecologist for immediate treatment. Although overall diagnostic accuracy rate was relatively high, the management of potentially life-threatening gynaecological conditions such as ectopic pregnancy was poor. These results emphasise the need to improve in-service gynaecological training in A&E departments. PMID:7598417

Gilling-Smith, C.; Panay, N.; Wadsworth, J.; Beard, R. W.; Touquet, R.

1995-01-01

128

Ectopic cervical thymus: case report.  

PubMed

Ectopic cervical thymus is rarely considered in the differential diagnosis of cervical masses: this lesion is essentially asymptomatic and generally occupies a position in the neck along the carotid sheath, underneath the sterno-cleido-mastoid muscle. It is supposed that most of these masses arise as a consequence of migration defects during glandular embryogenesis. Ectopic thymus rarely invades contiguous structures but in the literature some cases of malignant transformation of aberrant cervical thymus have been reported. Some non-invasive investigations (MRI, ultrasonography) are useful but accurate diagnosis depends eventually on surgical excision and histologic examination. PMID:8877356

Lima, M; Ruggeri, G; Trizzino, V; Domini, M; Libri, M; Zanetti, G; Tani, G

1996-08-01

129

Satisfaction with hospital care and interventions after pregnancy loss  

Microsoft Academic Search

Hospital practices after pregnancy loss have changed considerably over the past decade, yet they have not been well evaluated. In a longitudinal study of 194 women and men who experienced miscarriage, ectopic pregnancy, stillbirth, or newborn death, the recommended interventions at the time of loss are examined. In most cases, parents were more satisfied if they had experienced an intervention

Judith N. Lasker; Lori J. Toedter

1994-01-01

130

Grieving after early pregnancy loss--a common reality.  

PubMed

A miscarriage can be very traumatic for a couple and their immediate family. The aim of this study was to assess, using the Perinatal Grief Scale (PGS), whether the type of early pregnancy loss influences the severity of grief and whether the presence of living children influences the severity of grief. Over a period of 6 months in 2008, seventy five patients were recruited for the study, of which 7 (9.3%) had molar pregnancies, 20 (26.7%) had ectopic pregnancies, 43 (573%) had a miscarriage and 5 (6.7%) had recurrent miscarriages. In this study there was no significant difference in severity of grief, between women that had a miscarriage and ectopic pregnancy (p = 0.14) or, between women that had a miscarriage and a molar pregnancy (p = 0.85). Women who had experienced a ectopic pregnancy did not have a higher grief intensity than the women that had a molar pregnancy (p = 0.75). However, for women with a child, the grief intensity significantly increases with the number of miscarriages (p = 0.015). Women with no children with an ectopic pregnancy grieve significantly more than those with a child (p = 0.019). An appointment for the 'Miscarriage Clinic' should be offered to all of these women but special attention should be paid to those in the categories most at risk PMID:23495541

Purandare, N; Ryan, G; Ciprike, V; Trevisan, J; Sheehan, J; Geary, M

2012-01-01

131

Radiation risks in pregnancy  

SciTech Connect

A major contraindication of radiodiagnostic procedures is pregnancy. Approximately 1% of all pregnant women are given abdominal x-rays during the first trimester of pregnancy. Evaluation of radiation exposure should involve consideration of the types of examinations performed and when performed, as well as radiation dose and risk estimation. This information is then weighed against other possible risks of the pregnancy as well as personal factors. In the authors' experiences, radiation exposures usually result in doses to the embryo of less than 5 cGy (rad); the resulting radiation risks are usually small compared with other risks of pregnancy. Procedures to minimize diagnostic x-ray exposure of the fetus are also discussed.

Mossman, K.L.; Hill, L.T.

1982-08-01

132

Another Positive Pregnancy Test.  

PubMed

A 16-year-old female presented to an emergency department with complaints of nausea and vomiting, dehydration, increasing weakness, and resting tremor. The past history included mild exercise-induced asthma. She denied sexual activity, but a urine test for beta-human chorionic gonadotropin was positive and she was transferred to a gynecology service for management of pregnancy. She also had primary amenorrhea and delayed growth for age. Further complaints included headaches accompanied with worsening of visual activity. Pelvic ultrasound revealed no intrauterine or ectopic pregnancy. Head CT scan showed a suprasellar tumor, better defined on an MRI as a hypothalamic tumor. Pathology following partial tumor resection revealed a mixed germ cell tumor with negative metastatic work-up. PMID:10359984

Gordon; Radovick; Emans

1996-10-01

133

Successful pregnancy following medical management of heterotopic pregnancy  

PubMed Central

We present a case of sonographic demonstration of quadruplet heterotopic pregnancy consisting of twin intrauterine (IU) pregnancy and a twin adnexal pregnancy after ovulation induction (OI) with clomiphene citrate (CC) and timed intercourse (TI). Both heterotopic pregnancy and spontaneous twinning are frequent after OI, this combination although extremely rare must be kept in mind. The role of early transvaginal sonography and serum beta human chorionic gonadotrophin after missed periods helps in early diagnosis. It gives us an opportunity for medical management, saving the patient the agony of surgery along with loss of pregnancy. The management of heterotopic pregnancy is controversial. This patient did not have a viable IU pregnancy and both the sacs in the adnexa were small. Thus, we treated her successfully by medical management with systemic methotrexate, with regular follow-up. This patient successfully conceived after 6 months with OI and TI, with ovulation occurring from the same side of the previous ectopic. She had a viable IU gestation corresponding to 12 weeks. PMID:19562073

Lavanya, R; Deepika, K; Patil, Madhuri

2009-01-01

134

Ectopic eruption - A review and case report  

PubMed Central

Ectopic eruption is a disturbance in which the tooth does not follow its usual course. The purpose of this manuscript is to provide a brief review regarding the incidence, etiology, classification and different management techniques used for correcting ectopically erupting permanent first molar. The following manuscript further presents a case report for correction of ectopically erupting mandibular left permanent f irst molar by using a simple and effective appliance by the author. PMID:22114445

Yaseen, Syed Mohammed; Naik, Saraswati; Uloopi, K. S.

2011-01-01

135

Ectopic eruption - A review and case report.  

PubMed

Ectopic eruption is a disturbance in which the tooth does not follow its usual course. The purpose of this manuscript is to provide a brief review regarding the incidence, etiology, classification and different management techniques used for correcting ectopically erupting permanent first molar. The following manuscript further presents a case report for correction of ectopically erupting mandibular left permanent f irst molar by using a simple and effective appliance by the author. PMID:22114445

Yaseen, Syed Mohammed; Naik, Saraswati; Uloopi, K S

2011-01-01

136

Ectopic tooth in maxillary sinus: Case series  

PubMed Central

Ectopic eruption of a tooth within the dentate region of the jaws is often noticed in clinical practice and is well documented in the literature. But the ectopic eruption into the non dentate region is rare and scantly documented. The maxillary sinus is one such a non dentate region, apart from nasal septum, mandibular condyle, coronoid process and the palate, to accommodate such ectopic eruptions of teeth. Due to its rarity and lack of consensus over its management, the incidence deserves to be added to the literature and discussed. Early surgical intervention for removal of ectopic tooth along with enucleation of the associated cyst, if any, is the treatment of choice. PMID:23662268

Ramanojam, Shandilya; Halli, Rajshekhar; Hebbale, Manjula; Bhardwaj, Smita

2013-01-01

137

Abdominal Tuberculosis  

Microsoft Academic Search

. Throughout the world tuberculosis is\\u000a \\u000a associated with poverty, deprivation, and human immunodeficiency virus\\u000a \\u000a infection. Abdominal tuberculosis is usually of insidious onset with\\u000a \\u000a diverse symptoms and signs. A few present with acute complications of\\u000a \\u000a perforation, obstruction, or bleeding. The diagnosis is difficult,\\u000a \\u000a especially in areas where the disease is less common, as many patients\\u000a \\u000a do not have evidence of pulmonary

Niall O. Aston

1997-01-01

138

Ectopic cutaneous schistosomiasis - Case report*  

PubMed Central

Schistosomiasis is best known in its visceral form but it can attack the skin, its ectopic cutaneous manifestation being rare and clinically difficult to diagnose. It is characterized by isolated or coalescent papules, erythematous, pruritic or asymptomatic, with zosteriform distribution, often located on the trunk. The authors report a case of a 28-year-old female patient with lesions on the abdomen, with positive stool results for Schistosoma and absence of active symptoms of visceral disease. The case reveals rare exuberant cutaneous manifestation and the importance of the diagnosis of this entity in patients from endemic regions. PMID:25054754

Mota, Lívia de Souza; de Silva, Samuel Freire; de Almeida, Fabiana Carvalho; Mesquita, Ludmila de Sousa Ursino; Teixeira, Renata Dórea Leal; Soares, Aline Miranda

2014-01-01

139

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

2014-01-01

140

Laparoscopic surgery in the treatment of nonruptured tubal pregnancy  

NASA Astrophysics Data System (ADS)

Introduction of the endoscopic techniques into gynecology enabled a change in the procedures in the case of ectopic pregnancy. This paper aims at presenting 76 cases of non-ruptured tubal pregnancies treated conservatively by the laparoscopic surgery with the application of the electrocoagulation or the Nd:YAG laser. The investigated group consisted of 76 patients. Forty-one (54%) of them were operated on using electrocoagulation and 35 (46%) using the Nd:YAG laser. Sixty-three pregnancies (83%) were localized in the ampulla. The ectopic pregnancy was confirmed histopathologically in 74 cases (97%). There were no complications noticed in the postoperative course. There were no differences in the efficacy and the postoperative general condition in cases treated conservatively by the laparoscopic surgery with the application of the electrocoagulation or the laser.

Mutrynowski, Andrzej; Zabielska, Renata

1996-03-01

141

Teenage Pregnancy  

MedlinePLUS

... 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 ...

142

Pregnancy Complications  

MedlinePLUS

... and valid measures of pre-pregnancy weight and height, as well as weight change during pregnancy, are needed to monitor trends and conduct research that will inform the development of interventions. Effective approaches are crucial to increase the percentage of women who enter pregnancy at ...

143

Cervical Pregnancy  

PubMed Central

Cervical pregnancy is gaining recognition as a serious complication of early pregnancy. In view of the increasing incidence of the condition and the formidable therapeutic problems posed, a review of the literature is timely. This paper also presents a case report illustrating many of the typical features associated with cervical pregnancy. ImagesFigure 1 PMID:6381743

Kouyoumdjian, Alex

1984-01-01

144

Ectopic Axillary Breast during Systemic Lupus.  

PubMed

Many breast changes may occur in systemic lupus erythematosus. We report a 41-year-old woman with lupus who presented three years after the onset of lupus an ectopic mammary gland confirmed by histological study. PMID:22924044

Ben Dhaou, Besma; Boussema, Fatma; Aydi, Zohra; Baili, Lilia; Rokbani, Lilia

2012-01-01

145

Ectopic Axillary Breast during Systemic Lupus  

PubMed Central

Many breast changes may occur in systemic lupus erythematosus. We report a 41-year-old woman with lupus who presented three years after the onset of lupus an ectopic mammary gland confirmed by histological study. PMID:22924044

Ben Dhaou, Besma; Boussema, Fatma; Aydi, Zohra; Baili, Lilia; Rokbani, Lilia

2012-01-01

146

Spontaneous Heterotopic Pregnancy, Simultaneous Ovarian, and Intrauterine: A Case Report  

PubMed Central

Spontaneous heterotopic pregnancy is a rare clinical condition in which intrauterine and extrauterine pregnancies occur at the same time. The occurrence of an ovarian heterotopic pregnancy is a singular event as it comprises only 2.3% of all heterotopic pregnancies, extremely rare among women who conceive naturally. A case of a 28-year old patient was treated for spontaneously conceived heterotopic pregnancy. The patient was admitted to our center with lower abdominal pain and amenorrhoea. A transvaginal ultrasound scan showed an ovarian and an intrauterine heterotopic pregnancy. This was managed laparoscopically. Considering spontaneous pregnancies, every physician treating women of reproductive age should be aware of the possibility of heterotopic pregnancy. It can occur in the absence of any predisposing risk factors; only with an early diagnosis and treatment the intrauterine pregnancies will reach viability with a great chance of a favorable obstetric outcome. PMID:22997595

Basile, Francesca; Di Cesare, Cristina; Quagliozzi, Lorena; Donati, Laura; Bracaglia, Marina; Caruso, Alessandro; Paradisi, Giancarlo

2012-01-01

147

Unusual gestational choriocarcinoma arising in an interstitial pregnancy  

PubMed Central

INTRODUCTION Choriocarcinoma is a highly malignant trophoblastic neoplasm. Its association with ectopic pregnancy is very rare and usually with aggressive behavior. PRESENTATION OF CASE We report a new case arising in an interstitial pregnancy occurring in a 46-year-old woman. The patient was admitted for severe pelvic pain and abundant metrorrhagia. One month ago, she had had a laparoscopic resection of an interstitial pregnancy subsequent to failure of chemotherapy by methotrexate. The raise of serum ?hCG level and the hyperechoic intrauterine mass were in favor of gestational trophoblastic disease. Urgent laparotomy was performed for circulatory collapse. Hysterectomy was done. Histological examination revealed a choriocarcinoma. The patient underwent chemotherapy. Two years later, neither metastasis nor recurrence was detected. DISCUSSION Clinical diagnosis of primary interstitial choriocarcinoma is difficult, since it is rare and manifesting by non-specific abnormal vaginal bleeding. Imaging findings are also not helpful in ectopic location. The frequency of metastasis is related to the delayed diagnosis. Serial measurement of ?hCG level was the most useful marker of diagnosis and follow up. Histopathological examination remains the only tool of the precise diagnosis. Choriocarcinoma has a very good prognosis even in advanced stages, since it is very chemosensitive. CONCLUSION The current trend of the treatment of ectopic pregnancy by conservative surgery requires adequate monitoring of ?hCG and careful examination of pathologic specimens to avoid misdiagnosis of ectopic gestational trophoblastic disease. PMID:25290382

Meddeb, Sawsen; Rhim, Mohamed Salah; Zarrouk, Wissal; Bibi, Mohamed; Yacoubi, Mohamed Tahar; Khairi, Hedi

2014-01-01

148

Pregnancy Complications: Chlamydia  

MedlinePLUS

... is running out: 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 ...

149

Pregnancy Complications: Gonorrhea  

MedlinePLUS

... is running out: 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 ...

150

[Intestinal obstruction during pregnancy].  

PubMed

This is a review of literature concerning intestinal obstruction in pregnant women. Approximately 50-90% and 30% of pregnant women, respectively suffer from nausea and vomiting, mostly during the first trimester. There is also increased risk of constipation. During the perioperative period, the administration of tocolytics should be considered only in women showing symptoms of a threatening premature delivery. Intensive hydration should be ordered to sustain uterine blood flow. The incidence of intestinal obstruction during pregnancy is estimated at 1:1500-1:66431 pregnancies and is diagnosed in II and III trimester in most cases. However, it can also occur in the I trimester (6%) or puerperium. Symptoms of intestinal obstruction in pregnancy include: abdominal pains (98%), vomiting (82%), constipation (30%). Abdominal tenderness on palpation is found in 71% and abnormal peristalsis in 55% of cases. The most common imaging examination in the diagnosis of intestinal obstruction is the abdominal X-ray. However ionizing radiation may have a harmful effect on the fetus, especially during the first trimester. X-ray is positive for intestinal obstruction in 82% of pregnant women. Ultrasonography and magnetic resonance imaging are considered safe and applicable during pregnancy. Intestinal obstruction in pregnant women is mostly caused by: adhesions (54.6%), intestinal torsion (25%), colorectal carcinoma (3.7%), hernia (1.4%), appendicitis (0.5%) and others (10%). Adhesive obstruction occurs more frequently in advanced pregnancy (6% - I trimester 28% - II trimester; 45% - III trimester 21% - puerperium). Treatment should begin with conservative procedures. Surgical treatment may be necessary in cases where the pain turns from recurrent into continuous, with tachycardia, pyrexia and a positive Blumberg sign. If symptoms of fetal anoxia are observed, a C-section should be carried out before surgical intervention. The extent of surgical intervention depends on the intraoperative evaluation. Intestinal torsion during pregnancy mostly occurs in the sigmoid colon and cecum. Small bowel torsion secondary to adhesions is diagnosed in 42% of pregnant women with intestinal obstruction. The risk of intestinal torsion is higher in the 16-20 and 32-36 weeks of pregnancy and during puerperium. Intestinal torsion results in vessel occlusion which induces more severe symptoms and makes urgent surgical intervention necessary. The overall prognosis is poor--during II and III trimester the fetal mortality rate reaches 36% and 64%, respectively while the risk of maternal death is 6%. Acute intestinal pseudoobstruction can be diagnosed during puerperium, especially following a C-section. Diagnosis is made on the basis of radiological confirmation of colon distension at the cecum as > 9cm, lack of air in the sigmoid colon and rectum, exclusion of mechanical obstruction. In most cases, the treatment is based on easing intestine gas evacuation and administering neostigmine. The authors point out the need for multi-specialty cooperation in the diagnostic-therapeutic process of pregnant women suspected with intestinal obstruction, since any delay in making a correct diagnosis increases the risk of severe complications, both for the woman and the fetus. PMID:23668061

Stukan, Maciej; Kruszewski Wies?aw, Janusz; Dudziak, Miros?aw; Kopiej?, Arkadiusz; Preis, Krzysztof

2013-02-01

151

Rare entity: Ectopic liver tissue in the wall of the gallbladder - A case report  

PubMed Central

Ectopic liver tissue (ELT) is a rare condition, which is usually not diagnosed preoperatively, but coincidentally during abdominal surgery. While the location of ELT can vary, it is usually localized on the gallbladder wall or in close proximity. ELT is associated with various complications, a major complication being extrahepatic hepatocellular carcinoma. A 59-year-old female underwent elective surgery for chronic cholecystitis with stones. During laparoscopic exploration, a 2-cm-diameter ELT was detected in the anterior gallbladder wall and a laparoscopic cholecystectomy was performed. The case is presented due to the rare nature of ELT and as a reminder of ELT-related complications. PMID:25516872

Arslan, Yusuf; Altintoprak, Fatih; Serin, Kursat R; Kivilcim, Taner; Yalkin, Omer; Ozkan, Orhan V; Celebi, Fehmi

2014-01-01

152

Teenage Pregnancy  

MedlinePLUS

... Register About Us Contact Us My Cart Healthy Children > Ages & Stages > Teen > Dating & Sex > Teenage Pregnancy Ages & Stages Listen Teenage Pregnancy Article ... Decrease Children’s Calorie Intake Sports Success Rx! Your Child’s Prescription for the Best Experience Immunizations & Infectious ... Driving Safety School Substance Abuse Young ...

153

Thoracoscopic Removal of Ectopic Mediastinal Parathyroid Adenoma  

PubMed Central

Ectopic mediastinal parathyroid adenomas or hyperplasias account for up to 25% of primary hyperparathyroidism cases. Most abnormal parathyroid glands are found in the superior mediastinum within the thymus and can be removed through a cervical incision; however, a few of these glands are not accessible using standard cervical surgical approaches. Surgical resection has traditionally been performed via median sternotomy or thoracotomy. However, recent advancement in video-assisted thoracic surgery techniques has decreased the need for sternotomy or thoracotomy to remove these ectopic parathyroid glands. Here, we report a successful case of video-assisted thoracoscopic removal of a mediastinal parathyroid adenoma. PMID:25207237

Kim, Young Su; Kim, Jhingook; Shin, Sumin

2014-01-01

154

Ovarian pregnancy: uncommon mode of presentation.  

PubMed

Ovarian pregnancy is very rare, and its incidence is 1 in 3000 live births. In this condition, common risk factors for ectopic pregnancy not usually found. It usually occurs in fertile women and more commonly with in-situ intrauterine device (IUD). Preoperative diagnosis is always not possible although the patient commonly presents with abdomen-pelvic pain, per vaginal bleeding and hypovolemic shock. High degree of suspicion with estimation of serum beta HCG, transvaginal ultrasonography by an experienced sonologist and laparoscopy is required for confirming the diagnosis. Though, the usual treatment is surgery, it can be managed by medical methods only in hemodynamically stable patients. In this case report, we describe the unusual mode of clinical presentation in an elderly woman with ovarian pregnancy. PMID:25478415

Jena, Saubhagya Kumar; Kar, Gayatri; Samal, Soumya; Behera, Basanta Kumar

2014-10-01

155

Pregnancy Tumor  

MedlinePLUS

... Poor oral hygiene (not enough brushing, flossing or cleanings to remove food or plaque) Irritation of the ... of getting a pregnancy tumor. Have regular dental cleanings before you become pregnant. Visit the dentist very ...

156

Ectopic fetuses in two cottontail rabbits.  

PubMed

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

1975-10-01

157

American Pregnancy Association  

MedlinePLUS

... By Helpful Information About Contact Corporate Sponsors Videos Planning Adoption Birth & Beyond Getting Pregnant Labor and Birth Pregnancy Planning and Preparing Getting Pregnant Pregnancy Concerns Your Pregnancy ...

158

Synchronous thoracic and abdominal enteric duplication cysts: Accurate detection with 99mTc-pertechnetate scintigraphy  

PubMed Central

Enteric duplication cysts (EDCs) are uncommon congenital anomalies, which can occur anywhere along the gastrointestinal tract and vary greatly in presentation, size, location and symptoms. Ectopic gastric mucosa is reported to be found in 20-30% of these duplications. 99mTc-pertechnetate scintigraphy is a useful modality for preoperative localization of the ectopic functioning gastric mucosa in the EDCs. We report a case where 99mTc-pertechnetate scintigraphy was useful in detecting synchronous thoracic and abdominal duplication cysts with functioning gastric mucosa thus having an impact on the patient management. PMID:25589809

Kumar, Kunal; Dhull, Varun Singh; Karunanithi, Sellam; Chakraborty, Partha Sarathi; Roy, Shambo Guha; Ghosh, Shouriyo; Agarwala, Sandeep; Tripathi, Madhavi

2015-01-01

159

Body art and pregnancy.  

PubMed

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

2010-11-01

160

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; Zúniga-Muñoz, Alejandra M; Hernández-Godínez, Braulio; Ibáñez-Contreras, Alejandra; Graullera-Rivera, Verónica

2014-01-01

161

Two Live Births following Robotic-Assisted Abdominal Cerclage in Nonpregnant Women  

PubMed Central

Introduction. To report the robotic-assisted abdominal cerclage performed in two nonpregnant women and the success of live birth outcomes. Presentation of Cases. A 36-year-old woman with a complaint of recurrent second trimester pregnancy losses and a 35-year-old patient with a complaint of preterm deliveries and cervical insufficiency underwent robotic assisted abdominal cervicoisthmic cerclage placement in nonpregnant period. The two patients had spontaneous pregnancy after the robotic-assisted abdominal cerclage and delivered healthy infants. Discussion. The limitations of traditional laparoscopic abdominal cerclage have been accomplished with robotic surgery advantages especially intuitive movements and increased range of motion. There are only a few studies in the literature including robotic assisted abdominal cerclage in nonpregnant women, and only five successful live birth outcomes were reported. In this paper, we reported the sixth and seventh cases of achieved live pregnancy after robotic assisted abdominal cerclage in the literature. Conclusion. Robotic assisted abdominal cerclage is a good alternative surgical method with successful pregnancy outcomes. PMID:24109534

Göçmen, Ahmet; ?anl?kan, Fatih

2013-01-01

162

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.)

2006-01-01

163

Bupropion (Wellbutrin) and Pregnancy  

MedlinePLUS

Bupropion (Wellbutrin) and Pregnancy This sheet talks about the risks that exposure to bupropion can have during pregnancy. With each pregnancy, all women ... the general population. Can taking bupropion during my pregnancy cause birth defects? One study has suggested a ...

164

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.

2012-01-01

165

Intrathoracic Ectopic Liver in a Cow  

PubMed Central

ABSTRACT A solitary spherical mass was found in the caudal part of the cranial lobe of the left lung of a 28-month-old Japanese Black cow. The mass was circumscribed, embedded in the lung parenchyma and not connected to the liver or diaphragm. Histologically, the mass comprised hepatocytes, portal structures consisting of interlobular bile ducts, interlobular arteries and interlobular veins, and central veins. Based on the histological findings, a diagnosis of intrathoracic ectopic liver was made. Considering the absence of any previous history of traumatic diaphragmatic hernia or surgery, the mass might have resulted from a congenital abnormality. To our knowledge, this is the first report of intrathoracic ectopic liver in a cow that might have resulted from a congenital abnormality. PMID:24419875

HIFUMI, Tatsuro; KAWAGUCHI, Hiroaki; YAMADA, Manabu; MIYOSHI, Noriaki

2014-01-01

166

Intrathoracic ectopic liver in a cow.  

PubMed

A solitary spherical mass was found in the caudal part of the cranial lobe of the left lung of a 28-month-old Japanese Black cow. The mass was circumscribed, embedded in the lung parenchyma and not connected to the liver or diaphragm. Histologically, the mass comprised hepatocytes, portal structures consisting of interlobular bile ducts, interlobular arteries and interlobular veins, and central veins. Based on the histological findings, a diagnosis of intrathoracic ectopic liver was made. Considering the absence of any previous history of traumatic diaphragmatic hernia or surgery, the mass might have resulted from a congenital abnormality. To our knowledge, this is the first report of intrathoracic ectopic liver in a cow that might have resulted from a congenital abnormality. PMID:24419875

Hifumi, Tatsuro; Kawaguchi, Hiroaki; Yamada, Manabu; Miyoshi, Noriaki

2014-05-01

167

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

2011-01-01

168

Gasless laparoscopy for benign gynecological diseases using an abdominal wall-lifting system  

PubMed Central

Objectives: The use of gasless laparoscopy with an abdominal wall-lifting device for benign gynecological diseases was compared to conventional laparoscopy with CO2 pneumoperitoneum. Methods: From February 2007 to July 2007, 76 women with uterine and/or adnexal benign diseases and candidates for laparoscopic surgery were recruited in this study. Thirty-two women underwent gasless laparoscopic surgery and 44 women underwent pneumoperitoneum laparoscopic surgery. Results: Diverse pathologies, including adnexal cyst, uterine myoma and ectopic pregnancy, were treated successfully with gasless laparoscopic surgery. Compared with the patients in the pneumoperitoneum group, the similar hospital stay (P=0.353) and intraoperative blood loss (P=0.157) were observed. However, the mean operative time in the gasless group was significantly longer than that in the pneumoperitoneum group (P=0.003). No severe intraoperative or postoperative complications were found in either group, except for one case of laparotomic conversion in the pneumoperitoneum group due to dense pelvic adhesions. The total hospital charges were significantly less in the gasless group than in the pneumoperitoneum group (P=0.001). In 38 cases of ovarian cyst resection, the mean operative time in the gasless group remained longer than that in the pneumoperitoneum group (P=0.017). The total hospital charges were also significantly less in the gasless group than in the pneumoperitoneum group (P<0.001). Conclusion: Our preliminary results demonstrated that the laparoscopic procedure using the gasless technique was a safe, effective method to treat benign gynecological diseases. Moreover, it was easy to master. As a minimally invasive treatment, gasless laparoscopic surgery provides a good choice to patients in the undeveloped regions in China without increasing the patients’ and the government’s burden significantly. PMID:19882754

Wang, Yue; Cui, Heng; Zhao, Yan; Wang, Zhi-qi

2009-01-01

169

[Thoracic ectopic kidney. Report of a case].  

PubMed

We describe a 23 months old boy who presented a clinical picture of bronchial hyperreactivity and a tumoral intrathoracic mass in a plain thorax X-ray, receiving for these reasons, antibiotic therapy during 30 days. Intravenous pyelography and ultrasonography revealed the presence of an ectopic intrathoracic kidney. Since this renal anomaly is usually asymptomatic and do not requires treatment, it is necessary to suspect this abnormality whenever an intrathoracic mass is found. PMID:1295584

Marcano, D; Aguilera, G; Sánchez, O

1992-01-01

170

Pregnancy loss.  

PubMed

Women who lose desired pregnancies by miscarriage, stillbirth, or genetic termination are at risk of suffering from grief, anxiety, guilt and self-blame that may even present in subsequent pregnancies. It is important to find effective means of helping women deal with these losses. The approach to stillbirth has shifted from immediately removing the child from the mother to encouraging the parents to view and hold the baby. This approach has been questioned as possibly causing persistent anxiety and post-traumatic stress disorder. Women who miscarry are currently encouraged to find ways to memorialise the lost fetus. Couples who decide to terminate a pregnancy after discovering a defect may deal not only with sadness but also guilt. Immediate crisis intervention and follow-up care should be available, recognising that individual women may experience different reactions and their specific post-loss needs must be assessed. PMID:24047642

Robinson, Gail Erlick

2014-01-01

171

Spontaneous Rupture of Uterine Vein in Twin Pregnancy  

PubMed Central

Objective. Aim of our study is to present a case of a twin pregnancy following invitro fertilization cycle complicated with hemoperitoneum at third trimester. Case. A 26-year-old nulliparous pregnant woman at 32 weeks of gestation with twin pregnancy following invitro fertilization cycle complained of abdominal pain. After 48 hours of admission, laparotomy was performed with indications of aggravated abdominal pain and decreased hemoglobin levels. Utero-ovarian vein branch rupture was detected on the right posterior side of uterus and bleeding was stopped by suturing the vein. Etiopathogenesis of the present case still remains unclear. Conclusion. Spontaneous rupture of the uterine vessels during pregnancy is a rare complication and may lead to maternal and fetal morbidity and mortality. Diagnosis and treatment are based on the clinical symptoms of acute abdominal pain and laboratory tests of hypovolemic shock signs. PMID:24455353

Doger, Emek; Cakiroglu, Yigit; Yildirim Kopuk, Sule; Akar, Bertan; Caliskan, Eray; Yucesoy, Gulseren

2013-01-01

172

Spontaneous rupture of uterine vein in twin pregnancy.  

PubMed

Objective. Aim of our study is to present a case of a twin pregnancy following invitro fertilization cycle complicated with hemoperitoneum at third trimester. Case. A 26-year-old nulliparous pregnant woman at 32 weeks of gestation with twin pregnancy following invitro fertilization cycle complained of abdominal pain. After 48 hours of admission, laparotomy was performed with indications of aggravated abdominal pain and decreased hemoglobin levels. Utero-ovarian vein branch rupture was detected on the right posterior side of uterus and bleeding was stopped by suturing the vein. Etiopathogenesis of the present case still remains unclear. Conclusion. Spontaneous rupture of the uterine vessels during pregnancy is a rare complication and may lead to maternal and fetal morbidity and mortality. Diagnosis and treatment are based on the clinical symptoms of acute abdominal pain and laboratory tests of hypovolemic shock signs. PMID:24455353

Doger, Emek; Cakiroglu, Yigit; Yildirim Kopuk, Sule; Akar, Bertan; Caliskan, Eray; Yucesoy, Gulseren

2013-01-01

173

Multiple Pregnancy  

MedlinePLUS Videos and Cool Tools

... be looking for, and will explore the statistics, health and psychological risks to parents, children and siblings, and other issues ... are receiving infertility treatment, which carries a higher risk of multiple pregnancy ... to US health statistics, The twin birth rate has increased by ...

174

Clinicopathological Features and Treatment of Ectopic Varices with Portal Hypertension  

PubMed Central

Bleeding from ectopic varices, which is rare in patients with portal hypertension, is generally massive and life-threatening. Forty-three patients were hospitalized in our ward for gastrointestinal bleeding from ectopic varices. The frequency of ectopic varices was 43/1218 (3.5%) among portal hypertensive patients in our ward. The locations of the ectopic varices were rectal in thirty-two, duodenal in three, intestinal in two, vesical in three, stomal in one, and colonic in two patients. Endoscopic or interventional radiologic treatment was performed successfully for ectopic varices. Hemorrhage from ectopic varices should be kept in mind in patients with portal hypertension presenting with lower gastrointestinal bleeding. PMID:21994879

Sato, Takahiro; Akaike, Jun; Toyota, Jouji; Karino, Yoshiyasu; Ohmura, Takumi

2011-01-01

175

Intra-abdominal hypertension and abdominal compartment syndrome  

Microsoft Academic Search

Background: The effects of increased intra-abdominal pressure in various organ systems have been noted over the past century. The concept of abdominal compartment syndrome has gained more attention in both trauma and general surgery in the last decade. This article reviews the current understanding and management of intra-abdominal hypertension and abdominal compartment syndrome. Methods: Relevant information was gathered from a

K.-M. Sieh; Kent-Man Chu; John Wong

2001-01-01

176

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

2014-01-01

177

Antichlamydial Antibodies, Human Fertility, and Pregnancy Wastage  

PubMed Central

Genital infections with Chlamydia trachomatis (C. trachomatis) continue to be a worldwide epidemic. Immune response to chlamydia is important to both clearance of the disease and disease pathogenesis. Interindividual responses and current chlamydial control programs will have enormous effects on this disease and its control strategies. Humoral immune response to C. trachomatis occurs in humans and persistent antibody levels appear to be most directly correlated with more severe and longstanding disease and with reinfection. There is a close correlation between the presence of antichlamydial antibodies in females and tubal factor infertility; the closest associations have been found for antibodies against chlamydial heat shock proteins. The latter antibodies have also been shown to be useful among infertile patients with prior ectopic pregnancy, and their presence has been correlated with poor IVF outcomes, including early pregnancy loss. We review the existing literature on chlamydial antibody testing in infertile patients and present an algorithm for such testing in the infertile couple. PMID:21949601

Stephens, Amanda J.; Aubuchon, Mira; Schust, Danny J.

2011-01-01

178

Abdominal aortic aneurysm  

MedlinePLUS

Aneurysm - aortic; AAA ... pressure Male gender Genetic factors An abdominal aortic aneurysm is most often seen in males over age ... one or more risk factors. The larger the aneurysm, the more likely it is to break open. ...

179

Normal Abdominal CT  

NSDL National Science Digital Library

Set of normal abdominal CT images with various important anatomic structures outlined, for cine viewing to gain a 3D view of the structure and its relationship to adjacent organs.Annotated: trueDisease diagnosis: Normal

Shaffer, Kitt

180

Functional Abdominal Pain  

Microsoft Academic Search

Functional abdominal pain syndrome (FAPS) is a relatively less common functional gastrointestinal (GI) disorder defined by\\u000a the presence of constant or frequently recurring abdominal pain that is not associated with eating, change in bowel habits,\\u000a or menstrual periods (Drossman Gastroenterology 130:1377–1390, 2006), which points to a more centrally targeted (spinal and supraspinal) basis for the symptoms. However, FAPS is frequently

Madhusudan Grover; Douglas A. Drossman

2010-01-01

181

Total abdominal colectomy  

MedlinePLUS

... or nurse about the following things: Intimacy and sexuality Pregnancy Sports Work During the 2 weeks before your surgery: Two weeks before surgery you may be asked to stop taking drugs that make it harder for your blood to ...

182

Liver Disease in Pregnancy  

Microsoft Academic Search

Liver dysfunction during pregnancy can be caused by conditions that are specific to pregnancy or by liver diseases that are not related to pregnancy itself. This review attempts to summarize the epidemiology, pathophysiology, and management of the different pregnancy-related liver diseases, and to review different liver diseases not related to pregnancy and how they may affect or be effected by

Fabiana S. Benjaminov; Jenny Heathcote

2004-01-01

183

Genetic Analysis of Ectopic Circadian Clock Induction in Drosophila  

PubMed Central

Cell-autonomous feedback loops underlie the molecular oscillations that define circadian clocks. In Drosophila the transcription factor Clk activates multiple clock components of feedback loops many of which feed back and regulate Clk expression or activity. Previously the authors evoked similar molecular oscillations in putatively naïve neurons in Drosophila by ectopic expression of a single gene, Clk, suggesting a master regulator function. Using molecular oscillations of the core clock component PERIOD (PER), the authors observed dramatic and widespread molecular oscillations throughout the brain in flies expressing ectopic Clk. Consistent with the master regulator hypothesis, they found that Clk is uniquely capable of inducing ectopic clocks as ectopic induction of other clock components fails to induce circadian rhythms. Clk also induces oscillations even when expression is adult restricted, suggesting that ectopic clocks can even be induced in differentiated cells. However, if transgene expression is discontinued, PER expression disappears, indicating that Clk must be continually active to sustain ectopic clock function. In some cases Clk-mediated PER induction was observed without apparent synchronous cycling, perhaps due to desynchronization of rhythms between clocks or truly cell autonomous arrhythmic PER expression, indicating that additional factors may be necessary for coherent rhythms in cells ectopically expressing Clk. To determine minimal requirements for circadian clock induction by Clk, the authors determined the genetic requirements of ectopic clocks. No ectopic clocks are induced in mutants of Clk’s heterodimeric partner cyc. In addition, noncycling PER is observed when ectopic Clk is induced in a cryb mutant background. While other factors may contribute, these results indicate that persistent Clock induction is uniquely capable of broadly inducing ectopic rhythms even in adults, consistent with a special role at the top of a clock gene hierarchy. PMID:19755582

Kilman, Valerie L.; Allada, Ravi

2011-01-01

184

Pregnancy in a 50-year-old.  

PubMed

A 50-year-old women was admitted on suspicion of abdominal tumor. Clinical examination and ultrasonography revealed a living fetus of 24.2 weeks' gestational age. Amniocentesis revealed trisomy 18 (Edwards' syndrome). At 34 weeks the fetus died spontaneously, and by cesarean section a stillborn boy of 770 g was delivered. The risk of pregnancy in women after the age of 45 is emphasized. PMID:3176960

Helm, P; Ovlisen, B

1988-01-01

185

Innervation of ectopic endometrium in a rat model of endometriosis  

E-print Network

Innervation of ectopic endometrium in a rat model of endometriosis Karen J. Berkley* , Natalia, and approved June 16, 2004 (received for review May 24, 2004) Endometriosis (ENDO) is a disorder in which of the ectopic growths. uterus fertility pain transplant neuropeptides Endometriosis (ENDO) is a disorder

Berkley, Karen J.

186

Ectopic acromegaly due to growth hormone releasing hormone.  

PubMed

Acromegaly secondary to extra-pituitary tumors secreting growth hormone releasing hormone (GHRH) is rarely encountered. We review the literature on ectopic acromegaly and present the index report of ectopic acromegaly secondary to GHRH secretion from a mediastinal paraganglioma. Clinical and pathological manifestations and therapeutic management of 99 patients with ectopic acromegaly are reviewed. Acromegaly secondary to ectopic GHRH secretion is usually caused by a neuroendocrine tumor in the lung and pancreas. We report an additional cause of ectopic acromegaly from a mediastinal paraganglioma. Diagnostic criteria of ectopic GHRH syndrome include biochemical and pathologic tumoral confirmation of GHRH secretion and expression. Management of ectopic acromegaly consists of surgical resection of the primary tumor and biochemical normalization, with possible adjuvant use of somatostatin analogs. The review demonstrates that there are several tumor types, including paragangliomas which may secrete GHRH, leading to acromegaly. Clinical and laboratory manifestations of the syndrome and challenges in diagnosis and management of these rarely encountered patients require early diagnosis and appropriate treatment to prevent long-term morbidity and mortality with ectopic acromegaly. PMID:22983831

Ghazi, Ali A; Amirbaigloo, Alireza; Dezfooli, Azizollah Abbasi; Saadat, Navid; Ghazi, Siavash; Pourafkari, Marina; Tirgari, Farrokh; Dhall, Dheepti; Bannykh, Serguei; Melmed, Shlomo; Cooper, Odelia

2013-04-01

187

Bleeding Ectopic Varices as the First Manifestation of Portal Hypertension  

PubMed Central

Ectopic varices are defined as dilated portosystemic collateral veins in locations other than the gastroesophageal region. We present a case of recurrent upper gastrointestinal bleeding as the first manifestation of portal hypertension. We diagnosed ectopic duodenal varices without gastroesophageal varices on upper GI endoscopy and extrahepatic portal venous obstruction (EHPVO) on CT angiography and managed this case. PMID:25374725

Sharma, Brij; Raina, Sujeet; Sharma, Rajesh

2014-01-01

188

Folic Acid and Pregnancy  

MedlinePLUS

... What to Expect Ebola: What to Know Folic Acid and Pregnancy KidsHealth > Parents > Pregnancy & Newborn Center > Your ... before conception and during early pregnancy . About Folic Acid Folic acid, sometimes called folate, is a B ...

189

Abatacept (Orencia) and Pregnancy  

MedlinePLUS

... pregnancy, call OTIS at 1-866-626-6847 . Document Outline Abatacept (Orencia) and Pregnancy Makol A, et al. 2011. Rheumatoid arthritis and pregnancy: safety considerations in pharmacological management. Drugs. 22;71(15):1973-87.

190

Teen Pregnancy and Childbearing  

MedlinePLUS

... Health Topics Reproductive Health Teen Pregnancy & Childbearing Overview Teen Pregnancy and Childbearing Resources to Help Talking with ... Transmitted Diseases Teen Pregnancy & Childbearing In the States Adolescent Health Topics Reproductive Health Mental Health Physical Health ...

191

Sex during Pregnancy  

MedlinePLUS

... satisfying and safe sexual relationship during pregnancy. Is Sex During Pregnancy Safe? Sex is considered safe during ... frequently asked questions about sex during pregnancy. Can sex harm my baby? No. Your baby is fully ...

192

Usefulness of Transjugular Intrahepatic Portosystemic Shunt in the Management of Bleeding Ectopic Varices in Cirrhotic Patients  

SciTech Connect

Purpose. To evaluate the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in the control of bleeding from ectopic varices. Methods. From 1995 to 2004, 24 cirrhotic patients, bleeding from ectopic varices, mean age 54.5 years (range 15-76 years), were treated by TIPS. The etiology of cirrhosis was alcoholic in 13 patients and nonalcoholic in 11 patients. The location of the varices was duodenal (n = 5), stomal (n = 8), ileocolic (n = 6), anorectal (n = 3), umbilical (n = 1), and peritoneal (n 1). Results. TIPS controlled the bleeding in all patients and induced a decrease in the portacaval gradient from 19.7 {+-} 5.4 to 6.4 {+-} 3.1 mmHg. Postoperative complications included self-limited intra-abdominal bleeding (n = 2), self-limited hemobilia (n = 1), acute thrombosis of the shunt (n = 1), and bile leak treated by a covered stent (n = 1). Median follow-up was 592 days (range 28-2482 days). Rebleeding occurred in 6 patients. In 2 cases rebleeding was observed despite a post-TIPS portacaval gradient lower than 12 mmHg and was controlled by variceal embolization; 1 patient underwent surgical portacaval shunt and never rebled; in 3 patients rebleeding was related to TIPS stenosis and treated with shunt dilatation with addition of a new stent. The cumulative rate of rebleeding was 23% and 31% at 1 and 2 years, respectively. One- and 2-year survival rates were 80% and 76%, respectively. Conclusion. The present series demonstrates that bleeding from ectopic varices, a challenging clinical problem, can be managed safely by TIPS placement with low rebleeding and good survival rates.

Vidal, V. [CHUM - Saint-Luc Hospital, Department of Radiology (Canada); Joly, L. [CHUM - Saint-Luc Hospital, Clinical Research Center, Liver Unit (Canada); Perreault, P.; Bouchard, L.; Lafortune, M. [CHUM - Saint-Luc Hospital, Department of Radiology (Canada); Pomier-Layrargues, G. [CHUM - Saint-Luc Hospital, Clinical Research Center, Liver Unit (Canada)], E-mail: hepato.saint-luc@sympatico.ca

2006-04-15

193

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.

1996-05-01

194

Radionuclide Imaging of Dual Ectopic Thyroid in a Preadolescent Girl  

PubMed Central

Ectopic thyroid is a congenital defect in which the thyroid gland is located away from the usual pretracheal location. Dual ectopic thyroid, which consists of two foci of thyroid tissue, is very rare. In this case dual ectopic thyroid with subclinical hypothyroidism in a 10-year-old-girl was reported. The absence of the thyroid gland in the pretracheal location was revealed by ultrasonography (USG). Two foci of ectopic thyroid tissue located at the base of the tongue and infrahyoid region were determined by Technetium-99m pertechnetate thyroid scintigraphy. It can be concluded that if the thyroid gland is not visible by USG, ectopic thyroid tissue should be evaluated with scintigraphy. PMID:25541934

Y?ld?r?m, ?ule; At?lgan, Hasan ?kbal; Korkmaz, Meliha; Demirel, Koray; Koca, Gökhan

2014-01-01

195

Ruptured heterotopic pregnancy: an unusual presentation of an uncommon clinical problem  

PubMed Central

A 30-year-old nulliparous lady presented to our Emergency Gynaecology Service with a 3-day history of epigastric pain and vomiting at 7?weeks of gestation. An intrauterine pregnancy had been confirmed 3?days earlier when she had attended with an episode of left-iliac fossa pain. Unfortunately, she became more unwell within 1?h of admission and as the cause of her symptoms was unclear, she was taken to the theatre for a joint gynaecology and general surgical diagnostic laparoscopy. This revealed a haemoperitoneum of 2?litres and a ruptured ectopic pregnancy in her left fallopian tube. A left salpingectomy was undertaken to remove the ectopic pregnancy. The patient made an excellent recovery and delivered a healthy baby at 39?weeks of gestation without further complication. PMID:23192579

Gibson, Kyle R; Horne, Andrew W

2012-01-01

196

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.

2014-01-01

197

Fetal abdominal wall defects.  

PubMed

The most common fetal abdominal wall defects are gastroschisis and omphalocele, both with a prevalence of about three in 10,000 births. Prenatal ultrasound has a high sensitivity for these abnormalities already at the time of the first-trimester nuchal scan. Major unrelated defects are associated with gastroschisis in about 10% of cases, whereas omphalocele is associated with chromosomal or genetic abnormalities in a much higher proportion of cases. Challenges in management of gastroschisis are related to the prevention of late intrauterine death, and the prediction and treatment of complex forms. With omphalocele, the main difficulty is the exclusion of associated conditions, not all diagnosed prenatally. An outline of the postnatal treatment of abdominal wall defects is given. Other rarer forms of abdominal wall defects are pentalogy of Cantrell, omphalocele, bladder exstrophy, imperforate anus, spina bifida complex, prune-belly syndrome, body stalk anomaly, and bladder and cloacal exstrophy; they deserve multidisciplinary counselling and management. PMID:24342556

Prefumo, Federico; Izzi, Claudia

2014-04-01

198

EUS diagnosis of ectopic opening of the common bile duct in the duodenal bulb: A case report  

PubMed Central

Among the various congenital anomalies of the biliary system, an ectopic opening of the common bile duct (CBD) in the duodenal bulb is extremely rare. ERCP is essential for diagnosing the anomaly. A 55-year-old male was admitted to hospital for severe right upper quadrant abdominal pain, followed by fever, chills, elevated body temperature and mild icterus. The diagnosis of ectopic opening of CBD in the duodenal bulb was established on endoscopic ultraso-nography (EUS), which clearly demonstrated dilated CBD, with multiple stones and air in the lumen, draining into the bulb. A normal pancreatic duct, which did not drain into the bulb, was also observed. This finding was confirmed on ERCP and surgery. As far as we know, this is the first case of this anomaly diagnosed by EUS. Ectopic opening of the CBD in the duodenal bulb is not an incidental finding, but a pathologic condition which can be associated with clinical entities such as recurrent or intractable duodenal ulcer, recurrent biliary pain, choledocholithiasis or acute cholangitis. Endoscopic ultrasonography features allow preoperative diagnosis of this anomaly and can replace ERCP as a first diagnostic tool in such clinical circumstances. Embryology of the anomalies of the extrahepatic biliary tree has been also reviewed. PMID:16124069

Krstic, Miodrag; Stimec, Bojan; Krstic, Radmilo; Ugljesic, Milenko; Knezevic, Srbislav; Jovanovic, Ivan

2005-01-01

199

Incision for abdominal laparoscopy (image)  

MedlinePLUS

Abdominal laparoscopy is a useful aid in diagnosing disease or trauma in the abdominal cavity with less scarring than ... as liver and pancreatic resections may begin with laparoscopy to exclude the presence of additional tumors (metastatic ...

200

5-Year data analysis of patients following abdominal wall endometrioma surgery.  

PubMed

BackgroundEndometriosis is a disorder in which an ectopic endometrial tissue grows outside the uterine cavity. The ectopic endometrium embedded in the subcutaneous fatty layer and the muscles of abdominal wall is called as abdominal wall endometriosis (AWE). AWE is a rare condition; however, it is usually known to develop along with previous surgical scars. Caesarean section and hysterectomy are considered to be commonly associated with the development of AWE.MethodsWe evaluated the data of the patients who underwent AWE surgery between March 2009 and March 2014.ResultsThe mean age of the patients was 32.5 years. We found a previous history of caesarean section in all of the patients. The most frequent symptoms of the patients were abdominal mass sensation and abdominal pain. Invasion of endometriosis to fat layer, fascia, muscular layer, and peritoneum was recorded. Three masses were located within the scar regions.ConclusionsWe can conclude that there is a high prevalence of caesarean sections among the women with AWE. PMID:25476548

Khamechian, Tahere; Alizargar, Javad; Mazoochi, Tahere

2014-12-01

201

Living with Rh Incompatibility  

MedlinePLUS

... this page with Gmail. Bookmark this page with Google. Share this page from the NHLBI on LinkedIn. ... bleeding or abdominal trauma (for example, from a car accident) during the pregnancy. An ectopic pregnancy, a ...

202

Who Is at Risk for Rh Incompatibility?  

MedlinePLUS

... this page with Gmail. Bookmark this page with Google. Share this page from the NHLBI on LinkedIn. ... bleeding or abdominal trauma (for example, from a car accident) during the pregnancy. An ectopic pregnancy, a ...

203

Intra-abdominal cystic lymphangioma.  

PubMed

Cystic lymphangioma is an uncommon intra-abdominal lesion that is an occasional incidental finding. We report herein the case of a 27-year-old woman with a 3-year history of abdominal pain due to a large intra-abdominal cystic lymphangioma. The lesion was removed surgically with a complete resection that is the optimal treatment with excellent prognosis. PMID:16647365

Guinier, David; Denue, Pierre O; Mantion, George A

2006-05-01

204

Ectopic liver masquerading as a floating intracaval mass.  

PubMed

Ectopic liver is defined as liver parenchyma situated outside the liver proper with no connection to native hepatic tissue. This rare developmental anomaly is most commonly described as an attachment to the gallbladder with an incidence <0.3%, but it has been reported in other locations within the abdomen and thorax.(2-4) Most cases are found incidentally in asymptomatic patients, but ectopic liver has been known to cause visceral or vascular obstruction.(4,5) Herein we present a unique case of ectopic liver attached by a thin stalk seemingly floating in the suprahepatic inferior vena cava. PMID:22360917

Morris, Michael Wyatt; Helling, Thomas S; Creswell, Lawrence L; Jordan, Brenda; Mitchell, Marc E

2012-06-01

205

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))

1991-05-01

206

Pivotal points in interstitial pregnancy: new insights in conservative medical treatment of non-ruptured interstitial pregnancy.  

PubMed

We report the efficacy of a minimally invasive approach of the multidose protocol with methotrexate (MTX) in the management of three cases of interstitial pregnancy (IP), with elevated serum ?-hCG in two cases. New considerations and management strategies are discussed. Successful termination of IP and in one case, a subsequent successful pregnancy, was achieved. The process led to the development of an enhanced understanding of diagnostic modalities and their limitations, with regard to the particular entities under discussion. We also focused attention on pivotal points and anatomical features in the management of this dangerous occurrence. Long-term results with careful follow-up were analysed by instrumental procedure. This hazardous type of ectopic pregnancy can be managed with systemic administration of MTX, also in patients with elevated ?-hCG values. The present report underlines that an integrated approach in early diagnosis, multidose treatment and close follow-up, are essential forms of medical management. PMID:24359066

Pellegrino, A; Damiani, G R; Landi, S; Tartagni, M; Tafuri, S; Caringella, A; Sportelli, C; Gaetani, M; Loverro, G

2014-01-01

207

Prevalence of ectopic thymic tissue in myasthenia gravis and its clinical significance  

Microsoft Academic Search

Forty patients with myasthenia gravis underwent maximal thymectomy. Complete histologic study findings were available for 38 patients. The prevalence of ectopic thymic tissue was 39.5% (15 of 38). On the basis of the presence or absence of ectopic thymic tissue, patients were divided into two groups: group I had ectopic thymic tissue and group II had no ectopic thymic tissue.

M. Ashour

1995-01-01

208

Simple treatment of ectopic eruption with a triangular wedging spring.  

PubMed

The purpose of this clinical report was to introduce a simple and effective way of performing ectopic eruption treatment utilizing a triangular wedging spring. This consists of 3 helical loops in a triangular shape with 0.018-inch Australian wire. The middle helical loop is made for wedging spring action, while the other 2 helical loops are action arms inserted between the second primary molar and ectopically erupting permanent first molar. In this report, the ectopic eruption case was successfully treated with a triangular wedging spring in 2 months. This clinical report demonstrates that a triangular wedging spring can be utilized as a simple, less irritable, and more effective way of correcting ectopic eruption of the permanent first molar. PMID:15926292

Kim, Yong Heon; Park, Ki Tae

2005-01-01

209

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

2013-01-01

210

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

211

Robotic abdominal surgery  

Microsoft Academic Search

As a whole, abdominal surgeons possess excellent videoendoscopic surgical skills. However, the limitations of laparoscopy—such as reduced range of motion and instrument dexterity and 2-dimensional view of the operative field—have inspired even the most accomplished laparoscopists to investigate the potential of surgical robotics to broaden their application of the minimally invasive surgery paradigm. This review discusses data obtained from articles

Eric J. Hanly; Mark A. Talamini

2004-01-01

212

Rhinolithiasis due to supernumerary ectopic tooth: very rare case.  

PubMed

An ectopic supernumerary tooth causing the formation of rhinolith was never reported before in the medical literature. A 30 years old male patient presented to our hospital with one sided nasal obstruction, recurrent epistaxis, and nasal discharge. Anterior rhinoscopy, nasal endoscopy and X-ray paranasal sinuses revealed a rhinolith in the left nasal cavity. Preoperative evaluation and post operative examination of the specimen proved that the nidus of rhinolith was a supernumerary ectopic tooth. PMID:24427605

Janardhan, Nara; Kumar, S Rajesh; Reddy, R Raghavendra; Kumar, C Aruna

2013-12-01

213

Functional abdominal pain  

PubMed Central

Functional abdominal pain or functional abdominal pain syndrome (FAPS) is an uncommon functional gut disorder characterised by chronic or recurrent abdominal pain attributed to the gut but poorly related to gut function. It is associated with abnormal illness behaviour and patients show psychological morbidity that is often minimised or denied in an attempt to discover an organic cause for symptoms. Thus the conventional biomedical approach to the management of such patients is unhelpful and a person's symptom experience is more usefully investigated using a biopsychosocial evaluation, which necessarily entails a multidisciplinary system of healthcare provision. Currently the pathophysiology of the disorder is poorly understood but is most likely to involve a dysfunction of central pain mechanisms either in terms of attentional bias, for example, hypervigilance or a failure of central pain modulation/inhibition. Although modern neurophysiological investigation of patients is promising and may provide important insights into the pathophysiology of FAPS, current clinical management relies on an effective physician-patient relationship in which limits on clinical investigation are set and achievable treatment goals tailored to the patient's needs are pursued. PMID:15998821

Matthews, P; Aziz, Q

2005-01-01

214

Abdominal trauma by ostrich  

PubMed Central

Introduction Ostriches typically avoid humans in the wild, since they correctly assess humans as potential predators, and, if approached, often run away. However, ostriches may turn aggressive rather than run when threatened, especially when cornered, and may also attack when they feel the need to defend their offspring or territories. Presentation of case A 71-year-old male patient presented with intra abdominal injury sustained from being kicked in the abdominal wall by an ostrich. During laparotomy, were found free peritoneal effusion and perforation of the small intestine. Discussion The clinical history and physical examination are extremely important for diagnostic and therapeutic decision making. CT-scan is the most accurate exam for making diagnosis. Surgery is the treatment of choice, and is always indicated when there is injury to the hollow viscera. In general it is possible to suture the defect. Conclusion In cases of blunt abdominal trauma by animals is necessary to have a low threshold of suspicion for acute abdomen.

Usurelu, Sergiu; Bettencourt, Vanessa; Melo, Gina

2015-01-01

215

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

2014-01-01

216

Symptomatic epidural lipomatosis in ectopic Cushing's syndrome.  

PubMed

We report a case of spinal epidural lipomatosis (SEL) caused by ectopic Cushing's syndrome and give a review of the literature. The most common cause of SEL is prolonged therapy with glucocorticoids, only a very few cases are related to endogenous Cushing's syndrome. The pathophysiological mechanism is not clear but there is a possible role for the autonomic nervous system in the stimulation of growth of epidural fat. Severe neurological symptoms which indicate myelopathy and radiculopathy can occur, but there is often a delay in diagnosis because the non-specific initial symptoms are not recognized. The epidural fat is mostly located in the thoracic and lumbar region. Magnetic resonance imaging can establish the diagnosis rapidly. In patients with severe neurological symptoms, surgical decompression of the myelum and removal of the epidural fat is the treatment of choice. Most patients have partial or complete recovery of neurological deficits after surgical treatment or after discontinuing glucocorticoid therapy; mild cases can also be treated conservatively. Routine imaging for the detection of epidural-located lipomatosis in patients at risk is probably useful. PMID:15588244

Bodelier, Alexander G L; Groeneveld, Wim; van der Linden, Antonius N; Haak, Harm R

2004-12-01

217

First-trimester low-dose prednisolone in refractory antiphospholipid antibody-related pregnancy loss.  

PubMed

The objective of this study was to assess pregnancy outcome in women with a history of refractory antiphospholipid antibody-associated pregnancy loss(es) who were treated with early low-dose prednisolone in addition to aspirin and heparin. Eighteen women with antiphospholipid antibodies who had refractory pregnancy loss(es) were given prednisolone (10 mg) from the time of their positive pregnancy test to 14 weeks' gestation. Before low-dose prednisolone was given as treatment, 4 (4%) of 97 pregnancies had resulted in live births. Among 23 pregnancies supplemented with prednisolone, 9 women had 14 live births (61%), including 8 uncomplicated pregnancies. The remainder were complicated by preterm delivery, preeclampsia, and/or small-for-gestational-age infants. There were 8 first-trimester miscarriages and 1 ectopic pregnancy. There were no fetal deaths after 10 weeks' gestation and no evidence of maternal morbidity. The addition of first-trimester low-dose prednisolone to conventional treatment is worthy of further assessment in the management of refractory antiphospholipid antibody-related pregnancy loss(es), although complications remain elevated. PMID:21527518

Bramham, Kate; Thomas, Mari; Nelson-Piercy, Catherine; Khamashta, Munther; Hunt, Beverley J

2011-06-23

218

Management of unruptured ectopic gestation by linear salpingostomy: a prospective, randomized clinical trial of laparoscopy versus laparotomy.  

PubMed

This study was designed to compare prospectively the parameters of morbidity, cost, length of hospital stay, and fertility outcome after linear salpingostomy by laparoscopy versus laparotomy. Entry criteria included stable vital signs, hematocrit greater than 30%, age over 18 years, and desire for future fertility. All patients underwent diagnostic laparoscopy. Sixty patients with unruptured ectopic gestations of 5 cm or smaller were randomized to either laparoscopy (N = 30) or laparotomy (N = 30). Postoperative follow-up included serial measurements of serum beta-hCG titers at 3-day intervals and hysterosalpingography at 12 weeks. The laparoscopy and laparotomy groups were similar in age, height, weight, gravidity, gestational age, hematocrit, ectopic pregnancy size, and preoperative beta-hCG levels. The estimated blood loss was significantly (P less than .001) lower in patients undergoing laparoscopy, and was not affected by vasopressin injection. Two patients in the laparoscopy group required laparotomy for hemostasis, and two patients undergoing laparotomy had wound infection. One patient in each group had persistent trophoblastic activity. Baseline serum beta-hCG levels and the rate and magnitude of postoperative beta-hCG decline were similar in both groups. The length of hospital stay was significantly (P less than .001) shorter after laparoscopic salpingostomy (1.4 +/- 0.1 days) than after laparotomy (3.3 +/- 0.2 days). Postoperative hysterosalpingography showed patency of the involved tube in 16 of 20 (80%) and 17 of 19 (89%) of patients in the laparoscopy and laparotomy groups, respectively. Pregnancy rates were ten of 18 (56%) and 11 of 19 (58%) in these groups, respectively, and all pregnancies were conceived within 6 months of surgery.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2464777

Vermesh, M; Silva, P D; Rosen, G F; Stein, A L; Fossum, G T; Sauer, M V

1989-03-01

219

Abdominal Perfusion Computed Tomography  

PubMed Central

The purpose of this article is to provide an up to date review on the spectrum of applications of perfusion computed tomography (CT) in the abdomen. New imaging techniques have been developed with the objective of obtaining a structural and functional analysis of different organs. Recently, perfusion CT has aroused the interest of many researchers who are studying the applicability of imaging modalities in the evaluation of abdominal organs and diseases. Per-fusion CT enables fast, non-invasive imaging of the tumor vascular physiology. Moreover, it can act as an in vivo biomarker of tumor-related angiogenesis.

Ogul, Hayri; Bayraktutan, Ummugulsum; Kizrak, Yesim; Pirimoglu, Berhan; Yuceler, Zeynep; Sagsoz, M. Erdem; Yilmaz, Omer; Aydinli, Bulent; Ozturk, Gurkan; Kantarci, Mecit

2013-01-01

220

Staphylococcus aureus and Pregnancy  

MedlinePLUS

... or visit us online at: www.OTISpregnancy.org . Staphylococcus aureus and Pregnancy In every pregnancy, a woman starts ... risk. This sheet talks about whether exposure to staphylococcus aureus may increase the risk for birth defects over ...

221

Street Drugs and Pregnancy  

MedlinePLUS

... been added to your dashboard . Street drugs and pregnancy A street drug (also called illegal or illicit ... are abused How can street drugs harm your pregnancy? Using street drugs can cause problems for you ...

222

Pregnancy and Fifth Disease  

MedlinePLUS

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

223

Tumors and Pregnancy  

MedlinePLUS

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. ...

224

Weight Gain during Pregnancy  

MedlinePLUS

... this page It's been added to your dashboard . Weight gain during pregnancy When you’re pregnant, you ... in sight! Be careful about the amount of weight you gain during your pregnancy. Gaining too much ...

225

Pregnancy and Healthy Weight  

MedlinePLUS

... Media Resources Selected Profiles & Interviews Multimedia Pregnancy & Healthy Weight Skip sharing on social media links Share this: ... Content New research shows that maintaining a healthy weight before and during pregnancy can reduce the likelihood ...

226

Thalidomide and Pregnancy  

MedlinePLUS

... or visit us online at: www.OTISpregnancy.org . Thalidomide and Pregnancy In every pregnancy, a woman starts ... advice from your health care professional. What is thalidomide? Thalidomide is a sedative agent that also changes ...

227

Depression and Pregnancy  

MedlinePLUS

... miscarriage, low birth weight, and babies who are small-for-gestational age when depression is left untreated in pregnancy. Pre- ... pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry 67( ...

228

Alcohol during Pregnancy  

MedlinePLUS

... 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 ...

229

Pregnancy Complications: Genital Herpes  

MedlinePLUS

... page It's been added to your dashboard . Genital herpes and pregnancy Genital herpes is a sexually transmitted ... the United States has genital herpes. Can genital herpes cause complications during pregnancy? Yes. Genital herpes can ...

230

Immunization and Pregnancy  

MedlinePLUS

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/ ...

231

Planning for Pregnancy  

MedlinePLUS

... this? Submit Button Information For... Media Policy Makers Planning for Pregnancy Language: English Español (Spanish) Share Compartir ... and dietary or herbal supplements. If you are planning a pregnancy, you should discuss the need for ...

232

Familiy Planning and Pregnancy  

MedlinePLUS

... 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 ...

233

[Dermatoses of pregnancy].  

PubMed

Pregnancy is associated with hormonal, metabolic, immunologic, haemodynamic and vascular changes which produce physiological and pathological cutaneous manifestations. Most skin disorders during pregnancy represent physiological changes. The specific dermatoses of pregnancy are disease entities almost exclusively related to the pregnancy or the postpartum period. Some dermatoses characteristically improve or exacerbate during pregnancy. Dermatoses of pregnancy can potentially be a serious risk to the foetus. Although the foetal outcome is almost always favourable, early diagnosis and prompt treatment are essential. Use of any medication during pregnancy should be carefully considered, and as few medications as possible should be administered. In this review, the authors discuss the various dermatoses of pregnancy in detail, based on novel classification, aetiology and pathogenesis, diagnostic approach, disease course, prognosis, foetal risk and therapy. PMID:23996922

Sziray, Agnes; Károlyi, Zsuzsánna

2013-09-01

234

Isotretinoin (Accutane) and Pregnancy  

MedlinePLUS

... or visit us online at: www.OTISpregnancy.org . Isotretinoin (Accutane ® ) and Pregnancy In every pregnancy, a woman ... advice from your health care professional. What is isotretinoin? Isotretinoin is a prescription medication taken by mouth ...

235

Mold and Pregnancy  

MedlinePLUS

... or visit us online at: www.OTISpregnancy.org . Mold and Pregnancy In every pregnancy, a woman starts ... and advice from your healthcare professional. What is mold? Molds are fungi that can be found both ...

236

HIV and Pregnancy  

MedlinePLUS

... week of pregnancy until the end of pregnancy. Human Immunodeficiency Virus (HIV): A virus that attacks certain cells of the body’s immune system and causes acquired immunodeficiency syndrome (AIDS). Immune System: ...

237

Paint and Pregnancy  

MedlinePLUS

... or visit us online at: www.OTISpregnancy.org . Paint and Pregnancy In every pregnancy, a woman starts ... and advice from your healthcare professional. What is paint? Paint is made up of pigment particles (color) ...

238

Metformin and Pregnancy  

MedlinePLUS

... and Pregnancy available at www.MotherToBaby.org. References: Briggs GG, et al. 2005. Excretion of metformin into ... 203(5):457.e1-9, 2010 Nov. Feig DS et al. 2007. Oral antidabetic agents in pregnancy ...

239

Medication Use during Pregnancy  

MedlinePLUS

... Button CDC Features Medication Use During Pregnancy Language: English Español (Spanish) Share Compartir The safety of most ... Folic Acid : Helping to Ensure a Healthy Pregnancy. ( English or Spanish ) Ten Tips to Prevent Infections during ...

240

Diabetes and Pregnancy  

Microsoft Academic Search

Diabetes mellitus is the most common complication in pregnancy, affecting nearly 8% of all pregnancies. Nearly 90% of women\\u000a with diabetes develop the condition during pregnancy; diabetes in the other 10% antedated the pregnancy. Since the discovery\\u000a of insulin, perinatal mortality rates for women with diabetes have decreased, however, infant morbidity remains higher than\\u000a in the nondiabetes pregnant population.\\u000a \\u000a Diabetes

Alyce M. Thomas

241

The Anatomical Considerations of Ectopic Gestation  

E-print Network

, which has a narrow lumen and i s markedly convoluted and lengthened; (c) D i v e r t i c u l a , accessory lumina or o s t i a and cu l de sacs; (d) puerperal atrophy of the tubes; (e) Congenital or acquired stenosis; ( f ) Polypi p r o j e c t i n... f f i c i e n t c o n d i t i o n . The value of these experiments i s g r e a t l y reduced by the statement of Bland Sutton (7) that extra-uterine pregnancy r a r e l y , i f ever, occurs i n lower animals. I f t h i s be true, i t would seem...

Guffey, Don Carlos

1908-01-01

242

Pregnancy and Skin  

PubMed Central

Pregnancy is associated with complex of endocrinological, immunological, metabolic, and vascular changes that may influence the skin and other organs in various ways. Pregnancy is a period in which more than 90% women have significant and complex skin changes that may have great impact on the woman's life. The dermatoses of pregnancy represent a heterogeneous group of skin diseases related to pregnancy and/or the postpartum period. The dermatoses of pregnancy can be classified into the following three groups: Physiologic skin changes in pregnancy, pre-existing dermatoses affected by pregnancy, and specific dermatoses of pregnancy. Though most of these skin dermatoses are benign and resolve in postpartum period, a few can risk fetal life and require antenatal surveillance. Most of the dermatoses of pregnancy can be treated conservatively but a few require intervention in the form of termination of pregnancy. Correct diagnosis is essential for the treatment of these disorders. This article discusses the current knowledge of various skin changes during pregnancy and the evaluation of the patient with pregnancy dermatoses with special emphasis on clinical features, diagnostic tests, maternal and fetal prognosis, therapy, and management.

Vora, Rita V.; Gupta, Rajat; Mehta, Malay J.; Chaudhari, Arvind H.; Pilani, Abhishek P.; Patel, Nidhi

2014-01-01

243

Bulimia Nervosa During Pregnancy  

Microsoft Academic Search

Pregnant women with bulimia nervosa present interesting practice challenges for dietitians and healthcare professionals due to potential complications of bulimia nervosa for both mothers and fetuses. This review summarizes case study reports, case series reports, and retrospective studies of women with bulimia nervosa during pregnancy, and focuses on relationships among bulimic behaviors, pregnancy results, and birth outcomes. Pregnancy and birth

ELIZABETH S MORRILL; HARON M NICKOLS-RICHARDSON

2001-01-01

244

Weight gain in pregnancy  

Microsoft Academic Search

Pregnancy and body weight development are intertwined in complicated patterns. Of the obese patients at our Obesity Unit, 73% had retained >10 kg in connection with a pregnancy. For the general population the effect of a preg- nancy on future weight development is surpris- ingly difficult to predict. In the Stockholm pregnancy and weight development study the estimated mean weight

Stephan Rossner

245

Depression during pregnancy  

Microsoft Academic Search

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

Deirdre Ryan; Lisa Milis; Nicholas Misri

2005-01-01

246

Vaccinations during Pregnancy  

MedlinePLUS

... 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 ...

247

Hyperthermia and Pregnancy  

MedlinePLUS

... 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 ...

248

Travel during Pregnancy  

MedlinePLUS

When is the best time to travel during pregnancy? The best time to travel is probably the middle of your pregnancy—between weeks 14 and 28. Most ... and Gynecologists f AQ • When is the best time to travel during pregnancy? • What should I know about planning ...

249

Outcome of pregnancy in survivors of Wilms' tumor  

SciTech Connect

Outcome of pregnancy was reported by 99 patients who were cured of childhood Wilms' tumor at seven pediatric cancer centers during 1931 to 1979. These patients carried or sired 191 singleton pregnancies of at least 20 weeks in duration. Among the 114 pregnancies in women who had received abdominal radiotherapy for Wilms' tumor, an adverse outcome occurred in 34 (30%). There were 17 perinatal deaths (five in premature low-birth-weight infants) and 17 other low-birth-weight infants. Compared with white women in the United States, the irradiated women had an increased perinatal mortality rate (relative risk, 7.9) and an excess of low-birth-weight infants (relative risk, 4.0). In contrast, an adverse outcome was found in two (3%) of the 77 pregnancies in nonirradiated female patients with Wilms' tumor and wives of male patients. The high risk of adverse pregnancy outcome should be considered in the counseling and prenatal care of women who have received abdominal radiotherapy for Wilms' tumor.

Li, F.P.; Gimbrere, K.; Gelber, R.D.; Sallan, S.E.; Flamant, F.; Green, D.M.; Heyn, R.M.; Meadows, A.T.

1987-01-09

250

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

2011-01-01

251

How I Manage Abdominal Injuries.  

ERIC Educational Resources Information Center

In sports, abdominal injuries occur most frequently in cycling, horseback riding, and skiing. Most involve children, not adults. Any athlete sustaining a severe blow to the abdomen should be examined. Guidelines are provided for recognizing and treating injuries to the abdominal muscles, kidneys, spleen, and liver. (Author/MT)

Haycock, Christine E.

1986-01-01

252

Single vessel abdominal arterial disease.  

PubMed

The long-standing discussion concerning the mere existence of single vessel abdominal artery disease can be closed: chronic gastrointestinal ischaemia (CGI) due to single vessel abdominal artery stenosis exists, can be treated successfully and in a safe manner. The most common causes of single vessel CGI are the coeliac artery compression syndrome (CACS) in younger patients, and atherosclerotic disease in elderly patients. The clinical symptoms of single vessel CGI patients are postprandial and exercise-related pain, weight loss, and an abdominal bruit. The current diagnostic approach in patients suspected of single vessel CGI is gastrointestinal tonometry combined with radiological visualisation of the abdominal arteries to define possible arterial stenosis. Especially in single vessel abdominal artery stenosis, gastrointestinal tonometry plays a pivotal role in establishing the diagnosis CGI. First-choice treatment of single vessel CGI remains surgical revascularisation, especially in CACS. In elderly or selected patients endovascular stent placement therapy is an acceptable option. PMID:19258186

van Noord, Désirée; Kuipers, Ernst J; Mensink, Peter B F

2009-01-01

253

Probiotics and pregnancy.  

PubMed

Complications of pregnancy are associated with adverse outcomes for mother and baby in the short and long term. The gut microbiome has been identified as a key factor for maintaining health outside of pregnancy and could contribute to pregnancy complications. In addition, the vaginal and the recently revealed placental microbiome are altered in pregnancy and may play a role in pregnancy complications. Probiotic supplementation could help to regulate the unbalanced microflora composition observed in obesity and diabetes. Here, the impact of probiotic supplementation during pregnancy and infancy is reviewed. There are indications for a protective role in preeclampsia, gestational diabetes mellitus, vaginal infections, maternal and infant weight gain and allergic diseases. Large, well-designed randomised controlled clinical trials along with metagenomic analysis are needed to establish the role of probiotics in adverse pregnancy and infancy outcomes. PMID:25398206

Gomez Arango, Luisa F; Barrett, Helen L; Callaway, Leonie K; Nitert, Marloes Dekker

2015-01-01

254

Aorta pathology and pregnancy.  

PubMed

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

2014-05-01

255

Ectopic ACTH-secreting pituitary adenoma of the sphenoid sinus: case report of endoscopic endonasal resection and systematic review of the literature.  

PubMed

Ectopic pituitary adenomas are exceedingly rare entities that are often misdiagnosed. The resulting delay in diagnosis may be particularly concerning in the case of Cushing syndrome caused by an ectopic adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma. Although the total resection of ectopic adenomas results in rapid and durable remission, persistent Cushing syndrome is often associated with permanently damaging invasive procedures and significantly higher risk of mortality. The authors report the case of a 48-year-old man with ACTH-dependent Cushing syndrome. On the morning before surgery, his serum cortisol measured 51 ?g/dl, his ACTH level was 195.7 pg/ml, and his urinary free cortisol level was 2109 ?g/day. Serum cortisol was not suppressed with the administration of high-dose dexamethasone. Imaging showed separate masses in both the sphenoid sinus and the pituitary gland, complicating the diagnostic process and requiring pathological assessment of both masses. No other abnormalities were found on thoracic, abdominal, or pelvic scans. Gross-total resection of both lesions was accomplished via an endoscopic endonasal transsphenoidal approach. Pathology confirmed an ectopic ACTH pituitary adenoma of the sphenoid sinus and a Crooke hyaline change of the pituitary gland. The patient achieved stable hormonal remission without significant postoperative complications, returned to full activity within 3 months, and remained disease free nearly 1 year after tumor resection. In a systematic literature review, the authors identified 41 cases of ectopic ACTH-secreting pituitary adenomas, including 18 arising in the sphenoid sinus without direct involvement of the sella. Including the case described here, the total number of ectopic ACTH pituitary adenomas arising in the sphenoid sinus was 19, and the total number of ectopic ACTH pituitary adenomas without regard to location was 42. For the 19 patients with adenomas found in the sphenoid sinus, ages ranged from 16 to 76 years, and there were 15 women and 4 men. The mean and median diameters of the resected sphenoid masses were 13.9 and 8 mm, respectively, with a range of 3-55 mm. Seven were microadenomas (< 1 cm). Fifteen of the 19 cases reported serum ACTH and morning cortisol levels, the means of which were 106.7 pg/ml and 32.5 ?g/dl, respectively. Gross-total tumor resection was achieved in all patients except one, and in all of them durable hormonal remission of Cushing syndrome was achieved (mean follow-up time 20 months). Ectopic pituitary adenomas are rare but important causes of Cushing syndrome and related endocrinopathies, particularly because of the rapid onset and severity of symptoms with atypical presentation. Ectopic pituitary adenomas, especially those in the nasal cavity, nasopharynx, or paranasal sinuses, are easily misidentified. Any patient presenting with signs and symptoms of Cushing syndrome without any obvious pituitary adenoma or other sources of hypercortisolemia should be thoroughly screened for an ectopic adenoma. However, as with the case presented here, the coincident existence of a sellar mass should not preclude the possibility of an ectopic source. There should be a high degree of clinical suspicion for any mass in the general area surrounding the sella when evaluating Cushing syndrome. PMID:25639312

Seltzer, Justin; Lucas, Joshua; Commins, Deborah; Lerner, Olga; Lerner, Alexander; Carmichael, John D; Zada, Gabriel

2015-02-01

256

Onset of obsessive compulsive disorder in pregnancy with pica as the sole manifestation.  

PubMed

Pica refers to eating of non-nutritious substances, which is usually seen in childhood or pregnancy. Here we report a case of an illiterate tribal woman who developed pica as the sole manifestation of obsessive compulsive disorder, with onset during pregnancy. The patient had compulsions of eating uncooked rice or wheat, which resulted in toothache and abdominal discomfort. She had this habit in three pregnancies, consecutively. In the first two pregnancies it resolved spontaneously after puerperium, but persisted in the last one. Probably physical stress of limb edema during the third pregnancy was reason for the persistence. She responded to fluoxetine 40 mg / day after three months of treatment, without behavioral therapy. We conclude that pica may either be only a manifestation of obsessive compulsive disorder during pregnancy or it is an obsessive compulsive spectrum disorder. PMID:23440014

Upadhyaya, Suneet Kumar; Sharma, Archana

2012-07-01

257

Onset of Obsessive Compulsive Disorder in Pregnancy with Pica as the Sole Manifestation  

PubMed Central

Pica refers to eating of non-nutritious substances, which is usually seen in childhood or pregnancy. Here we report a case of an illiterate tribal woman who developed pica as the sole manifestation of obsessive compulsive disorder, with onset during pregnancy. The patient had compulsions of eating uncooked rice or wheat, which resulted in toothache and abdominal discomfort. She had this habit in three pregnancies, consecutively. In the first two pregnancies it resolved spontaneously after puerperium, but persisted in the last one. Probably physical stress of limb edema during the third pregnancy was reason for the persistence. She responded to fluoxetine 40 mg / day after three months of treatment, without behavioral therapy. We conclude that pica may either be only a manifestation of obsessive compulsive disorder during pregnancy or it is an obsessive compulsive spectrum disorder. PMID:23440014

Upadhyaya, Suneet Kumar; Sharma, Archana

2012-01-01

258

Ectopic intrathyroidal thymoma: a case report and review.  

PubMed

Ectopic intrathyroidal thymomas are an exceedingly rare clinical entity that can be challenging to diagnose. This report describes a 39-year-old Japanese woman who presented with prominent left-sided thyroid enlargement that was thought to be a dominant thyroid nodule by ultrasound. Two fine-needle aspiration biopsies showed an atypical lymphoid proliferation that was suspicious for although not diagnostic of a low-grade lymphoma. A diagnosis of ectopic intrathyroidal thymoma was made only after appropriate histopathologic assessment of the surgical specimen. PMID:12729482

Cohen, Jason B; Troxell, Megan; Kong, Christina S; McDougall, I Ross

2003-03-01

259

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

260

Age-Related Different Relationships between Ectopic Adipose Tissues and Measures of Central Obesity in Sedentary Subjects  

PubMed Central

Accumulation of fat at ectopic sites has been gaining attention as pivotal contributor of insulin resistance, metabolic syndrome and related cardiovascular complications. Intermuscular adipose tissue (IMAT), located between skeletal muscle bundles and beneath muscle fascia, has been linked to physical inactivity, ageing and body mass index, but little is known about its relationship with the other AT compartments, in particular with increasing age. To address this issue, erector spinae IMAT, epicardial (EAT), intraabdominal (IAAT) and abdominal subcutaneous adipose tissue (SAT) were simultaneously measured by Magnetic Resonance Imaging (MRI) and related to waist circumference measurements and age in 32 sedentary subjects without cardiovascular disease (18 men; 14 women; mean age 48.5±14 years). Fasting glucose, triglycerides and HDL-cholesterol were also assessed. We observed that, after dividing individuals according to age (? or >50 years), IMAT and EAT depots were significantly more expanded in older subjects (63.2±8.3 years) than in the younger ones (38.4±5.2 years) (p<0.001). Overall, both IMAT and EAT showed stronger positive associations with increasing age (??=?0.63 and 0.67, respectively, p<0.001 for both) than with waist circumference (??=?0.55 and 0.49, respectively, p<0.01 for both) after adjusting for gender. In addition, the gender-adjusted associations of IMAT and EAT with waist circumference and IAAT were significant in individuals ?50 years only (p<0.05 for all) and not in the older ones. In contrast, no age-related differences were seen in the relationships of IAAT and SAT with waist circumference. Finally, serum triglycerides levels turned out not to be independently related with ectopic IMAT and EAT. In conclusion, the expansion of IMAT and EAT in sedentary subjects is more strongly related to age than waist circumference, and a positive association of these ectopic depots with waist circumference and IAAT amount can be postulated in younger individuals only. PMID:25051047

Guglielmi, Valeria; Maresca, Luciano; D'Adamo, Monica; Di Roma, Mauro; Lanzillo, Chiara; Federici, Massimo; Lauro, Davide; Preziosi, Paolo; Bellia, Alfonso; Sbraccia, Paolo

2014-01-01

261

Common skin conditions during pregnancy.  

PubMed

Common skin conditions during pregnancy generally can be separated into three categories: hormone-related, preexisting, and pregnancy-specific. Normal hormone changes during pregnancy may cause benign skin conditions including striae gravidarum (stretch marks); hyperpigmentation (e.g., melasma); and hair, nail, and vascular changes. Preexisting skin conditions (e.g., atopic dermatitis, psoriasis, fungal infections, cutaneous tumors) may change during pregnancy. Pregnancy-specific skin conditions include pruritic urticarial papules and plaques of pregnancy, prurigo of pregnancy, intrahepatic cholestasis of pregnancy, pemphigoid gestationis, impetigo herpetiformis, and pruritic folliculitis of pregnancy. Pruritic urticarial papules and plaques of pregnancy are the most common of these disorders. Most skin conditions resolve postpartum and only require symptomatic treatment. However, there are specific treatments for some conditions (e.g., melasma, intrahepatic cholestasis of pregnancy, impetigo herpetiformis, pruritic folliculitis of pregnancy). Antepartum surveillance is recommended for patients with intrahepatic cholestasis of pregnancy, impetigo herpetiformis, and pemphigoid gestationis. PMID:17263216

Tunzi, Marc; Gray, Gary R

2007-01-15

262

Acute incarcerated external abdominal hernia  

PubMed Central

External abdominal hernia occurs when abdominal organs or tissues leave their normal anatomic site and protrude outside the skin through the congenital or acquired weakness, defects or holes on the abdominal wall, including inguinal hernia, umbilical hernia, femoral hernia and so on. Acute incarcerated hernia is a common surgical emergency. With advances in minimally invasive devices and techniques, the diagnosis and treatment have witnessed major changes, such as the use of laparoscopic surgery in some cases to achieve minimally invasive treatment. However, strict adherence to the indications and contraindications is still required. PMID:25489584

Yang, Xue-Fei

2014-01-01

263

Acute incarcerated external abdominal hernia.  

PubMed

External abdominal hernia occurs when abdominal organs or tissues leave their normal anatomic site and protrude outside the skin through the congenital or acquired weakness, defects or holes on the abdominal wall, including inguinal hernia, umbilical hernia, femoral hernia and so on. Acute incarcerated hernia is a common surgical emergency. With advances in minimally invasive devices and techniques, the diagnosis and treatment have witnessed major changes, such as the use of laparoscopic surgery in some cases to achieve minimally invasive treatment. However, strict adherence to the indications and contraindications is still required. PMID:25489584

Yang, Xue-Fei; Liu, Jia-Lin

2014-11-01

264

Localized Ectopic Expression of Dpp Receptors in a Drosophila Embryo  

E-print Network

Localized Ectopic Expression of Dpp Receptors in a Drosophila Embryo By A. D. Lander, Q. Nie, F. Y of elevated receptor level in a Drosophila embryo by modeling mathematically the basic biological processes and Drosophila embryos is now known to be regulated by bone morphogeneric proteins (BMP). The BMP activity

Zhang, Yong-Tao

265

Localized Ectopic Expression of Dpp Receptors in a Drosophila Embryo  

E-print Network

Localized Ectopic Expression of Dpp Receptors in a Drosophila Embryo A.D. Landera,b , Q. Nieb of depression of Dpp signaling outside the area of elevated tkv in a Drosophila embryo by modeling and Drosophila embryos is now known to be regulated by bone morphogeneric proteins (BMP). The BMP ac- tivity

Wan, Frederic Yui-Ming

266

Ectopic cervical thymoma located in the carotid triangle.  

PubMed

Ectopic cervical thymoma is an extremely rare tumor thought to arise from ectopic thymic tissue caused by the aberrant migration of the embryonic thymus. We present the case of a 44-year-old woman with an ectopic cervical thymoma located in the carotid triangle. A computed tomography (CT) scan detected a mass in her right carotid triangle. On an unenhanced scan, the tumor showed homogeneous isodensity compared with muscles, and neither fat nor calcification was detected. A contrast-enhanced CT image obtained during the arterial phase showed intratumoral septa, while an image obtained during the parenchymal phase showed cystic changes within the mass. The patient underwent a surgical resection. A histological study enabled a diagnosis of type AB thymoma in which foci with the features of type A thymoma are admixed with foci rich in lymphocytes. This subtype is a benign tumor with a good prognosis. Ectopic cervical thymoma should be included in the differential diagnosis of solid masses located in the carotid triangle when the CT findings are typical of a thymoma. PMID:23073822

Tsukada, Jitsuro; Hasegawa, Ichiro; Sato, Hiroaki; Kakefuda, Toshihiro; Sugiura, Hitoshi; Narimatsu, Yoshiaki

2013-02-01

267

Ectopic Fat Deposition in Prediabetic Overweight and Obese Minority Adolescents  

E-print Network

Ectopic Fat Deposition in Prediabetic Overweight and Obese Minority Adolescents Claudia M. Toledo ethnicities with high risk. Objective: The aim of this study was to examine the contribution of visceral adipose tissue (VAT), hepatic fat fraction (HFF), and pancreatic fat fraction (PFF) to prediabetes

Southern California, University of

268

Ectopic integration of chromosomal genes in Streptococcus pneumoniae  

SciTech Connect

When a DNA fragment containing a marker gene was ligated to random chromosomal fragments of Streptococcus pneumoniae and used to transform a recipient strain lacking that gene, the gene was integrated at various locations in the chromosome. Such ectopic integration was demonstrated for the malM gene, and its molecular basis was analyzed with defined donor molecules consisting of ligated fragments containing the malM and sul genes of S. pneumoniae. In a recipient strain deleted in the mal region of its chromosome, these constructs gave Mal/sup +/ transformants in which the malM and sul genes were now linked, with malM located between duplicate sul segments. Ectopic integration was unstable under nonselective conditions; mal(sul) ectopic insertions were lost at a rate of 0.05% per generation. Several possible mechanisms of ectopic integration were examined. The donor molecule is most likely to be a circular form of ligated homologous and nonhomologous fragments that, after entry into the cell, undergoes circular synapsis with the recipient chromosome at the site of homology, followed by repair and additive integration.

Mannarelli, B.M.; Lacks, S.A.

1984-12-01

269

Studies on ectopic granule cells in the cerebellar cortex  

Microsoft Academic Search

In order to strengthen a hypothesis concerning the occurrence of ectopic granule cells, one of the assumptions made was tested systematically. The reaction of the EGL to partial destruction by various single doses of hydroxyurea at various ages was followed. Under all conditions examined, re-population of the EGL takes place—rapidly after lower doses, slowly after high doses of HU. The

Ebel J. Ebels; Ieteke Peters; Aaltje Thijs

1975-01-01

270

Ectopic ACTH-secreting pituitary adenomas within the sphenoid sinus.  

PubMed

Ectopic pituitary adenomas are defined by the presence of adenomatous pituitary tissue outside the sella and distinctly separate from the pituitary gland. Ectopic ACTH-secreting pituitary adenomas (EAPAs) are a rare cause of Cushing's syndrome. Detecting these radiologically can prove difficult, in part, due to their typically small size and unpredictable anatomical location. In ACTH-dependent Cushing's syndrome, if, despite comprehensive testing, the source of excess ACTH remains occult (including negative work up for ectopic ACTH syndrome) thought should be given to the possibility of the patient harboring an EAPA. In most cases, ectopic ACTH pituitary adenomas within the sphenoid sinus will manifest with symptoms of hormonal excess, have an obvious sphenoid sinus mass on pre-operative imaging and will demonstrate resolution of hypercortisolism after surgical excision if located and removed. Twenty cases of EAPAs have been reported in the literature to date. This paper will review the current literature on all previously reported EAPAs within the sphenoid sinus in addition to the current case. PMID:24927792

Johnston, Philip C; Kennedy, Laurence; Weil, Robert J; Hamrahian, Amir H

2014-12-01

271

Redefining anatomy in a case of midline subhyoid ectopic thyroid.  

PubMed

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

2014-08-01

272

Brief Review of Models of Ectopic Bone Formation  

PubMed Central

Ectopic bone formation is a unique biologic entity—distinct from other areas of skeletal biology. Animal research models of ectopic bone formation most often employ rodent models and have unique advantages over orthotopic (bone) environments, including a relative lack of bone cytokine stimulation and cell-to-cell interaction with endogenous (host) bone-forming cells. This allows for relatively controlled in vivo experimental bone formation. A wide variety of ectopic locations have been used for experimentation, including subcutaneous, intramuscular, and kidney capsule transplantation. The method, benefits and detractions of each method are summarized in the following review. Briefly, subcutaneous implantation is the simplest method. However, the most pertinent concern is the relative paucity of bone formation in comparison to other models. Intramuscular implantation is also widely used and relatively simple, however intramuscular implants are exposed to skeletal muscle satellite progenitor cells. Thus, distinguishing host from donor osteogenesis becomes challenging without cell-tracking studies. The kidney capsule (perirenal or renal capsule) method is less widely used and more technically challenging. It allows for supraphysiologic blood and nutrient resource, promoting robust bone growth. In summary, ectopic bone models are extremely useful in the evaluation of bone-forming stem cells, new osteoinductive biomaterials, and growth factors; an appropriate choice of model, however, will greatly increase experimental success. PMID:22085228

Scott, Michelle A.; Levi, Benjamin; Askarinam, Asal; Nguyen, Alan; Rackohn, Todd; Ting, Kang; Soo, Chia

2012-01-01

273

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

2013-01-01

274

Pregnancy in adolescents.  

PubMed

Adolescent pregnancy remains a public health issue with significant medical, emotional, and societal consequences for the adolescent mother, her child, and her family. Teenage pregnancies are at higher risk of many adverse outcomes, including preterm delivery, low birth weight, and neonatal and infant mortality. Teen pregnancy and motherhood may have detrimental effects on the teen mother and her child; antenatal and postpartum care need to be adapted to meet the special needs of pregnant adolescents because standard obstetrical environments may not do so. This comprehensive review of adolescent pregnancy will highlight global statistics, factors contributing to adolescent pregnancy, social implications of adolescent pregnancy, obstetrical and neonatal outcomes, and the importance of multidisciplinary antenatal and postnatal care. PMID:22764559

Black, Amanda Y; Fleming, Nathalie A; Rome, Ellen S

2012-04-01

275

ECTOP1C FETUSES IN TWO COTTONTAIL RABBITSW  

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)

DOUGLAS P. KIBBEE; Jand ROY L KIRKPATRICK

276

Cushing's syndrome in pregnancy.  

PubMed

Abstract Cushing's syndrome is a rare condition in the general population and is even less common during pregnancy with only a few cases reported in literature. The diagnosis of Cushing's syndrome may be difficult during pregnancy because the typical features of the disorder and pregnancy may overlap. However, Cushing's syndrome results in increased fetal and maternal complications, and diagnosis and treatment are critical. This report describes a case of 26-year-old female at the 19th week of pregnancy with symptoms and signs of hypercortisolism, where ACTH-independent Cushing's syndrome was diagnosed and treated by robotic laparoscopic adrenalectomy at the 21th week of gestation. PMID:25430821

Nassi, Rossella; Ladu, Cristina; Vezzosi, Chiara; Mannelli, Massimo

2015-02-01

277

Hypertensive emergencies in pregnancy.  

PubMed

Hypertensive disorders of pregnancy complicate 7% to 10% of pregnancies and are among the major causes of maternal and perinatal morbidity and mortality. Recently American College of Obstetricians and Gynecologists Taskforce on Hypertension during Pregnancy modified the diagnosis and management of hypertension in pregnancy, recommending prompt diagnosis, admission, close monitoring, and treatment. They strive to decrease maternal mortality and systemic complications. Labetalol, hydralazine, or nifedipine are considered first-line treatment, and either can be used to stabilize the patient with similar outcomes. Definite treatment is delivery of the fetus and should be considered based on the etiology of the hypertensive crisis and gestational age. PMID:25314092

Vadhera, Rakesh B; Simon, Michelle

2014-12-01

278

Autoimmunity and pregnancy loss.  

PubMed

Clinicians have recognized for several decades that certain autoimmune conditions, such as systemic lupus erythematosus (SLE), are associated with pregnancy loss. During the 1980s, investigations focused attention on fetal wastage in women with antiphospholipid antibodies and the antiphospholipid antibody syndrome (APS) was characterized. Its defining features include fetal wastage in the presence of significant levels of anticardiolipin antibodies. Since that time, interest in other autoimmune diatheses and various specific autoantibodies as possible causes of pregnancy loss has increased. Investigators have attempted to establish an association between recurrent pregnancy loss and the presence of a specific autoantibody or patterns of autoantibodies. Thus far, only modest evidence supports the concept that other autoantibodies are linked to, much less cause, pregnancy loss. In this review, we will define pregnancy loss in its various forms and discuss pregnancy loss in well-characterized autoimmune diseases such as SLE and APS. We will focus on the diagnosis and management of these conditions in women attempting to achieve successful pregnancies. Later we discuss the evidence concerning the less well defined association of antiphospholipid antibodies other than the lupus anticoagulant and anticardiolipin antibodies to recurrent pregnancy loss. We then outline the significance of antinuclear antibodies and antithyroid antibodies pertaining to adverse pregnancy outcome and conclude by summarizing and making some suggestions for further study. PMID:11355797

Faussett, M B; Branch, D W

2000-01-01

279

Functional Abdominal Pain in Children  

MedlinePLUS

... be intermittent (recurrent abdominal pain or RAP) or continuous. Although the exact cause is not known, nerve ... fearful, anxious, or depressed child however should be fully assessed by a psychiatrist or psychologist. Some psychological ...

280

JAMA Patient Page: Abdominal Hernia  

MedlinePLUS

... Weight lifting, coughing, straining during bowel movement • Cystic fibrosis and chronic lung infections • Previous abdominal surgery COMPLICATIONS ... hernia recurring, but the mesh material can become infected. In some cases, hernia repairs may be performed ...

281

Hepatobiliary diseases during pregnancy and their management: An update  

PubMed Central

Liver diseases in pregnancy although rare but they can seriously affect mother and fetus. Signs and symptoms are often not specific and consist of jaundice, nausea, vomiting, and abdominal pain. Although any type of liver disease can develop during pregnancy or pregnancy may occur in a patient already having chronic liver disease. All liver diseases with pregnancy can lead to increased maternal and fetal morbidity and mortality. It is difficult to identify features of liver disease in pregnant women because of physiological changes. Physiological changes of normal pregnancy can be confounding with that of sign and symptoms of liver diseases. Telangiectasia or spider angiomas, palmar erythema, increased alkaline phosphatase due to placental secretion, hypoalbuminemia due to hemodilution. These normal alterations mimic physiological changes in patients with decompensated chronic liver disease. Besides all these pathological changes however, blood flow to the liver remains constant and the liver usually remains impalpable during pregnancy. The diagnosis of liver disease in pregnancy is challenging and relies on laboratory investigations. The underlying disorder can have a significant effect on morbidity and mortality in both mother and fetus, and a diagnostic workup should be initiated promptly. If we see the spectrum of liver disease in pregnancy, in mild form there occur increase in liver enzymes to severe form, where liver failure affecting the entire system or maternal mortality and morbidity. It can not only complicate mother's life but also poses burden of life of fetus to growth restriction. Most of the times termination is only answer to save life of mother but sometimes early detection of diseases, preventive measures and available active treatment is helpful for both of the life. Extreme vigilance in recognizing physical and laboratory abnormalities in pregnancy is a prerequisite for an accurate diagnosis. This could lead to a timely intervention and successful outcome. PMID:24404454

Lata, Indu

2013-01-01

282

The intricate role of mast cell proteases and the annexin A1-FPR1 system in abdominal wall endometriosis.  

PubMed

Endometriosis is a continuous and progressive disease with a poorly understood aetiology, pathophysiology and natural history. This study evaluated the histological differences between eutopic and ectopic endometria (abdominal wall endometriosis) and the expression of mast cell proteases (tryptase and chymase), annexin A1 (ANXA1) and formyl peptide receptor 1 (FPR1). Ectopic endometrium from 18 women with abdominal wall endometriosis and eutopic endometrium from 10 women without endometriosis were obtained. The endometrial samples were analysed by histopathology, immunohistochemistry and ultrastructural immunogold labeling to determine mast cell heterogeneity (tryptase and chymase positive cells) and the expression levels of ANXA1 and FPR1. Histopathological analysis of the endometriotic lesions showed a glandular pattern of mixed differentiation and an undifferentiated morphology with a significant influx of inflammatory cells and a change in mast cell heterogeneity, as evidenced by a significant increase in the number of chymase-positive cells and endogenous chymase expression. The undifferentiated glandular pattern of endometriotic lesions was positively associated with a marked increase and co-localization of ANXA1 and FPR1 in the epithelial cells. In conclusion, the co-upregulated expression of mast cell chymase and ANXA1-FPR1 system in ectopic endometrium suggests their involvement in the development of endometriotic lesions. PMID:25201101

Paula, Rubens; Oliani, Antonio H; Vaz-Oliani, Denise C M; D'Ávila, Solange C G P; Oliani, Sonia M; Gil, Cristiane D

2015-02-01

283

Updates on abdominal desmoid tumors  

PubMed Central

Desmoid tumor is a monoclonal, fibroblastic proliferation arising in musculoaponeurotic structures. This connective tissue hyperplasia infiltrates locally, recurs frequently after resection but does not metastasize. Abdominal desmoid occurs sporadically, in association with some familial syndromes and often represents a clinical dilemma for surgeons. The enigmatic biology and anatomical location of abdominal desmoids make treatment recommendations difficult. This distinct pathological entity is reviewed with a specific focus on aetiology and management. PMID:18023087

Rampone, Bernardino; Pedrazzani, Corrado; Marrelli, Daniele; Pinto, Enrico; Roviello, Franco

2007-01-01

284

Management of functional abdominal pain  

Microsoft Academic Search

Opinion statement  The diagnosis of functional abdominal pain should be made based on the Rome II symptom criteria with only limited testing\\u000a to exclude other disease. During physical examination the clinician may look for evidence of pain behavior which would be\\u000a supportive of the diagnosis. Reassurance and proper education regarding the clinical entity of functional abdominal pain is\\u000a critical for successful

Yuri A. Saito; Jean C. Fox

2004-01-01

285

Chronic abdominal pain in children.  

PubMed

Chronic abdominal pain, defined as long-lasting intermittent or constant abdominal pain, is a common pediatric problem encountered by primary care physicians, medical subspecialists, and surgical specialists. Chronic abdominal pain in children is usually functional, that is, without objective evidence of an underlying organic disorder. The Subcommittee on Chronic Abdominal Pain of the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition has prepared this report based on a comprehensive, systematic review and rating of the medical literature. This report accompanies a clinical report based on the literature review and expert opinion. The subcommittee examined the diagnostic and therapeutic value of a medical and psychological history, diagnostic tests, and pharmacologic and behavioral therapy. The presence of alarm symptoms or signs (such as weight loss, gastrointestinal bleeding, persistent fever, chronic severe diarrhea, and significant vomiting) is associated with a higher prevalence of organic disease. There was insufficient evidence to state that the nature of the abdominal pain or the presence of associated symptoms (such as anorexia, nausea, headache, and joint pain) can discriminate between functional and organic disorders. Although children with chronic abdominal pain and their parents are more often anxious or depressed, the presence of anxiety, depression, behavior problems, or recent negative life events does not distinguish between functional and organic abdominal pain. Most children who are brought to the primary care physician's office for chronic abdominal pain are unlikely to require diagnostic testing. Pediatric studies of therapeutic interventions were examined and found to be limited or inconclusive. PMID:15741363

2005-03-01

286

Abdominal emergencies in the geriatric patient  

PubMed Central

Abdominal pain is one of the most frequent reasons that elderly people visit the emergency department (ED). In this article, we review the deadliest causes of abdominal pain in this population, including mesenteric ischemia, abdominal aortic aneurysm, and appendicitis and potentially lethal non-abdominal causes. We also highlight the pitfalls in diagnosing, or rather misdiagnosing, these clinical entities. PMID:25635203

2014-01-01

287

Complete cloacal duplication imaged before and during pregnancy  

PubMed Central

The authors describe a 31 year-old female who presented emergently with abdominal pain and was found at CT to have complete genitourinary duplication including separate urinary bladders, uteri, cervices, and vaginas, and also duplication of the rectum. No etiology for abdominal pain was identified. The patient was referred to urology for further evaluation, and an intravenous urographic study was obtained, which confirmed complete lower urinary tract duplication. The patient presented emergently 9 months later during a subsequent pregnancy for further evaluation of abdominal pain. A second CT scan was ordered to rule out appendicitis. Findings consistent with cloacal duplication were again noted. There was also dilatation of the urinary collecting systems, more prominently on the right side. A Cesarean section was performed and confirmed total genitourinary and rectal duplication. PMID:22470627

Ragab, Omar; Landay, Melanie; Shriki, Jabi

2009-01-01

288

Overweight and Obesity during Pregnancy  

MedlinePLUS

... 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’ ...

289

Ectopic Thyroid Tissue in the Adrenal Gland: Report of a Case.  

PubMed

Foci of ectopic thyroid tissue are uncommon. Most sites of thyroid ectopia are confined to the neck region. The presence of ectopic thyroid tissue outside the migration pathway of the primitive thyroid in other locations is exceptional. Given that any disease of the thyroid gland may also affect ectopic thyroid tissue, pathologists has to recognize benign or malignant conditions that may develop in the ectopic focus. We present the case of a 32-year-old woman with ectopic thyroid parenchyma in the adrenal gland. Clinically, postoperative thyroid ultrasound echography and computed tomography scans did not reveal any thyroid tumor. The ectopic tissue was a cyst bordered by mature follicular thyroid structures and was histologically benign, without the molecular alterations associated with malignant tumors of follicular cell derivation (BRAFV600E, N-RAS, H-RAS, K-RAS). Review of the literature reveals that adrenal ectopic thyroid tissue is nearly always cystic and has distinctive pathologic features. PMID:24997195

Casadei, Gian Piero; Bertarelli, Claudia; Giorgini, Eleonora; Cremonini, Nadia; de Biase, Dario; Tallini, Giovanni

2014-07-01

290

Stone disease in pregnancy: imaging-guided therapy.  

PubMed

Renal colic is the most frequent nonobstetric cause for abdominal pain and subsequent hospitalization during pregnancy. The physio-anatomical changes in the urinary tract and the presence of the fetus may complicate the clinical presentation and management of nephrolithiasis. Ultrasound (US) is the primary radiological investigation of choice. Magnetic resonance urography (MRU) and low-dose computed tomography (CT) have to be considered as a second- and third-line test, respectively. If a study that uses ionizing radiation has to be performed, the radiation dose to the fetus should be as low as possible. The initial management of symptomatic ureteric stones is conservative during pregnancy. Intervention will be necessary in patients who do not respond to conservative measures. Therefore, it is crucial to obtain a prompt and accurate diagnosis to optimize the management of these patients. Teaching Points • In pregnancy, renal colic is the most frequent nonobstetric cause for abdominal pain and hospitalization. • Magnetic resonance urography should be considered when ultrasound is nondiagnostic. • Low-dose CT should be considered as a last-line test during pregnancy. PMID:25249333

Masselli, Gabriele; Derme, Martina; Bernieri, Maria Giulia; Polettini, Elisabetta; Casciani, Emanuele; Monti, Riccardo; Laghi, Francesca; Framarino-Dei-Malatesta, Marialuisa; Guida, Marianna; Brunelli, Roberto; Gualdi, Gianfranco

2014-12-01

291

Pregnancy outcome in patients with a history of recurrent spontaneous miscarriages and documented thrombophilias.  

PubMed

The aim of this study was to evaluate the effect of treatment in patients analyzed for recurrent spontaneous miscarriage with a diagnosis of a hereditary thrombophilia, the presence of antiphospholipid and/or autoimmune antibodies, and/or hyperhomocystinemia (HHC) with or without methylenetetrahydrofolate reductase (MTHFR) polymorphisms. In total, 76 women with 2 or more embryonic or fetal losses were analyzed. Of these, 49 (64.4%) women were found to have one or more thrombophilias and/or autoimmune antibodies, and 33 (43.4%) women were found to have a MTHFR polymorphism and/or HHC. Since completion of the recurrent miscarriage analysis, 39 women conceived again. All women with a thrombophilia were treated with low-dose aspirin plus low molecular weight heparin. All women with previously diagnosed HHC and/or MTHFR polymorphisms were treated with folate and vitamin B(6) and B(12) supplementation. In the thrombophilia group, 27 women conceived resulting in 20 successful pregnancies (74.1%) and 7 pregnancy losses (2 trisomy 16, 1 ectopic pregnancy and 4 unexplained miscarriages), i.e. an unexplained pregnancy loss rate of 14.8%. In the HHC/MTHFR group 22 women conceived, resulting in 17 successful pregnancies (77.3%) and 5 pregnancy losses (1 trisomy 16, 1 Turner syndrome and 3 unexplained miscarriages), i.e. an unexplained pregnancy loss rate of 13.6%. PMID:14691342

Krabbendam, Ineke; Dekker, Gustaaf A

2004-01-01

292

Medical Care during Pregnancy  

MedlinePLUS

The Importance of Prenatal Care Millions of American women give birth every year, and nearly a third of them will have some kind of pregnancy- ... health of both moms and their babies. Prenatal Care Before Pregnancy Prenatal care should start before you ...

293

Thrombosis and pregnancy  

Microsoft Academic Search

Ten women die from thrombosis in pregnancy every year in the UK. Thromboembolism is the leading cause of maternal mortality in the UK with 25 deaths from pulmonary embolus and 5 deaths from cerebral vein thrombosis reported in the most recent Confidential Enquiry into Maternal Deaths (CEMD) 2000–2002. Substandard care was identified in over 50% of cases. Pregnancy itself is

Catherine Calderwood; Ian Greer

2005-01-01

294

Premarital Pregnancies in Australia  

ERIC Educational Resources Information Center

Incidence of premarital pregnancies among brides marrying in 1970-1972 in Australia is analyzed with respect to relative ages of bride and bridegroom, bridegroom's occupation, and bride's country of birth. Relative frequency of such pregnancies was very high among very young couples but declined with increasing age. (Author)

Ruzicka, Lado T.

1977-01-01

295

Diagnosing rhinitis during pregnancy.  

PubMed

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

2014-09-01

296

Methadone Treatment During Pregnancy  

Microsoft Academic Search

Methadone maintenance has been used for decades to treat opioid-dependent pregnant women. The outcomes of pregnancies thus treated are vastly improved over the outcomes of pregn ancies complicated by street drug use. Despite its long history of successful use durin g pregnancy, little is known about the long-term effects of methad one on the fetus and the newborn. Studies done

Margaret A. E. Jarvis; Sidney H. Schnoll

1994-01-01

297

Huge desmoid tumor of the anterior abdominal wall mimicking an intraabdominal mass in a postpartum woman: a case report  

PubMed Central

Desmoid tumors are benign neoplasms that most often arise from muscle aponeurosis and have been associated with both trauma and pregnancy. The etiology of desmoids has not been determined. We report the case of anterior abdominal wall desmoid tumor in a female patient with previous history of cesarean section. Preoperative ultrasound and computed tomography demonstrated a large mass mimicking a large hematoma or an intraabdominal mass. The tumor was removed by wide excision with safe margins. The abdominal wall defect was reconstructed with polypropylene mesh. Subsequent histology revealed a desmoid tumor. Desmoid tumors in females are often associated with pregnancy or occur post-partum. The reasons behind this association are unclear. The most common sites are in the abdominal muscles. PMID:23593530

Trigui, Khaled; Bouassida, Mahdi; Kilani, Houda; Mighri, Mohamed Mongi; Sassi, Selim; Chebbi, Fathi; Touinsi, Hassen; Sassi, Sadok

2013-01-01

298

Uterine Artery Embolization vs. Abdominal Myomectomy: A Long-term Clinical Outcome Comparison  

PubMed Central

Purpose: To assess long-term clinical efficacy of uterine artery embolization compared to abdominal myomectomy. Materials and Methods Consecutive women who received either uterine artery embolization or abdominal myomectomy for symptomatic uterine leiomyomata between 2000 and 2002 at a single institution were enrolled. We include patients whose procedures were performed 5 years prior to the study. Symptom evaluations using symptom severity scores, pregnancy rates and satisfaction of the procedures were obtained by IRB-approved questionnaires. Chart reviews were performed to supplement analyses. Results The retrospective cohort included 185 patients, including 87 uterine artery embolization patients (47.0%) and 98 abdominal myomectomy patients (53.0%). Eighty nine patients (48.1%) completed the long-term follow-up, of whom 48 had uterine artery embolization and 41 had abdominal myomectomy. Follow up ranged from 50 to 83 months. A higher but not statistically significant number of patients received repeat interventions after abdominal myomectomy (14%) than uterine artery embolization (8%) (p=0.204). Statistically significantly higher symptom severity score improvement in patients with uterine artery embolization than abdominal myomectomy was seen (34 vs 31, p = 0.02). Uterine artery embolization patients were less likely to attempt to get pregnant (p = 0.02), however those who did had a 66.7% success rate compared with 58.8% for abdominal myomectomy patients. Similar numbers of patients with uterine artery embolization were satisfied (p= 0.57), reported effectiveness in relieving symptoms (p=0.43), and would recommend the procedure (p=0.37) compared with abdominal myomectomy patients. Conclusion Uterine artery embolization results in long-term clinical success with outcomes comparable or superior to abdominal myomectomy. PMID:20570178

Narayan, Anand; Lee, Adrea S; Kuo, George; Powe, Neil; Kim, Hyun S

2010-01-01

299

Hypertension in pregnancy.  

PubMed

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

2014-03-01

300

In vitro assessment of mouse fetal abdominal aortic vascular function.  

PubMed

Fetal growth restriction (FGR) affects 3-8% of human pregnancies. Mouse models have provided important etiological data on FGR; they permit the assessment of treatment strategies on the physiological function of both mother and her developing offspring. Our study aimed to 1) develop a method to assess vascular function in fetal mice and 2) as a proof of principle ascertain whether a high dose of sildenafil citrate (SC; Viagra) administered to the pregnant dam affected fetal vascular reactivity. We developed a wire myography methodology for evaluation of fetal vascular function in vitro using the placenta-specific insulin-like growth factor II (Igf2) knockout mouse (P0; a model of FGR). Vascular function was determined in abdominal aortas isolated from P0 and wild-type (WT) fetuses at embryonic day (E) 18.5 of gestation. A subset of dams received SC 0.8 mg/ml via drinking water from E12.5; data were compared with water-only controls. Using wire myography, we found that fetal aortic rings exhibited significant agonist-induced contraction, and endothelium-dependent and endothelium-independent relaxation. Sex-specific alterations in reactivity were noted in both strains. Maternal treatment with SC significantly attenuated endothelium-dependent and endothelium-independent relaxation of fetal aortic rings. Mouse fetal abdominal aortas reproducibly respond to vasoactive agents. Study of these vessels in mouse genetic models of pregnancy complications may 1) help to delineate early signs of abnormal vascular reactivity and 2) inform whether treatments given to the mother during pregnancy may impact upon fetal vascular function. PMID:25056105

Renshall, Lewis J; Dilworth, Mark R; Greenwood, Susan L; Sibley, Colin P; Wareing, Mark

2014-09-15

301

Acute fatty liver of pregnancy associated with severe acute pancreatitis: A case report  

PubMed Central

Acute fatty liver of pregnancy is a rare disease that affects women in the third trimester of pregnancy. Although infrequent, the disease can cause maternal mortality. The diagnosis is not always clear until the pregnancy is terminated, and significant complications, such as acute pancreatitis, can occur. Pancreatic involvement typically only occurs in severe cases after the development of hepatic and renal impairment. To date, little knowledge is available regarding how the disease causes pancreatitis. Treatment involves supportive measures and pregnancy interruption. In this report, we describe a case of a previously healthy 26-year-old woman at a gestational age of 27 wk and 6 d who was admitted with severe abdominal pain and vomiting. This case illustrates the clinical and laboratory overlap between acute fatty liver of pregnancy and pancreatitis, highlighting the difficulties in differentiating each disease. Furthermore, the hypothesis for this overlapping is presented, and the therapeutic options are discussed. PMID:25068005

de Oliveira, Cássio Vieira; Moreira, Alecsandro; Baima, Julio P; Franzoni, Leticia de C; Lima, Talles B; Yamashiro, Fabio da S; Coelho, Kunie Yabuki Rabelo; Sassaki, Ligia Y; Caramori, Carlos Antonio; Romeiro, Fernando G; Silva, Giovanni F

2014-01-01

302

THERAPEUTIC ABORTION ON ACCOUNT OF X-RAY EXAMINATION DURING PREGNANCY  

Microsoft Academic Search

In Denmark in recent years, x-ray examination of pregnant women has in ; some instances been either the sole or a contributory indication for therapeutic ; abortion. The case histories are discussed of 11 pregnant women who had one or ; more abdominal x-ray examinations during the first 3 months of pregnancy. ; Therapeutic abortion was later performed in 8

Hammer-Jacobsen

1959-01-01

303

A functional ectopic vaginal anus: a rare clinical entity.  

PubMed

A case of functional ectopic vaginal anus is presented in a 20 years old girl. Patient complained of passage of stool through her vagina. She was continent and had no complaint of constipation. Her examination revealed imperforated anus with functional ectopic vaginal anus. Her surgery was performed in two stages. In first stage, anoplasty was performed at midpoint between the vulval and anal opening. The posterior vaginal wall was repaired in two layers and protective loop colostomy was made. In the second stage, after a period of 3 months loop colostomy was closed. Patient's recovery was smooth, she is not constipated and continent with Wexner score of 3. She was advised pelvic floor rehabilitation exercises.She improved within a month with Wexner score of zero. PMID:23058153

Mehboob, Mukhtar; Naz, Samina; Tabassum, Shahina; Khan, Jamil Ahmed

2012-10-01

304

Combined SHOOT MERISTEMLESS and WUSCHEL trigger ectopic organogenesis in Arabidopsis.  

PubMed

Almost all aerial parts of plants are continuously generated at the shoot apical meristem (SAM). To maintain a steady pool of undifferentiated cells in the SAM while continuously generating new organs, it is necessary to balance the rate of cell division with the rate of entrance into differentiation pathways. In the Arabidopsis meristem, SHOOT MERISTEMLESS (STM) and WUSCHEL (WUS) are necessary to keep cells undifferentiated and dividing. Here, we tested whether ectopic STM and WUS functions are sufficient to revert differentiation and activate cell division in differentiating tissues. Ectopic STM and WUS functions interacted non-additively and activated a subset of meristem functions, including cell division, CLAVATA1 expression and organogenesis, but not correct phyllotaxy or meristem self-maintenance. Our results suggest that WUS produces a non-cell autonomous signal that activates cell division in combination with STM and that combined WUS/STM functions can initiate the progression from stem cells to organ initiation. PMID:12070095

Gallois, Jean-Luc; Woodward, Claire; Reddy, G Venugopala; Sablowski, Robert

2002-07-01

305

An ectopic wing in a wild black vulture (Coragyps atratus).  

PubMed

An approximately 5-month-old black vulture (Coragyps atratus) was presented with the chief complaint of cervicomelia. A full-sized ectopic wing, with its own pectoral girdle, was found attached to the dorsal surface of the last few cervical vertebrae. There was deformation (right dorsolateral narrowing) of the spinal canal at the point of attachment with a corresponding compression of the spinal cord. PMID:2241705

Osofsky, S A; Brown, T P; Carrig, C B

1990-01-01

306

Branchiooculofacial syndrome and bilateral ectopic thymus: report of a family.  

PubMed

Branchiooculofacial syndrome (BOFS) is a rare autosomal-dominant condition characterized by branchial cleft sinus and ophthalmologic and craniofacial abnormalities that can range from mild to severe forms. Ectopic thymus, an uncommon condition with just over 100 cases reported in the literature, is seen in BOFS. We report a family with BOFS affecting the mother and two daughters, showing the dominant inheritance and variable phenotypical expression of BOFS. PMID:23106675

Loh, James; El-Hakim, Hamdy; Sergi, Consolato Maria; Fiorillo, Loretta

2012-01-01

307

Transcriptome, Methylome and Genomic Variations Analysis of Ectopic Thyroid Glands  

PubMed Central

Background Congenital 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 with sporadic CHTD. Moreover, a survey of monozygotic twins yielded a discordance rate of 92%, suggesting that somatic events, genetic or epigenetic, probably play an important role in the etiology of CHTD. Methodology/Principal Findings To assess the role of somatic genetic or epigenetic processes in CHTD, we analyzed gene expression, genome-wide methylation, and structural genome variations in normal versus ectopic thyroid tissue. In total, 1011 genes were more than two-fold induced or repressed. Expression array was validated by quantitative real-time RT-PCR for 100 genes. After correction for differences in thyroid activation state, 19 genes were exclusively associated with thyroid ectopy, among which genes involved in embryonic development (e.g. TXNIP) and in the Wnt pathway (e.g. SFRP2 and FRZB) were observed. None of the thyroid related transcription factors (FOXE1, HHEX, NKX2.1, NKX2.5) showed decreased expression, whereas PAX8 expression was associated with thyroid activation state. Finally, the expression profile was independent of promoter and CpG island methylation and of structural genome variations. Conclusions/Significance This is the first integrative molecular analysis of ectopic thyroid tissue. Ectopic thyroids show a differential gene expression compared to that of normal thyroids, although molecular basis could not be defined. Replication of this pilot study on a larger cohort could lead to unraveling the elusive cause of defective thyroid migration during embryogenesis. PMID:20976176

Lefort, Anne; Libert, Frederick; Chanoine, Jean-Pierre; Vassart, Gilbert; Deladoëy, Johnny

2010-01-01

308

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. PMID:25431598

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

2014-01-01

309

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.

2012-01-01

310

Ectopic Thyroid Tissue in the Adrenal Gland: A Report of Two Cases with Pathogenetic Implications  

PubMed Central

Background: Ectopic thyroid tissue is usually found anywhere along the embryonic descent pathway of the medial thyroid anlage from the tongue to the trachea (Wölfler area). However, ectopic thyroid tissue in the adrenal gland (ETTAG) is not easy to understand on the basis of thyroid embryology; because it is so rare, the possibility of metastasis should first be considered. Here, we describe two cases of ETTAG with pathogenetic implications and review the associated literature. Patient findings: Two cases of ETTAG presented as incidental cystic adrenal masses in adult females, one having a congenital hernia of Morgagni. The ETTAG was histologically indistinguishable from normal orthotopic thyroid tissue, and its follicular nature was confirmed by immunohistochemical positivity for thyroglobulin, thyroperoxidase, thyroid transcription factor-1 (TTF-1/Titf-1/Nkx2.1), cytokeratin AE1/AE3, cytokeratin 7, pendrin, human sodium iodide symporter, paired box gene 8, and forkhead box E1 (TTF-2), as well as positivity for the messenger RNA of the thyroglobulin gene by in situ hybridization analysis. No C cells (negativity for calcitonin, chromogranin, and synaptophysin) were present. Neither BRAF nor KRAS mutations were detected with real-time polymerase chain reaction analysis. Further work-up did not show evidence of thyroid malignancy. Summary: ETTAG is a rare finding, with only seven cases reported; women are much more frequently affected than men (8:1), and it usually presents in the fifth decade (mean age 54, range 38–67) as a cystic adrenal mass incidentally discovered on abdominal ultrasonography and/or in computed tomography images. ETTAG is composed of normal follicular cells without C cells. The expression of some transcription factors (TTF-1, paired box gene 8, and FOXE1) involved in development and/or migration of the medial thyroid anlage is preserved. Coexistence of a congenital hernia of Morgagni in one patient suggests an overdescent of medial thyroid anlage–derived cells in its pathogenesis. Conclusion: Although ETTAG pathogenesis remains unknown, the lack of C cells together with the coexistence of a congenital defect of the anterior diaphragm (hernia of Morgagni) in one of our patients could suggest an overdescent of medial thyroid anlage–derived cells in the origin of this heterotopia. PMID:23510370

Romero-Rojas, Alfredo; Bella-Cueto, María Rosa; Meza-Cabrera, Ivonne A.; Cabezuelo-Hernández, Angeles; García-Rojo, Darío; Vargas-Uricoechea, Hernando

2013-01-01

311

Laparoscopic Approach to Fibroid Torsion Presenting as an Acute Abdomen in Pregnancy  

PubMed Central

Uterine leiomyomas (fibroids) are seen in up to 4% of pregnancies, and most commonly present with pain in pregnancy, which can be due to red degeneration or torsion. Most cases previously have been managed with open resection. We report the case of a 35-y-old primagravida woman, presenting with acute lower abdominal pain at 11 wk gestation. Ultrasound demonstrated an 8-cm fibroid only. She demonstrated features of lower abdominal peritonitis and was scheduled for a diagnostic laparoscopy. At operation, a torsed subserosal fibroid was found. She successfully underwent laparoscopic myomectomy with the endoGIA vascular stapler and subsequent Pfannenstiel delivery. The patient was discharged 48 h postoperatively to continue her pregnancy. This case demonstrates the safe application of laparoscopic excisional myomectomy in the first trimester of pregnancy. Previously reported cases in the literature have focused on open resection or bipolar diathermy enucleation and morcellation. A high degree of suspicion should be maintained for the diagnosis in patients presenting to the surgical service with acute lower abdominal peritoneal signs during pregnancy. PMID:24398215

Bradley, Elizabeth; McEwen, Marcus; Al-Shabibi, Nawar; Willson, Peter D.

2013-01-01

312

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.

1989-02-01

313

Diagnosis of a sigmoid volvulus in pregnancy: ultrasonography and magnetic resonance imaging findings  

PubMed Central

Sigmoid volvulus complicating pregnancy is a rare, non-obstetric cause of abdominal pain that requires prompt surgical intervention (decompression) to avoid intestinal ischemia and perforation. We report the case of a 31-week pregnant woman with abdominal pain and subsequent development of constipation. Preoperative diagnosis was achieved using magnetic resonance imaging and ultrasonography: the large bowel distension and a typical whirl sign - near a sigmoid colon transition point - suggested the diagnosis of sigmoid volvulus. The decision to refer the patient for emergency laparotomy was adopted without any ionizing radiation exposure, and the pre-operative diagnosis was confirmed after surgery. Imaging features of sigmoid volvulus and differential diagnosis from other non-obstetric abdominal emergencies in pregnancy are discussed in our report, with special emphasis on the diagnostic capabilities of ultrasonography and magnetic resonance imaging. PMID:24967020

Palmucci, Stefano; Lanza, Maria Letizia; Gulino, Fabrizio; Scilletta, Beniamino; Ettorre, Giovanni Carlo

2014-01-01

314

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

2009-01-01

315

Chronic abdominal pain in children.  

PubMed

Chronic abdominal pain in children is usually not caused by organic disease. Diagnostic triage focuses on the assessment of alarm symptoms by means of history and physical examination. Additional diagnostic evaluation is not required in children without alarm symptoms. Family characteristics have an important influence on the chronicity of abdominal pain. A specific intervention is not recommended owing to lack of evidence of a beneficial effect. The greatest challenge is to identify children at risk of a prolonged course of pain and its correlated functional disability. The evaluation of family for coping strategies, psychosocial factors and appropriate follow-up can prevent ineffective use of healthcare resources. PMID:22886462

Singh, Utpal Kant; Prasad, Rajniti; Verma, Nishant

2013-02-01

316

Abdominal aortic aneurysms: case report  

PubMed Central

A 71-year-old male presented to a chiropractic clinic with subacute low back pain. While the pain appeared to be mechanical in nature, radiographic evaluation revealed an abdominal aortic aneurysm, which required the patient to have vascular surgery. This case report illustrates the importance of the history and physical examination in addition to a thorough knowledge of the features of abdominal aortic aneurysms. The application of spinal manipulative therapy in patients with (AAA) is also discussed. ImagesFigure 1Figure 2Figure 3

Hadida, Camille; Rajwani, Moez

1998-01-01

317

Pulmonary embolus in pregnancy.  

PubMed

Venous thromboembolism remains in the top three leading causes of maternal death in the US, representing 10.2% of pregnancy-related deaths. Risk of developing a pulmonary embolus appears to increase throughout pregnancy, with a peak in incidence in the early postpartum period. Overall the incidence of VTE is 0.6-1.8 VTEs per 1000 deliveries. Diagnosis and management of pulmonary embolus can prove challenging, but the aim should be to optimize maternal outcome while minimizing hemorrhagic complications. Low-molecular-weight heparin is a safe and effective treatment for the majority of cases of pregnancy-related pulmonary embolus. PMID:23916021

Donnelly, Jennifer C; D'Alton, Mary E

2013-08-01

318

Sugar substitutes during pregnancy  

PubMed Central

Abstract Question I have a pregnant patient who regularly consumes sugar substitutes and she asked me if continuing their use would affect her pregnancy or child. What should I tell her, and are there certain options that are better for use during pregnancy? Answer Although more research is required to fully determine the effects of in utero exposure to sugar substitutes, the available data do not suggest adverse effects in pregnancy. However, it is recommended that sugar substitutes be consumed in moderate amounts, adhering to the acceptable daily intake standards set by regulatory agencies. PMID:25392440

Pope, Eliza; Koren, Gideon; Bozzo, Pina

2014-01-01

319

Complications in late pregnancy.  

PubMed

Complications of late pregnancy are managed infrequently in the emergency department and, thus, can pose a challenge when the emergency physician encounters acute presentations. An expert understanding of the anatomic and physiologic changes and possible complications of late pregnancy is vital to ensure proper evaluation and care for both mother and fetus. This article focuses on the late pregnancy issues that the emergency physician will face, from the bleeding and instability of abruptio placentae to the wide spectrum of complications and management strategies encountered with preterm labor. PMID:23137403

Meguerdichian, David

2012-11-01

320

Cystic lymphangiomatosis with severe intra-abdominal bleeding in a newborn: case report.  

PubMed

We report the case of a newborn girl with intestinal cystic lymphangiomatosis who presented with abdominal distension and intra-abdominal bleeding following a prenatal ultrasound diagnosis of intestinal anomaly. Postnatal abdominal ultrasound revealed disseminated submucosal and intramural cystic dilatations of various sizes in the bowel and intestinal lymphangiomatosis was diagnosed. The presence of severe bleeding diathesis and widespread disease led to conservative treatment. The patient died on postnatal day 7 and postmortem examination confirmed cystic lymphangiomatosis. Detection of intestinal hyperechogenicity and/or dilatation in prenatal ultrasonography and the persistence of these findings during pregnancy are suggestive for pathologies such as meconium ileus, meconium peritonitis, and intestinal atresia. Although rare, intestinal lymphangiomatosis should be kept in mind in patients whose prenatal sonographic findings persist until birth. PMID:22729896

Bask?n, Didem; Narc?, Adnan; Okur, Nazan; U?ra?, Meltem; Nadirgil Köken, Gülengül; Ali Tuncer, Ahmet; Tokyol, Çi?dem; Çetinkur?un, Salih

2013-05-01

321

Contraception and unwanted pregnancy.  

PubMed

An overview of research findings in the US on the psychological and social variables associated with unwanted pregnancy and on the consequences of unwanted pregnancy was provided. Studies which examined personality differences between women and adolescent females who practicaed effective contraception and thesse who experienced unwanted pregnancy consistently found that the latter group, compared to the former group, had lower self-esteem, were more passive, tended to engage in more risk taking behavior, and were less achievement and future oriented. Several studies found that those who experienced unwanted pregnancies were often poorly informed about sex and contraception. Sex education, however, did not always lead to an increase in the knowledge and use of contraception. Sex education was unable to overcome the effects of male and female sexual socialization processes in which adolescents were inculcated with a double sex standard and females with a sense of guilt concerning the use of contraception. Numerous studies showed that unperceived or denied motives played a role in the occurence of unwanted pregnancies. Unwanted pregnancies were associated with loss, and these pregnancies probably represented an attempt to replace the loss of a loved person. Women who were in conflict about their work and mothering roles, and women who did not want to work but felt pressured to do so, frequently had inappropriate pregnancies. Teenagers who were not interested in school or in future careers often had unwanted pregnancies. These pregnancies probably represented an attempt to establish a social identity. W.B. Miller identified 8 stages in the reproductive life span when unwanted pregnancies were most likely to occur. These stages were 1) the initial stage of adolescence when the individual may not be fully aware of her fertility, 2) the 1st 6 months following the initiation of sexual activity, 3) at the beginning of a new relationship, 4) during the initial stage of marriage, 5) immediately following geographical mobility, 6) immediately following a pregnancy, 7) toward the end of the reproductive period, and 8) during menopause. Several researchers investigated the factors which play a role in contraceptive decision making. All the options available to those who experienced unwanted pregnancies entailed some degree of pain. Women who chose abortion, compared to those who had term pregnancies tended to suffer less serious, longterm consequences. Most abortion patients suffered only mild or temporary stress. Abortion patients who had more serious reactions tended to be young, single, Catholid, and socially immature. Individuals who a history of psychological problems, had negative relationships with their mothers, felt ambivalent about the abortion, or felt pressured to have an abortion were also more likely to experience psychological disturbances at some point following abortion. Most studies of unwanted pregnancy were retrospective, correlational, and based on small samples. Many were based on self-selected samples. Several social factors hinder efforts to investigate this sensitive social problem. As a result, intervention strategies, designed to prevent unwanted pregnancy, are frequently based on inadequate research. Efforts must be made to increase research on unwanted pregnancy and to utilize this research to develop effective preventive strategies. PMID:12313429

Adler, N E

1984-01-01

322

Myasthenia gravis during pregnancy.  

PubMed

Myasthenia gravis (MG) affects women in the second and third decades of life, overlapping with the childbearing years. During pregnancy, the course of this disease is unpredictable; worsening of symptoms occurs more likely during the first half of pregnancy and postpartum. MG can be well managed during pregnancy with relatively safe and effective therapies. Cesarean section is recommended only for obstetric reasons; epidural anesthesia is advised to reduce physical and emotional stress. Anticholinesterase drugs are the mainstay of treatment, when MG symptoms are not satisfactorily controlled, corticosteroids, azathioprine and in some cases cyclosporin A may be used. Life-threatening conditions (e.g., respiratory insufficiency) may occur during pregnancy; therefore, intensive check-ups by a gynecologist and a neurologist are necessary. PMID:18505362

Ferrero, Simone; Esposito, Francesca; Biamonti, Mariangela; Bentivoglio, Giorgio; Ragni, Nicola

2008-06-01

323

Health Problems in Pregnancy  

MedlinePLUS

... 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 ...

324

About Teen Pregnancy  

MedlinePLUS

... other STDs, and pregnancy (including methods of prevention). Perception of HIV risk. Personal values about sex and abstinence. Attitudes toward condoms (pro and con). Perception of peer norms and sexual behavior. Individual ability ...

325

Pregnancy and Reproductive Issues  

MedlinePLUS

Pregnancy - National Multiple Sclerosis Society Skip to navigation Skip to content Menu Navigation National Multiple Sclerosis Society Sign In In Your Area ... answers to some of these questions. Effects of MS on fertility There is no evidence that MS ...

326

Marijuana and Pregnancy  

MedlinePLUS

... or visit us online at: www.OTISpregnancy.org . Marijuana and Pregnancy This sheet talks about the risks ... advice from your health care provider. What is marijuana? Marijuana, also called pot, weed, or cannabis, is ...

327

Psoriasis: Pregnancy and Nursing  

MedlinePLUS

... Find Us Online YouTube Twitter Facebook Pregnancy and Nursing In general, psoriasis does not affect the male ... psoriasis and birth » Treating psoriasis while pregnant or nursing There is little research on the impact of ...

328

FAQ: Pregnancy and Breastfeeding  

MedlinePLUS

... gov . West Nile Virus Share Compartir FAQ: Pregnancy & Breastfeeding I am pregnant. Am I at higher risk ... Top of Page If I am pregnant or breastfeeding, should I use insect repellents? Yes. Protecting yourself ...

329

Seizure Disorders in Pregnancy  

MedlinePLUS

... a barrier method along with a hormonal method. Sterilization is an option if you have completed your ... coverings. Preterm: Born before 37 weeks of pregnancy. Sterilization: A permanent method of birth control. Ultrasound: A ...

330

Pregnancy and Rheumatic Disease  

MedlinePLUS

... some rheumatic diseases (SLE, APS, Sjögren’s and, particularly, scleroderma), also warrants mention. Because this severe disease frequently ... period—pregnancy isconsidered inadvisable. Other diseases such as scleroderma (in the absence of pulmonary hypertension or lung ...

331

Lupus and Pregnancy  

MedlinePLUS

... trying to get pregnant. Will lupus make it harder for me to get pregnant? No. Lupus itself ... Also having severe kidney disease may make it harder for you to become pregnant. How will pregnancy ...

332

Alcohol and pregnancy  

MedlinePLUS

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 ...

333

Pseudoephedrine, Phenylephrine and Pregnancy  

MedlinePLUS

... pregnancy loss. I just found out that I am pregnant and I took some pseudoephedrine for a ... possibly associated with birth defects like gastroschisis. I am 8 months pregnant and for the past few ...

334

Miglustat (Zavesca) and Pregnancy  

MedlinePLUS

... of Gaucher Disease in Pregnancy and Breastfeeding.) I am currently taking miglustat and would like to become ... been taking miglustat and just found out I am pregnant. Should I stop? No. You should not ...

335

Pregnancy Complications: Preexisting Diabetes  

MedlinePLUS

... ready to try to get pregnant again. Are gallstones common during pregnancy? Not common, but they do ... gallbladder for too long, hard, solid nuggets called gallstones can form. The stones can block the flow ...

336

Pregnancy Complications: Bacterial Vaginosis  

MedlinePLUS

... ready to try to get pregnant again. Are gallstones common during pregnancy? Not common, but they do ... gallbladder for too long, hard, solid nuggets called gallstones can form. The stones can block the flow ...

337

Pregnancy Complications: Placenta Previa  

MedlinePLUS

... ready to try to get pregnant again. Are gallstones common during pregnancy? Not common, but they do ... gallbladder for too long, hard, solid nuggets called gallstones can form. The stones can block the flow ...

338

Pregnancy Complications: Placental Abruption  

MedlinePLUS

... ready to try to get pregnant again. Are gallstones common during pregnancy? Not common, but they do ... gallbladder for too long, hard, solid nuggets called gallstones can form. The stones can block the flow ...

339

Pregnancy Complications: HELLP Syndrome  

MedlinePLUS

... ready to try to get pregnant again. Are gallstones common during pregnancy? Not common, but they do ... gallbladder for too long, hard, solid nuggets called gallstones can form. The stones can block the flow ...

340

Pregnancy Complications: Shoulder Dystocia  

MedlinePLUS

... ready to try to get pregnant again. Are gallstones common during pregnancy? Not common, but they do ... gallbladder for too long, hard, solid nuggets called gallstones can form. The stones can block the flow ...

341

Seasonal Flu and Pregnancy  

MedlinePLUS Videos and Cool Tools

... opportunities Advocacy in government For health professionals General health information I have personal experience with: Prematurity NICU experience Birth Defects High-risk pregnancy Loss Infertility Multiples None Of Above March ...

342

Smoking during Pregnancy  

MedlinePLUS Videos and Cool Tools

... opportunities Advocacy in government For health professionals General health information I have personal experience with: Prematurity NICU experience Birth Defects High-risk pregnancy Loss Infertility Multiples None Of Above March ...

343

Alcohol and Pregnancy  

MedlinePLUS Videos and Cool Tools

... opportunities Advocacy in government For health professionals General health information I have personal experience with: Prematurity NICU experience Birth Defects High-risk pregnancy Loss Infertility Multiples None Of Above March ...

344

Exercise during Pregnancy  

MedlinePLUS Videos and Cool Tools

... opportunities Advocacy in government For health professionals General health information I have personal experience with: Prematurity NICU experience Birth Defects High-risk pregnancy Loss Infertility Multiples None Of Above March ...

345

Risperidone and Pregnancy  

MedlinePLUS

... is Risperdal ® . Risperidone is an atypical (second generation) antipsychotic in the benzisoxazole class. Risperidone may cause weight ... looked at 151 women who took various atypical antipsychotics during pregnancy, including 49 who took risperidone. There ...

346

Schistosomal appendicitis in pregnancy.  

PubMed

Acute appendicitis is the most common acute surgical infection during pregnancy. Although usually pyogenic in origin, parasitic infections account for a small percentage of cases. Despite the relatively high prevalence of acute appendicitis in our environment, it is not commonly associated with schistosomiasis. We report here the association of pregnancy and appendicitis caused by Schistosoma haematobium. Schistosomiasis is very common complication of pregnancy in hyperendemic areas. Schistosome egg masses can lodge throughout the body and cause acute inflammation of the appendix, liver and spleen. Congestion of pelvic vessels during pregnancy facilitates passage of eggs into the villi and intervillous spaces, causing an inflammatory reaction. Tourism and immigration make this disease a potential challenge for practitioners everywhere. PMID:12125335

Halkic, N; Abdelmoumene, A; Gintzburger, D; Mosimann, F

2002-01-01

347

Pregnancy and herpes  

MedlinePLUS

HSV; Congenital herpes; Herpes - congenital; Birth-acquired herpes; Herpes during pregnancy ... Newborn infants can become infected with herpes virus: In the uterus (this is ... herpes, the most common method of infection) Right ...

348

Viral infections during pregnancy.  

PubMed

Viral infections during pregnancy have long been considered benign conditions with a few notable exceptions, such as herpes virus. The recent Ebola outbreak and other viral epidemics and pandemics show how pregnant women suffer worse outcomes (such as preterm labor and adverse fetal outcomes) than the general population and non-pregnant women. New knowledge about the ways the maternal-fetal interface and placenta interact with the maternal immune system may explain these findings. Once thought to be 'immunosuppressed', the pregnant woman actually undergoes an immunological transformation, where the immune system is necessary to promote and support the pregnancy and growing fetus. When this protection is breached, as in a viral infection, this security is weakened and infection with other microorganisms can then propagate and lead to outcomes, such as preterm labor. In this manuscript, we review the major viral infections relevant to pregnancy and offer potential mechanisms for the associated adverse pregnancy outcomes. PMID:25582523

Silasi, Michelle; Cardenas, Ingrid; Kwon, Ja-Young; Racicot, Karen; Aldo, Paula; Mor, Gil

2015-03-01

349

HPV Vaccine and Pregnancy  

MedlinePLUS

... or visit us online at: www.OTISpregnancy.org . HPV Vaccine and Pregnancy This sheet talks about the risks ... onset recurrent respiratory papillomatosis (JORRP). What is the HPV vaccine? The HPV vaccine provides protection against some types ...

350

Fluoxetine (Prozac) and Pregnancy  

MedlinePLUS

... risks of untreated depression during pregnancy. Can J Psychiatry 49(11):726-735. Burch KJ and Wells ... of fluoxetine in human breast milk. J Clin Psychiatry 51:169. Jimenez-Solem E et al. 2012. ...

351

Sertraline (Zoloft) and Pregnancy  

MedlinePLUS

... risks of untreated depression during pregnancy. Can J Psychiatry 49(11):726-735. Casper R, et al. ... and fluvoxamine by nursing women. British Journal of Psychiatry. 179:163-166. Källén B, Olausson PO. 2008. ...

352

Father's Guide to Pregnancy  

MedlinePLUS

... color. Gestational Diabetes: Diabetes that arises during pregnancy. Human Immunodeficiency Virus (HIV): A virus that attacks certain cells of the body’s immune system and causes acquired immunodeficiency syndrome (AIDS). Pelvic Exam: ...

353

Pregnancy Complications: Syphilis  

MedlinePLUS

... this page It's been added to your dashboard . Syphilis Syphilis is a sexually transmitted disease (also called ... women are diagnosed with syphilis each year. Can syphilis cause problems during pregnancy and for your baby? ...

354

Determining Pregnancy in Cattle  

E-print Network

The process of palpating to determine pregnancy in cattle and the equipment used during palpation are described and illustrated in this bulletin. The female reproductive system is discussed, along with the developmental stages of the embryo/fetus....

Beverly, John R.; Sprott, L. R.; Carpenter, Bruce B.

2008-12-16

355

Cystic Fibrosis and Pregnancy  

MedlinePLUS

... can have either of these tests: Chorionic villus sampling (also called CVS). This test checks tissue from ... pregnancy exams like an amniocentesis, a chorionic villus sampling or an external cephalic version (when your provider ...

356

Pesticides and Pregnancy  

MedlinePLUS

... are needed. February 2015. Copyright by MotherToBaby. References: Briggs GG, et al. 2005. Excretion of metformin into ... 203(5):457.e1-9, 2010 Nov. Feig DS et al. 2007. Oral antidabetic agents in pregnancy ...

357

Acute Pancreatitis and Pregnancy  

MedlinePLUS

... is high fat levels in the blood called triglycerides. Again, the hormonal changes of pregnancy can predispose certain women to developing this condition. When the triglyceride levels become too high, oxygen cannot adequately travel ...

358

Stages of Pregnancy  

MedlinePLUS

... 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 ...

359

Cocaine and Pregnancy  

MedlinePLUS

... or visit us online at: www.OTISpregnancy.org . Cocaine and Pregnancy This sheet talks about the risks ... advice from your health care provider. What is cocaine? Cocaine is a local anesthetic and a powerful ...

360

Formoterol and Pregnancy  

MedlinePLUS

... Lung and Blood Institute. Tamasi L, et al. 2005. The management of bronchial asthma during pregnancy – Hungarian experiences. Orv Hetil. 146(45):2035-2039. Wilton LV and Shakir SA. 2002. A postmarketing surveillance study of formoterol (Foradil). ...

361

Asthma, Allergies and Pregnancy  

MedlinePLUS

... Resources My Membership About the AAAAI Share | Asthma, Allergies and Pregnancy: Tips to Remember If you are pregnant and have asthma or allergies, you may feel uneasy about taking medications, but ...

362

Fluconazole and Pregnancy  

MedlinePLUS

... patient. Am J Med Genet 72:253-6. Carey JC, et al. 2009 . Determination of human teratogenicity ... 866-626-6847 . Document Outline Fluconazole and Pregnancy Carey JC, et al. 2009. Determination of human teratogenicity ...

363

Skin Conditions during Pregnancy  

MedlinePLUS

... varicose veins? The weight and pressure of your uterus can decrease blood flow from your lower body ... 3-month periods into which pregnancy is divided. Uterus: A muscular organ located in the female pelvis ...

364

Pregnancy and Anesthesia  

MedlinePLUS

Pregnancy and Anesthesia Bringing a child into the world is hard work…and painful. Fortunately, there are a number of options, ... body below your belly button. It is regional anesthesia, meaning it relieves pain in only part of ...

365

Fetal Intra-Abdominal Umbilical Vein Varix in Monochorionic Twins: Is it Significant?  

PubMed Central

A 30-years-old Taiwanese female in her second pregnancy spontaneously conceived a monochorionic twin pregnancy. A routine ultrasound at 27 weeks of gestation revealed a selective intrauterine growth restriction (sIUGR) fetus and an appropriate gestational age (AGA) fetus. The AGA fetus was found to have a fetal intra-abdominal umbilical vein (FIUV) varix. Serial ultrasounds showed no changes in the FIUV varix. 2 weeks later, the pregnancy progressed to twin–twin transfusion syndrome (TTTS). Repeated amnioreductions were required at 29 and 30 weeks gestation. The babies were delivered by caesarean section at 31 weeks due to fetal distress in the sIUGR fetus. Both fetuses survived the neonatal period with problems of prematurity. The FIUV varix disappeared a few days after delivery. PMID:23785250

Ismail, Hamizah; Chang, Yao-Lung; Chang, Shuenn-Dyh; Nusee, Zalina

2012-01-01

366

Outcome of prenatally diagnosed anterior abdominal wall defects  

PubMed Central

One hundred consecutive cases of confirmed anterior abdominal wall defect, identified prenatally in the Oxford Prenatal Diagnosis Unit over 11 years, were studied. Fifty nine per cent of cases were suspected omphaloceles and 41% suspected gastroschisis. Fifty four per cent of omphaloceles were accompanied by other defects compared with 5% of those with gastroschisis. Overall, 29% of fetuses with omphalocele had an abnormal karyotype, and of those with another abnormality identified on scan (excluding four cases with no karyotype performed), 54% had an abnormal karyotype. Of the 27 cases with suspected isolated omphalocele, 14 were live born, all of whom have survived. If the 11 whose parents opted for termination of pregnancy are excluded, survival to birth was 88%. Six of the suspected isolated omphaloceles have Beckwith Wiedemann syndrome (BWS). Eight (57%) of the live born babies with omphaloceles had major problems up to the age of 2, but only one (7%) has long term major problems. This child has BWS and is deaf.? Of the 39 cases of suspected isolated gastroschisis, 33 (85%) pregnancies resulted in live birth and one in neonatal death after surgery. Survival rate (excluding terminated pregnancies) was 97%. Gastroschisis was associated with a younger maternal age than omphalocele (p<0.001) and lower birthweight centile (p<0.01).? Fifteen per cent of the gastroschisis babies had major problems up to the age of 2 years and 12% long term developmental problems. Ninety three per cent of the omphalocele babies and 88% of those who had gastroschisis have no long term problems. Over the study period there have been major changes in scanning equipment and expertise. Since 1991 no woman with a suspected isolated lesion has opted for termination of pregnancy.?? PMID:9713034

Boyd, P; Bhattacharjee, A; Gould, S; Manning, N; Chamberlain, P

1998-01-01

367

Abdominal pain - children under age 12  

MedlinePLUS

Stomach pain in children; Pain - abdomen - children; Abdominal cramps in children; Belly ache in children ... When your child complains of abdominal pain, see if they can ... kinds of pain: Generalized pain or pain over more than half ...

368

Pregnancy and stroke  

Microsoft Academic Search

This review details the evidence that the risk of stroke is increased in the peripartum and postpartum period rather than\\u000a the entire 9 months of pregnancy. In women with prior stroke, available evidence suggests that the excess risk of a stroke\\u000a recurrence in pregnancy is approximately 1% to 2%. Although certain conditions have a particularly strong association with\\u000a stroke in

Mohammed Pathan; Steven J. Kittner

2003-01-01

369

Nutrition in Multifetal Pregnancy  

Microsoft Academic Search

All multifetal pregnancies can be considered high risk due to frequent obstetrical complications associated with this type\\u000a of pregnancies. Nutritional assessment with current dietary recommendations and specialized antenatal care are important for\\u000a a good outcome. Maternal weight and weight gain are also important factors, but nutritional supplements, assessment of calorie\\u000a intake, and adjustments as needed are crucial as well. Confounding

Elliot H. Philipson

370

DENGUE IN PREGNANCY  

Microsoft Academic Search

This was a retrospective study of patients with dengue infection in pregnancy from year 2000 till 2004. Data were analyzed by looking at the presentation, complications of pa- tient and fetus, and pregnancy outcomes. There was a total of 16 cases with an increasing trend (0.12% in 2003 vs 0.25% in 2004). The mean age of patients was 30.19 ±

Nor Azlin Mohamed Ismail; Nirmala Kampan; Muhammad Abdul Jamil; Zainul Rashid Mohd Razi

371

[Alcohol and pregnancy].  

PubMed

Alcohol consumption during pregnancy is a major cause of mental retardation in Western countries. Fetal alcohol syndrome (FAS) is mainly characterized by pre- and postnatal stunted growth, neurocognitive disorders, and facial dysmorphism. It compromises the intellectual and behavioral prognosis of the child. Prevention tools exist, through better information of health professionals, for optimal care of high-risk women before, during, and after pregnancy, which would decrease the incidence of SAF in the future. PMID:19683904

Seror, E; Chapelon, E; Bué, M; Garnier-Lengliné, H; Lebeaux-Legras, C; Loudenot, A; Lejeune, C

2009-10-01

372

Depression symptoms during pregnancy  

Microsoft Academic Search

Summary  Pregnancy impacts common symptoms of major depressive disorder (MDD), such as energy, appetite, weight change, and sleep and\\u000a somatic complaints. However, it is not known whether the presentation of depression during pregnancy is different from that\\u000a at other times in women’s lives. This study compares the severity of symptoms of depression in 61 pregnant women with MDD\\u000a (PD), 50 nonpregnant

R. Manber; C. Blasey; J. J. B. Allen

2008-01-01

373

[Post-rape pregnancy].  

PubMed

A rape is a traumatizing circumstance for the victim. This aggression often has, regrettably, immediate repercussions, and then medium and long-term ones. Its complications are psychological, but also sometimes somatic, like pregnancy. Through an international literature review, and the study of the national legislation, we will summarize the main essential elements of the medical and forensic care of a pregnancy arising after a rape. PMID:23375987

Muhlstein, J; Martrille, L; Guillet-May, F; Routiot, T; Coudane, H; Judlin, P

2013-02-01

374

Radiofrequency catheter ablation of atrial fibrillation initiated by spontaneous ectopic beats  

Microsoft Academic Search

Several reports have demonstrated that most paroxysmal atrial fibrillation is initiated by ectopic beats from a focal area,\\u000a and radiofrequency catheter ablation can effectively cure atrial fibrillation. Although most of the ectopic beats originate\\u000a from the orifices of the pulmonary veins or from the myocardial sleeves in the pulmonary veins, ectopic beats can also originate\\u000a from superior vena cava, crista

Shih-Ann Chen; Ching-Tai Tai; Ming-Hsiung Hsieh; Chin-Feng Tsai; Yung-Kuo Lin; Yu-An Ding; Mau-Song Chang

2000-01-01

375

Abdominal obesity and metabolic syndrome  

Microsoft Academic Search

Metabolic syndrome is associated with abdominal obesity, blood lipid disorders, inflammation, insulin resistance or full-blown diabetes, and increased risk of developing cardiovascular disease. Proposed criteria for identifying patients with metabolic syndrome have contributed greatly to preventive medicine, but the value of metabolic syndrome as a scientific concept remains controversial. The presence of metabolic syndrome alone cannot predict global cardiovascular disease

Jean-Pierre Després; Isabelle Lemieux

2006-01-01

376

Hematologic Complications of Pregnancy  

PubMed Central

Pregnancy induces a number of physiologic changes that affect the hematologic indices, either directly or indirectly. Recognizing and treating hematologic disorders that occur during pregnancy is difficult owing to the paucity of evidence available to guide consultants. This paper specifically reviews the diagnosis and management of benign hematologic disorders occurring during pregnancy. Anemia secondary to iron deficiency is the most frequent hematologic complication and is easily treated with oral iron formulations,; however care must be taken not to miss other causes of anemia, such as sickle cell disease. Thrombocytopenia is also a common reason for consulting the hematologist and distinguishing gestational thrombocytopenia from immune thrombocytopenia (ITP), preeclampsia, HELLP syndrome, or thrombotic thrombocytopenic purpura (TTP) is essential since the treatment differs widely. Occasionally the management of mother and infant involves the expeditious recognition of neonatal alloimmune thrombocytopenia (NAIT), a condition that is responsible for severe life-threatening bleeding of the newborn. Additionally, inherited and acquired bleeding disorders affect pregnant women disproportionately and often require careful monitoring of coagulation parameters in order to prevent bleeding in the puerperium. Finally, venous thromboembolism (VTE) during pregnancy is still largely responsible for mortality during pregnancy and the diagnosis, treatment options and guidelines for prevention of VTE during pregnancy are explored. PMID:23953339

Townsley, Danielle M.

2013-01-01

377

Ectopic Fat and Insulin Resistance: Pathophysiology and Effect of Diet and Lifestyle Interventions  

PubMed Central

The storage of triglyceride (TG) droplets in nonadipose tissues is called ectopic fat storage. Ectopic fat is associated with insulin resistance and type 2 diabetes mellitus (T2DM). Not the triglycerides per se but the accumulation of intermediates of lipid metabolism in organs, such as the liver, skeletal muscle, and heart seem to disrupt metabolic processes and impair organ function. We describe the mechanisms of ectopic fat depositions in the liver, skeletal muscle, and in and around the heart and the consequences for each organs function. In addition, we systematically reviewed the literature for the effects of diet-induced weight loss and exercise on ectopic fat depositions. PMID:22675355

Snel, M.; Jonker, J. T.; Schoones, J.; Lamb, H.; de Roos, A.; Pijl, H.; Smit, J. W. A.; Meinders, A. E.; Jazet, I. M.

2012-01-01

378

[Ectopic hamartomatous thymoma. Case report with special reference to differential diagnosis].  

PubMed

We report the case of an ectopic hamartomatous thymoma in a 56-year-old male patient. The lesion arose subcutaneously in the supraclavicular region. Histologically, the well-circumscribed but unencapsulated tumour was composed of uniform fusiform tumour cells. In addition, mature fatty tissue, scattered T-lymphocytes, and an epithelial and a myoepithelial tumour cell component were found. The epithelial differentiation of the spindle cell tumour component was confirmed immunohistochemically and by electron microscopy. Ectopic hamartomatous thymoma has to be distinguished from ectopic cervical thymoma, thymolipoma, ectopic salivary tissue, teratoma, peripheral nerve sheath tumours, malignant epithelial tumours with thymus-like differentiation, biphasic synovial sarcoma, and skin adnexal tumours. PMID:7479610

Mentzel, T; Kriegsmann, J; Kosmehl, H; Katenkamp, D

1995-09-01

379

Vaginal mesh erosion after abdominal sacral colpopexy  

Microsoft Academic Search

Objective: Our goal was to compare the prevalence of vaginal mesh erosion between abdominal sacral colpopexy and various sacral colpoperineopexy procedures. Study Design: We undertook a retrospective analysis of all sacral colpopexies and colpoperineopexies performed between March 1, 1992, and February 28, 1999. The patients were divided into the following 4 groups: abdominal sacral colpopexy, abdominal sacral colpoperineopexy, and 2

Anthony G. Visco; Alison C. Weidner; Matthew D. Barber; Evan R. Myers; Geoffrey W. Cundiff; Richard C. Bump; W. Allen Addison

2001-01-01

380

[Thyroid dysfunction in pregnancy].  

PubMed

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

2014-10-01

381

Radical Abdominal Trachelectomy for IB1 Cervical Cancer at 17 Weeks of Gestation: A Case Report and Literature Review  

PubMed Central

Background. With regard to the therapy for early invasive cervical carcinoma during pregnancy, radical trachelectomy is also a treatment of choice, along with its advantages and disadvantages. Case Report. A 28-year-old woman, para 1-0-0-1, was diagnosed with FIGO stage IB1 squamous cell carcinoma of the cervix at 12 weeks of gestation. The patient underwent radical abdominal trachelectomy with pelvic lymphadenectomy at 17 weeks of gestation. Her pregnancy was successfully maintained after the surgery. The patient underwent a planned cesarean section at 38 weeks of gestation. A healthy baby girl weighing 2970?g was born with an Apgar score of 8/9. The mother and child in overall good health were discharged. Ten months after the delivery, there was no clinical evidence of recurrence. Conclusions. We believe that it is appropriate to perform radical abdominal trachelectomy in the early second trimester with preserving uterine arteries, although it is a technically challenging approach. It may be possible that radical abdominal trachelectomy during pregnancy can help women avoid the triple losses of a desired pregnancy, fertility, and motherhood. PMID:25548694

Aoki, Yoichi; Inamine, Morihiko; Ohishi, Sugiko; Nagai, Yutaka; Masamoto, Hitoshi

2014-01-01

382

Imaging of ectopic thyroid tissue and thyroglossal duct cysts.  

PubMed

When a child or young adult presents with a mass in the anterior portion of the neck, diagnostic considerations include a thyroglossal duct cyst and ectopic thyroid tissue. These entities are often suspected clinically, and imaging provides an opportunity to evaluate the extent, confirm the diagnosis, and evaluate for complications. Imaging characteristics of a thyroglossal duct cyst as a simple cyst and of ectopic thyroid tissue as a hyperattenuating soft-tissue mass can help identify these lesions at computed tomography (CT); however, intrinsic magnetic resonance, CT, and ultrasonographic imaging characteristics alone cannot be used to confirm the diagnosis. Rather, knowledge of the typical course of the thyroid primordium during embryologic development is essential to understand the variant locations along this path where thyroid tissue can be found. The migration of thyroid primordium begins at the foramen cecum at the base of the tongue and then loops around the hyoid bone anteriorly and inferiorly and descends anteriorly to the thyrohyoid membrane into the orthotopic location in the infrahyoid portion of the neck. Thyroid ectopia is categorized into one of four typical locations with respect to this embryologic course: (a) the base of the tongue, (b) adjacent to the hyoid bone, (c) the midline infrahyoid portion of the neck, and, rarely, (d) the lateral part of the neck. The differential diagnosis includes metastatic thyroid carcinoma, branchial cleft cyst, lymphatic malformation, abscess, saccular cyst, epidermoid cyst, and squamous cell carcinoma. The relationship of a mass to landmarks such as the foramen cecum, hyoid bone, strap muscles, thyrohyoid membrane, and thyroid cartilage can help differentiate a thyroglossal duct cyst and ectopic thyroid tissue from other anterior neck masses when the embryologic thyroid course is considered. PMID:24428281

Zander, David A; Smoker, Wendy R K

2014-01-01

383

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

2014-01-01

384

Metabolic effects of telmisartan in subjects with abdominal obesity: a prospective randomized controlled trial.  

PubMed

BACKGROUND. Abdominal obesity, characterized by ectopic fat deposition in skeletal muscle and liver tissue, has been associated with insulin resistance and increased risk for type 2 diabetes mellitus. The aim of this study was to evaluate whether treatment with the angiotensin II type 1 (AT-1) receptor blocker telmisartan can reduce intramyocellular lipid (IMCL) and hepatic fat storage, thereby improving insulin sensitivity among individuals with abdominal obesity. METHODS. Ninety-five adults with abdominal obesity (body mass index ? 30 kg/m(2) and waist circumference > 102 cm in men and > 88 cm in women) were randomized to double-blind treatment with telmisartan or placebo for 24 weeks. Following 4 weeks of 80 mg telmisartan per day, the dose was increased to 160 mg telmisartan for the duration of the study. Soleus muscle IMCL and liver fat content were assessed by (1)H-magnetic resonance imaging ((1)H-MRI) spectroscopy. Secondary outcomes included changes in body composition, plasma lipids, glucose profiles, insulin sensitivity, beta-cell function and total adiponectin levels. RESULTS. There was no significant effect of telmisartan in abdominally obese individuals consuming either a low or high glycemic diet, on IMCL content (5.73 ± 1.11 vs 6.11 ± 1.11; p = 0.13) or liver fat (0.08 ± 0.05 vs 0.09 ± 0.05; p = 0.60). Body composition, lipid and glucose profiles, insulin sensitivity and adiponectin were likewise unaffected. Beta-cell function, as determined by the insulinogenic index (IGI), improved significantly (19.3 ± 13.7 vs 22.5 ± 17.6; p = 0.03; 16.5% increase from baseline in the telmisartan group). CONCLUSIONS. Telmisartan increased beta-cell function but did not decrease IMCL or liver fat content or other metabolic parameters among individuals with abdominal obesity. PMID:23731019

Chetty, V Tony; Damjanovic, Suzana; Gerstein, Hertzel; Singh, Nina; Yusuf, Salim; Anand, Sonia S; Sharma, Arya M

2014-02-01

385

[Pregnancy and antiphospholipid syndrome].  

PubMed

Antiphospholipid syndrome (APS) is associated with a risk of obstetrical complications, affecting both the mother and the fetus. Obstetrical APS is defined by a history of three consecutive spontaneous miscarriages before 10 weeks of gestation (WG), an intra-uterine fetal death after 10 WG, or a premature birth before 34 WG because of severe pre-eclampsia, eclampsia or placental adverse outcomes (intrauterine growth retardation, oligohydramnios). Pregnancy in women with a diagnosis of obstetric APS is at increased risk for placental abruption, HELLP (Hemolysis, Elevated Liver enzymes, Low Platelet count) syndrome and thrombosis that may be part of a catastrophic antiphospholipid syndrome (CAPS). A previous thrombosis and the presence of a lupus anticoagulant are risk factors for pregnancy failure. A multidisciplinary approach, associating the internist, the anesthesiologist and the obstetrician, is recommended for these high-risk pregnancies. Preconception counseling is proposed to identify pregnancy contraindications, and to define and adapt the treatment prior and during the upcoming pregnancy. Heparin and low-dose aspirin are the main treatments. The choice between therapeutic or prophylactic doses of heparin will depend on the patient's medical history. The anticoagulant therapeutic window for delivery should be as narrow as possible and adapted to maternal thrombotic risk. There is a persistent maternal risk in the postpartum period (thrombosis, HELLP syndrome, CAPS) justifying an antithrombotic coverage during this period. We suggest a monthly clinical and biological monitoring which can be more frequent towards the end of pregnancy. The persistence of notches at the Doppler-ultrasound evaluation seems to be the best predictor for a higher risk of placental vascular complications. Treatment optimization and multidisciplinary antenatal care improve the prognosis of pregnancies in women with obstetric APS, leading to a favorable outcome most of the time. PMID:22341691

Costedoat-Chalumeau, N; Guettrot-Imbert, G; Leguern, V; Leroux, G; Le Thi Huong, D; Wechsler, B; Morel, N; Vauthier-Brouzes, D; Dommergues, M; Cornet, A; Aumaître, O; Pourrat, O; Piette, J-C; Nizard, J

2012-04-01

386

How Your Baby Grows During Pregnancy  

MedlinePLUS

... its normal size. What happens during the first month of pregnancy? During the first month of pregnancy, ... change during pregnancy? • What happens during the first month of pregnancy? • What happens during the second month ...

387

Alport's Syndrome in Pregnancy  

PubMed Central

Background. Alport's syndrome is an X-linked hereditary disorder affecting the glomerular basement membrane associated with ocular and hearing defects. In women, the disease is much less severe compared to that in men. However, women with Alport's syndrome can have an accelerated form of their disease during pregnancy with worsening of kidney function and can also develop preeclampsia. There are only four described cases of Alport's syndrome in pregnancy. Case Presentation. 20-year-old woman with a history of Alport's syndrome, which during pregnancy worsened resulting in hypertension, proteinuria, and acute kidney injury. Fortunately, there was complete resolution of the proteinuria and kidney injury with delivery, and the patient did not require any renal replacement therapy. Conclusion. One of the four reported cases had an accelerated form of the disease during pregnancy with rapid progression of kidney injury and end-stage renal disease. There are no definite guidelines to monitor these patients during pregnancy. Further studies are required to understand the exact pathophysiology of kidney damage that occurs in pregnant women with Alport's syndrome. This may give us some insight into the prognostic predictors, so that we can monitor these women more thoroughly and prevent adverse outcomes. PMID:23861686

Mehta, Suchita; Saifan, Chadi; Abdellah, Marie; Choueiry, Rita; Nasr, Rabih; El-Sayegh, Suzanne

2013-01-01

388

Diabetic retinopathy and pregnancy.  

PubMed

Diabetes mellitus and pregnancy have reciprocal influences between them, therefore diabetes mellitus may complicate the course of pregnancy as well as pregnancy can worsen the performance of diabetes especially at the fundus oculi. Several factors seem to play a role in retinal neovascularization. Actually it's not possible to understand the mechanisms underlying this progression. Moreover chronic hyperglycemia leads to several events such as: the activation of aldose reductase metabolic pathway, the activation of the diacylglycerol-protein kinase C, the non-enzymatic glycation of proteins with formation of advanced glycation endproducts and the increase of hexosamines pathway. Although every structure of the eye can be affected by diabetes, retinal tissue, with all its vessels, is particularly susceptible. Pregnancy may promote the onset of diabetic retinopathy, in about 10 % of cases, as well as contribute to its worsening when already present. The proliferative retinopathy must always be treated; treatment should be earlier in pregnant women compared to non-pregnant women. Pregnancy can also cause macular edema; it spontaneously regresses during the postpartum and therefore does not require immediate treatment. In summary, collaboration between the various specialists is primary to ensure the best outcomes for both mother's health and sight, and fetus' health. PMID:24482250

Pescosolido, Nicola; Campagna, Orazio; Barbato, Andrea

2014-08-01

389

Hyperthyroidism in pregnancy.  

PubMed

Hyperthyroidism is second to diabetes mellitus as the most common endocrinopathy in pregnancy. Inappropriate secretion of hCG is the most common cause of hyperthyroidism in the first part of gestation. In addition to hydatidiform mole and hyperemesis gravidarum, nonpathologic-conditions including multiple gestation, mild nausea and vomiting, and even normal pregnancies may present with transient undetectable or suppressed serum TSH values. The syndrome of transient hyperthyroidism of hyperemesis gravidarum is defined as severe nausea and vomiting, dehydration, ketonuria, and weight loss of more than 5% by 6 to 9 weeks of pregnancy. Thyroid tests are in the hyperthyroid range, and the abnormalities are related to the severity of symptoms. Tests normalize with resolution of the vomiting, and ATD therapy is not indicated. The natural history of Graves' disease in pregnancy is characterized by aggravation in the first trimester, amelioration in the second half, and recurrence in the year following delivery. ATD treatment is the therapy of choice in pregnancy. Either PTU or MMI may be used; the goal is to keep the FT4I in the upper limits of normal with the minimum dose of ATD. In approximately 30% of patients, ATDs may be discontinued in the last few weeks of gestation. Maternal, fetal, and neonatal complications are frequent when hyperthyroidism is not under control. Postpartum hyperthyroidism may be caused by an episode of silent thyroiditis or Graves' disease. PMID:9534033

Mestman, J H

1998-03-01

390

Chromosomal aberrations detected by chromogenic in situ hybridization in abdominal wall endometriosis after cesarean section.  

PubMed

The goal of this study is to evaluate the chromosomal loss in abdominal wall endometriosis by chromogenic in situ hybridization (CISH). Twenty-four cases of abdominal wall endometriosis that developed after cesarean section at the Korea University Medical Center between January 1997 and December 2006 were selected. CISH was performed in the sections of tissue microarray block using the Zymed CISH centromeric probes for chromosomes 3, 7, 8, 9, 10, 11, 17, and 18. Monosomy was defined when the percentage of the nuclei with a single dot was more than mean+3 SD of the respective probe in normal control endometrium. CISH study was possible in more than half of the endometriosis samples, except for chromosome 9, and was most successful for chromosome 17. The frequency of monosomy was high for chromosomes 9 (75.0%) and 17 (73.9%), moderate for chromosomes 10 (57.1%) and 18 (56.3%), and low for chromosomes 3 (12.5%), 7 (22.2%), 8 (10.5%), and 11 (10.5%). Monosomy for >2 and 3 chromosomes occurred in 66.7% and 42.9% of the cases, respectively. It is concluded that CISH method may be considered a useful laboratory technique in detecting chromosomal loss, and multiple chromosomal loss is involved in the formation of ectopic endometrium in abdominal wall endometriosis. PMID:22653345

Jeong, Kyungah; Lee, Sangho; Kim, Insun; Kang, Jae Seong

2012-07-01

391

Ectopic Epithelial Implants following Surface Ablation of the Cornea  

PubMed Central

Purpose. To determine the direct contribution of the epithelium to the generation of complications using a phototherapeutic keratectomy model. Methods. A mouse model with a genetically labeled epithelium was used to determine whether any epithelium-derived cells persist in the stroma up to 1 month after surgery. Also, gross histology and macrophotography of excimer-ablated rabbit corneas were analyzed for evidence epithelial ingrowths into the stroma. Results. Epithelium-derived cells were present in the wounded stroma 1 month after surgery. Micrographs taken during the first 4 days during healing evidenced epithelial invasion of the stroma in one and sometimes more locations in the same cornea. Gross histology also revealed that the epithelial invasions can result in complete delamination of stromal tissue and subsequent inclusion of the stromal material in the epithelium. The epithelial inclusions ultimately created a highly irregular corneal surface. Conclusions. Ectopic epithelia are a known complication of LASIK and LASIK-like procedures. The data presented here indicate that ectopic epithelia are also a complication of surface ablation techniques. The knowledge that these complications are present following surface ablations provides a new understanding of the biological response to surface ablation techniques and suggests new avenues of study to improve clinical outcomes of those for whom LASIK-based techniques are not an option. PMID:23132801

Gibson, Daniel J.; Schultz, Gregory S.

2012-01-01

392

[A case ectopic hepatocellular carcinoma with peritoneal dissemination].  

PubMed

An 83-year-old man was admitted to our hospital for further investigation of liver dysfunction. Laboratory examination revealed serum alpha-fetoprotein (AFP) levels of 4205ng/ml, an AFP/AFP-L3 ratio of 32.3%, an indocyanine green retention rate at 15 minutes of 25.9%, and negative serology for viral hepatitis. Ultrasonography, contrast-enhanced computed tomography, and magnetic resonance imaging revealed an early enhanced tumor measuring approximately 3cm at its maximal dimension. The tumor contacted segment 6 of the liver, and there was no other specific space-occupying lesion in the liver. Detailed angiography revealed that the tumor received its blood supply from the gastroduodenal artery. A diagnosis of ectopic hepatocellular carcinoma was made and laparoscopy with partial liver resection was performed. Intraoperative findings revealed a small amount of bloody ascites and peritoneal dissemination. The tumor, which was attached to the liver, was resected. Histopathologically, the tumor was a moderately differentiated hepatocellular carcinoma without connection to the liver parenchyma. A final diagnosis of ectopic hepatocellular carcinoma accompanied by peritoneal dissemination was thus confirmed. PMID:24189826

Nakamura, Noriaki; Irie, Takumi; Tanaka, Shinji; Arii, Shigeki

2013-11-01

393

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

2014-01-01

394

Ectopic Thyroid Tissue in Submandibular and Infrahyoid Region  

PubMed Central

The thyroid is the first endocrine gland to form during embryogenesis. At this stage, incomplete or anomalous migration of thyroid tissue causes ectopic localization of the gland. Submandibular ectopic thyroid tissue with a coexisting normally located thyroid gland is extremely rare. In this case aimed to present the findings of the 65-years-old female patient who is bilateral subtotal thyroidectomy operation performed for multinodular goiter of 12 years ago. Case, painless mass in the right submandibular and infrahyoid region for 6 months was admitted to our clinic with complaints. Result of contrast-enhanced neck computed tomography, ultrasound-guided fine-needle aspiration biopsy and thyroid scintigraphy were found of functional residual thyroid tissue in the normal localization as well as 2×3 cm mass in the submandibular area and 1×2 cm mass lesion in the infrahyoid region. The patient referred to excisional biopsy. Normal thyroid follicules and no evidence of malignancy were found in specimen pathologically. Postoperative follow-up of thyroid function tests were normal.

Mutlu, Vahit

2014-01-01

395

High Blood Pressure in Pregnancy  

MedlinePLUS

... 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 ...

396

Pregnancy, Breastfeeding, and Bone Health  

MedlinePLUS

... supported by your browser. Home Osteoporosis Women Pregnancy, Breastfeeding, and Bone Health Publication available in: PDF (233 ... Anorexia Nervosa Partner Resources An Easy Guide to Breastfeeding (OWH) Pregnancy and Medications (OWH) Prenatal Care (OWH)

397

Pregnancy and High Blood Pressure  

MedlinePLUS Videos and Cool Tools

... right-hand corner of the player. Pregnancy and High Blood Pressure HealthDay January 29, 2015 Related MedlinePlus Page High Blood Pressure in Pregnancy Transcript Does keeping tight control of ...

398

Vaginal bleeding in early pregnancy  

MedlinePLUS

... can happen any time from conception (when the egg is fertilized) to the end of pregnancy. About 2 or 3 out of every 10 pregnant women have vaginal bleeding during their first 20 weeks of pregnancy.

399

Prednisone/Prednisolone and Pregnancy  

MedlinePLUS

... or visit us online at: www.OTISpregnancy.org . 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 ...

400

Methamphetamine/Dextroamphetamine and Pregnancy  

MedlinePLUS

... or visit us online at: www.OTISpregnancy.org . Methamphetamine/Dextroamphetamine and Pregnancy In every pregnancy, a woman ... your health care professional. What are dextroamphetamine and methamphetamine? Dextroamphetamine is a legal prescription medication that is ...

401

Pregnancy and injecting drug use  

Microsoft Academic Search

Injecting drug use has adverse effects on pregnancy and perinatal outcomes. Methadone treatment improves birth rate but carries a risk of neonatal abstinence syndrome; withdrawal of methadone during pregnancy is not recommended

James Bell; Lucy Harvey-Dodds

2008-01-01

402

Pregnancy as a harm?  

PubMed

Michigan's Appellate Court ruled in 2004 that a pregnancy that resulted from a rape should be considered a bodily injury for sentencing purposes. Interestingly, all three possible outcomes of a pregnancy-abortion, miscarriage, or childbirth-are considered to bring with them significant and substantial physical, psychological, and emotional changes. While the immediate impact of the ruling in People v. Cathey affected only the guilty individual, there are larger implications for this ruling beyond just sentencing guidelines. The ruling can be considered a step forward in prosecuting rapists, but possibly at the expense of reimagining the female body. This article considers the Cathey ruling itself, the potential benefits and consequences of this understanding on feminist discourse, and, crucially, the impact of this decision on abortion discussions. The central question that emerges is, can we both consider pregnancy a harm and believe that this harm is not always wrong-making? PMID:22643758

Kraft, Rory E

2012-01-01

403

Anorectal abscess during pregnancy.  

PubMed

Anorectal symptoms and complaints caused by hemorrhoids or anal fissures are common during pregnancy. It is known that one-third of pregnant women complain of anal pain in the third trimester. Anal pain may be caused by a wide spectrum of conditions, but if it begins gradually and becomes excruciating within a few days it may indicate anorectal abscess. We experienced a case of anorectal abscess during pregnancy which was diagnosed by magnetic resonance imaging and treated by incision and seton drainage at 36 weeks of gestation, followed by a normal spontaneous delivery at 38 weeks of gestation. To our knowledge, this is the first case report of anorectal abscess during pregnancy in the English-language published work. The clinical course of our case and clinical considerations of anorectal abscesses are discussed. PMID:24118245

Koyama, Shinsuke; Hirota, Masaki; Kobayashi, Masaki; Tanaka, Yusuke; Kubota, Satoshi; Nakamura, Ryo; Isobe, Masanori; Shiki, Yasuhiko

2014-02-01

404

The management of an ectopic ovary in the inguinal canal: literature review and discussion.  

PubMed

We report the case of a female adolescent who had an ectopic ovary in the inguinal canal without an associated hernia, a unicornuate uterus, and ipsilateral renal agenesis. The incidental discovery of the ectopic ovary and other Mullerian anomalies, as well as the surgical correction that followed, highlights important fertility considerations in children and available treatment algorithms for these rare cases. PMID:25096300

Webb, James B; Fallon, Sara C; Lopez, Monica E; Boswell, Hillary B; Dietrich, Jennifer E; Brandt, Mary L

2014-10-01

405

Successful application of technetium-99m-labeled octreotide acetate scintigraphy in the detection of ectopic adrenocorticotropin-producing bronchial carcinoid lung tumor: a case report  

PubMed Central

Introduction The diagnostic efficacy of somatostatin receptor scintigraphy labeling with 111 indium in the localization of tumors has been assessed in a limited number of patients with contradictory outcomes. Here, we describe the case of a patient with an ectopic adrenocorticotropic hormone-producing bronchial carcinoid tumor diagnosed preoperatively using technetium-99m-labeled octreotide acetate scintigraphy. Case presentation A 29-year-old Asian man presented to our hospital with the typical clinical features of Cushing's syndrome, which he had had for a duration of 18 months. The results of a biochemical evaluation revealed he had adrenocorticotropic hormone-dependent Cushing's syndrome. The results of a spiral abdominal computed tomography scan showed he had bilateral adrenal hypertrophy. A magnetic resonance image of the patient's brain showed he had a normal hypophysis. Whole body technetium-99m-labeled octreotide acetate scintigraphy was performed to check for the presence of an ectopic adrenocorticotropic hormone-producing tumor. The scan results showed a small focal increase in uptake in the lower lobe of our patient's right lung, just above his diaphragm. A spiral chest computed tomography scan also revealed a small non-specific lesion in the same region. A transthoracic biopsy was then performed. Pathological evaluation confirmed the diagnosis of a carcinoid tumor, of the adrenocorticotropic hormone-producing type. After surgical removal, the patient's symptoms resolved and significant clinical improvement was achieved. Conclusions This case report shows that technetium-99m-labeled octreotide acetate scintigraphy can effectively detect an ectopic adrenocorticotropic hormone-producing bronchial carcinoid. PMID:20955547

2010-01-01

406

New antidepressants in pregnancy.  

PubMed Central

QUESTION: I have read that fluoxetine is the drug of choice for treating depression during pregnancy. One of my patients, who did not respond to the "old" selective serotonin reuptake inhibitors, is doing well on venlafaxine and is now 6 weeks pregnant. What advice should I give her? ANSWER: Fluoxetine is recommended because to date it has the most evidence of its safety. It is important that women be treated appropriately for depression during pregnancy, and some research on the newer antidepressants, such as venlafaxine, will be useful to you and your patient in making an informed decision regarding treatment. PMID:15000332

Einarson, Adrienne; Koren, Gideon

2004-01-01

407

Cancer and pregnancy  

SciTech Connect

The most common malignancies occurring in women of child-bearing ages include breast, cervical, genital, and GI malignancies, and melanoma, lymphoma, and leukemia. Pregnancy does not appear to adversely affect the outcome of most tumors but may affect those that are known to be hormonally dependent. The approach in general to malignancy during pregnancy needs to be individualized. Therapy, whether by radiation or with cytotoxic drugs, has the greatest potential for fetal risk during the first trimester but more acceptable risk in the second and third trimesters. There are many unanswered questions concerning long-term effects of malignancy and its therapy upon the surviving child. 58 references.

Williams, S.F.; Bitran, J.D.

1985-10-01

408

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

2009-01-01

409

Determining Pregnancy in Cattle.  

E-print Network

jifferenc DETERMINING PREGNANCY IN CATTLE A. M. Sorensen, J r and J. R. Beverly* Economic returns from the beef cattle industry depend largely on the percent calf crop and the weaning weight of calves to be sold. Much has been done in the area... pregnant cows should be culled on the basis of age and condition of the udder, feet, legs and teeth which make them poor breeding stock. The following discussioh describes a way of improv- ing the calf crop percentage through pregnancy de- termination...

Sorensen, A. M. Jr.; Beverly, J. R.

1968-01-01

410

PREGNANCY NUTRITION SURVEILLANCE SYSTEM (PNSS)  

EPA Science Inventory

The Pregnancy Nutrition Surveillance System (PNSS) is a program based surveillance system developed in order to assist health professionals in achieving of the goals of identifying and reducing pregnancy-related health risks that contribute to adverse pregnancy outcomes. Its purp...

411

Genetic Amniocentesis in Multiple Pregnancy  

Microsoft Academic Search

Objectives: Second-trimester genetic amniocentesis is the most frequently used invasive prenatal diagnostic technique. Several reports have been published about the effect of genetic amniocentesis on fetal loss in multiple pregnancies over the past two decades. Here we analyze our experience with genetic amniocentesis in multiple pregnancies over the past 10 years. Methods: Details of 184 multiple pregnancies were processed in

Csaba Papp; Artúr Beke; Zoltán Bán; Zoltán Papp

2004-01-01

412

Laparoscopic surgery of interstitial (cornual) pregnancy, a case report  

PubMed Central

We report a successful laparoscopic management of an interstitial pregnancy of a 24- year-old single woman, treated by cornuostomy. The patient was first managed with methotrexate treatment. After the 2. methotrexate administration, the patient suffered from low abdominal pain, and intraabdominal bleeding signs were reported by transvaginal ultrasonograpy. The hemoglobin level was decreased from 12.8 gr/dl to 11.8 gr/dl and the beta hCG level was increased from 8,314 mIU/l to 11,541 mIU/l. The laparoscopic approach to interstitial pregnancy was presented and other management strategies such as medical treatment and laparotomy have been reviewed. PMID:24591909

Günenç, Ziya; Bingöl, Banu; Çelik, Aygen; Bozkurt, Serpil; Özekici, Ümit

2010-01-01

413

Fertility and pregnancy outcomes following conservative treatment for placenta accreta  

PubMed Central

Objective To estimate the fertility and pregnancy outcomes after successful conservative treatment for placenta accreta. Methods This retrospective national multicenter study included women with a history of conservative management for placenta accreta in French university hospitals from 1993 through 2007. Success of conservative treatment was defined by uterine preservation. Data were retrieved from medical files and telephone interviews. Results Follow-up data were available for 96 (73.3%) of the 131 women included in the study. Eight women had severe intrauterine synechiae and were amenorrheic. Of the 27 women who wanted more children, three women were attempting to become pregnant (mean duration: 11.7 months, range: 7–14 months), and 24 (88.9% [95% CI, 70.8–97.6%]) women had had 34 pregnancies (21 third-trimester deliveries, one ectopic pregnancy, two elective abortions, and 10 miscarriages) with a mean time to conception of 17.3 months (range, 2–48 months). All 21 deliveries resulted in healthy babies born after 34 weeks of gestation. Placenta accreta recurred in 6 of 21 cases (28.6% [95% CI, 11.3–52.2%]) and was associated with placenta previa in 4 cases. Postpartum hemorrhage occurred in four (19.0% [95% CI, 5.4–41.9%]) cases, related to placenta accreta in three and to uterine atony in one. Conclusions Successful conservative treatment for placenta accreta does not appear to compromise the patients’ subsequent fertility or obstetric outcome. Nevertheless, these women should be advised of the high risk that placenta accreta may recur during future pregnancies. PMID:20833739

Sentilhes, Loïc; Ambroselli, Clémence; Kayem, Gilles; Provansal, Magali; Fernandez, Hervé; Perrotin, Franck; Winer, Norbert; Pierre, Fabrice; Benachi, Alexandra; Dreyfus, Michel; Bauville, Estelle; Mahieu-Caputo, Dominique; Marpeau, Loïc; Descamps, Philippe; Bretelle, Florence; Goffinet, François

2010-01-01

414

SIMPLE Technique of Laparoscopic Nephrectomy for Ectopic Nonfunctioning Pelvic Kidney Secondary to Pelviureteric Junction Obstruction: A Feasible and Safe Technique  

PubMed Central

Ectopic kidneys are rare developmental anomalies. Anomalous blood supply of the pelvic ectopic kidneys poses a problem for a minimally invasive surgery. Although laparoscopic nephrectomies have been described for symptomatic nonfunctioning pelvic ectopic kidney, this is the first case report that highlights the safety and feasibility of SIMPLE technique of laparoscopic nephrectomy in a pelvic kidney. PMID:25140271

Parmar, Kalpesh Mahesh; Shankaregowda Ajjoor, Sriharsha; Jayant, Kumar; Singh, Shrawan Kumar

2014-01-01

415

Human thrombin for the treatment of gastric and ectopic varices  

PubMed Central

AIM: To evaluate the efficacy of human thrombin in the treatment of bleeding gastric and ectopic varices. METHODS: Retrospective observational study in a Tertiary Referral Centre. Between January 1999-October 2005, we identified 37 patients who were endoscopically treated with human thrombin injection therapy for bleeding gastric and ectopic varices. Patient details including age, gender and aetiology of liver disease/segmental portal hypertension were documented. The thrombin was obtained from the Scottish National Blood Transfusion Service and prepared to give a solution of 250 IU/mL which was injected via a standard injection needle. All patient case notes were reviewed and the total dose of thrombin given along with the number of endoscopy sessions was recorded. Initial haemostasis rates, rebleeding rates and mortality were catalogued along with the incidence of any immediate complications which could be attributable to the thrombin therapy. The duration of follow up was also listed. The study was conducted according to the United Kingdom research ethics guidelines. RESULTS: Thirty-seven patients were included. 33 patients (89%) had thrombin (250 U/mL) for gastric varices, 2 (5.4%) for duodenal varices, 1 for rectal varices and 1 for gastric and rectal varices. (1) Gastric varices, an average of 15.2 mL of thrombin was used per patient. Re-bleeding occurred in 4 patients (10.8%), managed in 2 by a transjugular intrahepatic portosystemic shunt (TIPSS) (one unsuccessfully who died) and in other 2 by a distal splenorenal shunt; (2) Duodenal varices (or type 2 isolated gastric varices), an average of 12.5 mL was used per patient over 2-3 endoscopy sessions. Re-bleeding occurred in one patient, which was treated by TIPSS; and (3) Rectal varices, an average of 18.3 mL was used per patient over 3 endoscopy sessions. No re-bleeding occurred in this group. CONCLUSION: Human thrombin is a safe, easy to use and effective therapeutic option to control haemorrhage from gastric and ectopic varices. PMID:23139607

McAvoy, Norma C; Plevris, John N; Hayes, Peter C

2012-01-01

416

Parathyroid carcinoma in pregnancy  

PubMed Central

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

2014-01-01

417

Nutrition during pregnancy  

Technology Transfer Automated Retrieval System (TEKTRAN)

The optimal nutritional support of a mother and her developing fetus begins before conception. This poses a challenge for pediatricians caring for pregnant adolescents. Approximately 1 million teenagers become pregnant in the United States each year. Of these pregnancies, 51% end in live births, 35%...

418

Acetaminophen (Tylenol) and Pregnancy  

MedlinePLUS

... 4):343-6. McElhatton PR, et al. 1997. Paracetamol overdose in pregnancy analysis of the outcomes of 300 cases referred to the Teratology Information Service. Reprod Toxicol 11(1):85-94. Niederhoff H ... MS, et al. 2010. Prenatal acetaminophen exposure and risk of wheeze at age 5 ...

419

Intracranial mucocele in pregnancy  

Microsoft Academic Search

Intracranial mucocele is rare. They are slow-growing lesions and usually form as a result of an obstruction of the paranasal sinuses, particularly by osteoma, fibrosis, trauma, previous surgery or inflammation. The effect of pregnancy in the development of intracranial mucocele is unclear. We report a pregnant patient who was admitted to our clinic with severe headache and diplopia. A giant

Murat Cosar; Mustafa Aziz Hatiboglu; Emine Cosar; A. Celal Ipl?kc?oglu

2007-01-01

420

[Seat belts and pregnancy].  

PubMed

The best safety for the mother and her unborn child while driving a car is the proper use of a seat belt. Only a correctly constructed and fitted lap-shoulder safety harness should be used. The instruction to wear a seat belt and to wear it correctly should be part of the pregnancy-care-program for each physician. PMID:971900

Schumann, K

1976-09-23

421

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

2014-01-01

422

Renal Physiology of Pregnancy  

PubMed Central

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.

2014-01-01

423

Air travel during pregnancy  

Microsoft Academic Search

In the absence of obstetric or medical complications, pregnant women can observe the same general precautions for air travel as the general population and can fly safely up to 36 weeks of gestation. In-craft environmental conditions, such as low cabin humidity and changes in cabin pressure, coupled with the physiologic changes of pregnancy, do result in maternal adaptations, which could

2002-01-01

424

Endocrine problems in pregnancy  

Microsoft Academic Search

This paper aims to describe the pathophysiology and management of the main endocrine complications of pregnancy. For each endocrine dysfunction, the issues with the fetus, the mother, obstetric complications, and the long term prognosis for the disease itself need to be considered. Key management issues are highlighted with each condition. Thyroid dysfunction and goitre are common while management is relatively

Anjali Amin; Stephen Robinson; Tiong Ghee Teoh

2010-01-01

425

Pregnancy Complications: Salmonellosis  

MedlinePLUS

... Staying at a healthy weight during pregnancy can help lower your risk of gallstones. Exercise and eating foods that are low in fat and high in fiber, like veggies, fruits and whole grains, can help, too. Symptoms of gallstones include nausea, vomiting and ...

426

Ophthalmic considerations in pregnancy  

PubMed Central

The eyes are our window to the world and offer us an island of vision in the sea of darkness. Equally, the eyes are also a window to peep into what is going on in the milieu interior. Pregnancy is a natural state of physiological stress for the body. Each organ system of the body in a pregnant lady behaves at variation than in a non-pregnant state. A complex interplay exists between how the pregnancy affects the eye and how ocular physiology and pathology may lead to the modification of the management of pregnancy. Added to this is the effect of systemic conditions on the eye which gets modified by pregnancy. An awareness of the interaction of Ophthalmology and Obstetrics for the benefit of the mother and the child requires a basic understanding of these complex interactions. This article aims at presenting to the reader in a simplified and organized manner the common ophthalmic issues encountered in a pregnant woman, their management and the effect of various ophthalmic medication on the fetus. PMID:24600123

Chawla, Sushil; Chaudhary, Tarun; Aggarwal, S.; Maiti, G.D.; Jaiswal, Kulharsh; Yadav, Jairam

2013-01-01

427

Smoking cessation in pregnancy.  

PubMed Central

Smoking during pregnancy harms the fetus, newborn infant, young child, and mother. Smoking during the last two trimesters greatly increases the risk of stillbirth, spontaneous abortion, premature delivery, neonatal death, and low birth weight. Risk is in direct proportion to cigarette smoke exposure. PMID:8924801

Brown, D. C.

1996-01-01

428

Gastrointestinal endoscopy in pregnancy.  

PubMed

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

2014-11-01

429

Transvaginal ultrasound-guided local methotrexate administration as the first-line treatment for cesarean scar pregnancy: Follow-up of 18 cases.  

PubMed

Cesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy, which occurs in previous cesarean section scar tissue, with an incidence of 1 in 1800-3000 pregnancies. Transvaginal ultrasound-guided local methotrexate (MTX) administration presents as a non-systemic option with possible better penetration to the pregnancy site. We present the management of 18 patients with CSP solely by transvaginal ultrasound-guided local MTX administration. All patients were treated with local MTX with a dose of 50?mg/m(2) . Eleven (61.1%) of the patients did not need any further intervention. Four patients (22.2%) were treated with additional single-dose systemic MTX due to inadequate alteration in blood ?-human chorionic gonadotrophin levels. Three patients (16.7%) required hysteroscopy and/or laparotomy. We suggest that transvaginal ultrasound-guided local MTX treatment may be considered as a first-line treatment for CSP. PMID:25491022

Cok, Tayfun; Kalayci, Hakan; Ozdemir, Halis; Haydardedeoglu, Bulent; Parlakgumus, Ayse H; Tarim, Ebru

2014-12-10

430

Blunt abdominal trauma to a pregnant woman resulting in a child with hemiplegic spastic cerebral palsy and permanent eye damage  

PubMed Central

Background In today's life trauma is a common and important complication of pregnancy and remains one of the major contributors to maternal and fetal morbidity and mortality. Case presentation The authors reported a case of 4 years old child with hemiplegic spastic cerebral palsy and permanent left eye damage due to antenatal trauma. He was an off spring to a 33 years old woman gravida 6 para 5 from western Sudan, who sustained a domestic blunt abdominal trauma during her routine daily activities. The abdominal trauma occurred during the third trimester at 36th week gestation of the pregnancy when the mother hit herself by the woody part of an axe non intentionally. Conclusions The findings from this case conclude that relatively minor trauma can have significant adverse effects on the fetus and can be devastating. PMID:24314440

2013-01-01

431

Large Abdominal Wall Endometrioma Following Laparoscopic Hysterectomy  

PubMed Central

Background: Endometriosis is a common condition in women that affects up to 45% of patients in the reproductive age group by causing pelvic pain. It is characterized by the presence of endometrial tissue outside the uterine cavity and is rarely found subcutaneously or in abdominal incisions, causing it to be overlooked in patients with abdominal pain. Methods: A 45-year-old woman presented with lower abdominal pain 2 years following a laparoscopic supracervical hysterectomy. She was found to have incidental cholelithiasis and a large abdominal mass suggestive of a significant ventral hernia on CT scan. Results: Due to the peculiar presentation, surgical intervention took place that revealed a large 9cm×7.6cm×6.2cm abdominal wall endometrioma. Conclusion: Although extrapelvic endometriosis is rare, it should be entertained in the differential diagnosis for the female patient who presents with an abdominal mass and pain and has a previous surgical history. PMID:21902990

Borncamp, Erik; Mehaffey, Philip; Rotman, Carlos

2011-01-01

432

Syphilis in pregnancy  

PubMed Central

Syphilis can seriously complicate pregnancy and result in spontaneous abortion, stillbirth, non-immune hydrops, intrauterine growth restriction, and perinatal death, as well as serious sequelae in liveborn infected children. While appropriate treatment of pregnant women often prevents such complications, the major deterrent has been inability to identify the infected women and get them to undergo treatment. Screening in the first trimester with non-treponemal tests such as rapid plasma reagin (RPR) or venereal disease research laboratory (VDRL) test combined with confirmation of reactive individuals with treponemal tests such as the fluorescent treponemal antibody absorption (FTA-ABS) assay is a cost effective strategy. Those at risk should be retested in the third trimester. Treatment during pregnancy should be with penicillin. In determining a penicillin regimen, the clinician must consider the stage of the maternal infection and the HIV status of the mother. Patients who are allergic to penicillin should be desensitised before treatment. Despite appropriate treatment, as many as 14% will have a fetal death or deliver infected infants. Treatment may further be complicated by the Jarich–Herxheimer reaction, a complex allergic response to antigens released from dead micro-organisms, which can cause fetal distress and uterine contractions. Thanks to effective intervention strategies and inexpensive penicillin, syphilis rarely complicates pregnancy in the Western world today. In parts of the world where the traditional sexually transmitted diseases have not been controlled, the magnitude of problems associated with syphilis during pregnancy is reminiscent of that faced by the West during the early 1900s. Key Words: syphilis; pregnancy PMID:10858706

Genc, M.; Ledger, W.

2000-01-01

433

Ectopic meningioma anterior to the lacrimal gland fossa.  

PubMed

A 66-year-old man reported a slowly growing tumor on the lateral edge of his left upper eyelid. This lesion was hard but movable on palpation. A neoplasm of the lacrimal gland was suspected. CT showed a highly calcified lesion at the left upper eyelid. Resection of the tumor was performed, which was located just behind the orbital septum and in front of the lacrimal gland. Anatomopathologic investigation of the excised specimen with immunohistochemistry revealed a benign meningioma of a meningotheliomatous type, containing multiple bone elements. An ectopic orbital meningioma is rare, and this is the first case of a unique lateral localization of this lesion. Therefore, it should be included in the differential diagnosis of a lacrimal gland tumor. PMID:19273931

Decock, Christian E; Kataria, Sandeep; Breusegem, Christophe M; Van Den Broecke, Caroline M; Claerhout, Ilse J

2009-01-01

434

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

2011-01-01

435

Wnt signaling, de novo lipogenesis, adipogenesis and ectopic fat  

PubMed Central

Wnt signaling is as a major regulator of adipogenesis. It differentially regulates the fate of mesenchymal stem cells (MSC) by promoting osteogenesis and myogenesis, and inhibiting adipogenesis[1]. Its loss of function has been associated with impaired osteogenesis[2] and diverse congenital and adult cardiovascular disorders[3,4]. Our group has identified loss of function mutations in Wnt coreceptor LRP6 that underlie autosomal dominant early onset coronary artery (CAD), osteoporosis and most features of the metabolic syndrome, including high plasma triglyceride and LDL-C, diabetes, hypertension, hyperuricemia and fatty liver disease (unpublished data). Following we will describe our most pertinent findings related to Wnt/LRP6 regulation of de novo lipogenesis and adipogenesis and the role of impaired Wnt signaling in generation of ectopic fat, insulin resistance, elevated plasma lipids and non-alcoholic fatty liver disease (NAFLD). PMID:25526027

Song, Kangxing; Wang, Shuxia; Mani, Mitra; Mani, Arya

2014-01-01

436

Wnt signaling, de novo lipogenesis, adipogenesis and ectopic fat.  

PubMed

Wnt signaling is as a major regulator of adipogenesis. It differentially regulates the fate of mesenchymal stem cells (MSC) by promoting osteogenesis and myogenesis, and inhibiting adipogenesis[1]. Its loss of function has been associated with impaired osteogenesis[2] and diverse congenital and adult cardiovascular disorders[3,4]. Our group has identified loss of function mutations in Wnt coreceptor LRP6 that underlie autosomal dominant early onset coronary artery (CAD), osteoporosis and most features of the metabolic syndrome, including high plasma triglyceride and LDL-C, diabetes, hypertension, hyperuricemia and fatty liver disease (unpublished data). Following we will describe our most pertinent findings related to Wnt/LRP6 regulation of de novo lipogenesis and adipogenesis and the role of impaired Wnt signaling in generation of ectopic fat, insulin resistance, elevated plasma lipids and non-alcoholic fatty liver disease (NAFLD). PMID:25526027

Song, Kangxing; Wang, Shuxia; Mani, Mitra; Mani, Arya

2014-11-30

437

Extrahepatic Portal Hypertension Following Abdominal Surgery  

Microsoft Academic Search

We present a case of non-cirrhotic extrahepatic portal hypertension in a 31-year-old woman following exten- sive abdominal laparotomy for the drainage of multiple retroperitoneal and liver abscesses following a perfo- rated appendix. Chronic portal, splenic, and mesenteric vein thrombosis with portal hypertension was caused by a hypercoagulable state due to the abdominal infec- tion and abdominal surgery. Various etiological aspects

Ajit Singh Ahluwalia; Joseph J. Mazza; Steven H. Yale

438

Carcinoid abdominal crisis: a case report.  

PubMed

Over the past 40 years, the incidence of neuroendocrine tumors (NETs) has been increasing. Distal small bowel (i.e., midgut) NETs most often cause carcinoid syndrome manifested as cutaneous flushing, diarrhea, bronchial constriction, and cardiac involvement. Carcinoid abdominal crisis occurs when submucosal tumors impede the vascular supply to the gut leading to mesenteric ischemia and worsening abdominal pain. Here, we report the case of a young woman with progressively worsening abdominal pain. PMID:24860963

Jacobs, Ramon E A; Bai, Shuting; Hindman, Nicole; Shah, Paresh C

2014-09-01

439

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

2007-12-03

440

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.

2007-12-05

441

[Surgical abdominal pain in children].  

PubMed

Abdominal pain in child could be related to surgical pathologies in 10 to 20 % of cases. The more frequent etiology remains appendicitis. Regarding to clinical presentation, age and medical history, intestinal intussusception, incarcerated hernia, adhesive occlusion and Meckel's diverticulum could be evocated. But the most dreadful diagnosis is malrotation with volvulus, because of mortality and morbidities induced by bowel necrosis. Usually, medical history and clinical exam allowed diagnosis. Ultrasound remains the more helpful exam in children with surgical pathologies and in some selected cases, CT scan and others biological and/or radiological exams could be performed. PMID:21698888

Arnaud, Alexis; Sauvat, Frédérique

2011-05-01

442

Abdominal wall endometriosis: case report.  

PubMed

Abdominal wall endometriosis, also known as scar endometrioma, is a rare condition, in most cases occurring after previous cesarean section or pelvic surgery. The incidence of scar endometrioma is estimated to 0.03%-1.5% of all women with previous cesarean delivery. The predominant clinical picture is cyclic pain. Due to a wide range of mimicking conditions and a relative rarity, a significant delay is often observed from the onset of symptoms to proper treatment. We report on a case of a 36-year-old patient with scar endometrioma after two previous cesarean deliveries. The possible diagnostic pitfalls and treatment options are discussed. PMID:23115952

Eljuga, Damir; Klari?, Petar; Bolanca, Ivan; Grbavac, Ivan; Kuna, Krunoslav

2012-06-01

443

Regeneration of Leydig cells in ectopically autografted adult mouse testes.  

PubMed

Ectopic autografting of testis tissue is a promising approach for studying testicular development, male germline preservation and restoration of male fertility. In this study, we examined the fate of various testicular cells in adult mouse testes following ectopic autografting at 1, 2, 4 and 8 weeks post grafting. Histological examination showed no evidence of re-establishment of spermatogenesis in autografts, and progressive degeneration of seminiferous tubules was detected. Expression of germ cell-specific proteins such as POU5F1, DAZL, TNP1, TNP2, PRM1 and PRM2 revealed that, although proliferating and differentiating spermatogenic germ cells such as spermatogonia, spermatocytes and spermatids could survive in autografts until 4 weeks, only terminally differentiated germ cells such as sperm persisted in autografts until 8 weeks. The presence of Sertoli and peritubular myoid cells, as indicated by expression of WT1 and ACTA2 proteins, respectively, was evident in the autografts until 8 weeks. Interestingly, seminal vesicle weight and serum testosterone level were restored in autografted mice by 8 weeks post grafting. The expression of Leydig cell-specific proteins such as CYP11A1, HSD3B2 and LHCGR showed revival of Leydig cell (LC) populations in autografts over time since grafting. Elevated expression of PDGFRA, LIF, DHH and NEFH in autografts indicated de novo regeneration of LC populations. Autografted adult testis can be used as a model for investigating Leydig cell regeneration, steroidogenesis and regulation of the intrinsic factors involved in Leydig cell development. The success of this rodent model can have therapeutic applications for adult human males undergoing sterilizing cancer therapy. PMID:25516990

Makala, Himesh; Pothana, Lavanya; Sonam, Surabhi; Malla, Ashwini; Goel, Sandeep

2015-03-01

444

Physical violence during pregnancy and pregnancy outcomes in Ghana  

PubMed Central

Background In pregnancy, violence can have serious health consequences that could affect both mother and child. In Ghana there are limited data on this subject. We sought to assess the relationship between physical violence during pregnancy and pregnancy outcomes (early pregnancy loss, perinatal mortality and neonatal mortality) in Ghana. Method The 2008 Ghana Demographic and Health Survey data were used. For the domestic violence module, 2563 women were approached of whom 2442 women completed the module. After excluding missing values and applying the weight factor, 1745 women remained. Logistic regression analysis was performed to assess the relationship between physical violence in pregnancy and adverse pregnancy outcomes with adjustments for potential confounders. Results About five percent of the women experienced violence during their pregnancy. Physical violence in pregnancy was positively associated with perinatal mortality and neonatal mortality, but not with early pregnancy loss. The differences remained largely unchanged after adjustment for age, parity, education level, wealth status, marital status and place of residence: adjusted odds ratios were 2.32; 95% CI: 1.34-4.01 for perinatal mortality, 1.86; 95% CI: 1.05-3.30 for neonatal mortality and 1.16; 95% CI: 0.60-2.24 for early pregnancy loss. Conclusion Our findings suggest that violence during pregnancy is related to adverse pregnancy outcomes in Ghana. Major efforts are needed to tackle violence during pregnancy. This can be achieved through measures that are directed towards the right target groups. Measures should include education, empowerment and improving socio-economic status of women. PMID:24528555

2014-01-01

445

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

2014-01-01

446

Recurrent abdominal pain in childhood.  

PubMed

Recurrent abdominal pain in childhood is common, and continues to be a diagnostic and therapeutic challenge. It is usually attributed to a functional gastrointestinal disorder rather than an organic disease. In most cases, a comprehensive history and physical examination should enable one to make a positive diagnosis of functional disorder. The presence of alarm symptoms and signs, such as weight loss, gastrointestinal bleeding and chronic severe diarrhoea, warrants further investigations and referral to a paediatric gastrointestinal specialist. The mainstay of therapy in functional abdominal pain is education, reassurance and avoidance of triggering factors. While symptom-based pharmacological therapy may be helpful in patients who do not respond to simple management, it is best used on a time-limited basis due to the lack of good evidence of its efficacy. The primary goal of therapy is a return to normal daily activities rather than complete elimination of pain. In recalcitrant cases, psychological interventions such as cognitive behaviour therapy and relaxation training have proven to be efficacious. PMID:23624445

Chiou, Fang Kuan; How, Choon How; Ong, Christina

2013-04-01

447

Mechanical ventilation in abdominal surgery.  

PubMed

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

2014-01-01

448

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

PubMed

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

2014-08-01

449

Hypokalemic Paraplegia in Pregnancy  

PubMed Central

Hypokalemic myopathy may range from numbness/weakness to complete paralysis. The aetiology may be congenital or acquired. It is characterized by acute muscular weakness with low levels of potassium (<3.5 meq/L). We present a case of 26-year-old multigravida at 36 weeks of gestation with gestational hypertension on treatment, who came with acute onset of pain, numbness and weakness of both legs which worsened following betamethasone injection. She was diagnosed to have Hypokalemic paralysis with potassium levels of 2.1 meq/L. The medical profile remitted promptly on intravenous potassium replacement. Pregnancy was continued till 37 weeks with oral potassium supplements, antihypertensives and regular monitoring of serum potassium levels. The pregnancy was terminated after 37 weeks in view of gestational hypertension. Postpartum period was uneventful, patient was discharged after two weeks when potassium levels and BP returned to normal. PMID:25121034

TV, Srividya; Gopal, N

2014-01-01

450

[Acne therapy in pregnancy].  

PubMed

Acne should be treated during pregnancy to prevent worsening, scarring, secondary infection or psychological impairment of the mother. Safe products must be chosen. Systemic tetracycline, doxycycline, minocycline or isotretinoin can not be used. Topical benzoyl peroxide or topical azelaic acid are safe therapeutic options. According to the guidelines, systemic corticosteroids or systemic erythromycin (the latter not in lactation) can be employed beginning in the second trimester for severe flares of acne and should be started in cooperation with the patient's gynecologist. Oral zinc is another option, but not for longer than 3 months. Accessory cosmetic measures may be useful, including mechanical peeling or chemical peeling with glycolic or alpha-hydroxy-acids. In contrast, salicylic acid, trichloracetic acid or phenol peels should not be performed in pregnancy. Camouflage makeup can clearly lower the psychological stress. PMID:23430167

Bayerl, C

2013-04-01

451

Treating constipation during pregnancy  

PubMed Central

Abstract Question Many of my patients experience constipation during pregnancy, even after increasing dietary fibre and fluids. Are there any safe treatments I can recommend to them? Answer Although the recommended first-line therapy for constipation includes increasing fibre, fluids, and exercise, these are sometimes ineffective. Therefore, laxatives such as bulk-forming agents, lubricant laxatives, stool softeners, osmotic laxatives, and stimulant laxatives might be considered. Although few of the various types of laxatives have been assessed for safety in pregnancy, they have minimal systemic absorption. Therefore, they are not expected to be associated with an increased risk of congenital anomalies. However, it is recommended that osmotic and stimulant laxatives be used only in the short term or occasionally to avoid dehydration or electrolyte imbalances in pregnant women. PMID:22893333

Trottier, Magan; Erebara, Aida; Bozzo, Pina

2012-01-01

452

Aggressive angiomyxoma in pregnancy.  

PubMed

Aggressive angiomyxoma (AA) is a rare, slow-growing mesenchymal neoplasm of vulvo-perineal region. Although AA is common in females of reproductive age, only a few cases during pregnancy have been documented in the English literature. It carries a high risk of local recurrence but rarely metastasizes. The high recurrence rate can partially be due to inadequate excision, which may be due to an incorrect preoperative diagnosis. We present a case of 25-year-old pregnant female presenting with a painless and soft mass attached to left labia majora by a stalk. This mass was clinically thought to be a lipoma. It was completely excised and was diagnosed as AA on histopathology. Gynecologists should consider the diagnosis of AA when a young female especially during her pregnancy presents with a vulvo-perineal mass. Incorrect diagnosis may lead to incomplete excision and recurrence. PMID:25002951

Goyal, Prashant; Agrawal, Dipti; Sehgal, Shelly; Ghosh, Soumyesh; Kumar, Awanindra; Singh, Sompal

2014-05-13

453

Mycoplasmas in pregnancy.  

PubMed

The genital mycoplasmas have been implicated in a number of adverse outcomes of pregnancy. Spontaneous preterm labour and preterm birth is an important contributor to perinatal mortality and morbidity. If Mycoplasma hominis plays an integral part in this problem, it is likely to contribute through its involvement with bacterial vaginosis. Ureaplasmas induce cytokines and inflammation, making a casual association compelling. The role of Mycoplasma genitalium and Mycoplasma fermentans is less clear, but M. genitalium is potentially pathogenic and should be treated if detected. There is considerable evidence for the role of M. hominis in post-partum and post-abortal sepsis, and for ureaplasmas causing chronic lung disease or death in very low birthweight infants. The role of the genital mycoplasmas in adverse outcomes of pregnancy is complicated by the presence or absence of bacterial vaginosis, and this association requires further research. PMID:21091927

Taylor-Robinson, D; Lamont, R F

2011-01-01

454

Aggressive Angiomyxoma in Pregnancy  

PubMed Central

Aggressive angiomyxoma (AA) is a rare, slow-growing mesenchymal neoplasm of vulvo-perineal region. Although AA is common in females of reproductive age, only a few cases during pregnancy have been documented in the English literature. It carries a high risk of local recurrence but rarely metastasizes. The high recurrence rate can partially be due to inadequate excision, which may be due to an incorrect preoperative diagnosis. We present a case of 25-year-old pregnant female presenting with a painless and soft mass attached to left labia majora by a stalk. This mass was clinically thought to be a lipoma. It was completely excised and was diagnosed as AA on histopathology. Gynecologists should consider the diagnosis of AA when a young female especially during her pregnancy presents with a vulvo-perineal mass. Incorrect diagnosis may lead to incomplete excision and recurrence. PMID:25002951

Goyal, Prashant; Agrawal, Dipti; Sehgal, Shelly; Ghosh, Soumyesh; Kumar, Awanindra; Singh, Sompal

2014-01-01

455

[Mental illness and pregnancy].  

PubMed

Pregnancy was once thought a period of bliss devoid of mental illness. We now know this is not so. It is well documented that pregnancy and the peripartum are not only a time when preexisting mental illness will persist but that it is also a high-risk period for renewed episodes of mental illness, whether de novo or relapse. In this paper, we will describe the three main axis of management of maternal mental illness during the peripartum: maternal psychiatric illness, fetal, neonatal and infant development and future mother-infant relationship. We will give an overview of how to organize care for mothers with schizophrenia and bipolar disorder. Good practice management of psychotropic medication during this period will be described. Finally the importance of networking and multidisciplinary management of these situations will be underlined. PMID:23236865

Apter, Gisèle; Garez, Valérie; Medjkane, François

2012-09-01

456

Pregnancy and women radiologists  

SciTech Connect

Concerns about conceptus exposure to ionizing radiation, the level of conceptus dose that is likely to result from the mother's occupation, precautions to insure low conceptus dose, and the effects of radiation on the conceptus are discussed as they relate to the woman radiologist, her career and possible pregnancy. The amounts of radiation per examination are tabulated for the various radiologic modalities, and a summary is given of exposure levels.

Wagner, L.K. (Univ. of Texas Medical School, Houston); Hayman, L.A.

1982-11-01

457

Pregnancy and substance abuse  

Microsoft Academic Search

Summary  \\u000a The fetal consequences of drug abuse during pregnancy remain underestimated. Obstetrical complications of cigarette smoking\\u000a include growth retardation, spontaneous abortion and sudden infant death syndrome; alcohol abuse leads to nutritional deficiencies\\u000a and fetal alcohol syndrome. Heroin and cocaine consumption result in medical, nutritional and social neglect; cocaine and\\u000a amphetamine cause hypertension, abruptio placentae; all three drugs of abuse cause

G. Fischer; M. Bitschnau; A. Peternell; H. Eder; A. Topitz

1999-01-01

458

Cytomegalovirus infection in pregnancy  

Microsoft Academic Search

Objectives: To investigate the effects of intrauterine human cytomegalovirus (HCMV) infection on pregnancy outcomes and infant development. Methods: The study group consisted of the HCMV-IgM-positive offspring of 75 pregnant women, and a control group of the non-infected offspring of 73 pregnant women. Chorionic villi, amnionic fluid, and umbilical blood were obtained to detect HCMV–late mRNA with a reverse transcriptase-polymerase chain

L. Z. Wen; W. Xing; L. Q. Liu; L. M. Ao; S. H. Chen; W. J. Zeng

2002-01-01

459

Exercise and Pregnancy  

PubMed Central

Evidence is beginning to appear that complications of pregnancy are fewer in the athlete than the non-athlete. Studies show that after childbirth, sports performance improves in a majority of women. A few activities could prove hazardous to the woman and her fetus. In view of the increased participation of women in sports and recreation, it is imperative that the benefits as well as the dangers are considered and discussed as part of prenatal care. PMID:21289749

Bullard, J. A.

1981-01-01

460

Asthma and Pregnancy  

Microsoft Academic Search

Asthma is probably the most common serious medical disorder that may complicate pregnancy. A third of pregnant women with\\u000a asthma will experience worsening of their symptoms, a third will see improvement of their symptoms and a third will see no\\u000a change. The primary goal is to maintain optimal control of asthma for maternal health and well-being as well as fetal

Rani Reddy Vatti; Suzanne S. Teuber

461

[Metformin in pregnancy].  

PubMed

Metformin is an oral insulin-sensitizing anti-diabetic drug. Polycystic ovary syndrome (PCOS) and gestational diabetes (GDM) are both associated with insulin resistance and hyperinsulinemia. Metformin can bring potential benefits in pregnant women due to its favorable metabolic effect. Nevertheless, there is a possibility of adverse effects on the fetus as metformin crosses the placenta. In this review we discuss safety and indications for metformin administration in pregnancy. PMID:25118505

Bijok, Julia; Bi?kowska, Ma?gorzata; Jakiel, Grzegorz

2014-07-01

462

Postoperative Adhesion Development Following Cesarean and Open Intra-Abdominal Gynecological Operations  

PubMed Central

In this review, we discuss the pathophysiology of adhesion development, the impact of physiological changes associated with pregnancy on markers of adhesion development, and the clinical implications of adhesion development following cesarean delivery (CD). Although peritoneal adhesions develop after the overwhelming majority of intra-abdominal and pelvic surgery, there is evidence in the literature that suggests that patients having CD may develop adhesions less frequently. However, adhesions continue to be a concern after CD, and are likely significant, albeit on average less than after gynecological operations, but with potential to cause significant delay in the delivery of the baby with serious, lifelong consequences. Appreciation of the pathophysiology of adhesion development described herein should allow a more informed approach to the rapidly evolving field of intra-abdominal adhesions and should serve as a reference for an evidence-based approach to consideration for the prevention and treatment of adhesions. PMID:21775773

Awonuga, Awoniyi O.; Fletcher, Nicole M.; Saed, Ghassan M.; Diamond, Michael P.

2011-01-01

463

Chromosomal Anomalies in Abnormal Human Pregnancies  

Microsoft Academic Search

Objective: The aim of this study was to describe the cytogenetic observations on abnormal human pregnancies (anembryonic pregnancy, early fetal loss, and hydatidiform moles), and to detect the most frequent or typical chromosomal aberration for anembryonic pregnancy and early fetal loss. Study Design: Abnormal pregnancies were divided into three clinical and morphological groups: (a) anembryonic pregnancy; (b) early fetal loss,

1998-01-01

464

Pregnancy and multiple sclerosis.  

PubMed

MS is an unpredictable, potentially disabling condition that occurs most commonly in women of reproductive age. The decision to have a baby after this diagnosis is a difficult and very personal one. Each couple considering a family deserves preconception counseling with accurate information and support to facilitate an informed decision. Consistently, studies have found that pregnancy is a period of safety from worsening of MS but that exacerbation occurs at two to three times the expected rate after delivery. Gestational history does not seem to affect the ultimate prognosis of the disease. The decision to bear children then seems to depend first on the desire of the woman to have a family. Additional issues to consider for a woman with MS considering pregnancy are current physical impairment and support available from father, family, and friends. There is considerable evidence that some protective factor exists during pregnancy to cause the disease to be less active. Presumably, this is a soluble factor or factors that suppress the cellular immune system. This is of great potential scientific interest, since it may contribute to our understanding of MS and potentially lead to newer avenues of research and treatment. PMID:2461576

Birk, K; Smeltzer, S C; Rudick, R

1988-09-01

465

Cardiomyopathy in pregnancy.  

PubMed

Cardiomyopathy during pregnancy is uncommon but potentially catastrophic to maternal health, accounting for up to 11% of maternal deaths. Peripartum cardiomyopathy is diagnosed in women without a history of heart disease 1 month before delivery or within 5 months postpartum. About half of all women will have full myocardial recovery within 6 months of diagnosis, but complications such as severe heart failure or death are not rare. African-American women have higher rates of diagnosis and adverse events. Women with preexisting cardiomyopathy, such as dilated or hypertrophic cardiomyopathy, followed closely during pregnancy often tolerate pregnancy and delivery. Risk factors for adverse outcomes include functional status at baseline, severity of systolic dysfunction or outflow tract gradient, or history of prior cardiac event, such as arrhythmia or stroke. The level of brain natriuretic peptide (BNP) can be used to risk stratify women for adverse events. Pregnant women with cardiomyopathy should be followed closely by a multidisciplinary team comprised of nurses, obstetricians, neonatologists, cardiologists, anesthesiologists, and cardiac surgeons. PMID:25037522

Lewey, Jennifer; Haythe, Jennifer

2014-08-01

466

Liver diseases in pregnancy: Diseases not unique to pregnancy  

PubMed Central

Pregnancy is a special clinical state with several normal physiological changes that influence body organs including the liver. Liver disease can cause significant morbidity and mortality in both pregnant women and their infants. Few challenges arise in reaching an accurate diagnosis in light of such physiological changes. Laboratory test results should be carefully interpreted and the knowledge of what normal changes to expect is prudent to avoid clinical misjudgment. Other challenges entail the methods of treatment and their safety for both the mother and the baby. This review summarizes liver diseases that are not unique to pregnancy. We focus on viral hepatitis and its mode of transmission, diagnosis, effect on the pregnancy, the mother, the infant, treatment, and breast-feeding. Autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, Wilson’s disease, Budd Chiari and portal vein thrombosis in pregnancy are also discussed. Pregnancy is rare in patients with cirrhosis because of the metabolic and hormonal changes associated with cirrhosis. Variceal bleeding can happen in up to 38% of cirrhotic pregnant women. Management of portal hypertension during pregnancy is discussed. Pregnancy increases the pathogenicity leading to an increase in the rate of gallstones. We discuss some of the interventions for gallstones in pregnancy if symptoms arise. Finally, we provide an overview of some of the options in managing hepatic adenomas and hepatocellular carcinoma during pregnancy. PMID:24282352

Almashhrawi, Ashraf A; Ahmed, Khulood T; Rahman, Rubayat N; Hammoud, Ghassan M; Ibdah, Jamal A

2013-01-01

467

VAGAL WITHDRAWAL AND RECURRENT ABDOMINAL PAIN  

Microsoft Academic Search

Recurrent abdominal pain (RAP) is a common pediatric problem characterized by recurrent bouts of abdominal pain in children with no identifiable etiology. RAP affects 10 to 15% of the children in elementary school, increasing to nearly 20% in middle and high school. The symptoms are severe enough to cause disruption of daily activities and are associated with learning difficulties, perhaps

Elizabeth Bigham

468

Abdominal Situs inversus in a sheep  

Microsoft Academic Search

ExtractMadam:— Transposition of thoracic and\\/or abdominal viscera is recognised in humans, rats, mice, hamsters, dogs, amphibians and fish, but does not appear to have been previously described in sheep. We report the finding of an apparently complete transposition of abdominal viscera in a nine-month-old castrated male lamb slaughtered at the Tomoana Freezing Works, Hastings

C. Larsen; E. J. Kirk

1987-01-01

469

[Embryo-fetal development in the early stages of pregnancy].  

PubMed

The introduction of high resolution transvaginal US in obstetrical clinical practice permits earlier and more detailed visualization of embryo-fetal structures in early pregnancy. A transvaginal US examination with a high-resolution probe (5.0-6.0 MHz) was performed in 1246 pregnant patients between 9 and 16 weeks of gestation and known gestational age. Ten embryo-fetal biometric parameters were measured (crown-rump length, biparietal diameter, head circumference, transverse cerebellar diameter, thoracic circumference, mean abdominal diameter, abdominal circumference, femur length, humerus length and foot length). Reference ranges with 5 degrees and 95 degrees percentile intervals were constructed for all biometric parameters in relation to gestational age. Only one scan per patient was considered for this study. All the parameters evaluated demonstrated a high correlation with gestational age at polynomial regression analysis. The mean coefficient of determination (r2) ranged from 97.15 for biparietal diameter to 88.17 for transverse cerebellar diameter. The data are useful as reference range for the assessment of normal embryofetal development by transvaginal US in the early stages of pregnancy. PMID:9280943

Guariglia, L; Rosati, P

1997-05-01

470

21 CFR 884.5225 - Abdominal decompression chamber.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Abdominal decompression chamber. 884.5225 Section...Devices § 884.5225 Abdominal decompression chamber. (a) Identification. An abdominal decompression chamber is a hoodlike device...

2010-04-01

471

Maternal complications in diabetic pregnancy.  

PubMed

Pregnant women with diabetes have to manage both the effect of pregnancy on glucose control and its effect on pre-existing diabetic complications. Most women experience hypoglycaemia as a consequence of tightened glycaemic control and this impacts on daily living. Less commonly, diabetic ketoacidosis, a serious metabolic decompensation of diabetic control and a medical emergency, can cause foetal and maternal mortality. Microvascular complications of diabetes include retinopathy and nephropathy. Retinopathy can deteriorate during pregnancy; hence, regular routine examination is required and, if indicated, ophthalmological input. Diabetic nephropathy significantly increases the risk of obstetric complications and impacts on foetal outcomes. Pregnancy outcome is closely related to pre-pregnancy renal function. Diabetic pregnancy is contraindicated if the maternal complications of ischaemic heart disease or diabetic gastropathy are known to be present before pregnancy as there is a significant maternal mortality associated with both of these conditions. PMID:21130689

Hawthorne, Gillian

2011-02-01

472

Abdominal Pain following Gastric Bypass: Suspects & Solutions  

PubMed Central

Introduction Gastric bypass remains the mainstay of surgical therapy for obesity. Abdominal pain after gastric bypass is common, and accounts for up to half of all postoperative complaints and emergency room visits. This manuscript reviews the most important causes of abdominal pain specific to gastric bypass and discusses management considerations. Data Sources The current surgical literature was reviewed using PubMed, with a focus on abdominal pain after gastric bypass and the known pathologies that underlie its pathogenesis. Conclusions The differential diagnosis for abdominal pain after gastric bypass is large and includes benign and life-threatening entities. Its diverse causes require a broad evaluation that should be directed by history and clinical presentation. In the absence of a clear diagnosis, the threshold for surgical exploration in patients with abdominal pain after gastric bypass should be low. PMID:21333269

Greenstein, Alexander J.; O’Rourke, Robert W.

2010-01-01

473

Pulmonary complications of abdominal wall defects.  

PubMed

The abdominal wall is an integral component of the chest wall. Defects in the ventral abdominal wall alter respiratory mechanics and can impair diaphragm function. Congenital abdominal wall defects also are associated with abnormalities in lung growth and development that lead to pulmonary hypoplasia, pulmonary hypertension, and alterations in thoracic cage formation. Although infants with ventral abdominal wall defects can experience life-threatening pulmonary complications, older children typically experience a more benign respiratory course. Studies of lung and chest wall function in older children and adolescents with congenital abdominal wall defects are few; such investigations could provide strategies for improved respiratory performance, avoidance of respiratory morbidity, and enhanced exercise ability for these children. PMID:25458796

Panitch, Howard B

2015-01-01

474

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

2009-03-18

475

Hormones and Hemodynamics in Pregnancy  

PubMed Central

Context: Normal pregnancy is associated with sodium and water retention, which results in plasma volume expansion prior to placental implantation. The explanation offered for these events is that pregnancy ‘resets’ both volume and osmoreceptors. Evidence Acquisition: The mechanisms for such an enigmatic ‘resetting’ in pregnancy have not previously been explained. However, recent human pregnancy studies have demonstrated that the earliest hemodynamic change in pregnancy is primary systemic arterial vasodilation. This arterial underfilling is associated with a secondary increase in cardiac output and activation of the neurohumoral axis, including stimulation of the renin-angiotensin-aldosterone, sympathetic, and non-osmotic vasopressin systems. Resistance to the pressor effects of angiotensin and sympathetic stimulation in pregnancy is compatible with an increase in endothelial nitric oxide synthase activity. Results: In contrast to the sodium and water retention which occur secondary to the primary arterial vasodilation in cirrhosis, glomerular filtration and renal blood flow are significantly increased in normal pregnancy. A possible explanation for this difference in arterial vasodilation states is that relaxin, an arterial vasodilator which increases during pregnancy, has a potent effect on both systemic and renal circulation. Endothelial damage in pregnancy is pivotal in the pathogenesis of preeclampsia in pregnancy. Conclusions: Against a background of the primary arterial vasodilation hypothesis, it is obvious that reversal of the systemic vasodilatation in pregnancy, without subsequent activation of the renin-angiotensin-aldosterone system (78), will evoke a reversal of all the links in the chain of events in normal pregnancy adaptation, thus, it may cause preeclampsia. Namely, a decrease of renal vasodilation will decrease glomerular filtration rate. PMID:24803942

Tkachenko, Oleksandra; Shchekochikhin, Dmitry; Schrier, Robert W.

2014-01-01

476

Complementary medicine for pregnancy complications.  

PubMed

For some women, pregnancy can bring a myriad of distressing symptoms. Nausea affects up to 85% of women during early pregnancy and about half of these women also experience vomiting. For some women, it can be very debilitating. Conventional anti-emetics bring with them a risk of potential teratogenic effects during the critical stage of early pregnancy. Women tend to feel more comfortable taking a natural or herbal substance to help manage these issues. PMID:16969438

Woolhouse, Michelle

2006-09-01

477

Size Matters: Non-LTR Retrotransposable Elements and Ectopic Recombination in Drosophila  

E-print Network

Size Matters: Non-LTR Retrotransposable Elements and Ectopic Recombination in Drosophila Dmitri A Sciences, Stanford University The Drosophila melanogaster genome contains approximately 100 distinct families in the Drosophila euchromatin appear to be only marginally affected by purifying selection

Bensasson, Douda

478

Chromosome Rearrangement by Ectopic Recombination in Drosophila Melanogaster: Genome Structure and Evolution  

PubMed Central

Ectopic recombination between interspersed repeat sequences generates chromosomal rearrangements that have a major impact on genome structure. A survey of ectopic recombination in the region flanking the white locus of Drosophila melanogaster identified 25 transposon-mediated rearrangements from four parallel experiments. Eighteen of the 25 were generated from females carrying X chromosomes heterozygous for interspersed repeat sequences. The cytogenetic and molecular analyses of the rearrangements and the parental chromosomes show: (1) interchromosomal and intrachromosomal recombinants are generated in about equal numbers; (2) ectopic recombination appears to be a meiotic process that is stimulated by the interchromosomal effect to about the same degree as regular crossing over; (3) copies of the retrotransposon roo were involved in all of the interchromosomal exchanges; some copies were involved much more frequently than others in the target region; (4) homozygosis for interspersed repeat sequences and other sequence variations significantly reduced ectopic recombination. PMID:1783293

Montgomery, E. A.; Huang, S. M.; Langley, C. H.; Judd, B. H.

1991-01-01

479

Spontaneous Forniceal Rupture in Pregnancy  

PubMed Central

Forniceal rupture is a rare event in pregnancy. We report a case of a 26-year-old primigravid woman who experienced a forniceal rupture at 23 weeks of gestation with no inciting cause except for pregnancy. Pregnancy is associated with ureteral compression due to increase in pelvic vasculature with the right ureter more dilated due to anatomic reasons. Hormones such as prostaglandins and progesterone render the ureter more distensible to allow for pressure build-up and an obstructive picture at the collecting system. We will discuss physiologic changes in pregnancies that predispose to this uncommon phenomenon and the most up-to-date management strategies. PMID:25648411

Upputalla, Roshni; Moore, Robert M.; Jim, Belinda

2015-01-01

480

Influence of Chm-I knockout on ectopic cartilage regeneration and homeostasis maintenance.  

PubMed

Ectopic ossification of mesenchymal stem cell (MSC) regenerated cartilage have greatly restricted its application in repairing subcutaneous cartilage defects (such as nasal or auricular). Different from MSCs, chondrocytes can maintain stable chondrogenic phenotype in ectopic microenvironment, which was speculated to be related with the existence of anti-angiogenic factors such as Chondromodulin-I (Chm-I). Therefore, the purpose of this study was to illustrate whether Chm-I was indispensable for stable ectopic chondrogenesis by chondrocyte, which may help to solve the problem of MSC ectopic ossification in future. The current study demonstrated that Chm-I knockout did not obviously influence articular cartilage development in situ. However, native articular cartilage from Chm-I knockout (Chm-I-/-, KO) but not wild type (WT) mice showed obvious ossification after subcutaneously implanted into nude mice for 16 d. Interestingly, cell morphology, cartilage specific matrix expression, and pellet culture demonstrated that Chm-I knockout had no obvious influence on phenotype, function, and chondrogenic ability of chondrocytes in vitro, except that cells in WT group proliferated a little faster than those in KO group. Nevertheless, Chm-I knockout directly interfered with in vivo ectopic cartilage regeneration when chondrocytes were subcutaneously injected into nude mice with matrigel. Moreover, Chm-I knockout obviously compromised ectopic stability of in vitro regenerated cartilage after subcutaneous implantation. These findings indicated that Chm-I was an indispensable factor for ectopic cartilage regeneration and the maintenance of cartilage homeostasis, which may provide a clue for solving the stability problem of MSC regenerated cartilage in ectopic niche. In addition, this study also provides a novel model based on tissue engineering strategy to properly evaluate the function of other targeted genes. PMID:25251892

Zhu, Yueqian; Zhang, Yingying; Liu, Yu; Tao, Ran; Xia, Huitang; Zheng, Rui; Shi, Yuan; Tang, Shengjian; Zhang, Wen-Jie; Liu, Wei; Cao, Yilin; Zhou, Guangdong

2014-09-24

481

Ectopic thymic tissue presenting as a neck mass in children: a report of 3 cases.  

PubMed

The presentation of ectopic cervical thymic tissue as an anterior neck mass is rare. We report 3 similar cases in 3 boys-2 who had a thymic cyst and 1 who had an ectopic cervical thymus. We discuss the radiographic presentation on ultrasound and magnetic resonance imaging in these cases. We also review the typical histologic picture; histology is the only way of diagnosing this condition. PMID:20461685

Meyer, Estie; Mulwafu, Wakisa; Fagan, Johannes J; Brown, Robin A; Taylor, Kathryn

2010-05-01

482

The influence of morphogene Wg on the formation of an ectopic eye in Drosophila melanogaster  

Microsoft Academic Search

Due to the ectopic expression of the ey gene in the wing imaginal disc under the action of the 1096-Gal4 driver, a part of the wing disc cells change their fate and become eye cells. Ectopic eyes are induced in definite regions\\u000a of the wing disc and form a stable pattern on the wing of an adult fly. Here, we

S. A. Kopyl; T. D. Dubatolova; E. I. Volkova; E. V. Marilovtseva; L. V. Omel’yanchuk

2011-01-01

483

Metastatic pancreatic neuroendocrine tumor with ectopic adrenocorticotropic hormone production  

PubMed Central

We describe a 71-year-old man who presented with abdominal pain, lower-extremity edema, recent unintentional weight loss, hypertension, hyperglycemia, hypokalemia, and metabolic alkalosis. Serum cortisol levels remained elevated after overnight high-dose dexamethasone suppression. Magnetic resonance imaging revealed a small mass in the head of the pancreas with scattered liver metastases. Both endoscopic ultrasound-guided pancreatic biopsy and liver biopsy revealed a well-differentiated neuroendocrine tumor. These lesions did not show significant uptake on octreotide scan. Medical management and hepatic artery chemoembolization were attempted. Ultimately, the patient underwent bilateral adrenalectomy, but died within 4 months of symptom onset secondary to postoperative complications. PMID:25552797

Nagarur, Amulya; Kerr, Darcy A.; Lauter, Kelly B.; Padmanabhan, Arun; Raghavan, Srivatsan; Pallais, Juan C.; Fenves, Andrew Z.

2015-01-01

484

Internal hernia in late pregnancy after laparoscopic Roux-en-Y gastric bypass.  

PubMed

A 27-year-old patient in late pregnancy presented to the department of obstetrics with crampy abdominal pain located in the right flank, 3?years after a laparoscopic Roux-en-Y gastric bypass. Clinical investigation showed tenderness on palpation in the upper abdomen without signs of peritonitis. The cardiotocogram and blood tests were normal. The ultrasound showed a hydronephrosis on the right side, and a pigtail catheter was inserted. The abdominal symptoms did not abate and the abdominal surgeon was consulted 36?hours after admission. Diagnostic laparoscopy was performed promptly because of high suspicion of internal hernia (IH). Laparoscopy showed IH at the mesojejunal intermesenteric defect with a herniated common channel and volvulus of the anastomosis. Conversion to open reduction and complete closure with non-absorbable interrupted sutures was performed. Small bowel resection was avoided. The patient was discharged 10?days after the operation and a healthy boy was born 4?weeks later. PMID:25538214

Gruetter, Florian; Kraljevi?, Marko; Nebiker, Christian A; Delko, Tarik

2014-01-01

485

Genetics Home Reference: Intrahepatic cholestasis of pregnancy  

MedlinePLUS

... OMIM Genetic disorder catalog Conditions > Intrahepatic cholestasis of pregnancy On this page: Description Genetic changes Inheritance Diagnosis ... Reviewed June 2012 What is intrahepatic cholestasis of pregnancy? Intrahepatic cholestasis of pregnancy is a liver disorder ...

486

Ectopic thyroid tissue surrounding the right laryngeal nerve: a case report  

PubMed Central

Ectopic thyroid tissue (ETT) is a rare developmental anomaly of the thyroid tissue which is defined as the presence of thyroid tissue in locations other than the pretracheal area. However, ectopic thyroid tissue in the lateral neck surrounding the recurrent laryngeal nerve is unusually found. Here we describe a case of a 64-year-old woman who was found bilateral thyroid goiter by the ultrasound examination. The total thyroidectomy plus a modified radical neck dissection was performed. Surprisingly we also found a nodule surrounding the right recurrent laryngeal nerve at the same time. Nevertheless the diagnosis of the nodule was confirmed by pathology and Histologic examination demonstrating that it was ectopic thyroid tissue. Ectopic thyroid tissue surrounding recurrent laryngeal nerve is a rare finding, with hardly any cases reported. For it is generally thought that any thyroid tissue found in the lateral aspect of the neck may indicate metastatic deposits from well-differentiated thyroid carcinoma. Although pathogenesis of ectopic thyroid tissue surrounding recurrent laryngeal nerve without any symptoms remains unknown, our case could suggest ectopic thyroid tissue should not be excluded in the differential diagnosis of lateral neck masses especially when the recurrent laryngeal nerves were surrounded by the nodules. PMID:25197416

He, Bin; Li, Peng; Yang, Kai; Shan, Yunfeng

2014-01-01

487