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1

Ectopic pregnancy three times in line of which two advanced abdominal pregnancies.  

PubMed

Three consecutive ectopic pregnancies were diagnosed in one patient. Two pregnancies (one following IVF-ET) proceeded as abdominal pregnancies till the third trimester of pregnancy. Neither abdominal pregnancies had been diagnosed prior to surgery. PMID:8735767

Moonen-Delarue, M W; Haest, J W

1996-05-01

2

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 ...

3

Ectopic Pregnancy  

MedlinePLUS

... Website of the American Society for Reproductive Medicine Ectopic pregnancy Developed in collaboration with the Society for Reproductive Surgeons What is ectopic pregnancy? An ectopic pregnancy is any pregnancy that ...

4

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. ...

5

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 ...

6

Ectopic/Tubal Pregnancy  

MedlinePLUS

Pregnancy: Ectopic/Tubal Pregnancy and Miscarriage Posted under Health Guides . Updated 8 July 2014. +Related Content Normal pregnancy: A ... to grow. What are the symptoms of an ectopic pregnancy? The early symptoms of an ectopic pregnancy ...

7

Ectopic Pregnancy  

MedlinePLUS

... uterus. He or she may also order a urine test and a blood test to check your levels of human chorionic gonadotropin (hCG). hCG is a hormone that is produced by the placenta. If you have an ectopic pregnancy, you may have a low hCG level. Your ...

8

[The early abdominal pregnancy--case report].  

PubMed

The abdominal ectopic pregnancies are 1-1.4% of all ectopic pregnancies. In this article we presents the case of 27-year-old patient in early abdominal pregnancy, situated in parietal peritoneum. This case justifies the need to take into account possibility of abdominal pregnancy in case of suspicion of ectopic pregnancy. PMID:25344980

Posadzka, Ewa; Jach, Robert; Pity?ski, Kazimierz; Matyszkiewicz, Anna

2014-01-01

9

Ectopic pregnancy (image)  

MedlinePLUS

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

10

Cervical ectopic pregnancy  

PubMed Central

Cervical pregnancy is a rare type of ectopic pregnancy and it represents <1% of all ectopic pregnancies. Early diagnosis and medical management with systemic or local administration of methotrexate is the treatment of choice. If the pregnancy is disturbed, it may lead to massive hemorrhage, which may require hysterectomy to save the patient. We report three cases of cervical pregnancy managed successfully with different approaches of management. Our first case, 28 years old G3P2L2 with previous two lower segment cesarean sections, presented with bleeding per vaginum following 6 weeks of amenorrhea. Clinical examination followed by transvaginal ultrasound confirmed the diagnosis of cervical pregnancy. Total abdominal hysterectomy was done in view of intractable bleeding to save the patient. The second case, a 26-year-old second gravida with previous normal vaginal delivery presented with pain abdomen and single episode of spotting per vaginum following 7 weeks of amenorrhea. Transvaginal ultrasound revealed empty endometrial cavity, closed internal os with gestational sac containing live fetus of 7 weeks gestational age in cervical canal and she was treated with intra-amniotic potassium chloride followed by systemic methotrexate. Follow up with serum beta human chorionic gonadotropin level revealed successful outcome. Our third case, a 27-year-old primigravida with history of infertility treatment admitted with complaints of bleeding per vaginum for 1 day following 8 weeks amenorrhea. She was diagnosed as cervical pregnancy by clinical examination, confirmed by transvaginal ultrasonography and subsequently managed by dilation and curettage with intracervical Foleys’ ballon tamponade.

Samal, Sunil Kumar; Rathod, Setu

2015-01-01

11

Ovarian ectopic pregnancy: A rare case  

PubMed Central

Background: Ovarian pregnancy is a rare form of the non-tubal ectopic pregnancy. It ends with rupture before the end of the first trimester. One of the important risk factors for ovarian pregnancy is in the use of Intra uterine devices (IUD). Case: We report here one such uncommon case of ovarian ectopic pregnancy. Our patient is a 30 years old multiparous woman with two previous cesarean sections with severe hypogastric abdominal pain. During laparotomy, ruptured ovarian ectopic pregnancy was diagnosed, and wedge resection of the ovary was only done. Histopathological examination confirmed it to be an ovarian ectopic pregnancy. Conclusion: IUD is one of contraceptive methods which prevents intra-uterine implantation in 99.5%, if implant occurs with IUD, it is tubal implantation in 95% of cases, and it is very rare in other places such as ovary. The most important risk factor of ovarian ectopic pregnancy is IUD as in this study it was showed. PMID:24976824

Ghasemi Tehrani, Hatav; Hamoush, Zaynab; Ghasemi, Mojdeh; Hashemi, Leila

2014-01-01

12

Ectopic molar pregnancy: a case report.  

PubMed

The incidence of hydatidiform moles is 1 per 1,000 pregnancies. Ectopic pregnancy occurs in 20 per 1,000 pregnancies. Thus, the incidence of the ectopic molar gestation is very rare. We report a case of tubal molar pregnancy diagnosed at the systematic histology exam of an ectopic pregnancy. We report the case of 32 years old nulliparus women who presented a vaginal bleeding, lower abdominal pain and 6 weeks amenorrhea corresponding to the last menstrual period. At the clinical examination, the arterial pressure was 100/60 mmHG. The gynecological examination was difficult because of lower abdominal pain. Serum gonadotropin activity was 3454 ui/l. Pelvic ultrasound revealed an irregular echogenic mass in the left adnexa. Diagnostic laparoscopy revealed a left-sided unruptured ampullary ectopic pregnancy. A left laparoscopic salpingectomy was performed. The systematic histologic test identified an ectopic partial molar pregnancy, which was confirmed by DNA ploidy image analysis. The patient was followed with weekly quantitative B-hCG titers until three successive B-hCG levels were negative. It is pertinent that clinicians take routine histological examination of tubal specimens in ectopic pregnancy very seriously in order to diagnose cases of ectopic molar gestations early and mount appropriate post treatment surveillance. PMID:22655097

Bousfiha, Najoua; Erarhay, Sanaa; Louba, Adnane; Saadi, Hanan; Bouchikhi, Chahrazad; Banani, Abdelaziz; El Fatemi, Hind; Sekkal, Med; Laamarti, Afaf

2012-01-01

13

Ectopic molar pregnancy: a case report  

PubMed Central

The incidence of hydatidiform moles is 1 per 1,000 pregnancies. Ectopic pregnancy occurs in 20 per 1,000 pregnancies. Thus, the incidence of the ectopic molar gestation is very rare. We report a case of tubal molar pregnancy diagnosed at the systematic histology exam of an ectopic pregnancy. We report the case of 32 years old nulliparus women who presented a vaginal bleeding, lower abdominal pain and 6 weeks amenorrhea corresponding to the last menstrual period. At the clinical examination, the arterial pressure was 100/60 mmHG. The gynecological examination was difficult because of lower abdominal pain. Serum gonadotropin activity was 3454 ui/l. Pelvic ultrasound revealed an irregular echogenic mass in the left adnexa. Diagnostic laparoscopy revealed a left-sided unruptured ampullary ectopic pregnancy. A left laparoscopic salpingectomy was performed. The systematic histologic test identified an ectopic partial molar pregnancy, which was confirmed by DNA ploidy image analysis. The patient was followed with weekly quantitative B-hCG titers until three successive B-hCG levels were negative. It is pertinent that clinicians take routine histological examination of tubal specimens in ectopic pregnancy very seriously in order to diagnose cases of ectopic molar gestations early and mount appropriate post treatment surveillance. PMID:22655097

Bousfiha, Najoua; Erarhay, Sanaa; Louba, Adnane; Saadi, Hanan; Bouchikhi, Chahrazad; Banani, Abdelaziz; Fatemi, Hind El; Sekkal, Med; Laamarti, Afaf

2012-01-01

14

Treating non-tubal ectopic pregnancy.  

PubMed

The purpose of this review is to examine the current state of knowledge regarding the treatment of non-tubal ectopic pregnancies. This review looks at the management of cervical, caesarean scar, ovarian, interstitial, cornual and abdominal pregnancies. Traditionally these pregnancies have been diagnosed late and managed by open surgery. Earlier diagnosis has led to the use of minimal access techniques, medical and conservative management for all types of non-tubal pregnancies. Increased awareness and the experience of specialised centres have led to an improved understanding of the best way to manage non-tubal ectopic pregnancies and the development of new techniques. PMID:19230785

Chetty, Maya; Elson, Janine

2009-08-01

15

Three consecutive recurrent ectopic pregnancies.  

PubMed

A case of three consecutive repeated ectopic pregnancies is presented in a 36-year-old woman who was being managed for infertility. The first two ectopic pregnancies occurred in the right fallopian tube, and both were treated conservatively. All three ectopic pregnancies were confirmed histopathologically. The aetiology, symptoms and management of the case are discussed, and the literature is reviewed. PMID:8181445

Adelusi, B; al-Meshari, A; Akande, E O; Chowdhury, N

1993-09-01

16

MR imaging findings of ectopic pregnancy: a pictorial review.  

PubMed

Because of its lack of ionizing radiation and excellent soft-tissue contrast, magnetic resonance (MR) imaging is being increasingly used in the evaluation of acute abdominal pain in the pregnant patient. Roughly 2% of all pregnancies are ectopic. Although ectopic pregnancy is usually diagnosed on the basis of a combination of clinical, laboratory, and ultrasonographic findings, it occasionally is initially identified at MR imaging. Thus, it is imperative that the radiologist should be familiar with the variable appearance of ectopic pregnancy at MR imaging and should evaluate for ectopic pregnancy at any time when (a) a patient has positive results of a pregnancy test and (b) an intrauterine pregnancy is not definitively seen. Because of potential issues of fetal safety, a conservative approach should be used for MR imaging in pregnancy. An MR imaging protocol for the evaluation of possible appendicitis in pregnant women is detailed. Specific findings that can aid in the diagnosis of ectopic pregnancy are the lack of an intrauterine pregnancy, isolated hemoperitoneum, tubal masses, hematosalpinx, and interstitial masses. In the differential diagnosis of acute abdominal pain in pregnancy, consideration should be given to the more unusual forms of ectopic pregnancy, such as angular pregnancy, cornual pregnancy, and abdominal pregnancy. Potential mimics of ectopic pregnancy include placental abnormalities, ovarian neoplasms, and corpus luteum cysts. PMID:22977029

Parker, Rex A; Yano, Motoyo; Tai, Angela W; Friedman, Michael; Narra, Vamsi R; Menias, Christine O

2012-01-01

17

Conservative treatment of ectopic pregnancy.  

PubMed

As a conservative nonsurgical treatment of an early ectopic pregnancy, local prostaglandin, parenteral or local methotrexate, local hyperosmolar glucose, and also expectant management have been used successfully in selected cases. The success rate of conservative treatment has been 71%-100% and that of tubal patency after different kinds of conservative treatment 72-93% of patients. In the present study of expectant management in early ectopic pregnancy in patients with decreasing serum hCG levels, spontaneous resolution was observed in 64.6% of patients and in the total series of 207 ectopic pregnancies in 15.0% of patients. Expectant management of early ectopic pregnancy is recommended when emergency surgery is not needed on admission and the serum hCG level is decreasing as noted in two consecutive estimations with an interval of 1-2 days. PMID:1829344

Ylöstalo, P; Cacciatore, B; Koskimies, A; Kääriäinen, M; Lehtovirta, P; Mäkelä, P; Siegberg, R; Stenman, U H; Tenhunen, A; Ylikorkala, O

1991-01-01

18

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

19

Bilateral ectopic pregnancy following ICSI.  

PubMed

Bilateral tubal ectopic pregnancy is a rare clinical condition with an estimated prevalence of 1/200,000 spontaneous pregnancies. There is paucity of data on the prevalence of this rare condition following intracytoplasmic sperm injection and embryo transfer (ICSI-ET) cycles. We report two patients with bilateral tubal ectopic pregnancy following ICSI-ET. Both patients had normal, reassuring ?-human chorionic gonadotropin dynamics during follow-up; the diagnosis was performed when no gestational sac was noted at the first planned antenatal visit. Of the two patients, one was treated medically and the other surgically with laparoscopic salpingotomy and salpingectomy for the right and left sides, respectively. Both patients thereafter conceived and delivered healthy infants following subsequent ICSI-ET attempts. PMID:24969072

Polat, Mehtap; Boynukal?n, Fazilet Kübra; Yaral?, ?rem; Yaral?, Hakan

2014-01-01

20

Biomarkers for Ectopic Pregnancy and Pregnancy of Unknown Location  

PubMed Central

Early pregnancy failure is the most common complication of pregnancy, and 1–2% of all pregnancies will be ectopic. As one of the leading causes of maternal morbidity and mortality, diagnosing ectopic pregnancy and determining the fate of a pregnancy of unknown location are of great clinical concern. Several serum and plasma biomarkers for ectopic pregnancy have been investigated independently and in combination. The following is a review of the state of biomarker discovery and development for ectopic pregnancy and pregnancy of unknown location. PMID:23290746

Senapati, Suneeta; Barnhart, Kurt T.

2013-01-01

21

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

22

Trends in ectopic pregnancy in Canada.  

PubMed Central

The incidence in Canada of one complication of sexually transmitted disease, ectopic pregnancy, was examined by age group for the years 1971 through 1980 by means of hospital statistics provided by Statistics Canada. The denominator was "reported pregnancies"--the total of live births, stillbirths, legal abortions and ectopic pregnancies in a given year. In 1980, 4123 ectopic pregnancies (9.3/1000 reported pregnancies) were reported, a 63% increase from 1970. The incidence had increased in each age stratum. This trend may be related to increasing rates of gonococcal infection and of hospitalization for pelvic inflammatory disease and lends confirmation to data from other countries that relate the increase in the rate of ectopic pregnancy to rising rates of sexually transmitted disease. PMID:6478362

Hockin, J C; Jessamine, A G

1984-01-01

23

Corpus luteum failure in ectopic pregnancy.  

PubMed

The endocrinology of ectopic pregnancy was studied in order to investigate the origin of the discordance in the circulating amounts of human chorionic gonadotrophin (HCG) and those of oestradiol and progesterone. Serial maternal blood samples were obtained at 4-9 weeks gestation from 93 patients who became pregnant following in-vitro fertilization and embryo transfer including 10 ectopic, 21 anembryonic and 62 normal singleton pregnancies. The samples were analysed for HCG, Schwangerschaft protein-1 (SP-1), pregnancy-associated plasma protein-A (PAPP-A), progesterone and oestradiol. In ectopic pregnancies, concentrations of all substances analysed were significantly reduced compared to singleton pregnancies from 5 weeks gestation (P < 0.05-0.001) but they were not significantly different from those of anembryonic pregnancies. In ectopic pregnancies, associations were found between the concentration of both HCG and SP-1 and those of progesterone and oestradiol. No associations were found between PAPP-A and any other substances analysed. This may be due to insensitivity of the PAPP-A assay; alternatively PAPP-A concentrations may be differentially reduced in ectopic pregnancy. These findings suggest that progesterone and oestradiol are derived from the corpus luteum in early ectopic pregnancy but that the corpus luteum fails rapidly and the dominant source of both hormones becomes the trophoblast as early as 5 weeks. PMID:7504682

Johnson, M R; Riddle, A F; Irvine, R; Sharma, V; Collins, W P; Nicolaides, K H; Grudzinskas, J G

1993-09-01

24

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

25

The ectopic pregnancy, a diagnostic and therapeutic challenge  

PubMed Central

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

Buss, J

2008-01-01

26

Spontaneous live recurrent ectopic pregnancy after ipsilateral partial salpingectomy leading to tubal rupture  

PubMed Central

Introduction Ectopic pregnancy accounts for 1–2% of all pregnancies in the United States. The most common site of implantation for an ectopic pregnancy is the fallopian tube. We present the first case describing a recurrent ectopic pregnancy with a fetal heartbeat after ipsilateral salpingectomy that led to tubal rupture. Presentation of case The patient presented with abdominal pain approximately six weeks after her last menstrual period. Seven years prior to presentation, a laparoscopic partial right salpingectomy had been performed for a tubal ectopic pregnancy. Physical exam was significant for diffuse abdominal tenderness and guarding. Ultrasonography revealed a right tubal pregnancy with a fetal pole and a fetal heart rate that was calculated to be 108 beats per minute. Free fluid was also noted. 1.5 l of hemoperitoneum was subsequently evacuated and the right fallopian tube remnant with the ectopic pregnancy was removed. Pathology of the tubal remnant showed immature chorionic villi and fetal parts. Discussion The mechanism by which a recurrent ectopic pregnancy after ipsilateral salpingectomy occurs is unclear, but is theorized to be secondary to contralateral fertilization and/or tubal recanalization that may occur due to inadequate diathermy. Conclusion Physicians should be aware that ectopic pregnancies may not only occur repeatedly but may also present a typically. We recommend when performing a salpingectomy that efforts be undertaken to minimize the length of the tubal remnant and to assure adequate coagulation of tissue so as to reduce the risk of recurrence. PMID:25594734

Abraham, Cynthia; Seethappan, Vanitha

2014-01-01

27

High-risk pregnancy in rhesus monkeys (Macaca mulatta): a case of ectopic, abdominal pregnancy with birth of a live, term infant, and a case of gestational diabetes complicated by pre-eclampsia  

PubMed Central

Several cases of abdominal pregnancy have been described in nonhuman primates. These previous occurrences have been mummified fetuses found in the abdominal cavity. This report describes a case of abdominal pregnancy in a timed-bred rhesus monkey with delivery of a live term infant. The mother died 14 days later from complications of septic peritonitis. At necropsy, the monkey had an intestinal adenocarcinoma that may have allowed leakage of intestinal contents into the abdomen. The second case of pregnancy complication was a rhesus monkey found to have gestational diabetes that later developed pre-eclampsia. She was treated for 5 days with a regimen similar to that used in women, and a live infant was delivered at day 157 of gestation by Caesarian section. These cases of high-risk pregnancy underscore the value of timed-breeding and careful monitoring of pregnant monkeys and the similarities between pregnancy complications in women and in nonhuman primates. PMID:19490364

Krugner-Higby, Lisa; Luck, Melissa; Hartley, Deborah; Crispen, Heather M.; Lubach, Gabriele R.; Coe, Christopher L.

2009-01-01

28

Female Sterilization: Risk of Ectopic Pregnancy After Tubal Sterilization  

MedlinePLUS

... Back to Female Sterilization Female Sterilization: Risk of Ectopic Pregnancy After Tubal Sterilization Fact Sheet Among 10,685 women studied, the risk of ectopic pregnancy within 10 years after sterilization was about ...

29

Transvaginal Endoscopic Surgery for Tubal Ectopic Pregnancy  

PubMed Central

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

Xu, Boqun; Liu, Yawen; Fan, Zhining

2014-01-01

30

Obstetrical catastrophe averted: successful outcome of an abdominal pregnancy.  

PubMed

Abdominal pregnancy is defined as an implantation in peritoneal cavity, exclusive of tubal, ovarian, or intraligmentary pregnancy.These pregnancies are rarely encountered and can go undiagnosed until advanced period of gestation [1]. Frequency of abdominal pregnancy has been directly related to the frequency of ectopic gestation as constituting 2% of ectopics and nearly 0.01% of all pregnancies [2-4]. These pregnancies are seen more commonly in developing countries and poses special challenges to the clinician. Advanced abdominal pregnancy is life-threatening condition and carries high risk of hemorrhage, disseminated intravascular coagulation, bowel injury, and fistulae [5]. The perinatal outcome is mainly influenced by the availability of blood supply and site of implantation [6]. Most of the fetus die in utero because of compromised environment, and those who survive face problems due to congenital malformations [3,7]. Patients of abdominal pregnancy can have variable clinical presentation, and physical examination may be inconclusive for making diagnosis [7,8]. Clinical features like irregular bleeding per vaginum, abdominal pain, dyspepsia, altered bowel habits, malpresentation, and extremely anteriorly placed cervix should raise the suspicion [2,3,8,9]. Diagnostic challenge with oxytocin stimulation, abdominal x-ray, hysterosalpingography, and ultrasonography has been used as tools to assist in diagnosis [10,11]. Magnetic resonance imaging is found to complement sonography in making accurate diagnosis and can be useful to demonstrate the relationship between fetus, the cervix, and the myometrium [12]. We hereby report a successful operative delivery of a live baby after a term extrauterine abdominal pregnancy in a multigravida in whom the diagnosis was made after laparotomy. PMID:24768335

Joshi, Bharti; Aggarwal, Neelam; Singh, Anju

2014-10-01

31

Recurrent Ectopic Pregnancy in the Tubal Remnant after Salpingectomy  

PubMed Central

We present two cases of ectopic pregnancy located within the remnant tube following ipsilateral salpingectomy. This particular pathology is rare and yet has significant consequences for the patient, with mortality rates 10–15 times higher than other ectopic pregnancies. It demonstrates that salpingectomy does not exclude ectopic pregnancy on the ipsilateral side. We suggest careful clinical consideration and bring attention to the current surgical technique. PMID:24151570

Samiei-Sarir, Bahareh; Diehm, Christopher

2013-01-01

32

Ectopic pregnancy and genital infections: a case-control study.  

PubMed

This case-control study was carried out to evaluate the significance of genital infections as risk factors in ectopic pregnancy. The study population consisted of 86 consecutive patients with ectopic pregnancy and two age- and parity-matched control groups of women with normal early pregnancy; those with planned pregnancy (I; 65 pairs) and those having legal abortion (II; 51 pairs). Histories of salpingo-oophoritis in the two groups (22% against 5%, P less than 0.05), and of cervical Chlamydia trachomatis infection (9% against 0%, P less than 0.05) were more common in patients with ectopic pregnancy than in their controls with planned pregnancy; women in the control group who had undergone legal abortion did not differ from patients with ectopic pregnancy. In serological studies antibodies against Herpes simplex viruses were commoner in patients with ectopic pregnancy than in both control groups (89% against 62%, and 88% against 57%, P less than 0.001). Antibodies against cytomegalovirus were also commoner in patients with ectopic pregnancy than in controls who had had a planned pregnancy (88% against 72%, P less than 0.05). The results support the concept that gynaecological infections are among factors predisposing to ectopic pregnancies. PMID:2158799

Tuomivaara, L M

1990-02-01

33

Clinical presentation of ectopic pregnancy in Transkei, South Africa.  

PubMed

Due to advances in diagnostic techniques, it has become possible to identify and manage ectopic pregnancies before they cause clinical symptoms in many developed countries. However, the situation appears not to be the same in developing countries. We carried out a cross-sectional study at Umtata General Hospital, which serves an underprivileged black South African population in order to document the incidence, risk factors, clinical presentation and complications of ectopic pregnancy. We found the incidence of ectopic pregnancy was 11 per 1000 reported pregnancies, and the mortality rate was 2.0%. Of 148 consecutive cases of ectopic pregnancy, 62.2% were in shock and two thirds were severely anaemic on arrival. About 71% of the cases had tubal rupture and 25% were chronic leaking ectopics. Only four intact unruptured ectopics were found in spite of the availability of modern diagnostic techniques such as ultrasonography and sensitive pregnancy tests. About 86% of the cases had evidence of previous pelvic infection, thus making pelvic inflammatory disease (PID) the most important risk factor for ectopic pregnancy. We conclude that most ectopic pregnancies in Transkei are associated with previous pelvic infection, and still present as acute emergencies. Preventive measures should aim at controlling sexually transmitted diseases and PID. PMID:8689974

Amoko, D H; Buga, G A

1995-12-01

34

Two consecutive ectopic pregnancies after in-vitro fertilization and embryo transfer. Case report.  

PubMed

Ectopic pregnancy is a known complication of in vitro fertilization and embryo transfer (IVF/ET). The overall incidence of ectopic pregnancy after IVF is 4.4-5.8% of clinical pregnancies. The risk factors associated with ectopic pregnancies are complex. We present a patient with two consecutive ectopic pregnancies after IVF/ET. PMID:12635751

Abu-Musa, A; Nassar, A; Sakhel, K; Usta, I

2002-01-01

35

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

36

Ectopic Pregnancy and Emergency Contraceptive Pills: A Systematic Review  

PubMed Central

Objective To evaluate the existing data to estimate the rate of ectopic pregnancy among emergency contraceptive pill treatment failures. Data Sources Our initial reference list was generated from a 2008 Cochrane review of emergency contraception. In August 2009, we searched Biosys Previews, the Cochrane Database of Systematic Reviews, Medline, Global Health Database, Health Source: Popline, and Wanfang Data (a Chinese database). Methods of Study Selection This study included data from 136 studies which followed a defined population of women treated one time with emergency contraceptive pills (either mifepristone or levonorgestrel), and in which the number and location of pregnancies were ascertained. Results Data from each article were abstracted independently by two reviewers. In the studies of mifepristone, 3 out of 494 (0.6%) pregnancies were ectopic; in the levonorgestrel studies, 3 out of 307 (1%) were ectopic. Conclusion The rate of ectopic pregnancy when treatment with emergency contraceptive pills fails does not exceed the rate observed in the general population. Since emergency contraceptive pills are effective in lowering the risk of pregnancy, their use should reduce the chance that an act of intercourse will result in ectopic pregnancy. PMID:20502299

Cleland, Kelly; Raymond, Elizabeth; Trussell, James; Cheng, Linan; Zhu, Haoping

2014-01-01

37

Ectopic Pregnancy: A Statistical Review of 360 Cases  

PubMed Central

In a statistical analysis of 360 cases of ectopic pregnancy admitted to the Montreal General Hospital over a 20-year period ending December 1964, ectopic gestation occurred once in every 83 admissions to the gynecological service. This incidence has remained constant over the years. Only one out of four patients had had more than one child and 30% of the patients had absolute or relative infertility. Diagnosis was delayed or not made in 58 patients. There was evidence that neurogenic factors play a role in the etiology of ectopic gestation. Ten per cent of the patients had had a previous operation for the same condition. Symptomatology is variable and the possibility of ectopic pregnancy must never be overlooked in a woman of child-bearing age. Once the diagnosis is made the treatment is early operation. The morbidity rate in this series was 28% and there was one death. PMID:6017696

Blanchet, Jean; Sparling, D. W.; MacFarlane, K. T.

1967-01-01

38

Spontaneous ectopic tubal pregnancy after laparoscopic tubal sterilisation by segmental isthmic partial salpingectomy.  

PubMed

A 33-year-old woman with a history of tubal sterilisation, presented to our gynaecological emergency unit with acute abdominal pain and signs of peritonism. The first day of her last menstruation occurred 4 weeks and 4 days before. Urine pregnancy test was positive and transvaginal ultrasound revealed an empty uterus with a heterogeneous mass below the right ovary. We performed a laparoscopy, which confirmed a previous isthmic partial salpingectomy and the presence of an ectopic pregnancy in the right distal remnant tube. Total salpingectomy of the remnant parts of the tube was performed and the postoperative course was uneventful. PMID:24658525

Drakopoulos, P; Julen, O; Petignat, P; Dällenbach, P

2014-01-01

39

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

E-print Network

Ectopic pregnancy treatment Australia n Malaysia n South Africa n Italy n India Methotrexate only Opportunity About 90 to 95 per cent of ectopic pregnancies that present are stable, where there is no clinical that can resolve ectopic pregnancies of any size could significantly impact on contemporary gynecological

Albrecht, David

40

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

41

Comparison of transvaginal and transabdominal ultrasonography in ectopic pregnancy.  

PubMed

The authors retrospectively reviewed 45 consecutive cases of proven ectopic pregnancy for which both transvaginal (TV) and transabdominal (TA) ultrasonography had been performed to compare the diagnostic efficacy of the two imaging techniques. The criteria for a diagnosis of ectopic gestation included an extrauterine gestational sac containing a fetus or a fetal pole, or an empty extrauterine sac. Solid or complex adnexal masses with evidence of hemoperitoneum were considered suggestive but nondiagnostic. TV ultrasonography was superior to TA ultrasonography in 22 cases (49%) and inferior in 3 (7%). In the remaining 20 cases (44%) the two methods yielded similar information. For cases in which TV ultrasonography was superior, this method provided clear evidence of ectopic pregnancy in 11 cases in which TA ultrasonography demonstrated nonspecific masses or normal adnexa; in the other 11 cases both methods led to the correct diagnosis, but TV ultrasonography provided additional useful information. The authors conclude that TV ultrasonography has a definite role in improving the diagnosis of ectopic pregnancy. PMID:1933503

Athey, P A; Lamki, N; Matyas, M A; Watson, A B

1991-10-01

42

Operative laparoscopy in the management of tubal ectopic pregnancy.  

PubMed

One hundred and seventeen consecutive patients with diagnosis of ectopic pregnancy admitted to Temple University Hospital between October 1989 and March 1992 were divided into two groups. Group 1 consisted of 56 patients with operative laparoscopy and Group 2 consisted of 61 patients treated by laparotomy. The two groups were similar for age, race, parity, gestation, presentation, and location of the ectopic gestations. Fifty seven percent of patients in the laparoscopy group were treated by salpingectomy and 43% by salpingostomy, compared to 84% and 16% respectively in the laparotomy group. Mean operative time for laparoscopy was 58 min and 42 min for laparotomy. Complication rates were similar in the two sub-groups. Only two patients in the laparoscopy group required subsequent laparotomy, one to assure hemostasis and one, 5 weeks following surgery, for persistent trophoblastic disease. Operative laparoscopy was associated with a significantly shorter length of hospital stay (1.25 v. 4.39 days). This reflected in a lower cost of hospital stay ($10,105 vs. $13,608). The present data demonstrates that operative laparoscopy is not only safe and effective, but also more economical than open laparotomy in the treatment of ectopic pregnancies. This procedure is expected to replace laparotomy for the treatment of most cases of tubal ectopic pregnancy. PMID:1489997

Chatwani, A; Yazigi, R; Amin-Hanjani, S

1992-12-01

43

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

44

Multiple induced abortions as risk factor for ectopic pregnancy. A prospective study.  

PubMed

To assess the association between induced abortion and subsequent ectopic pregnancy, 3754 Norwegian women 39 years or younger who had at least one induced abortion at the University Hospital of Trondheim during 1987-92 were followed for histologically confirmed ectopic pregnancies through the end of 1993. In a total of 164,167 woman-months of follow-up, 24 ectopic pregnancies were recorded. No woman had more than one ectopic pregnancy. The overall cumulative incidence of ectopic pregnancy among women with an induced abortion history rose from 3.5 per 1000 women at 1 year to 11.1 per 1000 women at 6 years of follow-up. The adjusted incidence density ratio (aIDR) for women with 2 or more induced abortions was 1.2 (95% confidence interval, 0.5-3.1). No dose-response to ectopic pregnancy was found between 2 consecutive (aIDR, 0.9) and 3 or more consecutive (aIDR, 1.1) abortions compared with the reference group. Ectopic pregnancy after the most recent abortion was more likely to occur among women whose first pregnancy ended as an ectopic one than among those whose first pregnancy resulted in a birth. Although the results of longer-term follow-up of this cohort of Norwegian women have not yet been analyzed, the present findings suggest that induced abortion does not increase the risk of ectopic pregnancy. PMID:9292646

Skjeldestad, F E; Gargiullo, P M; Kendrick, J S

1997-08-01

45

Advanced abdominal pregnancy: a study of 13 consecutive cases seen in 1993 and 1994 at Komfo Anokye Teaching Hospital, Kumasi, Ghana.  

PubMed

Thirteen cases of advanced abdominal pregnancy (AAP) managed at the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana, over a two-year period (1993-1994) are presented. An incidence ratio of one advanced abdominal pregnancy to 1,320 deliveries occurred during this period. The ratio of advanced abdominal pregnancy to ectopic pregnancy was 1:43.7. The perinatal mortality rate and maternal case fatality rates were 69.6% and 15.3% respectively. Recurrent abdominal pains in the gravid patient with abnormal fetal lie and prior history of tubal pregnancy and/or previous abdominal surgery were significant findings in the cases reviewed. These findings should, therefore, always prompt lucid and elaborate ultrasound examination of a pregnancy to exclude abdominal pregnancy. PMID:11000706

Opare-Addo, H S; Deganus, S

2000-04-01

46

Chronic tubal ectopic pregnancy: a rare but challenging diagnosis.  

PubMed

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

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

2014-01-01

47

Ectopic spleen presenting with anemia and an abdominal mass in a dog.  

PubMed

An 11.5-year-old, neutered male, golden retriever dog that had previously had a splenectomy for benign disease 2 years prior to presentation was diagnosed with anemia and a large abdominal mass. Necropsy and histopathology identified the abdominal mass as ectopic splenic tissue. PMID:24179243

Prosser, Kirsten J; Webb, Jinelle A; Hanselman, Beth A

2013-11-01

48

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

PubMed Central

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

2014-01-01

49

Fever after Cervical Ectopic Pregnancy; a case report from Gorgan, Iran  

PubMed Central

Ectopic pregnancy is a rare condition, and, although its prevalence has decreased in recent years, it is still an important cause of mortality and morbidity in women. Cervical ectopic pregnancy is less than 1% of all ectopic pregnancies. Fever is one of signs of infection, and it is necessary to monitor patients closely for other signs of infection. This paper presents and discusses a case of cervical ectopic pregnancy with fever after treatment. The patient had a high fever that became worse after three hospitalizations. The probable cause of her pyelonephritis was a urinary catheter, although it had been removed earlier, and she was receiving antibiotic therapy. Even though cervical ectopic pregnancy is a rare condition, it has certain complications that must be managed appropriately.

Tabandeh, Afsaneh; Besharat, Mahsa

2014-01-01

50

Diagnostic accuracy of serum activin A in detection of ectopic pregnancy  

PubMed Central

Background: Ectopic pregnancy (EP) still remains a main cause of maternal mortalities. This study is designed to evaluate the accuracy of serum Activin A in detection of ectopic pregnancy. Methods: This prospective observational study was conducted from 2009 to 2010 at two main referral university hospitals, Isfahan University of Medical Sciences, Isfahan, Iran. Two hundred subjects who were under 10 week's pregnancy with clinical presentations of abdominal pain and vaginal bleeding were enrolled. After sampling serum Activin A, patients underwent ultrasonography, titer of B-HCG and surgery (if indicated) and were divided into two groups: EP (n = 100) and intrauterine pregnancy (IUP) (n = 100). The mean of Activin A was compared between groups and by ROC curve, the optimal cut off with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were determined. Results: The mean age of women with IUP was 25.4 ± 4.3 years (15-40 years) compared with 25.9 ± 4.1 years in women in EP group (P = 0.448). Statistical difference was not found between EP versus IUP groups in gestational age (6.32 ± 1.03 vs. 6.85 ± 1.82 weeks, P = 0.124). The mean of serum Activin A in EP group was 0.264 ± 0.0703 ng/ml versus 0.949 ± 0.5283 ng/ml in IUP group (P < 0.05). According to ROC curve (area under the curve = 0.981, P < 0.05, confidence interval: 0.961-1.000), the optimal cut off was estimated as 0.504 ng/ml with sensitivity of 97% and specificity of 93.5%. Conclusion: This study indicated that the mean of serum Activin A is lower in EP compared with IUP. The serum Activin A has a fair accuracy in detecting EP. PMID:23267401

Roghaei, Mohammad Ali; Sabet, Fahimeh; Mohamadi, Keivan

2012-01-01

51

The expression of major histocompatibility complex antigens by trophoblast in ectopic tubal pregnancy.  

PubMed

The reactivity of the various trophoblast populations found in ectopic fallopian tube pregnancy with established trophoblast-reactive markers and monoclonal antibodies to MHC antigens has been studied. In ectopic tubal pregnancy fetal trophoblast shows an identical reaction pattern with these antibodies to that seen in intrauterine pregnancy, suggesting that ectopic implantation is not related to an inherent immunological abnormality of fetal trophoblast. However, from this and other studies, it appears that extravillous trophoblast displays an unusual class I MHC antigenic structure. This observation may explain the ability of class I MHC--bearing fetal trophoblast--to survive both in the uterus and at an abnormal implantation site. PMID:3900386

Earl, U; Wells, M; Bulmer, J N

1985-08-01

52

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

E-print Network

The accuracy of transvaginal ultrasonography for the diagnosis of ectopic pregnancy prior and Tom Bourne1 1 Early Pregnancy, Gynaecological Ultrasound and Minimal Access Surgery Unit, St George should be addressed at: Early Pregnancy, Gynaecological Ultrasound and MAS Unit, St George's Hospital

53

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

E-print Network

MAIN RESEARCH ARTICLE Ectopic pregnancy: using the hCG ratio to select women for expectant GEVAERT2 , SABINE VAN HUFFEL2 , BART DE MOOR2 , DIRK TIMMERMAN5 & TOM BOURNE5,6 1 Early Pregnancy (ESAT-SCD), Katholieke Universiteit Leuven, Belgium, 3 Early Pregnancy Unit and Advanced Endosurgery

54

Ectopic egg yolk in the abdominal cavity of a cockatiel.  

PubMed

A mature cockatiel was presented to the teaching hospital with acute, severe dyspnea and a markedly enlarged abdomen. The bird died 2 hours after admission and was necropsied. A 3-cm egg yolk was present in the abdominal cavity and caused cranial displacement of the abdominal viscera. Death occurred acutely and was probably due to severe respiratory distress. PMID:1417621

Gorham, S L; Akins, M; Carter, B

1992-01-01

55

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

56

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

Code of Federal Regulations, 2012 CFR

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

2012-10-01

57

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

Code of Federal Regulations, 2013 CFR

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

2013-10-01

58

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

Code of Federal Regulations, 2011 CFR

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

2011-10-01

59

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

Code of Federal Regulations, 2014 CFR

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

2014-10-01

60

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

Code of Federal Regulations, 2010 CFR

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

2010-10-01

61

Laparoscopic Excision of Coexisting Left Tubal and Right Pseudotubal Pregnancy after Conservative Management of Previous Ectopic Pregnancy with Methotrexate: An Unusual Clinical Entity  

PubMed Central

Tubal pregnancy concerns 97% of all ectopic pregnancies. Treatment can be either surgical (salpingostomy or salpingectomy) or medical (methotrexate administration). We present a case of a pseudotubal pregnancy after methotrexate treatment of a previous ectopic pregnancy. A37-year-old woman was diagnosed with ectopic pregnancy in the left Fallopian tube. A year ago, she had an ectopic pregnancy in the right tube, which was successfully treated with intramuscular methotrexate. During laparoscopy, two tubal masses were revealed, one in each Fallopian tube, and bilateral salpingectomy was performed. Histological analysis confirmed tubal pregnancy in the left Fallopian tube and presence of endosalpingitis in the right tube with no signs of chorionic villi. The optimal management of such cases has not yet been clarified. However, evaluation of tubal patency after a medically treated ectopic pregnancy would permit proper counsel of the patient on her fertility options, in order to choose the appropriate method of conception to achieve and accomplish a future pregnancy.

Xiromeritis, Panayotis; Margioula-Siarkou, Chrysoula; Miliaras, Dimosthenis; Kalogiannidis, Ioannis

2015-01-01

62

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

63

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

PubMed

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

64

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

65

[Indications for methotrexate in gynecology outside the first-line treatment of ectopic tubal pregnancies].  

PubMed

The objective of this work is to discuss the indications for methotrexate in gynecology outside the first-line treatment of tubal ectopic pregnancy. In tubal ectopic pregnancy, the prophylactic use of systemic methotrexate can be discussed when performing laparoscopic salpingotomy. In case of failure of salpingotomy, administration seems justified especially if it avoids re-intervention. The combination of methotrexate with other therapies such as mifepristone, potassium chloride or gefitinib is not recommended in the treatment of ectopic pregnancy. For non-tubal ectopic pregnancy, the intramuscular or local administration of methotrexate is an acceptable treatment for uncomplicated interstitial pregnancies. For uncomplicated cervical or cesarean scar pregnancies, the local administration of methotrexate should be considered as a first-line treatment. For ovarian pregnancies, methotrexate should not be a first-line treatment, surgical treatment remains the standard. Asymptomatic women presenting with a pregnancy of unknown location and plateauing serum hCG concentration<2000UI/L can be managed expectantly: it is recommended to take an additional quantitative hCG serum level after 48hours. Thus, methotrexate is not recommended in the first intention. Other gynecological indications were discussed: methotrexate is not recommended in the management of first-trimester miscarriages or in the management of placenta accreta. PMID:25666162

Misme, H; Agostini, A; Dubernard, G; Tourette, C

2015-03-01

66

Methotrexate treatment of unruptured ectopic pregnancy: a report of 100 cases.  

PubMed

In an ongoing clinical trial, 100 patients with an unruptured ectopic pregnancy of 3.5 cm or less in greatest dimension were treated with an outpatient protocol of methotrexate and citrovorum factor chemotherapy. Methotrexate and citrovorum were given on alternating days until the hCG titer had decreased by 15% on 2 consecutive days. The patients ranged in age from 16-40 years, gravidity from 1-8, and parity from 0-5. Twenty-three patients had a previous ectopic pregnancy. Of the 100 patients, 96 (96%) received methotrexate/citrovorum as primary therapy and four (4%) were treated for persistent hCG titers after a conservative surgical procedure. The tubal pregnancies of patient nos. 1-50 were confirmed by laparoscopy, whereas patient nos. 51-100 were diagnosed according to a nonlaparoscopic algorithm. Four patients of 100 failed medical therapy and required surgery. Of these, one had an ectopic pregnancy with cardiac activity, one ruptured after intercourse, and the remaining two cases had no specific identifiable risk factors. Of the ectopic pregnancies with cardiac activity, 80% were successfully treated. Five patients (5%) had methotrexate-related side effects, all after the fourth dose, but none required treatment for these side effects. Hysterosalpingograms done on 58 patients subsequently demonstrated tubal patency in 84.5% on the involved side. To date, 37 pregnancies have occurred in this group, of which 31 (89.2%) were intrauterine and four (10.8%) were recurrent ectopic pregnancies. We conclude that methotrexate/citrovorum is safe, effective, and helps to preserve reproductive performance when used as primary therapy for unruptured ectopic pregnancy and for treatment of persistent disease following a conservative surgical procedure. PMID:2014090

Stovall, T G; Ling, F W; Gray, L A; Carson, S A; Buster, J E

1991-05-01

67

Failure Rate of Single Dose Methotrexate in Managment of Ectopic Pregnancy  

PubMed Central

Background. One of the treatment modalities for ectopic pregnancy is methotrexate. The purpose of this study is to identify the failure rate of methotrexate in treating patients with ectopic pregnancy as well as the risk factors leading to treatment failure. Methods. A retrospective chart review of 225 patients who received methotrexate as a primary management option for ectopic pregnancy. Failure of single dose of methotrexate was defined as drop of BHCG level less than or equal to 14% in the seventh day after administration of methotrexate. Results. 225 patients had methotrexate. Most of the patients (151 (67%)) received methotrexate based on the following formula: f 50?mg X body surface area. Single dose of methotrexate was successful in 72% (162/225) of the patients. 28% (63/225) were labeled as failure of single dose of methotrexate because of suboptimal drop in BhCG. 63% (40/63) of failure received a second dose of methotrexate, and 37% (23/63) underwent surgical treatment. Among patient who received initial dose of methotrexate, 71% had moderate or severe pain, and 58% had ectopic mass size of more than 4 cm on ultrasound. Conclusion. Liberal use of medical treatment of ectopic pregnancy results in 71% success rate.

Sendy, Feras; AlShehri, Eman; AlAjmi, Amani; Bamanie, Elham; Appani, Surekha; Shams, Taghreed

2015-01-01

68

Surveillance in a Time of Changing Health Care Practices: Estimating Ectopic Pregnancy Incidence in the United States  

Microsoft Academic Search

Objectives: Ectopic pregnancy is a common condition with significant health consequences; complications are a major cause of maternal mortality in the United States. Accurate ascertainment of the number of ectopic pregnancies occurring in the United States has been dramatically affected by changing medical practices, causing estimates based on hospital data to be falsely low. This study was performed to identify

Suzanne B. Zane; Burney A. Kieke Jr; Juliette S. Kendrick; Carol Bruce

2002-01-01

69

Ovarian ectopic pregnancy: A 10 years’ experience and review of literature  

PubMed Central

Background: Primary ovarian pregnancy is one of the rarest forms of ectopic pregnancy having incidence of 1/7000-1/40,000 in live births and 0.5-3% of all ectopic gestations. Intrauterine contraceptive device (IUCD), salpingitis, infertility, and assisted reproductive techniques are the important risk factors. Approximately, 75% terminate in first trimester and are often misdiagnosed as corpus luteum haemorrhage. Preoperative diagnosis by ultrasonography (USG) in early pregnancy can help in conservative medical/ surgical management. Objective: The aim of the present study was to find the incidence, risk factors, role of USG in pre-operative diagnosis, feasibility of conservative management with medical method or minimal invasive surgery in developing countries like India. Materials and Methods: We did a retrospective cross-sectional study of ovarian pregnancies managed at Government Medical College and Hospital Chandigarh between July 2000 to July 2010. We analyzed the incidence, risk factors, clinical presentation, management of ovarian pregnancy, and reviewed the literature. Results: Incidence of ovarian pregnancy was 4.9% of all ectopic pregnancies (14/523). Thirteen (93%) patients presented in first trimester with acute pain abdomen and of these ten patients had bleeding per vaginum. One (7%) patient referred from peripheral hospital at term gestation with ultrasonographic diagnosis of breech presention with plecenta previa. Pre-operative diagnosis was made only in two cases (11%). All cases were managed by laparotomy. Excision of the sac with conservation of the ovary was done in eleven cases (78%) and oophorectomy was done in two cases (14%). Conclusion: Incidence of ovarian pregnancy is on the rise. Although ultrasonography can detect ovarian gestations in unruptured cases but cannot easily differentiate ovarian from other tubal gestation in ruptured state. Medical management is usually not feasible it most of the patients present in ruptured state. Conservative surgical approach is the management of choice. PMID:25709640

Goyal, Lajya Devi; Tondon, Rimpy; Goel, Poonam; Sehgal, Alka

2014-01-01

70

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

PubMed Central

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

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

2014-01-01

71

Abdominal Wall Synovial Sarcoma During Pregnancy-a Case Report.  

PubMed

Synovial sarcoma is rare, aggressive, malignant mesenchymal neoplasm. The recent literature does not validate its only prevalence in the extremities of the adult population. Statistics reveal that adult population has the highest prevalence rate; 30 % of reported cases occur in the children and adolescents. It is very rare in pregnancy. Carcinomas may be diagnosed concurrently with pregnancy in approximately 0.1 % of cases, but sarcomas are rare. We report a 21-year-old woman with synovial sarcoma on anterior abdominal wall at 34th week of gestation, which was clinically diagnosed as desmoid tumor. Tumor was totally excised. After 6 months, it relapsed in the form of multiple abdominal wall swellings and ascites. PMID:24426649

Kanade, Umesh S; Gadgil, Pradeep A; Birare, Shivaji D; Chaware, Suresh A; Kamra, Hemlata

2013-06-01

72

Quantitative analysis of total ?-subunit of human chorionic gonadotropin concentration in urine by immunomagnetic reduction to assist in the diagnosis of ectopic pregnancy  

PubMed Central

Background The initial diagnosis of ectopic pregnancy depends on physical examination, ultrasound, and serial measurements of total ?-subunit of human chorionic gonadotropin (hCG?) concentrations in serum. The aim of this study was to explore the possibility of using quantitative analysis of total hCG? in urine rather than in serum by immunomagnetic reduction (IMR) assay as an alternative method to diagnose an ectopic pregnancy. Methods We established a standard calibration curve of IMR intensity against total hCG? concentration based on standard hCG? samples, and used an IMR assay to detect total hCG? concentrations in the urine of pregnant women with lower abdominal pain and/or vaginal bleeding. The final diagnosis of ectopic pregnancy was based on ultrasound scans, operative findings, and pathology reports. In this prospective study, ten clinical samples were used to analyze the relationship of total hCG? IMR signals between urine and serum. Furthermore, 20 clinical samples were used to analyze the relationship between urine IMR signals and serum levels of total hCG?. Results The calibration curve extended from 0.01 ng/mL to 10,000 ng/mL with an excellent correlation (R2=0.999). In addition, an excellent correlation of total hCG? IMR signals between urine and serum was noted (R2=0.994). Furthermore, a high correlation between urine IMR signals and serum levels of total hCG? was noted (R2=0.862). Conclusion An IMR assay can quantitatively analyze total hCG? concentrations in urine, and is a potential candidate for point-of-care testing to assist in the diagnosis of ectopic pregnancy.

Chen, Chen-Yu; Hwu, Yuh-Ming; Chen, Chie-Pein; Chang, Chia-Chen

2015-01-01

73

Imaging diagnosis of hepatic ectopic pregnancy: A report of one case  

PubMed Central

Summary This article is about a case of hepatic ectopic pregnancy. A patient suffered from an acute abdomen with 14-day vaginal bleeding. A serum, human chorionic gonadotrophin (HCG) of 8,988 mIU/mL revealed a bit of pelvic effusion. A computed tomography (CT) plain scan displayed a polygonal, moderate density shadow of the left liver lobe. An enhanced CT had no sign of intensification. A magnetic resonance imaging (MRI) plain scan was undertaken. On a T1-weighted imaging (T1WI), the lesion appeared to be a low signal; on a T2-weighted imaging (T2WI), the lesion appeared to be a high signal. With enhanced MRI, the lesion showed an irregular mild plague-like intensification during the venous phase. It was excised by an operation and chorionic tissue was seen under a microscope. The result of pathological diagnosis was hepatic ectopic pregnancy. PMID:25343072

Wang, Chenglin; Cheng, Lin; Zhang, Ziqin; Yuan, Zhidong

2012-01-01

74

Enterobius vermicularis Salpingitis Seen in the Setting of Ectopic Pregnancy in a Malaysian Patient  

PubMed Central

We report a rare and unusual case of invasive Enterobius vermicularis infection in a fallopian tube. The patient was a 23-year-old Malaysian woman who presented with suprapubic pain and vaginal bleeding. A clinical diagnosis of ruptured right ovarian ectopic pregnancy was made. She underwent a laparotomy with a right salpingo-oophorectomy. Histopathological examination of the right fallopian tube showed eggs and adult remnants of E. vermicularis, and the results were confirmed using PCR and DNA sequencing. PMID:24989613

Ravindran, Sarala; Ong, Diana Bee Lan; Chow, Tak Kuan; Low, Kah Pin; Nureena, Zaidi Syeda; Rajoo, Yamuna; Chin, Yuee Teng; Amir, Amirah; Ahmad, Arine Fadzlun; Lim, Yvonne Ai Lian

2014-01-01

75

Enterobius vermicularis salpingitis seen in the setting of ectopic pregnancy in a Malaysian patient.  

PubMed

We report a rare and unusual case of invasive Enterobius vermicularis infection in a fallopian tube. The patient was a 23-year-old Malaysian woman who presented with suprapubic pain and vaginal bleeding. A clinical diagnosis of ruptured right ovarian ectopic pregnancy was made. She underwent a laparotomy with a right salpingo-oophorectomy. Histopathological examination of the right fallopian tube showed eggs and adult remnants of E. vermicularis, and the results were confirmed using PCR and DNA sequencing. PMID:24989613

Ngui, Romano; Ravindran, Sarala; Ong, Diana Bee Lan; Chow, Tak Kuan; Low, Kah Pin; Nureena, Zaidi Syeda; Rajoo, Yamuna; Chin, Yuee Teng; Amir, Amirah; Ahmad, Arine Fadzlun; Lim, Yvonne Ai Lian; Mahmud, Rohela

2014-09-01

76

Abdominal scanning with Tc-99m red blood cells. False-positive study due to ectopic kidney  

SciTech Connect

Abdominal scanning with Tc-99m red blood cells performed in a patient with gastrointestinal bleeding demonstrated a localized area of increased activity in the pelvic region that simulated either bleeding in a mass or encapsulated bleeding. Contrast angiography confirmed that the bleeding was due to a right ectopic kidney.

Suzuki, Y.; Ootaki, M.

1984-11-01

77

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

2015-04-01

78

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

PubMed Central

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

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

2015-01-01

79

A preoperative classification to predict the intrauterine and ectopic pregnancy rates after distal tubal microsurgery.  

PubMed

A simple preoperative classification is described to predict the intrauterine and ectopic pregnancy rates following distal tubal microsurgery. Laser CO2 microsurgical salpingostomies were performed on 76 patients between January 1979 and January 1984. All of the patients underwent a preoperative assessment, which included hysterosalpingogram and laparoscopy, to formulate a preoperative classification based on a point system. The patients were divided into four groups according to tubal damage, with a subsequent intrauterine pregnancy rate of 58.3% in grade I, 36.6% in grade II, 9.5% in grade III, and 0% in grade IV. The patients were divided into four groups according to adhesions, with a subsequent intrauterine pregnancy rate of 38.8% with no adhesion, 32.0% with mild adhesions, 26.6% with moderate adhesions, and 5.5% with severe adhesions. From these results, a preoperative management is proposed for patients being considered for either distal tubal microsurgery or in vitro fertilization. PMID:3781001

Mage, G; Pouly, J L; de Joliničre, J B; Chabrand, S; Riouallon, A; Bruhat, M A

1986-11-01

80

The Value of Peritoneal hCG and Vasopressin in Ectopic Pregnancy  

PubMed

From 1989 through 1991, 54 consecutive tubal pregnancies were managed by laparotomy by two surgeons. Serum and peritoneal fluid samples were collected to measure levels of human chorionic gonadotropin (hCG). One surgeon injected vasopressin into the mesosalpinx and the bed of the implantation site for hemostasis and the other did not. The two patient populations were similar with respect to gestation age and size, and serum and operative peritoneal hCG levels. Of the 42 women in whom hCG ratios were available, only 2 of 20 with initial serum titers less than 2000 had ratios less than 2. The peritoneal:serum hCG ratio is valuable in making a diagnosis of ectopic pregnancy when ultrasound is unreliable. There was no difference in the regression slopes of postoperative hCG or in hematocrit changes between the two groups. Of the 54 women, only 1 developed a persistent ectopic pregnancy; she did not receive vasopressin. Vasopressin is effective in managing hemostasis. The relative local hypoxia does not seem to affect the viability of remaining trophoblasts as measured by the rate of disappearance of hCG. PMID:9074243

Stock; Hansen; Reed

1996-08-01

81

Targeted nanoparticle delivery of doxorubicin into placental tissues to treat ectopic pregnancies.  

PubMed

Abnormal trophoblast growth can cause life-threatening disorders such as ectopic pregnancy, choriocarcinoma, and placenta accreta. EnGeneIC Delivery Vehicles (EDVs) are nanocells that can promote tissue-specific delivery of drugs and may be useful to medically treat such disorders. The objective of this study was to determine whether EDVs loaded with the chemotherapeutic doxorubicin and targeting the epidermal growth factor receptor (EGFR, very highly expressed on the placental surface) can regress placental cells in vitro, ex vivo, and in vivo. In female SCID mice, EGFR-targeted EDVs induced greater inhibition of JEG-3 (choriocarcinoma cells) tumor xenografts, compared with EDVs targeting an irrelevant antigen (nontargeted EDVs) or naked doxorubicin. EGFR-targeted EDVs were more readily taken up by human placental explants ex vivo and induced increased apoptosis (M30 antibody) compared with nontargeted EDVs. In vitro, EGFR-targeted EDVs administered to JEG-3 cells resulted in a dose-dependent inhibition of cell viability, proliferation, and increased apoptosis, a finding confirmed by continuous monitoring by xCELLigence. In conclusion, EGFR-targeted EDVs loaded with doxorubicin significantly inhibited trophoblastic tumor cell growth in vivo and in vitro and induced significant cell death ex vivo, potentially mediated by increasing apoptosis and decreasing proliferation. EDVs may be a novel nanoparticle treatment for ectopic pregnancy and other disorders of trophoblast growth. PMID:23288908

Kaitu'u-Lino, Tu'uhevaha J; Pattison, Scott; Ye, Louie; Tuohey, Laura; Sluka, Pavel; MacDiarmid, Jennifer; Brahmbhatt, Himanshu; Johns, Terrence; Horne, Andrew W; Brown, Jeremy; Tong, Stephen

2013-02-01

82

Ectopic Pregnancy  

MedlinePLUS

... in women who have had the following conditions: • Pelvic inflammatory disease (an infection of the uterus, fallopian tubes, and ... publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any ...

83

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; Weijdegĺrd, Birgitta; Wu, Gencheng; Shao, Ruijin; Billig, Hĺkan; Feng, Yi

2014-01-01

84

Hospital Resources Used for Ectopic Pregnancy Treatment by Laparoscopy and Methotrexate  

PubMed Central

Objective: To compare resources used in the medical and laparoscopic treatment of unruptured ectopic pregnancy. Methods: We prospectively recorded all the medical resources required in the treatment of unruptured ectopic pregnancy. The study period ranged from January 1, 1995 to June 30, 1998. Single-dose intramuscular methotrexate injections were administered in 55 women (group I). This therapeutic option was provided on an outpatient basis in small EP (?-HCG level < 5000 IU/L and hematosalpinx diameter < 3 cm). Serial clinical controls and biologic tests were performed until bHCG became negative. Forty women underwent a laparoscopic salpingostomy because they refused the methotrexate regimen or had “social” contra-indications (ie, predictable difficulties in the follow-up) (group II). Twenty-one patients underwent conservative laparoscopic treatment because of “medical” contraindications to methotrexate (group III). We recorded the resources used with the outpatient and inpatient treatment in each group (methotrexate consumption, operating room acts, length of hospital stay, clinical examinations, biological tests, and sonograms during the follow-up). Results: We observed similar cure rates in each group, but it took significantly longer for ?-HCG to become negative in group 1. However, hospitalization was significantly less often required, and the length of hospital stay was shorter in this group. But length of follow-up, number of office visits, biological tests, sonograms, and subsequent readmissions were significantly more frequent after methotrexate. Despite more severe clinical presentations for patients in group III, we didn't find any significant differences in the hospital resources used in this group in comparison with those used in group II. Conclusions: The outpatient methotrexate option may result in low consumption of resources for a hospital because most of the follow-up can be performed by city practitioners and laboratories. For the laparoscopic option, efforts should be made to reduce the postoperative hospital stay. PMID:11394423

Camatte, Sophie; Viens-Bitker, Catherine; Chasset, Sophie; Leonard, Franck; Taurelle, Roland

2001-01-01

85

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

86

The impact of tubal ectopic pregnancy in Papua New Guinea – a retrospective case review  

PubMed Central

Background Ectopic pregnancy (EP) is an important cause of morbidity and mortality amongst women of reproductive age. Tubal EP is well described in industrialised countries, but less is known about its impact in low-resource countries, in particular in the South Pacific Region. Methods We undertook a retrospective review of women with tubal EP treated at a provincial referral hospital in coastal Papua New Guinea over a period of 56 months. Demographic and clinical variables were obtained from patients’ medical records and analysed. The institutional rate of tubal EP was calculated, and diagnosis and management reviewed. Potential risk factors for tubal EP were identified, and delays contributing to increased morbidity described. Results A total of 73 women had tubal EP. The institutional rate of tubal EP over the study period was 6.3 per 1,000 deliveries. There were no maternal deaths due to EP. The mean age of women was 31.5+/?5.7 years, 85% were parous, 67% were rural dwellers and 62% had a history of sub-fertility. The most commonly used diagnostic aid was culdocentesis. One third of women had clinical evidence of shock on arrival. All women with tubal EP were managed by open salpingectomy. Tubal rupture was confirmed for 48% of patients and was more common amongst rural dwellers. Forty-three percent of women had macroscopic evidence of pelvic infection. Two-thirds of patients received blood transfusions, and post-operative recovery lasted six days on average. Late presentation, lack of clinical suspicion, and delays with receiving appropriate treatments were observed. Conclusions Tubal EP is a common gynaecological emergency in a referral hospital in coastal PNG, and causes significant morbidity, in particular amongst women residing in rural areas. Sexually transmitted infections are likely to represent the most important risk factor for tubal EP in PNG. Interventions to reduce the morbidity due to tubal EP include the prevention, detection and treatment of sexually transmitted infections, identification and reduction of barriers to prompt presentation, increasing health workers’ awareness of ectopic pregnancy, providing pregnancy test kits to rural health centres, and strengthening hospital blood transfusion services, including facilities for autotransfusion. PMID:23557190

2013-01-01

87

Epidemiology of ectopic pregnancy during a 28 year period and the role of pelvic inflammatory disease  

PubMed Central

Objectives: We analysed the epidemiology of ectopic pregnancy (EP) during a 28 year period, 1970–97, using methods applicable to ecological studies in order to test the hypothesis that a reduction of pelvic inflammatory disease (PID) will be associated with a decrease of EP. Methods: Hospital records of patients aged 15–54 admitted to our department of gynaecology were reviewed for EP and PID for the period 1 January 1970 to 31 December 1997. EP for the period 1970–4 was based on available statistics. The total number for EP was 1270 and for PID 2559. The total population for the catchment area was 100 000–120 000 during the study period. Incidences were age standardised and calculated using official population statistics to represent the average female population in the five 5 year periods 1970–4, 1975–9, 1980–4, 1985–9, 1990–4, and in each of the consecutive years 1995, 1996, and 1997. Incidences for EP were calculated per 1000 women and per 1000 pregnancies while those for PID per 1000 women. National statistical data of EP were available for 1975–94 and were used for comparison with the local study. Results: The EP incidences increased from 7.7 per 1000 pregnancies in the first 5 year period to 13.4 in the second, and continued to rise for another decade reaching the peak figures of 16.6 in 1985–9—that is, more than a twofold increase. Since then and to 1997 the EP incidence has decreased by 30%. PID admissions increased during the study period from 2.7 per 1000 women in the first 5 year period to 3.2 in the second. From then on they continuously decreased and reached a low of 0.5 in 1997. The greatest changes occurred in women ?24 years of age. The peak incidence for this age group was 7.7 in 1975–9, and the lowest was 0.4 per 1000 women in 1996. The greatest reduction of EPs was noted for women ?24 years old, from a high of 10.0 in 1975–9, coinciding with the peak incidence of PID, to a low of 4.0 in 1997, a reduction of 58.4%. The incidence of EP was two to three times higher in women ?25 years old, most obvious in those ?30 years, with peak figures of 20.9 per 1000 pregnancies in 1985–9, and 13.9 in 1997, a reduction of 33.4% and the lowest figures for the past 23 years. For women aged 25–29 years the incidence peaked in the previous 5 year period 1980–4—that is, one 5 year period later than for those ?24 years, which we interpret as cohort effects in relation to PID. Conclusions: Reduction of PID was strongly associated with a decline of EP. The decline was greater and immediate for women ?24 years old, than for those ?25 years. The two to three times higher EP incidence in women ?25 years of age was most probably due to a cohort effect as the peak of PID occurred a decade earlier in women ?24 years old. Prevention of PID may not only reduce EP but also reduce adverse effects on tubal patency. Key Words: ectopic pregnancy; pelvic inflammatory disease; gonorrhoea; Chlamydia trachomatis, sexually transmitted disease; Sweden PMID:10817065

Kamwendo, F; Forslin, L; Bodin, L; Danielsson, D

2000-01-01

88

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

89

Hemoperitoneum in advanced abdominal pregnancy with a live baby: a case report  

PubMed Central

Background Abdominal pregnancy is a rare condition which is usually missed during prenatal assessment particularly in settings lacking routine ultrasound surveillance. We report a case of abdominal pregnancy at 32 weeks, which is most likely to have been a tubal abortion with secondary implantation, leading to delivery of a healthy baby girl weighing 1.7 kg. Case presentation A 22-year-old woman, gravid 3 para 2 was referred to our centre from a district hospital with complaint of generalized abdominal pain and reduced fetal movements. Although the initial abdomino-pelvic ultrasound done at our centre was read as normal, there was subsequently a strong clinical suspicion of abdominal pregnancy, which was confirmed by a second ultrasound. The patient underwent laparotomy and was found to have an intact uterus with a viable fetus floating in the abdominal cavity without its amniotic sac and with hemoperitoneum of 1litre. The baby was extracted successfully; the placenta was found to be deeply implanted on the right cornual side extending to the fundus superiorly. Wedge resection of the cornual area and fundus was performed to remove the placenta. Intraoperatively, one unit of blood was transfused due to severe anemia prior to surgery. Both the mother and the baby were discharged home in good condition. Conclusion Abdominal pregnancy can be missed prenatally even when an imaging (ultrasound) facility is available. Emphasis should be placed on clinical assessment and thorough evaluation of patients. PMID:24564927

2014-01-01

90

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

91

[Extrauterine pregnancy with gestagen-releasing intrauterine device in situ].  

PubMed

The levonorgestrel-releasing intrauterine device (IUD) (Mirena) is a frequently used and effective method of contraception, with a Pearl index of 0.1. The ectopic pregnancy rate is 0.02 per 100 woman-years. Special attention is needed in situations where pregnancy is detected with a levonorgestrel-releasing IUD in situ, because almost two thirds of these pregnancies are ectopic. We describe one of these rare cases of ectopic pregnancy in a woman aged 37 years, who was admitted to hospital with abdominal pain and vaginal bleeding. PMID:20444400

Mikkelsen, Mette Schou; Hřjgaard, Astrid; Bor, Pinar

2010-04-26

92

Shotgun Proteomics Identifies Serum Fibronectin as a Candidate Diagnostic Biomarker for Inclusion in Future Multiplex Tests for Ectopic Pregnancy  

PubMed Central

Ectopic pregnancy (EP) is difficult to diagnose early and accurately. Women often present at emergency departments in early pregnancy with a ‘pregnancy of unknown location’ (PUL), and diagnosis and exclusion of EP is challenging due to a lack of reliable biomarkers. The objective of this study was to identify novel diagnostic biomarkers for EP. Shotgun proteomics, incorporating combinatorial-ligand library pre-fractionation, was used to interrogate pooled sera (n?=?40) from women undergoing surgery for EP, termination of viable intrauterine pregnancy and management of non-viable intrauterine pregnancy. Western blot was used to validate results in individual sera. ELISAs were developed to interrogate sera from women with PUL (n?=?120). Sera were collected at time of first symptomatic presentation and categorized according to pregnancy outcome. The main outcome measures were differences between groups and area under the receiver operating curve (ROC). Proteomics identified six biomarker candidates. Western blot detected significant differences in levels of two of these candidates. ELISA of sera from second cohort revealed that these differences were only significant for one of these candidates, fibronectin. ROC analysis of ability of fibronectin to discriminate EP from other pregnancy outcomes suggested that fibronectin has diagnostic potential (ROC 0.6439; 95% CI 0.5090 to 0.7788; P>0.05), becoming significant when ‘ambiguous’ medically managed PUL excluded from analysis (ROC 0.6538; 95% CI 0.5158 to 0.7918; P<0.05). Fibronectin may make a useful adjunct to future multiplex EP diagnostic tests. PMID:23826180

Brown, Jeremy K.; Lauer, Katarina B.; Ironmonger, Emily L.; Inglis, Neil F.; Bourne, Tom H.; Critchley, Hilary O. D.; Horne, Andrew W.

2013-01-01

93

Misdiagnosis of Abdominal Pain in Pregnancy: Acute Pancreatitis  

PubMed Central

We report a case of acute pancreatitis in a pregnant woman who presented to our emergency department with complaints of severe abdominal pain, was misdiagnosed as scar dehiscence and underwent emergency repeat caesarean section at 33 wks for fetal distress. The preterm baby developed severe respiratory distress and succumbed on the second postnatal day. Persistent severe pain in the postoperative period in the mother prompted further evaluation which led to a diagnosis of acute pancreatitis. Conservative and supportive management was instituted leading to an eventual favourable maternal outcome. PMID:25738042

Samal, Sunita; Gupta, Shweta; Begum, Jasmina; Ghose, Seetesh

2015-01-01

94

Misdiagnosis of abdominal pain in pregnancy: acute pancreatitis.  

PubMed

We report a case of acute pancreatitis in a pregnant woman who presented to our emergency department with complaints of severe abdominal pain, was misdiagnosed as scar dehiscence and underwent emergency repeat caesarean section at 33 wks for fetal distress. The preterm baby developed severe respiratory distress and succumbed on the second postnatal day. Persistent severe pain in the postoperative period in the mother prompted further evaluation which led to a diagnosis of acute pancreatitis. Conservative and supportive management was instituted leading to an eventual favourable maternal outcome. PMID:25738042

Pallavee, P; Samal, Sunita; Gupta, Shweta; Begum, Jasmina; Ghose, Seetesh

2015-01-01

95

Association between levonorgestrel emergency contraception and the risk of ectopic pregnancy: a multicenter case-control study.  

PubMed

Cases of ectopic pregnancy (EP) following levonorgestrel emergency contraception (LNG-EC) failure have been reported continuously, but whether there is an association between EP risk and LNG-EC is unclear. We concluded a case-control study to explore this association by recruiting 2,411 EP patients as case group, and 2,416 women with intrauterine pregnancy and 2,419 non-pregnant women as control groups. Odds ratios (ORs) and their 95% confidential intervals (CIs) were calculated and adjusted for potential confounding factors. Previous use of LNG-EC was not correlated with the EP. Compared to women who did not use contraceptives, current use of LNG-EC reduced the risk for intrauterine pregnancy (Adjusted OR [AOR] = 0.20, 95%CI: 0.14-0.27), but did not increase the risk for EP (AOR2 = 1.04, 95%CI: 0.76-1.42). Furthermore, compared to women who did not have further act of intercourse, women with unprotected further act of intercourse were at a higher risk of EP (AOR1 = 2.35, 95%CI: 1.17-4.71), and women with repeated use of LNG-EC for further intercourse during the same cycle was also associated with a higher risk for EP (AOR1 = 3.08, 95%CI: 1.09-8.71; AOR2 = 2.49, 95%CI: 1.00-6.19). A better understanding of the risk of EP following LNG-EC failure can optimize LNG-EC use and thus reduce the risk of EP. PMID:25674909

Zhang, Jian; Li, Cheng; Zhao, Wei-Hong; Xi, Xiaowei; Cao, Shu-Jun; Ping, Hua; Qin, Guo-Juan; Cheng, Linan; Huang, He-Feng

2015-01-01

96

Association between levonorgestrel emergency contraception and the risk of ectopic pregnancy: a multicenter case-control study  

PubMed Central

Cases of ectopic pregnancy (EP) following levonorgestrel emergency contraception (LNG-EC) failure have been reported continuously, but whether there is an association between EP risk and LNG-EC is unclear. We concluded a case-control study to explore this association by recruiting 2,411 EP patients as case group, and 2,416 women with intrauterine pregnancy and 2,419 non-pregnant women as control groups. Odds ratios (ORs) and their 95% confidential intervals (CIs) were calculated and adjusted for potential confounding factors. Previous use of LNG-EC was not correlated with the EP. Compared to women who did not use contraceptives, current use of LNG-EC reduced the risk for intrauterine pregnancy (Adjusted OR [AOR] = 0.20, 95%CI: 0.14–0.27), but did not increase the risk for EP (AOR2 = 1.04, 95%CI: 0.76–1.42). Furthermore, compared to women who did not have further act of intercourse, women with unprotected further act of intercourse were at a higher risk of EP (AOR1 = 2.35, 95%CI: 1.17–4.71), and women with repeated use of LNG-EC for further intercourse during the same cycle was also associated with a higher risk for EP (AOR1 = 3.08, 95%CI: 1.09–8.71; AOR2 = 2.49, 95%CI: 1.00–6.19). A better understanding of the risk of EP following LNG-EC failure can optimize LNG-EC use and thus reduce the risk of EP. PMID:25674909

Zhang, Jian; Li, Cheng; Zhao, Wei-Hong; Xi, Xiaowei; Cao, Shu-Jun; Ping, Hua; Qin, Guo-Juan; Cheng, Linan; Huang, He-Feng

2015-01-01

97

Abdominal pain and dysuria in pregnancy: urinary tract infection or life threatening haemorrhage?  

PubMed

This report describes the case of a 27 year old woman presenting at 19 weeks' gestation with epigastric pain and dysuria. Initially diagnosed with a urinary tract infection, she re-presented 10 days later with acute abdominal pain and haemoperitoneum. The diagnosis of placenta percreta was not made until laparotomy. This case highlights placenta percreta as a rare but serious complication of pregnancy that may become increasingly frequent as the rates of caesarean delivery rise. Early diagnosis, close monitoring, and prompt surgical management are essential as massive blood loss can occur. This can be challenging, as clinical presentation can be unusual. PMID:16299219

Lamyman, M J; Connor, H; Brown, R

2005-12-01

98

Omental pregnancy: case report and review of literature  

PubMed Central

Pregnancy, the implantation of a fertilized ovum outside the endometrial cavity, occurs in 1.5%-2% of pregnancies. It is one of the major causes (about 6%) of maternal death during the first trimester of pregnancy. The remaining 5% implant in the ovary, peritoneal cavity, within the cervix, and the omental pregnancy is the least common form of abdominal pregnancies. A review of the literature on Medline for the period 1958-2012 reported only 16 cases of omental pregnancy. Here we report a case of primary omental pregnancy in a nulliparous woman. A 24 year-old woman gravid 1, para 0, with lower abdominal pain. Her last menstrual period occurred 8 weeks before the visit. The physical examination revealed abdominal tenderness in the lower quadrants, she was not bleeding. Transvaginal ultrasound showed: a free anechoic/hypoechoic area of 30 x 57 mm in the pouch of Douglas and the endometrium was homogeneus with a thickness of 12 mm and no evidence of gestational sac in the uterine cavity. Laboratory data revealed a normal cell blood count and beta hcg levels of 8047 IU / L. Because of continuing abdominal pain and a diagnosis of ectopic pregnancy a diagnostic laparoscopy was performed, which showed hemoperitoneum. Further inspection of abdominal cavity revealed a bloody lesion that was tenaciously adherent to the omentum, using non traumatic laparoscopic forceps and bipolar scissors we carefully removed a friable mass of about 30 mm from the omental attachments. Histological examination showed the presence of blood clot material mixed with trophoblastic tissue. Ultrasound evaluation and and hCG assessment are important to determine the extrauterine location of the ectopic pregnancy but the early diagnosis of abdominal pregnancy requires also a laparoscopic evaluation and, as our case has highlighted, thorough abdominal exploration especially in the absence of adnexal findings when ectopic pregnancy is highly suspected. Early diagnosis of omental pregnancy is difficult but essential to reduce the high mortality risk for the mother.

Maiorana, Antonio; Incandela, Domenico; Giambanco, Laura; Alio, Walter; Alio, Luigi

2014-01-01

99

An Ovarian Pregnancy in a Patient with a History of Bilateral Salpingectomies: A Rare Case  

PubMed Central

Background. 1 in 200 ectopic pregnancies are true ovarian pregnancies that fulfill the Spiegelberg criteria. Despite being rare, multiple case reports and series have been reported. Few cases have been published in which the event was preceded by salpingectomy. Case. The patient is a 32-year-old female who presented to the emergency room with abdominal pain. She was found to be pregnant, despite a history of two previous ectopic pregnancies treated with salpingectomies. Sonography confirmed a left adnexal mass and free fluid. Surgery revealed a ruptured ovarian pregnancy which was also confirmed by pathology. Conclusion. This is a case of an ovarian pregnancy in a patient with two previous salpingectomies. It underscores the importance of searching for an ectopic pregnancy in patients with abdominal pain after fertility impairing surgery.

Chitkara, Pranav; Cochran, Eric; Cutler, Jed

2015-01-01

100

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

PubMed Central

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

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

2014-01-01

101

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

2015-01-01

102

Has increased clinical experience with methotrexate reduced the direct costs of medical management of ectopic pregnancy compared to surgery?  

PubMed Central

Background There is a debate about the cost-efficiency of methotrexate for the management of ectopic pregnancy (EP), especially for patients presenting with serum human chorionic gonadotrophin levels of >1500?IU/L. We hypothesised that further experience with methotrexate, and increased use of guideline-based protocols, has reduced the direct costs of management with methotrexate. Methods We conducted a retrospective cost analysis on women treated for EP in a large UK teaching hospital to (1) investigate whether the cost of medical management is less expensive than surgical management for those patients eligible for both treatments and (2) to compare the cost of medical management for women with hCG concentrations 1500–3000?IU/L against those with similar hCG concentrations that elected for surgery. Three distinct treatment groups were identified: (1) those who had initial medical management with methotrexate, (2) those who were eligible for initial medical management but chose surgery (‘elected’ surgery) and (3) those who initially ‘required’ surgery and did not meet the eligibility criteria for methotrexate. We calculated the costs from the point of view of the National Health Service (NHS) in the UK. We summarised the cost per study group using the mean, standard deviation, median and range and, to account for the skewed nature of the data, we calculated 95% confidence intervals for differential costs using the nonparametric bootstrap method. Results Methotrexate was Ł1179 (CI 819–1550) per patient cheaper than surgery but there were no significant savings with methotrexate in women with hCG >1500?IU/L due to treatment failures. Conclusions Our data support an ongoing unmet economic need for better medical treatments for EP with hCG >1500?IU/L. PMID:22985126

2012-01-01

103

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

104

Vaginal bleeding in pregnancy  

MedlinePLUS

... may be a sign of a miscarriage or ectopic pregnancy. Contact the doctor right away. During months ... Cervical polyp or growth Early labor (bloody show) Ectopic pregnancy Infection of the cervix Trauma to the ...

105

Methotrexate and Pregnancy  

MedlinePLUS

... have recently been treated with methotrexate for an ectopic pregnancy. How long should I wait before I ... you should confirm with your doctor that the ectopic pregnancy has been treated and you are no ...

106

Ectopic Kidney  

MedlinePLUS

... Info Statistics Research Resources About Us Espańol National Kidney and Urologic Diseases Information Clearinghouse Publications Tools and ... List of Topics and Titles : Ectopic Kidney Ectopic Kidney On this page: What is an ectopic kidney? ...

107

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

108

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

109

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 ...

110

An interesting case of intramyometrial pregnancy  

PubMed Central

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

Verghese, Tina; Wahba, Karim; Shah, Ahmar

2012-01-01

111

Massive bleeding from ectopic varices in the postpartum period: rare but serious complication in women with portal hypertension.  

PubMed

Portal hypertension (PHT) often leads to collateralization of blood flow through variceal vessels that shunt blood from the portal to the systemic circulation. Life-threatening bleeding from esophageal and ectopic varices often complicates severe PHT. Increase in PHT occurs during the last stages of the second trimester of pregnancy and is associated with increased risk of PHT bleeding in the later stages of pregnancy. In this report, we present two rare cases of pregnant women with PHT, who had postpartum bleeding from very uncommon sites. The first had a rupture of an intra-abdominal varix and the second had two episodes of bleeding from abdominal wall varices, after two emergent cesarean sections, in two consecutive pregnancies. On the basis of a literature review, we constructed an algorithm that includes instructions on how to handle women with PHT during the various stages of pregnancy and labor. PMID:19190497

Rosenfeld, Hadas; Hochner-Celnikier, Drorit; Ackerman, Zvi

2009-09-01

112

Cotinine exposure increases Fallopian tube PROKR1 expression via nicotinic AChRalpha-7: a potential mechanism explaining the link between smoking and tubal ectopic pregnancy.  

PubMed

Tubal ectopic pregnancy (EP) is the most common cause of maternal mortality in the first trimester of pregnancy; however, its etiology is uncertain. In EP, embryo retention within the Fallopian tube (FT) is thought to be due to impaired smooth muscle contractility (SMC) and alterations in the tubal microenvironment. Smoking is a major risk factor for EP. FTs from women with EP exhibit altered prokineticin receptor-1 (PROKR1) expression, the receptor for prokineticins (PROK). PROK1 is angiogenic, regulates SMC, and is involved in intrauterine implantation. We hypothesized that smoking predisposes women to EP by altering tubal PROKR1 expression. Sera/FT were collected at hysterectomy (n=21). Serum levels of the smoking metabolite, cotinine, were measured by enzyme-linked immunosorbent assay. FTs were analyzed by q-RT-PCR, immunohistochemistry, and Western blotting for expression of PROKR1 and the predicted cotinine receptor, nicotinic acetylcholine receptor ?-7 (AChR?-7). FT explants (n=4) and oviductal epithelial cells (cell line OE-E6/E7) were treated with cotinine and an nAChR?-7 antagonist. PROKR1 transcription was higher in FTs from smokers (P<0.01). nAChR?-7 expression was demonstrated in FT epithelium. Cotinine treatment of FT explants and OE-E6/E7 cells increased PROKR1 expression (P<0.05), which was negated by cotreatment with nAChR?-7 antagonist. Smoking targets human FTs via nAChR?-7 to increase tubal PROKR1, leading to alterations in the tubal microenvironment that could predispose to EP. PMID:20864676

Shaw, Julie L V; Oliver, Elizabeth; Lee, Kai-Fai; Entrican, Gary; Jabbour, Henry N; Critchley, Hilary O D; Horne, Andrew W

2010-11-01

113

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

114

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

115

[Primary sterility and cervical pregnancy. A case report].  

PubMed

Fortunately cervical pregnancy, an ectopic gestation that frequently represents obstetric urgency, is a rare entity. We present here the case of a woman who developed cervical pregnancy despite no risk factor associated with ectopic pregnancy was identified. The patient came to the office because of primary sterility of 4 years of evolution. Among her background she reported previous cervical surgery due to benign pathology. She reached pregnancy after medical and surgical treatment. In the week eleven of gestation, the patient presented to the hospital with clinical symptoms of abortion. An ultrasound revealed abdominal pregnancy. Laparotomy was "white", cervix was found enlarged with the external orifice closed, suggesting cervical pregnancy. Conservative treatment consisted in cervical evacuation, endometrial curettage and vaginal tampon. She evolved satisfactorily. We do not know about any previous report of cervical-pregnancy associated with cervical surgery and sterility. We also recognize the need to increase the number of similar cases to generalize results. Thus, it is important to highlight in this case the absence of known risk factors for cervical pregnancy and the background of cervical surgery and sterility. Therefore, we recommend to search for antecedents of cervical surgery and sterility when cervical pregnancy is suspected. PMID:12448054

Cano López, L M L; Vital Reyes, V S; Alvarado-Cabrero, I; Ferreira Ríos, A; Hinojosa-Cruz, J C

2002-09-01

116

Ruptured subcapsular hematoma of the liver due to pre-eclampsia presenting as interstitial pregnancy and the role of intra-abdominal packing.  

PubMed

Ruptured subcapsular hematoma of the liver (RSHL) can mimic ruptured interstitial pregnancy because each of these conditions occasionally presents at the same gestational period and both do manifest hemodynamic instability. The similarities between the two conditions pose a diagnostic challenge, especially in an unbooked patient. We report a case of an unbooked primigravida, at 21 weeks of gestation, who arrived at a regional hospital with evidence of intra-abdominal bleeding and hypovolemic shock. She was diagnosed as potentially having a ruptured interstitial pregnancy. During the ensuing emergency laparotomy, RSHL was discovered, the area around the ruptured liver capsule was packed with large abdominal swabs, and the patient recovered. This case report illustrates the need to consider RSHL in patients presenting with features of ruptured interstitial pregnancy, as this will assist in the planning of intraoperative care. We also describe abdominal packing and highlight the need for this essential surgical intervention to be taught to doctors practising in low-resource settings. PMID:25666012

Ngene, N C; Amin, N; Moodley, J

2015-01-01

117

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

PubMed Central

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

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

2014-01-01

118

The Anatomical Considerations of Ectopic Gestation  

E-print Network

1 cases there was lithopedion formation. Here as elsewhere, the pregnancy may be 28 "be terminated early without rupture, an ovarian tumor r e s u l t i n g . More careful microscopic examination may reveal a frequency of ovarian pregnancy l i... OF ECTOPIC PREGNANCY DON CARLOS GUFFEY (?) THE ANATOMICAL CONSIDERATIONS OF ECTOPIC GESTATION BT DON CARLOS GUFFEY (?) UNIVERSITY OF KANSAS 1908 Note: This thesis was placed for some time with others lacking author1s name and date. Guffey! s thesis...

Guffey, Don Carlos

1908-01-01

119

A case of spontaneous tubal pregnancy with caesarean scar pregnancy  

PubMed Central

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

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

2014-01-01

120

Heterotopic Pregnancy after Natural Conception: A Case Report  

PubMed Central

Heterotopic pregnancy (HP), i.e. the simultaneous development of an intrauterine and an ectopic pregnancy, is rare with a reported incidence of between 1?:?2600 and 1?:?30?000. Only a few cases have been described in the literature. We report here on an extremely rare case of HP after natural conception with cardiac activity noted on sonography in both the intrauterine and the ectopic foetus. Examination excluded appendicitis. Vaginal sonography (VS) was performed and revealed a second, extrauterine foetus with cardiac activity. The differential diagnosis included twin pregnancy in a bicornuate uterus, but HP could not be excluded. Diagnostic laparoscopy was scheduled due to progressive abdominal pain. Shortly before surgery the patient became acutely hypotensive. Laparoscopy confirmed a heterotopic pregnancy in the right tube. Due to acute rupture of the extrauterine pregnancy with intraabdominal bleeding, the procedure was converted to a laparotomy with right-sided salpingectomy. Subsequently, the intrauterine pregnancy continued without complications. The intrauterine pregnancy was uneventful with spontaneous delivery at term. PMID:25324578

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

2012-01-01

121

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

122

Diagnosis of Heterotopic Pregnancy Using Ultrasound and Magnetic Resonance Imaging in the First Trimester of Pregnancy: A Case Report  

PubMed Central

Heterotopic pregnancy is a condition characterized by implantation of one or more viable embryos into the uterine cavity while another one is implanted ectopically, particularly into the uterine tube. Its occurrence has increased drastically over the last few years due to assisted reproduction procedures. In general, the diagnosis is made during the first trimester by using endovaginal two-dimensional ultrasound (2DUS), through observing a complex para- or retrouterine mass in association with a viable uterine pregnancy. However, under some conditions such as atypical ultrasonographic presentations, 2DUS does not clarify the situation whereas magnetic resonance imaging (MRI) of the pelvis is able to do so. We present the case of a pregnant woman in her fifth pregnancy, with a clinical condition of lower abdominal pain and pallor. Endovaginal 2DUS showed a complex voluminous mass in the left pelvic region in association with a viable intrauterine pregnancy. 2DUS in power Doppler mode showed “ring” vascularization, compatible with an ectopic gestational sac. MRI was of great importance in that it suggested that the mass had hematic content, which together with the clinical features, indicated that laparotomy should be performed. This surgical choice was essential for the woman to achieve a clinical improvement and for good continuation of the intrauterine pregnancy. PMID:23259128

Sun, Sue Yazaki; Araujo Júnior, Edward; Elito Júnior, Julio; Rolo, Liliam Cristine; Campanharo, Felipe Favorette; Sarmento, Stéphanno Gomes Pereira; Nardozza, Luciano Marcondes Machado; Moron, Antonio Fernandes

2012-01-01

123

Pregnancy after failed tubal sterilization.  

PubMed

Various research studies have documented post-sterilization ectopic pregnancy rates ranging from 5% to 90%. To investigate this complication further, the pregnancy outcomes of the 12 women with failed tubal sterilizations who received care during 1989-91 at the Beaumont Army Medical Center in El Paso, Texas, and of 137 such patients at other Texas military hospitals during 1984-88 were reviewed. Ectopic pregnancies occurred in 8 (67%) women in the former group and 49 (36%) in the latter. The incidence of ectopic pregnancy was similar for minilaparotomy, cesarean section-associated sterilization, and laparoscopy, indicating that there is no significant advantage associated with any one procedure. A post-sterilization pregnancy may be due to tubal recanalization or to a proximal fistula. Recommended is the practice of electrocoagulating both cornual regions to cause scarring of the myometrium and closing of any fistula. PMID:8866391

Napolitano, P G; Vu, K; Rosa, C

1996-08-01

124

[Ectopic thyroid: two cases].  

PubMed

Ectopic thyroid is a rare condition (1/4000 to 1/8000 among patients with hypothyroidism). The underlying etiological pathogenic mechanisms remain unknown. Diagnosis is established on the basis of imaging findings. We report two cases of hypothyroidism in adult females who had ectopic sublingual thyroid glands. The first patient was a 20-Year-old woman who had been treated for hypothyroidism since the age of 13 Years before the diagnosis of ectopic thyroid 7 Years later. In both patients, the thyroid gland was palpable. In the first patient the physical examination revealed an ectopic sublingual gland. Scintigraphy confirmed the diagnosis in both patients. The CT-scan and MRI were positive in the second patient. Hormonal substitution therapy using L-thyroixine was given. PMID:15277982

Cherif, L; Lakhoua, Y; Khiari, K; Hadj-Ali, I; Rajhi, H; Kaffel, N; Mahjoubi, I; McHirgui, N; Ferjaoui, M; Hamza, R; Ben Abdallah, N

2004-05-01

125

The ectopic ACTH syndrome  

Microsoft Academic Search

Ectopic Cushing’s syndrome usually relates to the ectopic ACTH syndrome (EAS) and represents ?20% of ACTH-dependent and ?10%\\u000a of all types of Cushing’s syndrome (CS). Nearly any neuroendocrine or non-endocrine tumours may be associated with EAS, but\\u000a the more prevalent tumours are bronchial carcinoids, small cell lung carcinomas, pancreatic carcinoids, thymic carcinoids,\\u000a medullary carcinomas of the thyroid, and phaeochromocytomas. Occult

Krystallenia I. Alexandraki; Ashley B. Grossman

2010-01-01

126

Duplicated ectopic ureter in a nine-year-old Labrador.  

PubMed

A nine-year-old male neutered Labrador retriever presented with a history of chronic urinary tract infections and occasional dribbling of urine. Abdominal ultrasound showed changes suggestive of a left ectopic ureter. A pneumocystogram revealed an air-filled distended tubular and tortuous structure extending from the region of the prostatic urethra to the left kidney, consistent with an ectopic ureter. Intravenous urography depicted the presence of an additional left ureter with only slightly larger diameter than the right and with normal insertion in the bladder neck. A duplicated ectopic left ureter was suspected and confirmed during surgery. To the authors' knowledge, this is the first description of a duplicated ectopic ureter in the canine species. The combination of ultrasound and contrast radiography was important to reach the diagnosis. PMID:23551207

Novellas, R; Stone, J; Pratschke, K; Hammond, G

2013-07-01

127

Abdominal Migraine  

MedlinePLUS

Home » Abdominal Migraine Abdominal Migraine Submitted by Admin on Wed, 2007-10-24 12:10 Abdominal migraine is one of the variants of migraine headache. This variant most typically occurs in children, ...

128

Primary ectopic frontotemporal craniopharyngioma  

PubMed Central

Introduction Primary ectopic craniopharyngiomas have only rarely been reported. Craniopharyngiomas involve usually the sellar and suprasellar region, but can be originated from cell remnants of the obliterated craniopharyngeal duct or metaplastic change of andenohypophyseal cells. We present the first case of a primary ectopic frontotemporal craniopharyngioma. Presentation of case A 35-year old woman presented with a one-year history of headache and diplopia. MRI showed a large frontotemporal cystic lesion. Tumor resection was performed with a keyhole endoscopic frontal lateral approach. The pathological features showed an adamantinomatous craniopharyngioma with a cholesterol granuloma reaction. Discussion There have been reported different localizations for primary ectopic craniopharyngioma. Our case presented a lobulated frontotemporal cystic mass formed by a dense eosinophilic proteinaceous material dystrophic calcifications and cholesterol crystals, with epithelial remnants. No tumor regrowth was observed in the magnetic resonance image 27 months postoperatively. Conclusion Primary ectopic craniopharyngioma is a rare entity with a pathogenesis that remains uncertain. This is an unusual anatomic location associated with unique clinical findings. PMID:25725331

Ortega-Porcayo, Luis Alberto; Ponce-Gómez, Juan Antonio; Martínez-Moreno, Mauricio; Portocarrero-Ortíz, Lesly; Tena-Suck, Martha Lilia; Gómez-Amador, Juan Luis

2015-01-01

129

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

Microsoft Academic Search

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

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

1998-01-01

130

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

131

Pregnancy Complications  

MedlinePLUS

Home > Pregnancy > You're pregnant: Now what? Pregnancy This information in Spanish ( en espańol ) Pregnancy complications Health problems before pregnancy Pregnancy related problems Infections during pregnancy When to call the doctor ...

132

An Unusual Case of Ectopic ACTH Syndrome Due to Primary Retroperitoneal Carcinoid.  

PubMed

A 37-year-old woman with clinical and biochemical features of ectopic adrenocorticotropic hormone (ACTH) syndrome underwent Ga DOTANOC PET/CT to localize the source of ectopic ACTH secretion. The images showed 35 × 45-mm retroperitoneal mass with significantly increased tracer uptake. Plasma-free metanephrines and serum chromogranin levels were normal. Whole-body I-MIBG scan including the retroperitoneal mass did not show any abnormal uptake. On excision, histopathology of this paravertebral abdominal mass revealed carcinoid tumor. We suggest the use of Ga DOTANOC PET/CT as a first-line imaging modality for localization of source of ACTH secretion in ectopic ACTH syndrome. PMID:25608172

Kasaliwal, Rajeev; Malhotra, Gaurav; Lila, Anurag; Bandgar, Tushar; Shah, Nalini S

2015-04-01

133

Heterotopic triplet pregnancy after in vitro fertilization with favorable outcome of the intrauterine twin pregnancy subsequent to surgical treatment of the tubal pregnancy.  

PubMed

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

Felekis, Theodoros; Akrivis, Christodoulos; Tsirkas, Panagiotis; Korkontzelos, Ioannis

2014-01-01

134

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

135

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

136

Ultrasound diagnosis of ectopic ureterocele  

Microsoft Academic Search

Three children with ectopic ureteroceles were examined with ultrasound, intravenous urography and cystography. In all cases the ultrasound studies outlined the ectopic ureterocele within the fluid-filled bladder and in one case added additional information regarding the non-functional portion of the duplication and its ureter.

Judith S. Rose; Joseph McCarthy; Hsu-Chong Yeh

1979-01-01

137

Original article Pregnancy diagnosis in the bitch  

E-print Network

Original article Pregnancy diagnosis in the bitch: the development of a test based abdominal palpation is the preferred method for diagnos- ing pregnancy in bitches, the technique being most on occasion in small animal practice to confirm pregnancy but it is not until d 45 that the foetal skeleton

Paris-Sud XI, Université de

138

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

139

Ectopic pineal chordoma  

PubMed Central

Background: Chordomas are rare tumors that arise from the remnants of embryonic notochord anywhere along the neuroaxis. Even though they may occur in an extraosseous intradural location, the most common sites include the sacrococcygeal and clivus regions. The authors report a unique presentation encompassing the pineal region with metastasis to the peritoneum after a ventriculoperitoneal (VP) shunt procedure and review the current knowledge about their pathophysiology and management. The presentation and clinical history endorse the idea that intradural extraosseous chordomas may be distinct from ecchordosis physaliphora and probably do not derive from it. Case Description: An 18-year-old male with previous history of VP shunt presented to the emergency room with pain and abdominal distension. Computed tomography (CT) scans revealed a mass in the pineal region and in the abdominal cavity. Histopathologic exams showed chordoma in both abdominal and cranial samples. The patient died due to systemic complications. Conclusion: The authors hypothesized that notochord remnants may subsist within the brain and occasionally may generate a neoplastic lesion. PMID:22059140

Figueiredo, Eberval G.; Tavares, Wagner M.; Welling, Leonardo; Rosemberg, Sergio; Teixeira, Manoel Jacobsen

2011-01-01

140

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

141

Pregnancy Complications  

MedlinePLUS

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

142

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. PMID:25674027

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

2015-01-01

143

Limiting the caesarean section rate in low risk pregnancies is key to lowering the trend of increased abdominal deliveries: an observational study  

PubMed Central

Background As the rate of Caesarean sections (CS) continues to rise in Western countries, it is important to analyze the reasons for this trend and to unravel the underlying motives to perform CS. This research aims to assess the incidence and trend of CS in a population-based birth register in order to identify patient groups with an increasing risk for CS. Methods Data from the Flemish birth register 'Study Centre for Perinatal Epidemiology' (SPE) were used for this historic control comparison. Caesarean sections (CS) from the year 2000 (N = 10540) were compared with those from the year 2008 (N = 14016). By means of the Robson classification, births by Caesarean section were ordered in 10 groups according to mother - and delivery characteristics. Results Over a period of eight years, the CS rise is most prominent in women with previous sections and in nulliparous women with a term cephalic in spontaneous labor. The proportion of inductions of labor decreases in favor of elective CS, while the ongoing inductions of labor more often end in non-elective CS. Conclusions In order to turn back the current CS trend, we should focus on low-risk primiparae. Avoiding unnecessary abdominal deliveries in this group will also have a long-term effect, in that the number of repeat CS will be reduced in the future. For the purpose of self-evaluation, peer discussion on the necessity of CS, as well as accurate registration of the main indication for CS are recommended. PMID:22230339

2012-01-01

144

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 does not always reflect the seriousness ...

145

Unusual anatomic presentation of ectopic ureteroceles  

Microsoft Academic Search

The authors describe four patients with unusual anatomic presentation of ectopic ureteroceles and their surgical treatment. Over a 3-year period, four cases of unusual ectopic ureteroceles were encountered. A 6-month-old girl had a complex cloacal anomaly with an ectopic ureterocele within an ectopic ureterocele combined with a blind-ending ipsilateral ureter. A 3-year-old girl had an ectopic ureterocele combined with a

Eugene Minevich; Ali Moayed; Jeffrey Wacksman; Alfor G Lewis; Curtis A Sheldon

1999-01-01

146

Ectopic intracranial retinoblastoma in childhood.  

PubMed Central

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

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

1985-01-01

147

Primary Hepatocellular Carcinoma in Ectopic Liver and Later Metastasis to Mother Liver?? A Case Report and Review of the Literature  

Microsoft Academic Search

We are presenting a case of primary ectopic hepatocellular carcinoma (HCC) that later developed HCC in the mother liver during long-term follow-up. A 64-year-old woman presented with a sudden on- set of abdominal pain and internal bleeding. Ectopic HCC was diagnosed by the surgical resection of 2 tumors during laparotomy, which were found near the triangular ligament and lesser curvature

Yuan-Hung Kuo; Jing-Houng Wang; Tsung-Hui Hu; Chuan-Mo Lee; Chang Gung

2008-01-01

148

True ectopic ovary in the right iliac fossa mimicking acute appendicitis and associated with ipsilateral renal agenesis.  

PubMed

Ectopic ovarian tissue is a rare gynecologic condition. The presence of ectopic ovary may be accompanied by maldevelopments of the genital and urinary tract. We report an extremely rare case of a 39-year-old woman presenting with abdominal pain localized in the right lower quadrant. During the preoperative investigation and the exploratory laparotomy, an ectopic ovary in contact with the appendix accompanied by a single left kidney was found. The present report also includes a review of the related published work. To the best of our knowledge, this is one of the very few cases reported describing the co-occurrence of true ovarian ectopia and ipsilateral renal agenesis. PMID:24320118

Kollia, Paraskevi; Kounoudes, Christos; Veloudis, George; Giannakou, Nikoletta; Gourgiotis, Stavros

2014-03-01

149

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

PubMed Central

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

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

2014-01-01

150

[Cesarean scar pregnancy: a case report of conservative management].  

PubMed

A caesarean scar pregnancy is a rare type of ectopic pregnancy which engages the vital prognosis either by hemorrhage or by early uterine rupture. We report the case of a 38-years-old patient who presented an ectopic pregnancy developed inside a previous caesarean section scar. The diagnosis was made at eight weeks of gestation by ultra-sound and allowed a fast management. We chose a conservative medical treatment by methotrexate both systemic and in situ. A hemorrhagic complication occured in two months of the initial treatment, requiring an endovascular therapy as well. PMID:20227196

Maheut, L; Seconda, S; Bauville, E; Levęque, J

2010-05-01

151

Explaining Pregnancy Loss: Parents' and Physicians' Attributions.  

ERIC Educational Resources Information Center

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

Dunn, Dana S.; And Others

1991-01-01

152

Association between maternal seafood consumption before pregnancy and fetal growth: evidence for an association in overweight women. The "EDEN mother-child" cohort  

E-print Network

1 Association between maternal seafood consumption before pregnancy and fetal growth: evidence before and during the last three months of pregnancy (n=1805). Fetal circumferences were measured), a higher consumption before pregnancy was associated with higher fetal biparietal and abdominal

Paris-Sud XI, Université de

153

Successful pregnancy in association with Zollinger-Ellison syndrome  

Microsoft Academic Search

Persistent severe vomiting in pregnancy may be caused by underlying disease and should be investigated. A patient with intractable vomiting associated with abdominal pain and dental enamel erosion in two pregnancies had a gastrinoma. Symptoms were successfully controlled with omeprazole in a third pregnancy. All three babies were healthy.

M. Ann Harper; J. Enda McVeigh; William Thompson; Joy E. S. Ardill; Keith D. Buchanan

1995-01-01

154

Pregnancy test  

MedlinePLUS

HCG level rises rapidly during the first trimester of pregnancy and then slightly declines. ... hours in the beginning of a pregnancy. HCG level that does not rise appropriately may indicate a problem with your pregnancy. ...

155

Pregnancy after hydrosalpinx treatment with Essure  

PubMed Central

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

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

2013-01-01

156

Clinical management of pregnancy in cats.  

PubMed

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

Root Kustritz, Margaret V

2006-07-01

157

Pregnancy after hydrosalpinx treatment with Essure.  

PubMed

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

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

2013-01-01

158

Pregnancy Loss  

MedlinePLUS

... Stages of pregnancy Prenatal care and tests Twins, triplets, and other multiples Staying healthy and safe Body changes and discomforts Pregnancy complications Pregnancy loss Know your pregnancy rights Getting ready for baby Childbirth and beyond Mom-to-be tools Government ...

159

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

160

Ectopic bone induction by equine bone protein extract.  

PubMed

Demineralized bone matrix from horse has been reported to be osteoinductive. However, its performance was inferior to autogenous bone graft in terms of new bone formation. In the present experiment, an equine bone protein extract-COLLOSS E was investigated for its osteoinductivity in a rat model. At the mean time, carboxymethyl-cellulose (CMC) was tested as a potential carrier for the protein extract. 18 male Wistar rats (8 weeks) were employed in the experiment. Each rat was implanted randomly with the 2 of the following implants, one on each side of the abdominal muscle. 1) COLLOSS E lyophilisate. 2) PEEK ring holder. 3) 3% or 10% CMC .in gel or lyophilized form 4) COLLOSS E lyophilisate with 3% CMC, implanted as gel or in lyophilized form. 5) COLLOSS E suspension with 10% CMC, implanted as gel or in lyophilized form. The rats were followed up for 21 days. After termination, samples were subjected to macroscopic examination, plain radiograph, micro-CT and histological evaluations. The results showed that PEEK ring or CMC alone could not induce ectopic bone formation. COLLOSS E lyophilisate has a slightly higher (6 out of 7) positive bone formation rate over COLLOSS E/3% CMC (3 out of 5, both gel and lyophilized form), however, the difference is non-significant (p=0.36, Fisher's exact test). 10% CMC with COLLOSS E did not show ectopic bone formation when implanted as gel form (0/8), while 1 positive bone formation was found when implanted as the lyophilized form (1/4). Bone tissue volume ranged from 0 mm(3) to 23.1mm(3) for COLLOSS-E lyophilisate alone and 0 to 29.7mm(3) for COLLOSS E/3%CMC (gel or lyophilized form). We concluded that equine bone protein extract has the ability to induce ectopic bone formation in the rat model. CMC could be a potential carrier, however, further studies are needed to verify the proportion and efficacy. PMID:17120797

Li, Haisheng; Springer, Marco; Zou, Xuenong; Briest, Arne; Bünger, Cody

2006-01-01

161

Angular pregnancy.  

PubMed

Angular pregnancy, a type of cornual pregnancy, is a rare obstetric complication that can be life-threatening. In this situation, the embryo is implanted in the lateral angle of the uterine cavity, medial to the uterotubal junction and round ligament. Angular pregnancy must be distinguished from interstitial pregnancy, in which the embryo is implanted lateral to the round ligament. The report presented here describes a case of angular pregnancy that was diagnosed by endovaginal ultrasonography and magnetic resonance imaging. Laparoscopy can be useful for guiding dilatation and curettage in angular pregnancies, and may circumvent the need for invasive surgery or hysterectomy. PMID:15327452

Tarim, Ebru; Ulusan, Serife; Kilicdag, Esra; Yildirim, Tulin; Bagis, Tayfun; Kuscu, Esra

2004-10-01

162

ECTOPIC ACTH SECRETION AND CUSHING'S SYNDROME  

Microsoft Academic Search

SUMMARY - Ectopic ACTH secretion was the first paraneoplastic endocrine syndrome described in the literature. The most common tumors associated with ectopic ACTH production are small-cell lung cancer and atypical carcinoids. High cortisol levels have also been described in patients with adenocar- cinoma and large-cell carcinoma of the lung, other carcinoid tumors, thymoma, neural crest tumors, medullary carcinoma of the

Milan Vrkljan; B. Vizner; A. Zawawi; M. BekiĘ; I. Grbac

2000-01-01

163

A rare condition: Ectopic liver tissue with its unique blood supply encountered during laparoscopic cholecystectomy  

PubMed Central

Introduction Developmental abnormalities of liver including ectopic liver tissue (ELT) are rare conditions. Few cases presenting ELT have been reported in literature till now. Even though the most common area seen is gallbladder, it is detected both abdominal and thoracic sites. There is a relationship between HCC and ectopic liver that necessitates the removal. Presentation of case A 51-year-old female was hospitalized because of abdominal pain. Gallstone and bile duct dilatation were determined during ultrasonographic (USG) evaluation. The patient was operated for cholecystectomy following a successful endoscopic retrograde cholangiopancreatography (ERCP). During operation, a mass located on gallbladder with its unique vascular support was identified and resected together with gallbladder. The mass had a separate vascular stalk arising from liver parenchyma substance and it was clipped with laparoscopic staples. The histopathological examination revealed that the mass adherent to gallbladder was ectopic liver confirming the intraoperative observation. The postoperative course of patient was uneventfull and she was discharged at the second day after the operation. Discussion Ectopic liver tissue is incidentally found both in abdominal and thoracic cavity. ELT can rarely be diagnosed before surgical procedures or autopsies. It can be overlooked easily by radiological techniques. Although it does not usually produce any symptom clinically, it can rarely result in serious complications such as bleeding, pyloric and portal vein obstruction. ELT also has the capacity of malignant transformation to hepatocellular carcinoma that makes it essential to be removed. Conclusion Although ELT is rarely seen, it should be removed when recognized in order to prevent the complications and malignant transformation. PMID:25723748

Bal, Ahmet; Yilmaz, Sezgin; Yavas, Betul Demirciler; Ozdemir, Cigdem; Ozsoy, Mustafa; Akici, Murat; Kalkan, Mustafa; Ersen, Ogun; Saripinar, Baris; Arikan, Yuksel

2015-01-01

164

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 ...

165

Pregnancy Quiz  

MedlinePLUS

Skip Navigation Bar Home Current Issue Past Issues Pregnancy Quiz Past Issues / Winter 2008 Table of Contents ... what you should do to promote a healthy pregnancy True or False? I should not drink any ...

166

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

167

[Laparoscopic treatment of extrauterine pregnancy].  

PubMed

This study presents 45 consecutive cases of ectopic pregnancies, of which twenty six cases were managed by pelviscopic surgery and 19 by laparotomy. Laparoscopy failed in six of the nineteen laparotomy patients, probably due to poor hemostasis or an excessive hemoperitoneum. There was a significantly shorter hospital stay of 1.07 days for the laparoscopy group vs. 4.2 days for the group treated by laparotomy. Also a higher treatment cost was observed in the laparoscopy vs. laparotomy group. The operating time was not statistically different in the two groups, averaging 96 minutes in both groups. There were no complications in the laparoscopy group. PMID:2148791

Pasi?, R; Crossing, N; Wolfe, W M

1990-01-01

168

Cystic Fibrosis and Pregnancy  

MedlinePLUS

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

169

Costs of maternal conditions attributable to smoking during pregnancy  

Microsoft Academic Search

Context: Despite known adverse health effects, many women continue to smoke during pregnancy. Public attention has now focused on the economic as well as health effects of this behavior.Objective: To estimate health care costs associated with smoking-attributable cases of placenta previa, abruptio placenta, ectopic pregnancy, preterm premature rupture of the membrane (PPROM), pre-eclampsia, and spontaneous abortion.Design: Pooled odds ratios were

E. Kathleen Adams; Cathy L. Melvin

1998-01-01

170

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

SciTech Connect

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

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

2005-04-15

171

Effects of aerobic versus resistance exercise without caloric restriction on abdominal fat, intrahepatic lipid, and insulin sensitivity in obese adolescent boys: a randomized, controlled trial  

Technology Transfer Automated Retrieval System (TEKTRAN)

The optimal exercise modality for reductions of abdominal obesity and risk factors for type 2 diabetes in youth is unknown. We examined the effects of aerobic exercise (AE) versus resistance exercise (RE) without caloric restriction on abdominal adiposity, ectopic fat, and insulin sensitivity and se...

172

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

173

Formation of ectopic osteogenesis in weightlessness  

NASA Technical Reports Server (NTRS)

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

1977-01-01

174

Thirteen -weeks ovarian pregnancy following in vitro fertilization for primary infertility treatment: A case report  

PubMed Central

Background: Ovarian pregnancy constitutes 0.15-3% of all ectopic pregnancies. The incidence of ectopic pregnancy is on the rise owing to evolution in assisted reproductive techniques (ART). The incidence reported following In vitro fertilization (IVF) or embryo transfer (ET) is 0.27% per clinical pregnancy. Case: We present a case of a 13-weeks ovarian pregnancy following IVF-ET and through a review of the literature, the specific symptomatology, diagnostic criteria, and treatment of this particular pathology will be described. Conclusion: Ovarian pregnancy is a rare condition and its diagnosis is difficult and relies on criteria based on intraoperative and histopathological findings. The management is, in spite of medical improvement, based on surgery. But the trend has shifted towards conservative surgeries in majority of cases. PMID:25709634

Ashrafganjoei, Tahereh; Nemati Honar, Behzad; Defaee, Sara

2014-01-01

175

Post trauma abdominal cocoon  

PubMed Central

Abdominal cocoon or sclerosing peritonitis refers to a rare cause of intestinal obstruction due to formation of a membrane encasing the bowel. We report a case of abdominal cocoon post blunt trauma abdomen. The patient presented with a history of subacute intestinal obstruction and a mobile abdomen lump. Abdominal cocoon was diagnosed on computed tomography. He underwent adhesiolysis with excision of membrane. PMID:25590647

Kaur, Supreet; Doley, Rudra Prasad; Chabbhra, Mohinish; Kapoor, Rajeev; Wig, Jaidev

2014-01-01

176

Satisfaction with Hospital Care and Interventions after Pregnancy Loss.  

ERIC Educational Resources Information Center

Conducted longitudinal study of 194 women and men who experienced miscarriage, ectopic pregnancy, stillbirth, or newborn death to examine recommended interventions. Subjects were more satisfied if they had experienced intervention than if they had not, but having experienced more total interventions was not associated with lower grief or greater…

Lasker, Judith N.; Toedter, Lori J.

1994-01-01

177

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

178

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

PubMed Central

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

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

2014-01-01

179

Locating Ectopic Foci on a Cylinder  

NASA Astrophysics Data System (ADS)

Arrhythmia is a condition in which an additional ectopic pacemaker is present in the tissue of the heart. Localization of ectopic foci is essential for successful radio-frequency ablation, an important surgical way of treating arrhythmia. In one of the possible mechanisms, arrhythmia induced by an ectopic foci located in one of the main blood vessels leading out or onto the heart. The therapeutic procedure in this case is usually ablation of the whole junction of the blood vessel with heart wall. In this way, whatever excitation occurs inside the vessel, it cannot penetrate the ventricles perturbing their contraction cycle. Such an ablation procedure is long and burdened with the risk of the perforation. A more safe method would involve the localization of the source of the excitation (i.e. the ectopic foci) and its ablation. The methods used in cardiology at present involve complicated localization systems and are time-consuming with the patient spending a long time on the operating table. Recently, Hall and Glass have developed numerical methods which allow to quickly to model the localization of the ectopic foci in a flat, square sample of an inhomogeneous medium. Here, we demonstrate an extension of this model for the case of a cylinder containing an ectopic foci, that can be a model of a blood vessel with the source of the ectopic beat inside it. Three methods of localization are implemented. Standard electrodes containing several active tips are used to stimulate the medium locally and locate the foci judging from the reaction of the system. The first one uses electrode activation times to compute the location of the ectopic site. The second one localizes it by measuring the resetting response of the foci, and the third one, uses wavefront curvature. Specifically for the cylindrical geometry of the blood vessel, we developed a localization procedure that allows to quickly localize the pacemaker.

Kuklik, Pawel; Zebrowski, Jan J.

2003-07-01

180

[Adolescent pregnancy].  

PubMed

This exploration of adolescent pregnancy focuses on adolescents whose pregnancies are undesired. The physical and psychic transformations of puberty and adolescence may be experienced differently in different social contexts. The prolongation of school attendance in Western societies means that most adolescents remain financially dependent on their parents. But greater sexual freedom in the society at large has been reflected in an increase in early sexual activity among adolescents. Wider use of contraception has not completely eliminated prenatal pregnancy among adolescents. Adolescent pregnancies have actually declined in France as a proportion of all pregnancies carried to term, from 4% to 1.5-2% in the past 10 or 15 years. But in 1986, 42.5% of all induced abortions were performed on adolescents. Among causes of unwanted pregnancy in adolescents are their frequent inability to believe that they may be at risk of pregnancy, or that pregnancy can result from the 1st sexual intercourse. The episodic nature of sexual relations, the lack of ready availability of contraception, and specific shortcomings of different methods are factors in the frequent failure of adolescents to protect themselves against undesired pregnancy. Adolescents may become pregnant out of loneliness or to prove that they are women, or as a result of incest or prostitution. Adolescents who seek abortions are those who have discovered and acknowledged their pregnancies before the 12th week and had the courage to inform their parents and obtain legal permission for the abortion. Pregnancy terminations are more frequent in more advantaged societal sectors with more structured family life. The moral shock and sense of failure associated with abortion are often deeply felt by adolescents. Their experience is greatly influenced by the attitudes of those around them. Adolescents who carry their pregnancies to term are those who have not sought abortion in the 1st 12 weeks. Often they refuse to admit they might be pregnant. But adolescents from disadvantaged environments may wish to continue the pregnancy in order to attain social status. Most parents eventually resign themselves to the pregnancy. Adolescents who are closely monitored usually have normal pregnancies and deliveries. The proportion of adolescent mothers who place their infants for adoption has declined. Most of the infants kept by their mothers are entitled to 2 sets of social prestations, the allowances for the young infant and for single parents. School nurses have an important potential contribution in informing students about sexuality and contraception and in assisting those who become pregnant. PMID:1962262

Fatichi, B

1991-10-01

181

Portal Cavernoma during Pregnancy  

PubMed Central

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

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

2013-01-01

182

Pregnancy Complications: Syphilis  

MedlinePLUS

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

183

Pregnancy Complications: Chlamydia  

MedlinePLUS

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

184

Pregnancy Complications: HELLP Syndrome  

MedlinePLUS

... the community. Home > Pregnancy > Pregnancy Complications > HELLP syndrome Pregnancy complications Pregnancy complications may need special medical care. ... to get pregnant again. Are gallstones common during pregnancy? Not common, but they do happen. Elevated hormones ...

185

Pregnancy Complications: Gonorrhea  

MedlinePLUS

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

186

Pregnancy and IC  

MedlinePLUS

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

187

Gaucher Disease in Pregnancy  

MedlinePLUS

... prior to conception and avoid use in pregnancy. Enzyme replacement therapy has been used successfully in pregnancy and may ... in pregnancy, please see the OTIS fact sheets Enzyme Replacement Therapy, Miglustat and Pregnancy, and Bisphosphonates and Pregnancy. Are ...

188

Abdominal Decompression in Children  

PubMed Central

Abdominal compartment syndrome (ACS) increases the risk for mortality in critically ill children. It occurs in association with a wide variety of medical and surgical diagnoses. Management of ACS involves recognizing the development of intra-abdominal hypertension (IAH) by intra-abdominal pressure (IAP) monitoring, treating the underlying cause, and preventing progression to ACS by lowering IAP. When ACS is already present, supporting dysfunctional organs and decreasing IAP to prevent new organ involvement become an additional focus of therapy. Medical management strategies to achieve these goals should be employed but when medical management fails, timely abdominal decompression is essential to reduce the risk of mortality. A literature review was performed to understand the role and outcomes of abdominal decompression among children with ACS. Abdominal decompression appears to have a positive effect on patient survival. However, prospective randomized studies are needed to fully understand the indications and impact of these therapies on survival in children. PMID:22482041

Ejike, J. Chiaka; Mathur, Mudit

2012-01-01

189

[Thoracic and abdominal wounds].  

PubMed

Thoracic and abdominal wounds are characterized by their diversity, their possible danger and the necessity of a successful diagnosis and therapy strategy. Management of thoracic wounds and indications of surgical treatment are conditioned by airway and hemodynamic states, paraclinical exams and chest drainage. The approach of abdominal wounds is based upon their possible penetrating character. Surgical indications, even if very discussed, are still wider. Thoraco-abdominal wounds could concern the diaphragm and are remarkable for their surgical strategy. PMID:9208685

Martinod, E; Lang-Lazdunski, L; Liard, O; Jancovici, R

1997-05-01

190

Abdominal Aortic Aneurysms: Treatments  

MedlinePLUS

... renal disease Infertility Liver disease Needle biopsy Osteoporosis Pediatrics Pelvic pain ... Aortic Aneurysms Interventional Radiologists Treat Abdominal Aneurysms Nonsurgically Interventional radiologists ...

191

Suspected ovarian molar pregnancy after assisted reproductive technology conception: a diagnostic challenge.  

PubMed

A 32-year-old patient with primary infertility received in vitro fertilisation (IVF) therapy. Four weeks later she developed intermittent left iliac fossa pain. Transvaginal ultrasound showed an empty uterus and an adnexal mass adjacent to the right ovary. Serum ?-human chronic gonadotropin was 33?492?IU/L. At laparoscopy a mass attached to right ovary, suggestive of a right ovarian ectopic pregnancy, was excised. Histological examination confirmed an ovarian ectopic gestation, but noted enlarged chorionic villi and trophoblastic atypia, which raised the suspicion of molar pregnancy. Subsequent p57 immunohistochemistry and DNA ploidy studies excluded a mole, however. Cases of suspected molar disease in ectopic pregnancy present a diagnostic challenge for both clinicians and histopathologists, and establishing a definitive diagnosis may be difficult. PMID:25837656

Obeidi, Nedaa; Tchrakian, Nairi; Abu Saadeh, Feras; Mocanu, Edgar

2015-01-01

192

First ever case of spontaneous triplet cornual pregnancy: management of laparoscopic cornual resection with modified endoloop method.  

PubMed

A 23-year-old woman, gravida 2 para 0, presented at 8?weeks gestation with a spontaneously conceived triplet cornual ectopic pregnancy. She was at high risk of ectopic pregnancy as she had been previously treated for pelvic inflammatory disease and had also undergone laparoscopic salpingostomy for right-sided ectopic pregnancy. She was clinically stable and her abdomen was soft and non-tender. The diagnosis was made on transvaginal ultrasound scan and this was confirmed on the three-dimensional scan. She was counselled about her treatment options and subsequently underwent laparoscopic cornual resection using the modified endoloop method. The estimated blood loss was 20?ml intraoperatively and the patient recovered well. She subsequently conceived spontaneously with an intrauterine pregnancy and underwent lower segment caesarean section at 37?weeks in view of previous laparoscopic cornual resection. Intraoperatively, the right cornua appeared normal and there was no sign of thinning. PMID:25716043

Gosavi, Arundhati; Lim, Li Min; Agarwal, Anupriya; Fong, Yoke Fai

2015-01-01

193

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

194

Ovarian Pregnancy: Uncommon Mode of Presentation  

PubMed Central

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

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

2014-01-01

195

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

PubMed Central

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

2011-01-01

196

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

197

Synchronous thoracic and abdominal enteric duplication cysts: Accurate detection with (99m)Tc-pertechnetate scintigraphy.  

PubMed

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. (99m)Tc-pertechnetate scintigraphy is a useful modality for preoperative localization of the ectopic functioning gastric mucosa in the EDCs. We report a case where (99m)Tc-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

198

Pregnancy Discrimination  

MedlinePLUS

... however, that insurance coverage for expenses arising from abortion is not required, except where the life of ... is endangered or medical complications arise from an abortion. Pregnancy related expenses should be reimbursed in the ...

199

Adolescent pregnancy  

MedlinePLUS

... pregnancy include: Younger age Poor school performance Economic disadvantage Older male partner Single or teen parents ... the pregnant teen should be considered carefully, including abortion, adoption, and raising the child with community or ...

200

Diagnostic localization of ectopic parathyroid lesions: developmental consideration  

Microsoft Academic Search

Parathyroid glands arise from the third and fourth pharyngeal pouches. Parathyroid lesions sometimes develop ectopically.\\u000a The aim of this article is to illustrate the knowledge of pharyngeal apparatus development to assist with diagnostic localization\\u000a of ectopic parathyroid lesions. We retrospectively reviewed charts of 23 patients who received a diagnosis of ectopic parathyroid\\u000a lesions. The ectopic lesions were widely distributed; cranially

Itsuko Okuda; Yasuo Nakajima; Daishu Miura; Hirotaka Maruno; Tadasu Kohno; Kazuaki Hirata

2010-01-01

201

Adolescent Pregnancy  

Microsoft Academic Search

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

Brent C. Miller; Rayna Sage; Bryan Winward

202

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

203

Genesis of Ectopic Waves: Role of Coupling, Automaticity, and Heterogeneity  

Microsoft Academic Search

Many arrhythmias are believed to be triggered by ectopic sources arising from the border of the ischemic tissue. However, the development of ectopic activity from individual sources to a larger mass of cardiac tissue remains poorly understood. To address this critical issue, we used monolayers of neonatal rat cardiomyocytes to create conditions that promoted progression of ectopic activity from single

Alain Pumir; Ara Arutunyan; Valentin Krinsky; Narine Sarvazyanz

2005-01-01

204

Folic Acid and Pregnancy  

MedlinePLUS

... Flu Pregnancy Precautions Checkups: What to Expect 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 ...

205

Depression and Pregnancy  

MedlinePLUS

Depression and Pregnancy This sheet talks about the risks of depression during pregnancy. With each pregnancy, all women have a 3% ... is depression and how common is it in pregnancy? Depression is a serious medical illness that has ...

206

Tobacco Use and Pregnancy  

MedlinePLUS

... Office on Smoking and Health Tobacco Use and Pregnancy How Does Smoking During Pregnancy Harm My Health and My Baby? Most people ... or cleft palate . How Many Women Smoke During Pregnancy? According to the 2011 Pregnancy Risk Assessment and ...

207

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 ...

208

Lithium and Pregnancy  

MedlinePLUS

Lithium and Pregnancy This sheet talks about the risks that exposure to lithium can have during pregnancy. With each pregnancy, all ... miscarriage has been reported. Can taking lithium during pregnancy cause birth defects? Yes, although not very often. ...

209

Pregnancy and Rheumatic Disease  

MedlinePLUS

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

210

[Ultrasound for abdominal lymphadenopathy].  

PubMed

This CME-review is about the clinical importance of the abdominal lymph node diagnostic with special attention to various ultrasound techniques. This includes innovative techniques like contrast enhanced ultrasound and elastography. The clinical importance of ultrasound in relation to cross sectional imaging will be the target of the article as well as anatomic- topographic aspects. The article deals as well with endosonographic techniques because of the upmost importance of the technique for diagnosing mediastinal and abdominal lymphnode swellings. In conclusion of the article different clinical scenarios and clinical algorithms are presented to help the reader to diagnose abdominal lymphadenopathy correctly in an efficient way. PMID:23633280

Dietrich, C F; Hocke, M; Jenssen, C

2013-05-01

211

Abdominal compartment syndrome  

Microsoft Academic Search

Intra-abdominal hypertension (IAH) associated with organ dysfunction\\u0009\\u0009\\u0009 defines the abdominal compartment syndrome (ACS). Elevated intra-abdominal\\u0009\\u0009\\u0009 pressure (IAP) adversely impacts pulmonary, cardiovascular, renal, splanchnic,\\u0009\\u0009\\u0009 musculoskeletal\\/integumentary, and central nervous system physiology. The\\u0009\\u0009\\u0009 combination of IAH and disordered physiology results in a clinical syndrome\\u0009\\u0009\\u0009 with significant morbidity and mortality. The onset of the ACS requires prompt\\u0009\\u0009\\u0009 recognition and appropriately timed and staged intervention

Jeffrey Bailey; Marc J Shapiro

2000-01-01

212

[Acute pancreatitis and pregnancy].  

PubMed

Aetiologic factors (gallstones, hyperlipidemia I-IV, hypertriglyceridaemia) make their occurrence, mainly, in the third trimester of gestation. Two cases of acute pancreatitis in pregnancy are described; in both cases patients referred healthy diet, no habit to smoke and no previous episode of pancreatitis. An obstructive pathology of biliary tract was the aetiologic factor. Vomiting, upper abdominal pain are aspecific symptoms that impose a differential diagnosis with acute appendicitis, cholecystitis and obstructive intestinal pathology. Laboratory data (elevated serum amylase and lipase levels) and ultrasonography carry out an accurate diagnosis. The management of acute pancreatitis is based on the use of symptomatic drugs, a low fat diet alternated to the parenteral nutrition when triglycerides levels are more than 28 mmol/L. Surgical therapy, used only in case of obstructive pathology of biliary tract, is optimally collected in the third trimester or immediately after postpartum. Our patients, treated only medically, delivered respectively at 38th and 40th week of gestation. Tempestivity of diagnosis and appropriate therapy permit to improve prognosis of a pathology that, although really associated with pregnancy, presents high maternal mortality (37%) cause of complications (shock, coagulopathy, acute respiratory insufficiency) and fetal (37.9%) by occurrence of preterm delivery. PMID:8139793

Scollo, P; Licitra, G

1993-12-01

213

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

214

Pregnancy presenting as hyperthyroidism with negative urine pregnancy test.  

PubMed

A 22-year-old lactating mother presented with symptoms of uneasiness, palpitation, tachycardia and exophthalmos. She had an abdominal lump suggestive of 26?weeks uterine size but her urine pregnancy test was negative. Her thyroid profile was suggestive of hyperthyroidism. Gynaecological and ultrasonographic findings revealed a hydatidiform mole. She had a low ?-human chorionic gonadotropin level that surprisingly increased after suction and evacuation. The paradoxical findings that appeared as erroneous laboratory results could be explained by the 'high-dose hook effect' after a review of literature. One week after the evacuation, the patient's thyroid profile and symptoms resolved completely without any treatment for hyperthyroidism. PMID:24849632

Jindal, Rita; Deepak, Desh; Ghosh, Gopal Chandra; Gupta, Mamta

2014-01-01

215

Gallstone disease and pancreatitis in pregnancy.  

PubMed

Controversy exists over whether pregnancy is a risk factor for gallstone formation; however, changes in hepatobiliary function do occur during pregnancy to create a lithogenic environment; these changes include gallbladder stasis and secretion of bile with increased amounts of cholesterol and decreased amounts of chenodeoxycholic acid. In women with existing gallstones, pregnancy may bring out symptoms, including pain and even acute cholecystitis. This may be more common during the postpartum period than during pregnancy itself; however, the overall occurrence of symptomatic biliary disease in association with pregnancy is low. The effects of pregnancy, if any, on pancreatic exocrine function are undefined. Acute pancreatitis can occur during pregnancy but does not appear to do so with either increased or, alternatively, decreased frequency. The concept of pancreatitis caused by pregnancy per se is not valid, although in susceptible women with lipid disorders, hypertriglyceridemia can occur and serve as an etiologic factor. Gallstones are a common cause of pancreatitis, but in contrast to nonpregnant women, alcohol is unusual as a cause. Although the presentation of both acute cholecystitis and acute pancreatitis may be similar to that in the nonpregnant state, the differential diagnosis of both these disorders is expanded because of unique pregnancy-related conditions and the shift of abdominal viscera by the enlarging uterus. The diagnosis is clinical and supported with conventional laboratory studies and ultrasound; management is supportive and in most patients successful. Cholecystectomy is seldom necessary during pregnancy, either for acute cholecystitis or gallstone pancreatitis, but can be safely performed if necessary after the first trimester. Endoscopic papillotomy and stone removal for choledocholithiasis are possible during pregnancy and may be the treatment of choice for this unusual condition. Specific enteral or parenteral nutrition may be necessary in women with pancreatitis associated with hypertriglyceridemia. PMID:1478736

Scott, L D

1992-12-01

216

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

217

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

218

Abdominal aortic aneurysm  

MedlinePLUS

... main blood vessel that supplies blood to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs ... dissection). Symptoms of rupture include: Pain in the abdomen or back. The pain may be severe, sudden, ...

219

Abdominal x-ray  

MedlinePLUS

Abdominal film; X-ray - abdomen; Flat plate; KUB x-ray ... Diagnose a pain in the abdomen or unexplained nausea Identify suspected problems in the urinary system, such as a kidney stone Identify blockage in the intestine Locate ...

220

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

221

Abdominal ultrasound (image)  

MedlinePLUS

Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X-ray, MRI, ... it has its place as a diagnostic tool. Ultrasound scans use high frequency sound waves to produce ...

222

Teenage pregnancy.  

PubMed

Teen pregnancy is a social problem not resolved in developing and some developed countries. Adolescent fecundity has become the most exact bio-demographic and health indicator of development. In developing countries that are expected to follow the sexual behaviour patterns of developed countries, without offering the levels of education and services for adolescents, the consequences will be adolescent fecundity and STI prevalence increase. The ignorance about sexuality and reproduction both in parents, teachers and adolescents increases the early initiation of coital relations and of unwanted pregnancies. Extreme poverty and being the son or daughter of an adolescent mother are risk factors of repeating the early pregnancy model. The application of predictive risk criteria in pregnant adolescents to facilitate the rational use of Health Services to diminish the maternal and perinatal mortality is discussed as well as the social factors associated with adolescent pregnancy as socioeconomic levels, structure - types and characteristics of the family, early leaving school, schooling after delivery, female employment, lack of sexual education, parental and family attitudes in different periods of adolescent pregnancy, adolescent decisions on pregnancy and children, unstable partner relationship and adoption as an option. Social consequences are analyzed as: incomplete education, more numerous families, difficulties in maternal role, abandonment by the partner, fewer possibilities of having a stable, qualified and well-paid job, greater difficulty in improving their socioeconomic level and less probability of social advancement, lack of protection of the recognition of the child. Finally, based on evidence, some measures that can reduce adverse consequences on adolescent mothers, fathers and their children are suggested. PMID:22846537

Molina Cartes, Ramiro; González Araya, Electra

2012-01-01

223

Mobilization of ectopic yolk in Gallus gallus domesticus: a novel reverse lipid transport process.  

PubMed

In many oviparous animals, bursting type atresia of ovarian follicles occurs during the reproductive cycle, resulting in the escape of yolk into the extracellular compartment. In birds, this ectopic yolk is rapidly cleared by an unknown process that involves the appearance of yolk-engorged macrophage-like cells. To study this unique type of lipid transport, we injected young male chickens intra-abdominally with egg yolk. Absorption of egg yolk from the body cavity markedly increased the triacylglyceride-rich fraction (TRL) of plasma lipoproteins and was coincident with increased levels of plasma triacylglycerides (TAGs) but not non-esterified fatty acids (NEFAs). Thus, the transport of yolk lipids from the abdominal cavity appears to occur in lipoproteins and be more similar to the transport of hepatic TAGs to the periphery via lipoproteins than to transport of adipose TAGs to the periphery via NEFAs released by the action of lipases. When macrophages were exposed to yolk in vitro, they quickly phagocytized yolk; however, it is unclear whether this level of phagocytosis contributes significantly to total yolk clearance. Instead, the chicken macrophage may function more as a facilitator of yolk clearance through the modification of yolk lipoproteins and the regulation of the local and systemic immune response to ectopic yolk. Yolk appears to be anti-inflammatory in nature. Yolk did not increase levels of the inflammatory cytokines IL-1, IL-6 and IFN? either in vivo or in vitro; in fact, yolk dampened many inflammatory changes caused by lipopolysaccharide (LPS). Conversely, LPS-induced inflammation retarded yolk clearance from the abdominal cavity and plasma TAG levels. PMID:23348941

Cornax, Ingrid; Walzem, Rosemary L; Larner, Craig; Macfarlane, Ronald D; Klasing, Kirk C

2013-05-15

224

Ectopic prostatic tissue in the uterine cervix.  

PubMed

This is the first reported case of ectopic prostatic tissue in the uterine cervix, diagnosed in a 38-year-old woman. A cluster of benign prostatic glands with cribriform and papillary patterns and focal squamous metaplasia occupied the superficial endocervical stroma. The glands were immunoreactive for prostatic specific antigen and prostatic specific acid phosphatase. This lesion, which could be confused with microglandular hyperplasia, mesonephric rests, or adenocarcinoma in situ may represent an embryonic rest. PMID:9421098

Larraza-Hernandez, O; Molberg, K H; Lindberg, G; Albores-Saavedra, J

1997-07-01

225

Pregnancy in a unilaterally ovariohysterectomised queen.  

PubMed

A 4-year-old female Russian Blue cat presented with signs of right-sided abdominal distension, anorexia and a mucoid vaginal discharge. On the basis of clinical and ultrasonographical findings a tentative diagnosis of uterine torsion was made. Exploratory coeliotomy revealed a 900ş right uterine torsion along the longitudinal axis. Unilateral ovariohysterectomy was performed. Subsequently, the cat had two successful and uneventful pregnancies. To our knowledge this is the first case report of pregnancy in a unilaterally ovariohysterectomised queen. PMID:25414240

Jurka, Piotr; Kacprzak, Kamil J; Degórska, Beata

2015-04-01

226

Treatment of tubal pregnancy by laparoscopic laser surgery.  

PubMed

We present 150 consecutive cases of tubal pregnancy treated by laparoscopic techniques. A three-puncture technique was used. 74 cases were treated conservatively by linear salpingotomy with carbon dioxide laser laparoscopy and 76 cases were treated nonconservatively through the laparoscope by salpingectomy or tubal resection. Contra-indications to laparoscopic surgery were haemodynamically unstable patient and interstitial pregnancy. Seventy-five per cent of all tubal pregnancies were treated by laparoscopy in the period studied. No complications were encountered during the laparoscopic operations. Two patients needed a second laparoscopy, while 2 others underwent a subsequent laparotomy. This study has shown that tubal ectopic pregnancies can in most cases be effectively managed by laparoscopic techniques. PMID:1836086

Langebrekke, A; Kirschner, R; Skĺr, O J; Sřrnes, T; Urnes, A

1991-01-01

227

Complications In Pregnancy Part I: Early Pregnancy  

E-print Network

Complications In Pregnancy Part I: Early Pregnancy It is Sunday evening and the place is dead. You appendicitis until urine is obtained and, low and behold, she has a positive urine pregnancy test. Blood the study...... Pregnancy-related complications are, unfortunately, a common experience for women and often

228

Falloposcopic cannulation, oviductal appearances and prediction of treatment independent intrauterine pregnancy.  

PubMed

The purpose of this study was to determine whether there is an association between the appearance of the oviductal lumen during falloposcopic examination, and the occurrence of intrauterine pregnancy or ectopic pregnancy independent of treatment. Sixty-two consecutive women were recruited who were examined falloposcopically in-office, and who did not require subsequent surgical intervention to restore tubal patency. There was a heterogeneous group of presentations including unilateral and bilateral proximal tubal occlusion, unexplained infertility and the presence of minor laparoscopic abnormalities which might suggest the possibility of occult endotubal pathology. A stepwise Cox's model of life table analysis selected the number of falloposcopically normal and patent Fallopian tubes as the only variable significantly associated with intrauterine pregnancy, when all clinical, demographic and investigative data were analysed. The presence of minor distal intra-tubal adhesions was selected on stepwise analysis as the only variable significantly associated with the occurrence of ectopic pregnancy. A number of falloposcopic abnormalities were significantly associated with outcome in the clinical sub-group who presented with bilateral proximal tubal occlusion. These data suggest that falloposcopy is a valuable clinical tool which provides useful prognostic data for the prediction of intrauterine pregnancy or ectopic pregnancy. PMID:8822465

Dunphy, B C; Greene, C A

1995-12-01

229

Cardiac Circumference Measurement: Possible Screening Tool in Early Pregnancy for Anomalous Cardiac Development  

Microsoft Academic Search

Objective: In this study, cardiac circumference (CC), measured by transvaginal sonography, was analyzed to determine the growth during the early stage of pregnancy and its relationship to abdominal circumference and femur length (FL). Methods: Biometric measurements, including CC, were obtained in 1,182 euploid fetuses at 9–16 weeks’ gestation. The CC measurements were related to gestational age (GA), abdominal circumference, and

Lorenzo Guariglia; Paolo Rosati; Francesco Bartolozzi

2006-01-01

230

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

231

Parents' Grief Following Pregnancy Loss: A Comparison of Mothers and Fathers.  

ERIC Educational Resources Information Center

Examined gender differences in bereavement following miscarriage, ectopic pregnancy, stillbirth, and neonatal death. Interviewed 56 couples using Perinatal Grief Scale. Women scored significantly higher than men on most dimensions of grief at two months, one year, and two years postloss, except on dimension indicating most serious consequences of…

Stinson, Kandi M.; And Others

1992-01-01

232

Ectopic Sox3 activity elicits sensory placode formation  

Microsoft Academic Search

The induction of sensory organ placodes, in particular the lens placode, represents the paradigm for induction. We show that medaka Sox3 is expressed in the neuroectoderm and in the placodes of all sensory organs prior to placode formation and subsequently in placode-derived tissues. Ectopic Sox3 expression leads to ectopic expression of Pax6 and Eya1 in embryonic ectoderm and causes ectopic

Reinhard W. Köster; Ronald P. Kühnlein; Joachim Wittbrodt

2000-01-01

233

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

234

Endotracheal ectopic parathyroid adenoma mimicking asthma  

PubMed Central

Primary benign tumors of the trachea are uncommon. These tumors may cause tracheal occlusion and lead to a misdiagnosis of asthma. Ectopic parathyroid adenoma (EPA) can be seen anywhere between the mandibular angle and the mediastinum. The distal part of the trachea is a rare location for EPA, and EPA obstructing the endotracheal lumen has not been reported in the literature. We herein describe a 52-year-old female with a several-year history of asthma treatment who presented with progressive dyspnea. Computed tomography revealed a mass that was obstructing the tracheal lumen. Total mass excision was performed via endobronchial treatment, and pathologic examination revealed EPA.

Özgül, M. Akif; Seyhan, Ekrem Cengiz; Özgül, Güler; Çetinkaya, Erdo?an; Büyükkale, Songul; Ünver, Nurcan; Çak?r, Tansel; Sayar, Adnan

2014-01-01

235

Association between Foeto-maternal Bleeding and Hypertension in Pregnancy  

PubMed Central

A blind prospective survey of foeto-maternal bleeding in 200 primiparous pregnancies was carried out in an investigation of a possible association between foeto-maternal bleeding and hypertension in pregnancy. Evidence of foeto-maternal bleeding was found in 61% of 36 hypertensive pregnancies, and in 51% of 160 normotensive pregnancies, a difference which is not statistically significant. Significant differences between the hypertensive and the normotensive groups were found when foeto-maternal bleeding was related to gestation. In pregnancies that became hypertensive more foetal cells were found in the maternal circulation before week 36 than in normotensive pregnancies. In patients with oedema of the abdominal wall during pregnancy the incidence of foeto-maternal bleeding was significantly increased. These findings seem to explain why pre-eclamptic toxaemia is a significant predisposing factor in women who later develop Rh antibodies. It is recommended that anti-D gammaglobulin should be offered to all Rh-negative women with Rh-positive infants following a hypertensive pregnancy. Consideration should also be given to the question of administering anti-D gammaglobulin during Rh-negative hypertensive pregnancies if this procedure is proved to be both safe to mother and foetus and effective. The results provide contributory evidence that the placental vascular changes in toxaemic pregnancies precede the clinical signs and are not the result of hypertension. PMID:4186729

Jones, Peter; McNay, Angus; Walker, William

1969-01-01

236

Abdominal Aortic Aneurysm (AAA) Screening  

MedlinePLUS

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

237

Screening for Abdominal Aortic Aneurysm  

MedlinePLUS

Understanding Task Force Recommendations Screening for Abdominal Aortic Aneurysm The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation statement on Screening for Abdominal Aortic Aneurysm. This final recommendation ...

238

Acute pancreatitis in pregnancy.  

PubMed

During August 1989-August 1994 at the referral-based obstetric practice of MacKay Memorial Hospital in Taipei, Taiwan, obstetricians saw 8 pregnant women with acute pancreatitis. All but 1 patient had gallstones and/or hyperlipidemia. None had ever been diagnosed with pancreatitis or gallstones in the past. None suffered from alcoholism. One woman was lost to follow-up at 33 weeks gestation. No pregnant woman died. Magnesium sulfate and nifedipine controlled preterm labor in 2 patients. Two women underwent cesarean section (fetal distress and elective). Pancreatitis struck all but 1 during the 3rd trimester of pregnancy. One woman presented at 23 weeks gestation with loss of consciousness, abnormally low volume of circulating plasma in the body, upper gastrointestinal bleeding, and a dead fetus. She also had diabetes mellitus which had gone untreated for 2 years. After spontaneous delivery of the dead fetus, she developed metabolic encephalopathy, sepsis, respiratory distress, and acute renal failure. She completely recovered and left the hospital 62 days after arriving. Physicians instituted conservative treatment for pancreatitis and a fat-restricted diet for hyperlipidemia. Labor was induced in 3 women after determining fetal lung maturity. Pancreatitis symptoms diminished after delivery. At 2 weeks postpartum, they underwent cholecystectomy. In fact, all but 3 women underwent cholecystectomy. Five patients had a fever greater than 38 degrees Celsius upon admission. Three patients were jaundiced. All 8 patients experienced nausea and/or vomiting and abdominal pain. Six women had low serum calcium levels. Only 1 had a serum lactic dehydrogenase level above 350 IU/L. Primiparous women were just as likely to develop pancreatitis during pregnancy as multiparous women. These findings suggest that early diagnosis and prompt treatment of acute pancreatitis are essential to a favorable outcome. PMID:7660765

Chen, C P; Wang, K G; Su, T H; Yang, Y C

1995-09-01

239

Laparoscopic total abdominal colectomy  

Microsoft Academic Search

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

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

1992-01-01

240

Relaxin, CA-125, progesterone, estradiol, Schwangerschaft protein, and human chorionic gonadotropin as predictors of outcome in threatened and nonthreatened pregnancies.  

PubMed

Progesterone (P), estradiol (E2), relaxin, CA-125, Schwangerschaft protein, and human chorionic gonadotropin (hCG) were measured in 221 pregnancies (less than or equal to 77 days gestation). The cohort was divided into asymptomatic subjects (group I, n = 117) and those with threatening symptoms (group II, n = 104). Outcome was ascertained as viable (normal at 14 weeks, n = 131), spontaneous abortion (n = 58), or ectopic gestation (n = 32). Statistical analysis revealed no differences in the mean maternal or gestational ages among the viable pregnancies, abortions, and ectopics in group I and group II. In group I, significant differences in the means were noted for P, hCG, relaxin, and CA-125 among those destined to abort, compared with those who were not. In group II, differences were noted in P, hCG, relaxin, and E2 when viable and nonviable pregnancies were compared. Within group II, there were significant differences between the means of E2 and CA-125 when the aborters were contrasted with ectopics. Receiver operating characteristic curve analysis revealed that P was the single most reliable predictor and was most effective in threatened pregnancies. Stepwise logistic regression of the six markers in group II provided an equation of possible clinical utility in differentiating abortion versus ectopic pregnancy in threatened gestations based on CA-125 and E2 levels. PMID:2351224

Witt, B R; Wolf, G C; Wainwright, C J; Johnston, P D; Thorneycroft, I H

1990-06-01

241

Psoriasis: Pregnancy and Nursing  

MedlinePLUS

... Working With Health Plans For Your Patients Donate Pregnancy and Nursing In general, psoriasis does not affect ... for pregnancy and nursing. How psoriasis changes during pregnancy Some women see an improvement in the severity ...

242

Smoking during Pregnancy  

MedlinePLUS

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

243

Pregnancy and Medicines  

MedlinePLUS

... Our ePublications > Pregnancy and medicines fact sheet ePublications Pregnancy and medicines fact sheet Print this fact sheet ... and nurses find out about using medicines during pregnancy? Doctors and nurses get information from medicine labels ...

244

Being Overweight during Pregnancy  

MedlinePLUS

... been added to your dashboard . Being overweight during pregnancy Being overweight during pregnancy can cause complications for ... to your health care provider. What kinds of pregnancy complications can being overweight or obese cause? Before ...

245

Stress and Pregnancy  

MedlinePLUS

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

246

Heroin and Pregnancy  

MedlinePLUS

... It's been added to your dashboard . Heroin and pregnancy Heroin (also called smack or junk) is a ... liver disease Coma Can heroin cause problems in pregnancy? Yes. Using heroin during pregnancy can be dangerous, ...

247

Pregnancy and Childbirth  

MedlinePLUS

... Your Risk : Pregnancy & Childbirth Translate Text Size Print Pregnancy & Childbirth Can I Transmit HIV to My Baby? ... their babies. What Are the HIV Risks of Pregnancy and Childbirth? An HIV-positive mother who is ...

248

Caffeine in Pregnancy  

MedlinePLUS

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

249

Pregnancy and Reproductive Issues  

MedlinePLUS

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

250

Abuse during Pregnancy  

MedlinePLUS

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

251

Travel during Pregnancy  

MedlinePLUS

... time. What should I know about planning long car trips during pregnancy? During a car trip, make ... pregnancy? • What should I know about planning long car trips during pregnancy? • What should I know about ...

252

Ectopic thyroid in the adrenal gland  

Microsoft Academic Search

We report two cases of intraadrenal thyroid gland tissue, both found by abdominal computed tomography (CT) scan and ultrasound echography. Histologically, the lesions were composed of mature thyroid follicles, varying in size, and some with cystic dilatation. Immununohistochemical staining for thyroglobulin confirmed their thyroid follicular nature. In neither case was there any evidence of thyroid gland cancer or teratomatous elements.

Taizo Shiraishi; Hiroshi Imai; Kazuo Fukutome; Masatoshi Watanabe; Ryuichi Yatani

1999-01-01

253

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

254

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

255

Ectopic Sox3 activity elicits sensory placode formation.  

PubMed

The induction of sensory organ placodes, in particular the lens placode, represents the paradigm for induction. We show that medaka Sox3 is expressed in the neuroectoderm and in the placodes of all sensory organs prior to placode formation and subsequently in placode-derived tissues. Ectopic Sox3 expression leads to ectopic expression of Pax6 and Eya1 in embryonic ectoderm and causes ectopic lens and otic vesicle formation. The descendants of cells ectopically expressing Sox3-mRNA contribute to ectopic lens tissue. This suggests a permissive role for Sox3 in establishing a placodal competence. In addition, ectopic Sox3 expression leads to the dysgenesis of the endogenous sensory organs. Both effects of ectopic Sox3 expression can be separated by ectopic expression of a truncated Sox3 variant depending on its expression level. Our data suggests that Sox3 is a permissive factor for sensory placode formation and plays an important role in sensory organ development. PMID:10906460

Köster, R W; Kühnlein, R P; Wittbrodt, J

2000-07-01

256

Ectopic canine associated with a dentigerous cyst in the maxilla.  

PubMed

Ectopic eruption of a tooth is common in the dental arch, palate, and nose, but it is rare in the maxillary antrum. We present the case of a 35-year-old man with an ectopic canine and an associated dentigerous cyst in the maxillary sinus that masqueraded as an antrochoanal polyp. PMID:21674458

Thakur, Jagdeep S; Mohindroo, Narinder K; Sharma, Dev R; Minhas, Ravinder S; Thakur, Anamika

2011-06-01

257

Unilateral ectopic right kidney, an incidental finding during pelvic sonogram.  

PubMed Central

An ectopic renal kidney was found incidentally during pelvic sonogram of a woman with incomplete abortion. The importance of pelvic ectopic kidney in obstetrics and gynecology and the significance of looking for a contralateral kidney before any pelvic surgery is embarked upon are discussed. A short review of significant differential diagnosis was also made. Images Figure 1 Figure 2 PMID:17052069

Dabiri, Luqman; Cheung, Wellman

2006-01-01

258

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

259

Biomarkers in abdominal imaging  

Microsoft Academic Search

Imaging biomarkers are parameters measurable with imaging methods used to detect, stage or grade disease or assess the response\\u000a to treatment. Compared with biochemical or histological markers, imaging biomarkers have the advantage of remaining non-invasive\\u000a and being spatially and temporally resolved. Imaging biomarkers are used in multiple abdominal diseases, including cancer.\\u000a Anatomical imaging biomarkers such as the RECIST criteria are

Bernard E. Van Beers; Valérie Vilgrain

2009-01-01

260

Abdominal vascular injuries.  

PubMed

Injuries to major abdominal arteries and veins frequently are associated with exsanguinating hemorrhage and visceral ischemia. Expeditious management is the key to survival and good outcome. Knowledge of anatomic relationships between viscera and vessels forms the basis for directed dissection, optimal exposure, and lasting repair of vessels. Although penetrating mechanism of injury remains the most common cause of these injuries, trauma surgeons must be familiar with patterns of blunt trauma-mediated injury to avoid the devastating consequences of delayed management. PMID:8782475

Mullins, R J; Huckfeldt, R; Trunkey, D D

1996-08-01

261

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. PMID:25685344

Usurelu, Sergiu; Bettencourt, Vanessa; Melo, Gina

2015-01-01

262

Abdominal SPECT imaging  

SciTech Connect

Over the past several years, abdominal single photon emission computed tomography (SPECT) imaging has evolved from a research tool to an important clinical imaging modality that is helpful in the diagnostic assessment of a wide variety of disorders involving the abdominal viscera. Although liver-spleen imaging is the most popular of the abdominal SPECT procedures, blood pool imaging is becoming much more widely utilized for the evaluation of cavernous hemangiomas of the liver as well as other vascular abnormalities in the abdomen. Adjunctive indium leukocyte and gallium SPECT studies are also proving to be of value in the assessment of a variety of infectious and neoplastic diseases. As more experience is acquired in this area, SPECT should become the primary imaging modality for both gallium and indium white blood cells in many institutions. Renal SPECT, on the other hand, has only recently been used as a clinical imaging modality for the assessment of such parameters as renal depth and volume. The exact role of renal SPECT as a clinical tool is, therefore, yet to be determined. 79 references.

Van Heertum, R.L.; Brunetti, J.C.; Yudd, A.P.

1987-07-01

263

Simulated spaceflight effects on mating and pregnancy of rats  

NASA Technical Reports Server (NTRS)

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

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

1981-01-01

264

Conservative management for lingual thyroid ectopic.  

PubMed

Lingual thyroid gland is a rare clinical entity. The presence of an ectopic thyroid gland located at the base of the tongue may be presented with symptoms like dysphagia, dysphonia, and upper airway obstruction. We are introducing a case of an 8-year-old girl who had lingual thyroid that presented dysphagia and foreign body sensation in the throat. The diagnostic was reached with clinical examination, thyroid scintigraphy with Tc(99m) and ultrasound. A laryngoscopy was performed which confirmed a spherical mass at base of tongue. Investigation should include thyroid function tests. In this case we observed subclinical hypothyroidism. There are different types of surgical approaches for the treatment of this condition; however, the treatment with Levothyroxine Sodium allowed the stabilization of TSH levels and clinical improvement of symptoms in a follow-up of 2 years. PMID:25785216

Sigua-Rodriguez, Eder Alberto; Rangel Goulart, Douglas; Asprino, Luciana; de Moraes Manzano, Afonso Celso

2015-01-01

265

Conservative Management for Lingual Thyroid Ectopic  

PubMed Central

Lingual thyroid gland is a rare clinical entity. The presence of an ectopic thyroid gland located at the base of the tongue may be presented with symptoms like dysphagia, dysphonia, and upper airway obstruction. We are introducing a case of an 8-year-old girl who had lingual thyroid that presented dysphagia and foreign body sensation in the throat. The diagnostic was reached with clinical examination, thyroid scintigraphy with Tc99m and ultrasound. A laryngoscopy was performed which confirmed a spherical mass at base of tongue. Investigation should include thyroid function tests. In this case we observed subclinical hypothyroidism. There are different types of surgical approaches for the treatment of this condition; however, the treatment with Levothyroxine Sodium allowed the stabilization of TSH levels and clinical improvement of symptoms in a follow-up of 2 years. PMID:25785216

Sigua-Rodriguez, Eder Alberto; Rangel Goulart, Douglas; Asprino, Luciana; de Moraes Manzano, Afonso Celso

2015-01-01

266

Ectopic expression of the male BmDSX affects formation of the chitin plate in female Bombyx mori.  

PubMed

Mating structures are involved in successful copulation, intromission, and/or insemination. These structures enable tight coupling between external genitalia of two sexes. During Bombyx mori copulation, the double harpagones in the external genitalia of males clasp the female chitin plate, which is derived from the larval eighth abdominal segment; abnormal development of the female chitin plate affects copulation. We report that ERK phosphorylation (p-ERK) and expression of Abdominal-B (Abd-B) in the posterior abdomen of the female adult is lower than in the male. Ectopic expression of the male-specific spliced form of B. mori doublesex (Bmdsx(M)) in females, however, up-regulates Abd-B and spitz (spi) expression, increasing EGFR signaling activity, and thus forming an abnormal chitin plate and reduced female copulation. These findings indicate that Bmdsx affects the development of the eighth abdominal segment by regulating the activity of EGFR signaling and the expression of Abd-B, resulting in an extra eighth abdominal segment (A8) in males versus the loss of this segment in adult females. PMID:24420266

Duan, Jianping; Xu, Hanfu; Ma, Shangyuan; Guo, Huizheng; Wang, Feng; Zhang, Liying; Zha, Xingfu; Zhao, Ping; Xia, Qingyou

2014-03-01

267

Quick guide Male pregnancy  

E-print Network

Magazine R791 Quick guide Male pregnancy Adam G. Jones1 and John C. Avise2 Don't try this at home! Male pregnancy is an alien concept to us mammals. Yet this phenomenon is the universal reproductive `pregnancy'? During a mammalian pregnancy, the placenta allows mom to nourish her progeny in the womb

Avise, John

268

[Pregnancy-specific dermatoses].  

PubMed

Pregnancy-specific dermatoses include polymorphic eruption of pregnancy, atopic eczema of pregnancy, and pemphigoid gestationis. Intrahepatic cholestasis of pregnancy and impetigo herpetiformis are not real pregnancy-specific dermatoses but they are important to know considering the fetal and maternal risks. Polymorphic eruption of pregnancy is a pruritic disease that usually occurs in primiparous women during the last trimester of pregnancy. Atopic eczema of pregnancy is still controversial as an entity covering conditions with eczematous lesions, prurigo, or folliculitis, and inconstantly associated with a personal history of atopy. Skin biopsy with direct immunofluorescence or search for serum anti-BPAg1 (180kD) NC16a antibodies is mandatory in pruritic dermatoses of pregnancy in order to rule out pemphigoid gestationis. Serum bile salts levels should be tested whenever a generalized pruritus develops during pregnancy in order to rule out intrahepatic cholestasis. PMID:25194221

Soutou, B; Aractingi, S

2015-03-01

269

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

270

Advances in interspecific pregnancy  

Microsoft Academic Search

Interspecific pregnancy in which the conceptus and female carrying the pregnancy are of different species is a key step to\\u000a interspecific cloning. Cloning endangered animals by interspecific pregnancy is such a highlight catching people’s eyes nowadays.\\u000a In this article, the history of interspecific pregnancy, the methods for establishment of interspecific pregnancy, the corresponding\\u000a theories, barriers and applied prospects are reviewed.

Xichao Wang; Bojie Dai; Enkui Duan; Dayuan Chen

2001-01-01

271

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

PubMed Central

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

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

2014-01-01

272

Intramuscular ectopic lacrimal gland cyst masquerading as myocysticercosis.  

PubMed

Ectopic lacrimal gland within the orbit is an extremely rare choristoma occurring due to sequestration of a portion of normal lacrimal gland at an abnormal site during embryogenesis. Most cases of orbital ectopic lacrimal gland present with progressive unilateral proptosis and often become symptomatic in the first 3 decades of life. Although diagnosis is aided by a high clinical suspicion and radiologic features, histopathologic examination is confirmatory. To the best of the knowledge, the authors report the first case of an intramuscular ectopic lacrimal gland in the inferior rectus muscle simulating myocysticercosis. PMID:24492733

Pujari, Aditi; Ali, Mohammad Javed; Vemuganti, Geeta K; Naik, Milind N

2015-01-01

273

Chronic rhinorrhea revealing an actinomycotic rhinolithiasis with ectopic tooth.  

PubMed

Intranasal ectopic tooth is a rare nidus for a rhinolith where local infection may be concomitant. No description of the triple association 'actinomycotic rhinolithiasis ectopic tooth' could be found in the medical literature. Classically, the Actinomyces species are sensitive to regimens of penicillin from 6 to 12 months or longer. Immunocompetent patients can benefit from shorter courses of antibiotic therapy, such as ciprofloxacin, with a favourable outcome. The authors describe the case of a 25-year-old man who presented with an actinomycosis chronic discharge revealing actinomycosis associated with rhinolithiasis and ectopic tooth. They attempt to explain the likely mechanism of occurrence of this triple association. PMID:21865012

Zalagh, M; Akhaddar, A; Benariba, F

2012-03-01

274

Abdominal Cystic Lymphangioma Mimicking Appendicitis  

PubMed Central

A cystic lymphangioma arising within the abdomen is a rare entity in children. It may present with an abdominal mass and symptoms of abdominal pain, vomiting, and anorexia. These nonspecific clinical symptoms are often attributed to more common acute pediatric conditions. In this report, we describe two pediatric cases of intra-abdominal cystic lymphangioma that were initially diagnosed and treated as appendicitis. True diagnosis was only achieved on surgical excision and pathological investigation of cystic material.

Wake, Sarah; Abhyankar, Aruna; Hutton, Kim

2013-01-01

275

Abdominal imaging: An introduction  

SciTech Connect

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

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

1986-01-01

276

Minimally Invasive Abdominal Surgery  

PubMed Central

In the last decade, laparoscopy has been the most innovative surgical movement in general surgery. Minimally invasive surgery performed through a few small incisions, laparoscopy is the standard of care for the treatment of gallbladder disease and the gold standard for the treatment of reflux disease. The indications for a laparoscopic approach to abdominal disease continue to increase, and many diseases may be treated with laparoscopic techniques. At Ochsner, laparoscopic techniques have demonstrated better cosmetic results, shorter recovery times, and an earlier return to normal activity compared with open surgery. PMID:21765684

Richardson, William S.; Carter, Kristine M.; Fuhrman, George M.; Bolton, John S.; Bowen, John C.

2000-01-01

277

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

278

Uterine artery embolization with methotrexate infusion as treatment for cesarean scar pregnancy. Case report.  

PubMed

Cesarean scar pregnancy is a rare form of ectopic pregnancy. It is associated with many complications, including a high risk of massive bleeding and hysterectomy under unfavorable conditions. Conservative treatment with systemic methotrexate (MTX) has been used preferentially with the aim of allowing the patient to have a reproductive future. However, cases of complex ectopic masses in a cesarean scar with guarded prognosis demand techniques that are more effective, such as uterine artery embolization (UAE) in association with intra-arterial MTX infusion. We describe the case of a 35-year-old patient in the 8th week of pregnancy who was referred to us because of genital bleeding and suspected ectopic pregnancy in the cesarean scar. After confirmation of the diagnosis, an initial attempt at systemic treatment with MTX was made. This was abandoned due to the elevation of the hepatic transaminase level. In addition, because of the complexity of the mass and the patient's desire to preserve her reproductive capacity, it was decided to perform UAE with local MTX infusion. The procedure was performed successfully and the patient's fertility was preserved. PMID:23979621

Elito Júnior, Julio; Araujo Júnior, Edward; Martins Santana, Eduardo Félix; Szejnfeld, Denis; Helfer, Talita Micheletti; Nardozza, Luciano Marcondes Machado; Moron, Antonio Fernandes

2013-09-01

279

Spontaneous rectus sheath hematoma pregnancy: case report and review of the literature.  

PubMed

Rectus sheath hematoma (RSH) is a rare, but important potential cause of acute upper abdominal pain in pregnancy. We report a patient with history of hemolysis, elevated liver enzymes, low platelets syndrome who presented with upper abdominal pain, hypotension, elevated hepatic transaminase levels, and a visibly enlarging right costal margin mass at 33 weeks' gestation. She underwent emergent cesarean delivery and upper abdominal exploration with findings of a large hematoma involving the entire right rectus sheath. The current case illustrates that the diagnosis of an RSH in pregnancy can be difficult as its presentation can mimic many common causes of abdominal pain seen outside of pregnancy, as well as many specific to pregnancy. Review of the published cases from the past 20 years shows that correct diagnosis remains difficult in pregnancy despite advances in diagnostic imaging. Although management of an RSH outside of pregnancy is frequently conservative, it is very often treated surgically in pregnant patients and often leads to preterm delivery. PMID:20955630

Tolcher, Mary C; Nitsche, Joshua F; Arendt, Katherine W; Rose, Carl H

2010-08-01

280

Complications of misdiagnosis of maxillary canine ectopic eruption.  

PubMed

Ectopic eruption of maxillary canines can be associated with root resorption of adjacent teeth. This case report describes and discusses an interesting case of a 15-year-old girl with a Class III malocclusion and an impacted maxillary canine. Because of the unfavorable position of the ectopic canine and the severe root resorption of the maxillary left central and lateral incisors, the treatment options included extraction of the maxillary permanent canines. The mandibular first premolars were extracted to compensate for the Class III malocclusion. A panoramic radiograph taken earlier in the mixed dentition already indicated a possible eruption disturbance of the maxillary left permanent canine. The importance of early diagnosis of maxillary canine ectopic eruption is highlighted in this case report. The early identification of radiographic signs of an ectopic pathway of eruption should be followed by deciduous canine extraction to prevent canine retention and maxillary incisor root resorption. PMID:22858336

Garib, Daniela Gamba; Janson, Guilherme; Baldo, Taiana de Oliveira; dos Santos, Patrícia Bittencourt Dutra

2012-08-01

281

Transitional cell carcinoma in a duplicated ectopic ureter  

Microsoft Academic Search

We report a case of transitional cell carcinoma occurring within an ectopically located upper pole ureter of a completely duplicated collecting system in an 81-year-old man. Presentation, evaluation, and management issues are discussed.

Scott D. Dudak; Rafael A. Antun

1995-01-01

282

Ectopic lymphoid-like structures in infection, cancer and autoimmunity.  

PubMed

Ectopic lymphoid-like structures often develop at sites of inflammation where they influence the course of infection, autoimmune disease, cancer and transplant rejection. These lymphoid aggregates range from tight clusters of B cells and T cells to highly organized structures that comprise functional germinal centres. Although the mechanisms governing ectopic lymphoid neogenesis in human pathology remain poorly defined, the presence of ectopic lymphoid-like structures within inflamed tissues has been linked to both protective and deleterious outcomes in patients. In this Review, we discuss investigations in both experimental model systems and patient cohorts to provide a perspective on the formation and functions of ectopic lymphoid-like structures in human pathology, with particular reference to the clinical implications and the potential for therapeutic targeting. PMID:24948366

Pitzalis, Costantino; Jones, Gareth W; Bombardieri, Michele; Jones, Simon A

2014-07-01

283

Pruritus in pregnancy  

PubMed Central

Abstract Question Some of my pregnant patients complain about pruritus. Are there conditions in pregnancy that present with pruritus that might put the mother or fetus at risk? Answer Although most cases of pruritus can be attributed to itchy dry skin, there are conditions unique to pregnancy that involve pruritus as a leading symptom. These include pemphigoid gestationis, pruritic urticarial papules and plaques of pregnancy, intrahepatic cholestasis of pregnancy, and atopic eruption of pregnancy. These conditions are associated with severe pruritus and some might be associated with adverse fetal outcomes. Clinical history and physical examination are the most important diagnostic clues when evaluating pruritus in pregnancy. PMID:24336540

Bergman, Hagit; Melamed, Nir; Koren, Gideon

2013-01-01

284

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

285

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

286

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

287

Simultaneous bilateral tubal pregnancy after intracytoplasmic sperm injection treated by conservative medical treatment. Interest of sonographic follow-up.  

PubMed

We describe a case of early bilateral tubal pregnancy diagnosed by transvaginal ultrasonography after intracytoplasmic sperm injection (ICSI) and embryo transfer (ET). A follow-up by transvaginal sonography was done with a systematic second scan (5 days) after the first diagnosis of left tubal ectopic pregnancy in case of assisted conception procedure. This follow-up sonographic strategy permitted us to perform a conservative treatment for this case of spontaneous bilateral tubal pregnancy by two consecutive (left then right) in-situ methotrexate injections under vaginal ultrasonographic guidance without any complications. PMID:11134843

Mock, P; Olivennes, F; Doumerc, S; Frydman, R; Fernandez, H

2001-01-01

288

Case Report: Adrenal LH\\/hCG Receptor Overexpression and Gene Amplification Causing Pregnancy-Induced Cushing’s Syndrome  

Microsoft Academic Search

Transient pregnancy-induced Cushing’s syndrome (CS) is extremely rare, with only several cases reported in the literature.\\u000a Ectopic LH\\/hCG-receptors (LHCGR) in the adrenal gland have been suggested to be involved in the pathogenesis of this condition.\\u000a We report the clinical, molecular, and genetic features of a patient with pregnancy-induced CS. A 29-year-old female patient\\u000a developed CS during multiple pregnancies, leading to

Michael Herman Chui; Nese Colak Özbey; Shereen Ezzat; Yersu Kapran; Yesim Erbil; Sylvia L. Asa

2009-01-01

289

FACT SHEETS HIV and Pregnancy  

E-print Network

FACT SHEETS HIV and Pregnancy HIV Testing and Pregnancy Mother-to-Child Transmission of HIV Anti-HIV Medications for Use in Pregnancy Safety of Anti-HIV Medications During Pregnancy Preventing Transmission and Pregnancy These fact sheets on HIV and pregnancy are intended for women infected with HIV who are pregnant

Levin, Judith G.

290

Paroxetine (Paxil) and Pregnancy  

MedlinePLUS

... risks of untreated depression during pregnancy. Can J Psychiatry 49(11):726-735. Chambers C, et al. ... with use of paroxetine during pregnancy. Am J Psychiatry AiA:1-5. Einarson A, et al. 2009. ...

291

Pseudoephedrine, Phenylephrine and Pregnancy  

MedlinePLUS

... visit us online at: www.OTISpregnancy.org . Pseudoephedrine, Phenylephrine and Pregnancy In every pregnancy, a woman starts ... your health care professional. What are pseudoephedrine and phenylephrine? Pseudoephedrine and phenylephrine are oral decongestants that are ...

292

Valproic Acid and Pregnancy  

MedlinePLUS

... visit us online at: www.OTISpregnancy.org . Valproic acid and Pregnancy In every pregnancy, a woman starts ... from your health care professional. What is valproic acid? Valproic acid is a medication commonly used to ...

293

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 ...

294

Pregnancy and Fifth Disease  

MedlinePLUS

... Cheek Rash Parvovirus B19 and Other Illnesses References Pregnancy and Fifth Disease Recommend on Facebook Tweet Share ... with fifth disease. Testing for Parvovirus B19 During Pregnancy A blood test for parvovirus B19 can show ...

295

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. ...

296

Alcohol during Pregnancy  

MedlinePLUS

... It's been added to your dashboard . Alcohol during pregnancy Drinking alcohol when you're pregnant can be ... preterm birth and stillbirth . How does alcohol during pregnancy harm your baby? When you drink alcohol during ...

297

Pregnancy and Nutrition  

MedlinePLUS

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

298

E. Coli and Pregnancy  

MedlinePLUS

... or visit us online at: www.OTISpregnancy.org . E. coli and Pregnancy In every pregnancy, a woman starts ... advice from your health care provider. What is E. coli? E. coli (Escherichia coli) is a bacterium that ...

299

STDs and Pregnancy  

MedlinePLUS

STDs & Pregnancy - CDC Fact Sheet Women who are pregnant can become infected with the same sexually transmitted diseases (STDs) ... she becomes pregnant. Can STDs be treated during pregnancy? STDs, such as chlamydia, gonorrhea, syphilis, trichomoniasis and ...

300

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/ ...

301

American Pregnancy Association  

MedlinePLUS

... development. During pregnancy,… READ MORE Mercury Levels in Fish Despite the previous concern regarding mercury levels in ... is. Find out how. READ MORE Omega-3 Fish Oil and Pregnancy Scientific research is constantly expanding ...

302

Montelukast (Singulair) and Pregnancy  

MedlinePLUS

... or visit us online at: www.OTISpregnancy.org . Montelukast (Singulair ® ) and Pregnancy In every pregnancy, a woman ... advice from your health care professional. What is montelukast? Montelukast (Singulair ® ) is an asthma and allergy medication ...

303

Ibuprofen and Pregnancy  

MedlinePLUS

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

304

Miglustat (Zavesca) and Pregnancy  

MedlinePLUS

... a type of treatment used in individuals where enzyme replacement therapy is not recommended. People with Gaucher disease have ... OTIS fact sheets Gaucher Disease in Pregnancy and Enzyme Replacement Therapy for Treatment of Gaucher Disease in Pregnancy and ...

305

Mirtazapine (Remeron) and Pregnancy  

MedlinePLUS

... al. 2006. Exposure to mirtazapine during pregnancy: a prospective, comparative study of birth outcomes. J Clin Psychiatry ... antidepressant exposure in pregnancy: results of a large prospective cohort study. Can J Psychiatry 54(4): 242- ...

306

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 ...

307

Etanercept (Enbrel) and Pregnancy  

MedlinePLUS

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

308

Staphylococcus aureus and Pregnancy  

MedlinePLUS

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

309

CASE REPORT An Unusual Case of Abdominal Compartment Syndrome Following Resection of Extensive Posttraumatic Mesenteric Ossification  

PubMed Central

Introduction: Heterotopic mesenteric ossification is an extremely rare condition, which often follows trauma and is frequently symptomatic. To date, there are no reports in the literature of abdominal compartment syndrome occurring after surgical resection of mesenteric calcification. The present report documents an unusual case of compartment syndrome complicating resection of extensive mesenteric calcification despite abdominal closure with the components-separation technique. Method: A 48-year-old man undergoing components-separation technique for posttraumatic laparostomy hernia repair (ileostomy reversal and sigmoid stricture correction) was found to have extensive heterotopic mesenteric calcification, which needed resection. Results: Resection of the mesenteric calcification was complicated by intraoperative hemorrhage and unplanned small bowel resection. Later the patient developed secondary hemorrhage leading to an abdominal compartment syndrome, which was successfully treated by decompression, hemostasis, and Permacol-assisted laparotomy wound closure. The patient remains symptom-free more than 2 years after surgery. Discussion: The case herein reported gives an account of the rare occurrence of abdominal compartment syndrome following resection of posttraumatic ectopic mesenteric ossifications. It is highly unusual in that it occurred because of “secondary hemorrhage” and despite abdominal closure with the components-separation technique, which had been undertaken precisely to prevent compartment syndrome with direct closure. It therefore highlights the need for continued clinical vigilance in complex posttraumatic cases. PMID:23573333

Nabulyato, William M.; Alsahiem, Hebah; Hall, Nigel R.; Malata, Charles M.

2013-01-01

310

Addiction in Pregnancy  

Microsoft Academic Search

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

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

2010-01-01

311

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 ...

312

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 ˝ an ... 1 in 120 pregnancies at 15 to 20 weeks gestation. Most disappear during pregnancy or within several ...

313

Pregnancy Declaration Form Date: ______________  

E-print Network

Pregnancy Declaration Form Date: ______________ To: Curtis Plotkin., Radiation Safety Officer From this pregnancy. * The NRC defines a declared pregnant woman as "a woman who has voluntarily informed her employer in writing of her pregnancy and estimated date of conception." 9/20/11 tw #12;

de Lijser, Peter

314

Adolescent Pregnancy Prevention Programs  

Microsoft Academic Search

Adolescent pregnancy and parenting remains a pressing social and public health concern because the United States continues to have the highest teen pregnancy rate among Western developed nations and because of the attendant social, psychological, and physical problems for young parents and their children. Prevention efforts to reduce the incidence of pregnancy and parenting among all teens continue to be

Jeanne A. Saunders

2005-01-01

315

Liver disease in pregnancy  

PubMed Central

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

Lee, Noel M; Brady, Carla W

2009-01-01

316

Laparoscopic cholecystectomy during pregnancy  

Microsoft Academic Search

Summary  There is a strong association between pregnancy and gallstones. When acute cholecystitis or recurring bouts of biliary colic occur during pregnancy, medical therapy is usually initiated but occasionally fails. Laparoscopic cholecystectomy has recently been described for the treatment of symptomatic cholelithiasis, but many authors consider pregnancy to be an absolute contraindication to this operation. We herein describe the management of

Nathaniel J. Soper; John G. Hunter; Roy H. Petrie

1992-01-01

317

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. PMID:25657937

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

2014-01-01

318

Laparoscopy During Pregnancy: A Literature Review  

PubMed Central

Objective: To review the literature regarding the role of laparoscopy during pregnancy, particularly adnexal mass and non-obstetric surgery, incorporating the results of a series of 9 cases of laparoscopy during pregnancy at our centers. Materials and Methods: A Medline search was performed to review the literature, and the reference lists provided by those articles were further explored for citations regarding laparoscopic adnexal surgery, appendectomy, and cholecystectomy. Our series of 9 patients consisted of pregnant patients with adnexal mass or acute abdomen who would otherwise have undergone exploratory laparotomy. Follow-up data for these 9 cases were collected by office visits, inquiry to the primary referring physicians, and telephone calls to the patient. Results: The literature search yielded 42 additional cases of operative pelvic laparoscopy and 51 cases of abdominal operative laparoscopy (cholecystectomy and appendectomy). The publications, particularly regarding cholecystectomy, were supportive of the laparoscopic approach during pregnancy. All of the patients in our series had favorable outcomes. Conclusions: Advanced operative laparoscopy has been successfully performed for certain indications during pregnancy. PMID:9876642

Tazuke, Salli; Nezhat, Ceana H.; Seidman, Daniel S.; Phillips, Douglas R.; Nezhat, Camran R.

1997-01-01

319

Abdominal Mondor's disease presenting as acute abdominal pain.  

PubMed

We describe here the case of 41 yrs old male patient, who was admitted to the emergency department complaining for abdominal pain lasting for two days. The patient self-reported a history of idiopathic deep vein thrombosis five yrs before the visit. A subcutaneous cordlike induration, tender and painful, was clearly palpable in the left lower abdominal quadrant. Routine blood tests did not reveal any substantial abnormality, except increased D-dimer concentration. Ultrasound evaluation of the abdominal wall revealed diffuse thrombosis of the left superficial inferior epigastric vein, involving several small tributaries branches, extended until 1.5 cm from the confluence with the common femoral vein, which was finally classified as an atypical case of Abdominal Mondor's disease. Complete thrombophilia screening was negative. The patient was discharged with warfarin therapy 48 hours from admission. At 30 days follow-up, the patient self-reported a nearly complete recovery. PMID:24165464

Cervellin, Gianfranco; Creta, Michele; Riva, Michele; Di Comite, Vincenzo; Buttarelli, Lorenzo; Lippi, Giuseppe

2013-08-01

320

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

321

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

322

Clinical Therapeutics in Pregnancy  

PubMed Central

Most drugs are not tested for use during pregnancy, consequently, labeling, which may include information about fetal safety, includes nothing about dosing, efficacy, or maternal safety. Yet these are concerns of health care providers considering treatment of disease during pregnancy. Therefore, the practitioner treats the pregnant woman with the same dose recommended for use in adults (typically men) or may decide not to treat the disease at all. However, is the choice of not treating a woman during pregnancy better than dealing with the challenges which accompany treatment? This paper, which summarizes metabolic and physiologic changes induced by pregnancy, illustrates that standard adult dosing is likely to be incorrect during pregnancy. PMID:21785566

Feghali, Maisa N.; Mattison, Donald R.

2011-01-01

323

Musculoskeletal problems in pregnancy.  

PubMed

Physiological changes during normal pregnancy are likely to give rise to musculoskeletal symptoms. On the other hand, autoimmune rheumatological diseases disproportionately affect women, often presenting during the childbearing years and sometimes during pregnancy. Contrary to autoimmune rheumatological diseases, the management of non-autoimmune musculoskeletal manifestations is generally conservative and often tends to resolve after pregnancy. It is therefore important to be aware of various musculoskeletal problems seen in the course of pregnancy. In this narrative review, commonly encountered non-autoimmune musculoskeletal problems during pregnancy have been described. PMID:25253297

Thabah, Molly; Ravindran, Vinod

2015-04-01

324

[Ectopic teeth in the area of the paranasal sinuses].  

PubMed

In contrast to dentogenious affections of the sinus maxillaris ectopic or supernumerary teeth in the paranasal sinuses are seldom. Ectopic teeth located at the ostium of the sinus maxillaris are rare, intranasal teeth are very rare and ectopic/supernumerary teeth in the sinus etmoidalis are a curiosity. We report about two patients with such ectopic teeth. A 55 year old woman had a rootless tooth in her right sinus ethmoidalis which had caused a "pseudopolyposis" with consecutive nasal airway obstruction and severe headache. A 59 year old man had ectopic teeth in both sinus maxillaris which obstructed the left ostium, causing dumbness of the left cheek and severe headache. Both patients have been cured by operation. However the presented patients demonstrate that even elaborated radiological efforts could not prove diagnosis. The etiology, diagnostical steps and treatment of these teeth are discussed. The surrounding soft tissue should be examined histologically after resection of such a tooth to prevent the development of a residual cyst and to notice the extremely rare development of malignancies deriving from the highly potential tissue of the dental follicle. PMID:8365919

Weber, B P; Kempf, H G; Mayer, R; Braunschweig, R

1993-06-01

325

Osteopontin Inhibits Mineral Deposition and Promotes Regression of Ectopic Calcification  

PubMed Central

Ectopic calcification, the abnormal calcification of soft tissues, can have severe clinical consequences especially when localized to vital organs such as heart valves, arteries, and kidneys. Recent observations suggest that ectopic calcification, like bone biomineralization, is an actively regulated process. These observations have led a search for molecular determinants of ectopic calcification. A candidate molecule is osteopontin (OPN), a secreted phosphoprotein invariantly associated with both normal and pathological mineral deposits. In the present study, OPN was found to be a natural inhibitor of ectopic calcification in vivo. Glutaraldehyde-fixed aortic valve leaflets showed accelerated and fourfold to fivefold greater calcification after subcutaneous implantation into OPN-null mice compared to wild-type mice. In vitro and in vivo studies suggest that OPN not only inhibits mineral deposition but also actively promotes its dissolution by physically blocking hydroxyapatite crystal growth and inducing expression of carbonic anhydrase II in monocytic cells and promoting acidification of the extracellular milieu. These findings suggest a novel mechanism of OPN action and potential therapeutic approach to the treatment of ectopic calcification. PMID:12466120

Steitz, Susan A.; Speer, Mei Y.; McKee, Marc D.; Liaw, Lucy; Almeida, Manuela; Yang, Hsueh; Giachelli, Cecilia M.

2002-01-01

326

Hypopituitarism and successful pregnancy.  

PubMed

Hypopituitarism is a disorder characterized by the deficiency of one or more of the hormones secreted by the pituitary gland. Hypopituitarism patients may present the symptoms of amenorrhea, poor pregnancy potential, infertility, and no production of milk after delivery. Successful pregnancy in hypopituitarism patient is rare because hypopituitarism is associated with an increased risk of pregnancy complications, such as abortion, anemia, pregnancy-induced hypertension, placental abruption, premature birth, and postpartum hemorrhage. Hypopituitarism during pregnancy and perinatal period should be managed carefully. The hormone levels should be restored to normal before pregnancy. GH and HMG-hCG are combined to improve follicular growth and the success rate of pregnancy. Hypopituitary patients must be closely monitored as changes may need to be made to their medications, and serial ultrasound measurements are also necessary for fetal growth assessment. PMID:25663963

Du, Xue; Yuan, Qing; Yao, Yanni; Li, Zengyan; Zhang, Huiying

2014-01-01

327

Hypopituitarism and successful pregnancy  

PubMed Central

Hypopituitarism is a disorder characterized by the deficiency of one or more of the hormones secreted by the pituitary gland. Hypopituitarism patients may present the symptoms of amenorrhea, poor pregnancy potential, infertility, and no production of milk after delivery. Successful pregnancy in hypopituitarism patient is rare because hypopituitarism is associated with an increased risk of pregnancy complications, such as abortion, anemia, pregnancy-induced hypertension, placental abruption, premature birth, and postpartum hemorrhage. Hypopituitarism during pregnancy and perinatal period should be managed carefully. The hormone levels should be restored to normal before pregnancy. GH and HMG-hCG are combined to improve follicular growth and the success rate of pregnancy. Hypopituitary patients must be closely monitored as changes may need to be made to their medications, and serial ultrasound measurements are also necessary for fetal growth assessment. PMID:25663963

Du, Xue; Yuan, Qing; Yao, Yanni; Li, Zengyan; Zhang, Huiying

2014-01-01

328

Abdominal aortic feminism.  

PubMed

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

Mortimer, Alice Emily

2014-01-01

329

Aneurysms: abdominal aortic aneurysms.  

PubMed

Ruptured abdominal aortic aneurysms (AAAs) cause approximately 16,000 deaths per year in the United States. Smoking, male sex, advanced age, hypertension, and family history are risk factors. AAAs suspected on physical examination should be evaluated with ultrasonography. In addition, ultrasonography screening for AAA is recommend for men ages 65 to 75 years with smoking histories. For men ages 65 to 75 years who have never smoked, screening should be performed selectively, such as for those with family histories of AAA. Screening women currently is not recommended, regardless of smoking status. Surgical repair is indicated for men with AAA diameters of 5.5 cm or greater. The common practice for women is to repair AAAs with diameters of 5.0 cm or greater. For patients with smaller AAAs, cardiac risk factor management is recommended along with interval ultrasonography monitoring. Surgery is indicated if monitoring shows that an AAA is enlarging (by 1 cm or more per year) or reaches the noted limits. Repair of AAA (ruptured or unruptured) is accomplished with open surgery or endovascular procedures (eg, transcatheter placement of a stent graft). Endovascular procedures are now used more frequently than open surgery and have similar outcomes. PMID:25860135

Chun, Kevin C; Lee, Eugene S

2015-04-01

330

Cross-sectional analysis of adverse outcomes in 1,029 pregnancies of Afro-Caribbean women in Trinidad with and without systemic lupus erythematosus.  

PubMed

The objective of the study was to examine pregnancy outcomes in women with systemic lupus erythematosus (SLE) and population controls in Trinidad. We performed a cross-sectional analysis of adverse outcomes in pregnancies of Afro-Caribbean women with SLE and without SLE. One hundred and twenty-two female adult cases of SLE and 203 neighbourhood age-matched women without SLE were interviewed concerning details of their reproductive history, and the anticardiolipin antibody (ACL) status was established for women with SLE. A total of 1,029 pregnancies were reported (356 by women with SLE, 673 by women without SLE). In women with > or = 1 pregnancy the total number of pregnancies was similar in women with a diagnosis of SLE and women without; however, a lower proportion of women with SLE had ever been pregnant compared with women without SLE (80% versus 91%, P = 0.002). In multivariate logistic regression analyses adjusted for maternal age, district of residence, pregnancy order and smoking, SLE pregnancies were more than twice as likely to end in foetal death than non-SLE pregnancies (odds ratio (OR), 2.4; 95% confidence interval (CI), 1.2-4.7). This effect was driven by a large increase in the odds of stillbirth (OR, 8.5; 95% CI, 2.5-28.8). The odds of early miscarriage (OR, 1.4; 95% CI, 0.6-3.1) and of mid-trimester miscarriage (OR, 1.9; 95% CI, 0.4-9.5) were higher, but were not statistically significantly different, in SLE pregnancies than in non-SLE pregnancies. The odds of ectopic pregnancy (OR, 7.5; 95% CI, 0.9-62.5) and of preterm birth (OR, 3.4; 95% CI, 1.2-10.0) were higher in SLE pregnancies conceived after diagnosis than in non-SLE pregnancies. There was no evidence of raised levels of IgG or IgM ACL among the majority (93/97 women, 96%) of SLE cases who reported sporadic mid-trimester miscarriage or stillbirth, although there was evidence of high levels of IgM and IgG ACL among women reporting three or more miscarriages and three consecutive miscarriages, and of raised IgG ACL among those experiencing ectopic pregnancy. In conclusion, we found evidence for a large increase in risk of stillbirth in the pregnancies of Afro-Caribbean Trinidadian women with SLE (not accounted for by high ACL status). There was some evidence of an increased risk of preterm delivery and ectopic pregnancy in pregnancies conceived after a diagnosis of maternal SLE. PMID:18042277

Molokhia, Mariam; Maconochie, Noreen; Patrick, Alan Leslie; Doyle, Pat

2007-01-01

331

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

Code of Federal Regulations, 2010 CFR

...DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Abortions and Related Medical Services in Indian Health Service Facilities and Indian Health Service Programs § 136a.55...

2010-10-01

332

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

Code of Federal Regulations, 2013 CFR

...DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Abortions and Related Medical Services in Indian Health Service Facilities and Indian Health Service Programs § 136.55...

2013-10-01

333

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

Code of Federal Regulations, 2014 CFR

...DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Abortions and Related Medical Services in Indian Health Service Facilities and Indian Health Service Programs § 136a.55...

2014-10-01

334

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

Code of Federal Regulations, 2011 CFR

...DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Abortions and Related Medical Services in Indian Health Service Facilities and Indian Health Service Programs § 136.55...

2011-10-01

335

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

Code of Federal Regulations, 2014 CFR

...DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Abortions and Related Medical Services in Indian Health Service Facilities and Indian Health Service Programs § 136.55...

2014-10-01

336

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

Code of Federal Regulations, 2014 CFR

...Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS POLICIES OF GENERAL APPLICABILITY Abortions and Related Medical Services in Federally Assisted Programs of the Public Health Service § 50.308 Drugs and...

2014-10-01

337

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

Code of Federal Regulations, 2012 CFR

...Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS POLICIES OF GENERAL APPLICABILITY Abortions and Related Medical Services in Federally Assisted Programs of the Public Health Service § 50.308 Drugs and...

2012-10-01

338

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

Code of Federal Regulations, 2011 CFR

...DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Abortions and Related Medical Services in Indian Health Service Facilities and Indian Health Service Programs § 136a.55...

2011-10-01

339

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

Code of Federal Regulations, 2013 CFR

...Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS POLICIES OF GENERAL APPLICABILITY Abortions and Related Medical Services in Federally Assisted Programs of the Public Health Service § 50.308 Drugs and...

2013-10-01

340

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

Code of Federal Regulations, 2010 CFR

...Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS POLICIES OF GENERAL APPLICABILITY Abortions and Related Medical Services in Federally Assisted Programs of the Public Health Service § 50.308 Drugs and...

2010-10-01

341

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

Code of Federal Regulations, 2012 CFR

...DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Abortions and Related Medical Services in Indian Health Service Facilities and Indian Health Service Programs § 136.55...

2012-10-01

342

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

Code of Federal Regulations, 2011 CFR

...Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS POLICIES OF GENERAL APPLICABILITY Abortions and Related Medical Services in Federally Assisted Programs of the Public Health Service § 50.308 Drugs and...

2011-10-01

343

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

Code of Federal Regulations, 2013 CFR

...DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Abortions and Related Medical Services in Indian Health Service Facilities and Indian Health Service Programs § 136a.55...

2013-10-01

344

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

Code of Federal Regulations, 2012 CFR

...DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Abortions and Related Medical Services in Indian Health Service Facilities and Indian Health Service Programs § 136a.55...

2012-10-01

345

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

Code of Federal Regulations, 2010 CFR

...DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Abortions and Related Medical Services in Indian Health Service Facilities and Indian Health Service Programs § 136.55...

2010-10-01

346

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

347

Excision of ectopic mediastinal parathyroid adenoma via parasternal videomediastinoscopy.  

PubMed

Mediastinum is one of the place in which ectopic parathyroid adenomas can be located.Here, an ectopic mediastinal parathyroid adenoma, which was excised via parasternal videomediastinoscopy was presented. The patient with chronic renal insufficiency had increased calcium levels persistence after the surgery for cervical parathyroid adenoma.Radiologic and scintigraphic examinations revealed a focal intense nodule in anterior mediastinum. Parasternal videomediastinoscopy was performed via parasternal incision through the second intercostal space. Ex-vivo specimen radioactivity measurements and frozen examination confirmed parathyroid adenoma. Calcium levels were decreased dramatically after the operation. Parasternal videomediastinoscopy could be an alternative surgical way in anterior mediastinal small masses such as ectopic parathyroid adenoma. It is the first case in which parasternal videomediastinoscopy was used for excision of mediastinal parathyroid adenoma. PMID:23196665

Liman, Serife Tuba; Topcu, Salih; Dervisoglu, Erkan; Gorur, Gozde Daglioz; Elicora, Aykut; Burc, Korkmaz; Akgul, Asli Gul

2014-01-01

348

Ectopic maxillary canines: segregation analysis and a twin study.  

PubMed

The etiology of ectopic canines is controversial, with opinion divided as to a genetic or environmental mechanism. This study addressed the hypothesis that genetic factors play a role in the etiology of ectopic maxillary canines. Sixty-three probands were identified, and information on the dental status of 395 relatives was determined. Pedigrees were constructed and the Relative Risk calculated. Complex segregation analysis was carried out by means of the Pedigree Analysis Package. The best mathematical model obtained was a single dominant gene with autosomal transmission, incomplete penetrance, and highly variable expression. Only two of seven pairs of monozygotic twins were concordant for ectopic canines. This is consistent with environmental or epigenetic variables affecting the phenotype. The low concordance rate is consistent with the low penetrance determined by the segregation analysis and further supports the existence of environmental factors. PMID:18502969

Camilleri, S; Lewis, C M; McDonald, F

2008-06-01

349

Abdominal wall endometrioma: a case report and review of the literature.  

PubMed

Endometriosis is the presence of ectopic endometrial tissue that can respond to ovarian hormonal stimulation. Although it is uncommon, extrapelvic endometriosis can form a discrete mass known as an abdominal wall endometrioma. Endometriomas are thought to be caused by transfer of endometrial cells into a surgical wound, most often after a cesarean delivery. Endometriomas are diagnosed via ultrasound, computed tomography, magnetic resonance imaging, and ultrasound-guided fine needle aspiration. Treatment options can be medical, but surgical excision is the treatment of choice. Perioperative nursing care includes patient teaching, taking steps to prevent surgical site infection and inadvertent hypothermia, ensuring availability of supplies (eg, the graft for abdominal wall repair if needed), and postoperative pain management. PMID:20510946

Nissotakis, Christos; Zouros, Efstratios; Revelos, Kyriakos; Sakorafas, George H

2010-06-01

350

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

351

Fertility after conservative and radical surgery for tubal pregnancy.  

PubMed

A retrospective cohort study was set up to evaluate the effectiveness of conservative and radical surgery for tubal pregnancy towards subsequent fertility. Consecutive patients undergoing conservative or radical surgery for tubal pregnancy between January 1990 and August 1993 in two university hospitals were included in the study. Outcome measures were spontaneous intrauterine pregnancy (IUP) and repeat ectopic pregnancy (EP). Of the 135 patients analysed, 56 underwent conservative surgery and 79 underwent radical surgery. Patients treated with conservative surgery achieved a higher 3-year cumulative pregnancy rate than those treated radically (P < 0.001, log-rank test). In patients treated conservatively, there was only one spontaneous IUP in the period between 18 months and 3 years after the tubal pregnancy. In contrast, patients treated radically continued to conceive in this period. Multivariate analysis showed a fecundity rate ratio (FRR) of 1.9 [95% confidence interval (CI): 0.91 to 3.8] for IUP after conservative surgery in the first 18 months of follow-up. In patients with a history of bilateral tubal disease the FRR was 3.1 (95% CI: 0.76 to 12), whereas in patients without a history of bilateral tubal disease the FRR was 1.4 (95% CI: 0.13 to 16). The FRR for repeat EP was 2.4 (95% CI: 0.57 to 11). Our data indicate a beneficial effect of conservative surgery towards subsequent fertility that was not, however, statistically significant in the multivariate analysis. In view of these inconclusive data and the importance of this major health problem, randomized studies are required to assess whether conservative surgery really improves the fertility prospects of patients with tubal pregnancy. PMID:9740428

Mol, B W; Matthijsse, H C; Tinga, D J; Huynh, T; Hajenius, P J; Ankum, W M; Bossuyt, P M; van der Veen, F

1998-07-01

352

Pregnancy Precautions: FAQs on Pregnancy Hazards  

MedlinePLUS

... you eat during pregnancy, the better. Back Continue Computer Monitors (VDTs) Should I avoid them? No. There is no evidence that computer monitors (also called video display terminals, or VDTs) ...

353

Gene Duplication and Ectopic Gene Conversion in Drosophila  

PubMed Central

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

Arguello, J. Roman; Connallon, Tim

2011-01-01

354

Diphallus with ectopic bowel segment: a case report.  

PubMed

A 1-year-old boy presented with complete duplication of the penis, with an ectopic bowel segment as an associated anomaly. The boy had duplicated epispadiac urethras. The right one ended blindly whereas the left one was patent, leading into the bladder. There was separation of the symphysis pubis and bifid scrotum. Investigations revealed no other anomalies. A review of the literature concerning diphallus showed a preponderance of associated anomalies such as exstrophy, bladder duplication, ureteral or renal defects, and imperforate anus, but no cases with an ectopic bowel segment. We report this case because of its extreme rarity. PMID:15965694

Priyadarshi, Shivam

2005-08-01

355

Cross ectopic multicystic dysplastic kidney with ureterocele in nonectopic site  

PubMed Central

Crossed renal ectopy (CRE) is the second most common fusion anomaly of the kidney, with an incidence of 1 in 7000 autopsies; it comes in second after horseshoe kidney. Crossed renal ectopy is associated with an ectopic ureter and generally an ectopic kidney fused with a normal kidney. A 7-month-old boy who had left-to-right crossed non-fused renal ectopy and multicystic renal dysplasia with ureterocele in nonectopic kidney was reported in English language literature. In this article, we present the first case of CRE where surgical intervention has been performed. PMID:23293688

Narc?, Adnan; Korkmaz, Mevlit; Karaku?, Muhittin; ?en, Tolga Altu?; Surer, Îlham?; Çetinkur?un, Salih

2010-01-01

356

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

357

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

358

Abdominal Hysterectomy (Beyond the Basics)  

MedlinePLUS

... to prevent pregnancy before surgery. (See "Patient information: Deep vein thrombosis (DVT) (Beyond the Basics)" .) Damage to ... Postmenopausal hormone therapy (Beyond the Basics) Patient information: Deep vein thrombosis (DVT) (Beyond the Basics) Patient information: ...

359

[Thyroid illness during pregnancy].  

PubMed

Pregnancy causes a number of physiological alterations in thyroid hormone metabolism that need to be distinguished from the pathophysiological states 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:21814886

Führer, D

2011-10-01

360

[Pregnancy in Gaucher disease].  

PubMed

Gaucher disease is a lysosomal storage disorder due to deficiency of glucocerebrosidase. The association with pregnancy exposes the worsening of the disease and complications of pregnancy and puerperium. We report a case of pregnancy in a woman of 35 years, suffering from Gaucher disease type 1. Pregnancy had a favorable outcome. Complications occurred. They were kept under control. The outcome was favorable. The authors discuss the evolution of the disease during pregnancy and management of complications. They can occur during pregnancy, post-partum and breastfeeding. Support begins with preconception consultation. It involves finding and correcting the biological problems and deficiencies, and management of complications. Genetic counseling is important, it helps prevent inbreeding. PMID:23578492

Boufettal, H; Quessar, A; Jeddaoui, Z; Mahdoui, S; Noun, M; Hermas, S; Samouh, N

2014-05-01

361

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

362

Bilateral single system ectopic ureters opening into vestibule with bladder agenesis.  

PubMed

Almost 80% of ectopic ureters are associated with duplicated system, and 5-17% of ectopic ureters are bilateral. Ectopic ureters usually open into urethra, vestibule and vagina in females and into posterior urethra and seminal vesicles in males. Bilateral single-system ectopic ureter (BSSEU) is a rare entity in urology. BSSEU opening into a vestibule with the absence of urinary bladder is an extremely rare occurrence. We report such a case and briefly discuss its management. PMID:24474219

Baheti, Vishwas; Singh, Janak; Yadav, S S; Tomar, Vinay

2014-07-01

363

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

364

Taste sensitivity in pregnancy.  

PubMed

Taste sensitivity to Phenyl-thio-Carbamide (PTC) and glucose were studied in 150 females during the 3 trimesters of their pregnancy periods. The taste sensitivity to PTC was determined by Harris and Kalmus method. For taste intensity and hedonic evaluation, 7 concentrations of glucose solutions were used. Taste sensitivity to both PTC and glucose increases during the 1st trimester of pregnancy. In comparison to non-pregnant females (from previous study) taste thresholds and hedonics decreases in pregnancy. PMID:1791044

Bhatia, S; Puri, R

1991-04-01

365

Asthma in Pregnancy  

Microsoft Academic Search

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

Vanessa E. Murphy; Peter G. Gibson

366

Respiratory Physiology in Pregnancy  

Microsoft Academic Search

Pregnancy is a normal but altered physiologic state that results in significant hormonal, mechanical, and circulatory changes.\\u000a The increases in progesterone and estrogen associated with pregnancy contribute to vascular and central nervous system effects,\\u000a changes in the balance of bronchoconstrictor and bronchodilator prostanoids, and increases in peptide hormones that alter\\u000a connective tissue characteristics. The course of pregnancy is accompanied by

Meredith C. McCormack; Robert A. Wise

367

Pregnancy and Pregnancy Outcome among Women with Inflammatory Skin Diseases  

Microsoft Academic Search

Background\\/Aims: The effect of inflammatory skin diseases on pregnancy has been incompletely characterized. We sought to estimate the incidence of pregnancy and pregnancy outcomes among women with inflammatory skin diseases. Methods: Cohort study of women with atopic dermatitis (AD), psoriasis, other inflammatory skin diseases, and comparison group, followed for pregnancies and pregnancy outcomes. Results: There were 3,131 pregnancies among 64,773

John D. Seeger; Lee L. Lanza; William A. West; Carlos Fernandez; Elena Rivero

2007-01-01

368

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

369

Cushing's syndrome in pregnancy.  

PubMed

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

370

Permanent pacemakers in pregnancy.  

PubMed

Advances in cardiology and cardiovascular surgery have increased the use of permanent pacemakers in young adults such that there are more women with pacemakers becoming pregnant. This case report describes the pregnancy and delivery of a young woman with a demand pacemaker and reviews the principles of management of cardiac pacemakers in pregnancy. As part of the multidisciplinary team including cardiology, anesthesia, nursing and caring for these patients, it is important that obstetricians be informed and follow the principles of management of cardiac pacemakers in pregnancy to continue to achieve successful pregnancy outcomes. PMID:21995172

Coolen, J; Turnelp, R; Vonder Muhll, I; Chandra, S

2011-01-01

371

The tip of the iceberg: Post caesarean wound dehiscence presenting as abdominal wound sepsis  

PubMed Central

Introduction Uterine scar dehiscence can complicate caesarean section with complications like post partum hemorrhage, endomyometritis, localized/generalized peritonitis, and sepsis. Presentation of case Our patient had abdominal wound infection after LSCS surgery and features of sepsis. The wound infection was actually the presentation of a uterine scar dehiscence and localized peritonitis. Discussion Incidence of uterine scar dehiscence is around 0.6%. Presentation can be post partum hemorrhage, endomyometritis, and generalized/localized peritonitis. Peritonitis caused by uterine incisional necrosis must be dealt surgically. A high index of suspicion with appropriate investigations can highlight such problems for early treatment and cure with least morbidity especially related to further pregnancies. Conclusion Uterine scar dehiscence with infection requires high index of suspicion as rare cause for post partum localized/generalized peritonitis with sepsis. Severe abdominal wound infection after caesarean section may be associated with uterine wound dehiscence, which poses a grave risk to the mother in a future pregnancy. PMID:25728672

Bharatam, Kaundinya Kiran; Sivaraja, P.K.; Abineshwar, N.J.; Thiagarajan, Vasundhara; Thiagarajan, D.A.; Bodduluri, Sudeep; Sriraman, K.B.; Vasantha Ragavan, A.; Priya, Shanmuga

2015-01-01

372

The Association Between Prepregnancy Parental Support and Control and Adolescent Girls’ Pregnancy Resolution Decisions  

PubMed Central

Purpose To examine the influence of prepregnancy parental support and control on adolescent girls’ pregnancy resolution decisions. Methods Data from the National Longitudinal Study of Adolescent Health were analyzed. Girls whose first pregnancy reported in wave IV occurred after wave I and before age 20 were included (n = 1,107). Participants self-reported pregnancy disposition (abortion, ectopic or tubal pregnancy, miscarriage, stillbirth, live birth) for each pregnancy; responses were dichotomized as abortion versus other. Girls’ perceptions of parental support and control were measured at wave I. Controls were included for wave I age, age at pregnancy, year at the end of pregnancy, race/ethnicity, and parent characteristics (i.e., education, religious affiliation, age at first marriage, and educational expectations). Weighted multivariable logistic regression models were performed. Results Approximately 18% of girls reporting a teen pregnancy reported having an abortion. In crude analyses, parental support was marginally negatively related to abortion (odds ratio [OR] =.83, p =.06) and parental control was significantly negatively related to abortion (OR = .78, p = .02). In multivariable analyses, higher parental control was significantly negatively related to abortion versus other pregnancy outcomes (adjusted OR .80, 95% confidence interval .66–.98). Perceived parental support was unassociated with pregnancy resolution decisions. The only other factor associated with abortion decisions was parent education: odds of choosing abortion versus other pregnancy outcomes were significantly higher for adolescent girls whose parents had a bachelor’s degree or greater versus those with lower educational attainment. Conclusions Pregnant adolescents with less educated parents or parents exercising greater control were less likely to have an abortion. PMID:23763966

Madkour, Aubrey Spriggs; Xie, Yiqiong; Harville, Emily W.

2013-01-01

373

Laparoscope resection of retroperitoneal ectopic insulinoma: A rare case.  

PubMed

Ectopic insulinoma is a very rare and dormant tumor. Here we report the case of a 79-year-old female who presented with repeated episodes of hypoglycemia and was diagnosed with insulinoma based on laboratory and imaging examinations. Computed tomography and positron emission tomography revealed a tumor in the retroperitoneum under and left of the hepatoduodenal ligament, which was resected successfully using a laparoscopic approach. Pathologic results revealed an ectopic insulinoma, which was confirmed immunohistochemically. Ectopic insulinomas are accompanied by hypoglycemia that can be misdiagnosed as drug- or disease-induced. These tumors are difficult to diagnose and locate, particularly in atypical cases or for very small tumors. Synthetic or targeted examinations, including low blood glucose, elevated insulin, proinsulin, and C-peptide levels, 48-h fasting tests, and relevant imaging methods should be considered for suspected cases of insulinoma. Surgery is the treatment of choice for patients with insulinoma, and laparoscopic resection is a feasible and effective method for select ectopic insulinoma cases. PMID:25892896

Liu, Jie; Zhang, Cheng-Wu; Hong, De-Fei; Wu, Jia; Yang, Hong-Guo; Chen, Yuan; Zhao, Da-Jian; Zhang, Yu-Hua

2015-04-14

374

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

375

/sup 123/I-metaiodobenzylguanidine scintigraphy of ectopic intracranial retinoblastoma  

SciTech Connect

Radioiodinated metaiodobenzylguanidine (MIBG) has been used for diagnostic purposes to image neural crest tumors. We report the uptake of /sup 123/I MIBG in a child with ectopic intracranial retinoblastoma. It is felt that /sup 123/I MIBG scintigraphy may have a role in detecting occult metastatic disease in these patients.

Bomanji, J.; Kingston, J.E.; Hungerford, J.L.; Britton, K.E.

1989-01-01

376

Pleomorphic adenoma of a subconjunctival ectopic lacrimal gland  

PubMed Central

This report describes a case of pleomorphic adenoma of an ectopic lacrimal gland arising subconjunctivally in the lateral fornix in a 13-year-old girl. The tumor was removed surgically in toto with the capsule. This is probably the first reported case. PMID:20413934

Patyal, S; Banarji, Ajay; Bhadauria, Madhu; Gurunadh, V S

2010-01-01

377

Role of Carbonic Anhydrase 2 (CAR2) in Ectopic Calcification  

PubMed Central

Introduction Osteopontin (OPN) is a potent inhibitor of ectopic calcification. Previous studies suggested that, in addition to blocking apatite crystal growth, OPN promoted regression of ectopic calcification by inducing the expression of acid-generating carbonic anhydrase II (CAR2) in monocyte-derived cells. Methods To test this hypothesis, OPN and CAR2 expression and calcification of subcutaneously implanted glutaraldehyde fixed bovine pericardium (GFBP) were studied in CAR2 mutant mice. Results Consistent with previous studies in Black Swiss mice, GFBP calcified to a greater extent in OPN-/- mice compared to OPN+/+ mice on the C57Bl/6 background. GFBP implanted in CAR2 deficient mice (CAR2-/-) were significantly more calcified than those implanted into wildtype mice (CAR2+/+) (37 + 5 versus 20 + 6.5 ug Ca/mg tissue, respectively at 30 days (p<.001), and 42 + 5 versus 20 + 4 ug Ca/mg tissue at 60 days, respectively (p<.001)). On the other hand, OPN levels within and surrounding the implants were similar in CAR2+/+ and CAR2-/- mice, suggesting that OPN expression in the absence of CAR2 was not sufficient to mitigate ectopic calcification. Conclusions These results indicate that CAR2 expression is an important regulator of ectopic calcification, potentially by facilitating OPN mediated mineral regression. PMID:18402839

Rajachar, Rupak M.; Tung, Elyse; Truong, Anh Q.; Look, Amy; Giachelli, Cecilia M.

2014-01-01

378

Brief review of models of ectopic bone formation.  

PubMed

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; James, Aaron W

2012-03-20

379

Laparoscope resection of retroperitoneal ectopic insulinoma: A rare case  

PubMed Central

Ectopic insulinoma is a very rare and dormant tumor. Here we report the case of a 79-year-old female who presented with repeated episodes of hypoglycemia and was diagnosed with insulinoma based on laboratory and imaging examinations. Computed tomography and positron emission tomography revealed a tumor in the retroperitoneum under and left of the hepatoduodenal ligament, which was resected successfully using a laparoscopic approach. Pathologic results revealed an ectopic insulinoma, which was confirmed immunohistochemically. Ectopic insulinomas are accompanied by hypoglycemia that can be misdiagnosed as drug- or disease-induced. These tumors are difficult to diagnose and locate, particularly in atypical cases or for very small tumors. Synthetic or targeted examinations, including low blood glucose, elevated insulin, proinsulin, and C-peptide levels, 48-h fasting tests, and relevant imaging methods should be considered for suspected cases of insulinoma. Surgery is the treatment of choice for patients with insulinoma, and laparoscopic resection is a feasible and effective method for select ectopic insulinoma cases.

Liu, Jie; Zhang, Cheng-Wu; Hong, De-Fei; Wu, Jia; Yang, Hong-Guo; Chen, Yuan; Zhao, Da-Jian; Zhang, Yu-Hua

2015-01-01

380

Ectopic ureter with complete ureteric duplication: Conservative surgical management  

Microsoft Academic Search

To assess the outcome of conservative procedures, the authors reviewed their experience in the management of 31 ectopic ureters with complete ureteric duplication. Twentyeight girls and three boys (aged 19 days to 10 years; mean, 30 months) were operated on between 1968 and 1994. Twentyfour of the children presented for evaluation of dribbling urinary incontinence and\\/or febrile urinary tract infections;

Alaa El Ghoneimi; Josefina Miranda; Tam Truong; Gerard Monfort

1996-01-01

381

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

382

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

383

An ectopic breast tissue presenting with fibroadenoma in axilla.  

PubMed

Introduction. The congenital anomalies of breast, especially the polymastia (supernumerary breast) and polythelia (supernumerary nipple), always do not fail to amuse the clinicians because of their varied presentations, associated renal anomalies, and pathologies arising from them. The axillary polymastia is a variant of ectopic breast tissue (EBT). Ectopic breast tissue can undergo the same physiological and pathological processes as the normally located breast. The incidence of fibroadenoma developing in ectopic breast is reported as a rare entity, the most common being the carcinoma. Case Presentation. A 31-year-old Dravidian female presented with a lump of 4?cm in the right axilla for the past year which gradually increased in size, giving discomfort. Our initial differential diagnosis was fibroadenoma, lipoma, and lymphadenopathy. Further investigation and histopathological report of excision biopsy confirmed it as a fibroadenoma on ectopic breast tissue in the axilla. Patient has no associated urological or cardiac anomaly. Conclusion. This case has been reported for its rarity and to reemphasise the importance of screening of EBT for any pathology during routine screening of breast. PMID:23607040

Amaranathan, Anandhi; Balaguruswamy, Kanchana; Bhat, Ramachandra V; Bora, Manash Kumar

2013-01-01

384

Simple Treatment of Ectopic Eruption With a Triangular Wedging Spring  

Microsoft Academic Search

The purpose of this clinical report was to introduce a simple and effective way of per- forming 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

Yong Heon Kim

2005-01-01

385

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

386

Understanding Pregnancy and Birth Issues  

MedlinePLUS

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

387

[Surgery of ectopic ureterocele in children: strategy based on prenatal function].  

PubMed

From 1981 to 1993, we have treated 31 pediatric patients with ectopic ureterocele (associated to duplex system, intra and extravesicals). Diagnostic work-up included abdominal ultrasound, intravenous urography (IVU), sequence mictional cystouretrography (SM-CU) and diuresis renography (DTPA-DMSA o MAG-3). Patients were divided in two groups: 1. Good renal function in the affected system (5 cases) with 2 endoscopic incision of the ureterocele and 3 without surgical treatment (all intravesical). 2. Almost non-existent ipsilateral renal function (26 cases), treated by heminephrectomy and ureterocelic aspiration, and in the remaining a nephrectomy was done for ipsilateral non-existent renal function. 2 cases treated by endoscopic incision presented vesicoureteral reflux, and 4 cases treated by nephrectomy had a low grade reflux. There is no a definite treatment established. The choice should by made based on renal function. Endoscopic incision is a good choice in obstructed cases with good renal function. In those with no function at all, heminephrectomy with aspiration of the ureterocele will be the best treatment if we consider that almost 50 percent of the patients will need a second surgical procedure. PMID:8527314

Encinas Goenechea, A; Gómez Fraile, A; Aransay Bramtot, A; López Vázquez, F; Matute de Cárdenas, J A

1995-07-01

388

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

389

Lap Pak for Abdominal Retraction  

PubMed Central

Retraction of the bowels during abdominal surgery is generally facilitated by the use of a combination of various retractors along with surgical towels or sponges. The use of surgical towels and sponges may lead to retained foreign bodies or adhesions. In addition, these towels and sponges often require manipulation during long surgical procedures. The ideal way to avoid these problems in abdominal surgery is to develop a technique for retraction of the abdominal contents that eliminates the requirement for these foreign bodies. This article presents the results of a small trial for Lap Pak (Seguro Surgical, Columbia, MD), a disposable radio-opaque device that is made of silicone and retracts the bowels in a cephalad orientation without the need for towels or sponges. PMID:23526186

Sivarajan, Ganesh; Chang, Sam S; Fergany, Amr; Malkowicz, S. Bruce; Steinberg, Gary D; Lepor, Herbert

2012-01-01

390

Pregnancy and Perinatology Branch (PPB)  

E-print Network

Pregnancy and Perinatology Branch (PPB) NICHD Report to the NACHHD Council September 2008 U ............................................................................................. 52 INSTITUTE OF MEDICINE (IOM) PREGNANCY WEIGHT GUIDELINES

Rau, Don C.

391

Abdominal Bloating: Pathophysiology and Treatment  

PubMed Central

Abdominal bloating is a very common and troublesome symptom of all ages, but it has not been fully understood to date. Bloating is usually associated with functional gastrointestinal disorders or organic diseases, but it may also appear alone. The pathophysiology of bloating remains ambiguous, although some evidences support the potential mechanisms, including gut hypersensitivity, impaired gas handling, altered gut microbiota, and abnormal abdominal-phrenic reflexes. Owing to the insufficient understanding of these mechanisms, the available therapeutic options are limited. However, medical treatment with some prokinetics, rifaximin, lubiprostone and linaclotide could be considered in the treatment of bloating. In addition, dietary intervention is important in relieving symptom in patients with bloating. PMID:24199004

Seo, A Young; Oh, Dong Hyun

2013-01-01

392

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

393

Thyroid Function during Pregnancy  

Microsoft Academic Search

Background: This Case Conference reviews the normal changes in thyroid activity that occur during pregnancy and the proper use of laboratory tests for the diagnosis of thyroid dysfunction in the pregnant patient. Case: A woman in the 18th week of pregnancy pre- sented with tachycardia, increased blood pressure, se- vere vomiting, increased total and free thyroid hormone concentrations, a thyroid-stimulating

Corinne R. Fantz; Samuel Dagogo-Jack; Jack H. Ladenson; Ann M. Gronowski

394

Perineal Massage in Pregnancy  

MedlinePLUS

... massage. Does Perineal Massage in Pregnancy Help All Women? Massage seems to work better for some women than ... Volume 50, No. 1, January/February 2005 With women, for a lifetime™ AMERICAN COLLEGE OF NURSE-MIDWIVES PERINEAL MASSAGE IN PREGNANCY

395

Prolactinomas, cabergoline, and pregnancy.  

PubMed

Hyperprolactinemia, frequently caused by a prolactinoma, is an important cause of infertility among young women. Dopamine agonists (DA) are the treatment of choice. Although cabergoline (CAB) is currently considered the gold standard DA, bromocriptine (BRC) remains the drug of choice for women desiring pregnancy, as it was proven to be safe in more than 6,000 pregnancies. The purpose of this review is to perform a critical evaluation of CAB safety in pregnancy, as it is used by most patients harboring prolactinomas. Although the number of CAB-induced pregnancies (about 800) is still reduced as compared with those under BRC treatment, data in the literature do not point to increase risk of preterm delivery or fetal malformations, comparing to pregnancies induced by BRC and those in the general population. Moreover, CAB use throughout pregnancy was reported in about ten cases, without evidence of any harm to fetal development. Therefore, even though BRC still remains the recommended DA drug for pregnancy induction or use during pregnancy in women with prolactinomas, increasing evidences point to the safety of CAB for this purpose. PMID:24985062

Glezer, Andrea; Bronstein, Marcello D

2014-09-01

396

Orthopedic considerations in pregnancy  

Microsoft Academic Search

Almost all pregnant women experience musculoskeletal discomfort during pregnancy, with a good portion of them suffering from severe disability. The purpose of this article is to review normal physiologic musculoskeletal changes of pregnancy and distinguish them from pathological conditions. This article also will offer solutions to reduce patient pain or discomfort and call attention to some serious conditions that must

Jacqueline E. Monaco

1996-01-01

397

Pregnancy Complications in PCOS  

Microsoft Academic Search

A higher prevalence of several complications of pregnancy in women with polycystic ovary syndrome (PCOS), compared with healthy\\u000a mothers with no PCOS, has been described. These include an increased prevalence of spontaneous miscarriage, gestational diabetes,\\u000a pre-eclamptic toxaemia and pregnancy-induced hypertension (PIH) and the birth of small-for-gestational-age (SGA) babies.

Roy Homburg

398

Pregnancy and liver transplantation.  

PubMed

Since the first pregnancy in a transplant recipient in 1958, pregnancy in recipients of solid organ transplants has become increasingly common. Although previously considered a hazardous event, data collected over the last 50 years demonstrate that despite an increased risk of maternal and fetal complications, pregnancy in transplant recipients can have a successful outcome. As of 2006, there were over 3000 female liver transplant recipients of childbearing age in the USA. Two hundred and two pregnancies and 205 outcomes were reported in 121 liver transplant recipients in the National Transplantation Pregnancy Registry. Children born to female liver recipients have a greater risk of prematurity and low birth weight than the general population, but no malformation patterns have been observed. Mothers are more likely to experience pregnancy-induced hypertension, pre-eclampsia and caesarian section, but overall mortality is not worse. Rates of acute rejection and graft loss are similar to nonpregnant liver recipients. The optimal timing of conception post-transplant is controversial, but current recommendations suggest waiting for at least 1 year after transplantation. Choice of contraception is also debatable, although barrier methods have traditionally been preferred. Many medications used for post-transplant immunosuppression have potential effects during pregnancy and breast-feeding. The risks and benefits of each medication should be reviewed with patients contemplating pregnancy, and regimens should be tailored accordingly. PMID:18822076

Surti, Bijal; Tan, Jennifer; Saab, Sammy

2008-11-01

399

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 ...

400

Pregnancy Complications: Preexisting Diabetes  

MedlinePLUS

... during pregnancy. Specialists include a perinatologist, who treats women with high-risk pregnancies, and an endocrinologist, who treats women ... may have, such as high blood pressure or high cholesterol. Most healthy pregnant women need at least 2 1/2 hours of ...

401

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

402

Abdominal Fibromatosis in a Young Child: A Case Study and Review of the Literature  

PubMed Central

Fibromatoses comprise many different entities of well-differentiated fibroblastic proliferation with variable collagen production and form a firm nodular mass. Abdominal fibromatosis is distinguishable from other forms of fibromatosis because of its location and its tendency to occur in women of childbearing age during or following pregnancy. Abdominal fibromatosis in children is an extremely rare condition. A 15-month-old boy presented with an abdominal wall mass that had recently increased in size. Mass excision was perfomed. The tumor was 4.3×4.1 cm and partly circumscribed. Histologically, the tumor was composed of parallel long fascicles of spindle-cells with a uniform appearance. The edges of the resected mass were infiltrative, and the surgical margins were positive. Mitotic figures were <1/10 high power fields. No cellular atypia or necrosis was present. The tumor cells were positive for vimentin and nuclear ?-catenin staining. PMID:24255636

Chu, Hyun Hee; Hwang, Pyoung Han; Jeong, Yeon Jun

2013-01-01

403

[Hypothyroidism in pregnancy].  

PubMed

Because of its frequent occurrence during the reproductive period of a woman's life, hypothyroidism belongs to the most common endocrinopathies affecting women of childbearing age. The diagnosis of hypothyroidism in pregnant patients may be complicated by the fact that pregnancy has a considerable impact on thyroid homeostasis. Even overt hypothyroidism in these patients may be characterized by nonspecific signs or symptoms that are easily confused with complaints common to pregnancy itself. Unrecognised or untreated hypothyroidism during pregnancy is associated with adverse outcomes that can be ameliorated or prevented by adequate therapy with thyroxine. This article discusses the etiology, clinical manifestation, diagnosis, and management of hypothyroidism during pregnancy. We review the results of the current studies assessing the effect of the disease on pregnancy outcome or the offspring and provide the reader with recommendations concerning its diagnosis and treatment. PMID:22891567

Krysiak, Robert; Okopie?, Bogus?aw

2012-06-01

404

Orthodontic management of buccally erupted ectopic canine with two case reports  

PubMed Central

Ectopic canine teeth develop displaced from their normal position. Any permanent tooth can be ectopic, and the cause may be both genetic and environmental. Orthodontic treatment is justified because ectopic canine teeth can migrate in the jaw bone and may damage the adjacent teeth roots and bone. Orthodontic treatment is also justifiable for aesthetic reasons. Diagnosis and treatment of ectopically erupting permanent maxillary canines requires timely management by the orthodontist. Internal or external root resorption of teeth adjacent to the ectopic canine is the most common sequel. Malocclusion with severe crowding is difficult to treat without extraction. Non-extraction treatment of ectopic canines can compromise the patient's profile. This article represents two cases of extraction treatment approach for buccally displaced or ectopic canine in a patient with severe crowding in the mandibular arch. PMID:22557914

Sachan, Avesh; Chaturvedi, T. P.

2012-01-01

405

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

2015-04-01

406

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

407

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

408

[Unusual cause of abdominal lymphomas].  

PubMed

A 72 year old HIV-negative patient without relevant immunosuppression presented with abdominal lymphomas and inflammatory signs in the colon. Mycobacterium intracellulare was grown from colonic biopsies and stool. There was no sign of malignancy or chronic inflammatory bowel disease. We diagnosed an atypical, gastrointestinal mycobacteriosis und treated the patient accordingly. This led to a good response. PMID:20945056

Halevy, D; Schöntag, S; Küper-Steffen, R; Lobmann, R

2011-06-01

409

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

PubMed

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

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

2014-01-01

410

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

PubMed Central

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

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

2014-01-01

411

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

412

Abdominal Compartment Syndrome in the Open Abdomen  

Microsoft Academic Search

Background: Multiple methods exist to manage in the intensive care unit the patient with an open abdomen. An increasingly common method is the vacuum packed technique. This method accommodates considerable ex- pansion of intra-abdominal contents and should obvi- ate the potential development of the abdominal com- partment syndrome (ACS). Despite this, some patients with these temporary abdominal dressings will go

Vicente H. Gracias; Benjamin Braslow; Jon Johnson; John Pryor; Rajan Gupta; Patrick Reilly; C. William Schwab

2002-01-01

413

Primary aldosteronism in pregnancy.  

PubMed

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

Krysiak, R; Samborek, M; Stojko, R

2012-01-01

414

Three consecutive ipsilateral tubal pregnancies in a nulliparous African woman: the role of conservative treatment.  

PubMed

A very rare case of three consecutive ipsilateral tubal pregnancies, in a 31 year old nulliparous Malawian woman is presented. The three pregnancies occurred over a four year period between 1989 and 1993, and were treated at three different hospitals in Malawi and Britain. The first two were treated conservatively by "milking" the ectopic out in Malawi and Britain respectively while the third was treated by partial salpingectomy in Malawi. All three were confirmed clinically, ultrasonographically, at surgery and histopathologically. The rarity of such a condition, the role and value of conservative treatment of tubal pregnancy in Africa, especially in the light of the probable aetiological and/or predisposing factors are discussed. PMID:7788670

Lema, V M

1995-02-01

415

Ciclosporin use during pregnancy.  

PubMed

Ciclosporin (cyclosporine) is an immunosuppressive drug first approved for use in organ transplantation to prevent rejection. Ciclosporin is also known to be used for the treatment of psoriasis, rheumatoid arthritis, systemic lupus erythematosus and inflammatory bowel disease, among other indications. While it is recommended that all medications that are not absolutely necessary should be avoided during pregnancy, this may not be an option for many women whose quality of life is significantly impacted without treatment, or for those who must continue immunosuppressive therapy to avoid organ rejection. The purpose of this review is to provide a comprehensive report from the literature of ciclosporin exposure during pregnancy. PubMed, MEDLINE and the Cochrane Database of Systematic Reviews were searched for English-language articles published from 1970 to 2012 that included reports of pregnant women treated at any time during pregnancy with ciclosporin. On an initial search, it was evident that much of the available information is limited to pregnancy after transplant, which suggests that ciclosporin use during pregnancy appears to be associated with premature delivery and low birthweight infants. Comorbidities such as hypertension, pre-eclampsia and gestational diabetes mellitus are also reported at higher incidences than the general population. Medical literature concerning women with autoimmune disorders exposed to ciclosporin during pregnancy are currently limited to case reports and registry data, and, as such, it is difficult to determine if any risks associated with ciclosporin therapy during pregnancy are due to exposure to the drug alone or to pre-existing maternal comorbidities. The literature suggests that ciclosporin therapy during pregnancy should be carefully considered by the treating physician, but may be a safe alternative for patients with autoimmune disease refractory to conventional treatment. Continued monitoring of this patient population remains a key component to understanding the risk factors associated with ciclosporin exposure during pregnancy. PMID:23516008

Paziana, Karolina; Del Monaco, Magaly; Cardonick, Elyce; Moritz, Michael; Keller, Matthew; Smith, Bruce; Coscia, Lisa; Armenti, Vincent

2013-05-01

416

Diabetic ketoacidosis in pregnancy  

PubMed Central

The occurrence of diabetic ketoacidosis in pregnancy compromises both the fetus and the mother. It usually occurs in the later stages of pregnancy and is also seen in newly presenting type 1 diabetes patients. Despite improvement in its incidence rates and outcomes over the years, it still remains a major clinical problem since it tends to occur at lower blood glucose levels and more rapidly than in non-pregnant patients often causing delay in the diagnosis. This article illustrates a typical case of diabetic ketoacidosis in pregnancy and reviews the literature to provide an insight into its pathophysiology and management. PMID:12954957

Kamalakannan, D; Baskar, V; Barton, D; Abdu, T

2003-01-01

417

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

418

Cystic fibrosis in pregnancy.  

PubMed

Women with cystic fibrosis (CF) are living to childbearing age and many have successful pregnancies. Preconception care with optimization of pulmonary function, eradication of pulmonary infection, improved nutritional status, and diabetes care improve fertility and pregnancy outcome. Women with CF, poor pulmonary function and nutrition, and less than ideal body weight are more likely to suffer adverse outcomes. Women with CF and pulmonary hypertension risk mortality. Individuals with CF and end stage lung disease have improved survival after lung transplant. Women with lung transplants can have successful pregnancy, but the risk of organ rejection and death are high. PMID:20436312

Whitty, Janice E

2010-06-01

419

Multiple sclerosis and pregnancy.  

PubMed

The question of pregnancy in patients with multiple sclerosis is regularly raised due to the prevalence of the disease in middle age women. The multiple sclerosis think tank (Groupe de Réflexion sur la Sclérose en Plaques [GRESEP]) decided to develop recommendations on this issue, with consideration to both the impact of multiple sclerosis on pregnancy, and that of pregnancy on the disease. As with topics of previous works, the formal expert consensus method was used. The working group was composed of hospital-based and private practice neurologists. The reading group was composed of neurologists, anaesthetists and obstetricians. Each recommendation is presented with the relevant level of consensus. PMID:24684929

Bodiguel, E; Bensa, C; Brassat, D; Laplaud, D; Le Page, E; Ouallet, J-C; Zephir, H; De Seze, J

2014-04-01

420

Retrograde intrarenal surgery in cross-fused ectopic kidney.  

PubMed

Cross-fused renal ectopia is a rare congenital anomaly in which both kidneys are fused and located on the same side. We report a case of right-to-left cross-fused renal ectopia and nephrolithiasis, in whom retrograde intrarenal surgery was used to treat the stone disease. To our knowledge, this is the first case of retrograde intrarenal surgery of a crossed-fused ectopic kidney. PMID:25481231

Resorlu, Mustafa; Kabar, Mucahit; Resorlu, Berkan; Doluoglu, Omer Gokhan; Kilinc, Muhammet Fatih; Karakan, Tolga

2015-02-01

421

Single-system ectopic ureters associated with renal dysplasia  

Microsoft Academic Search

The purpose of this study was to inquire into the clinical features and methods for the diagnosis and therapy of single-system ectopic ureters associated with renal dysplasia . Intravenous urography (IVP), diuretic B-mode ultrasound (B-US), and, in four cases, computerized tomography (CT) were performed in twelve female patients with renal dysplasia—seven on the left and five on the right—and the clinical

Yuan Ji Yan; Zhou Xue Feng; Zhou Hong Min; Yang Xiao Jin

2004-01-01

422

Papillary carcinoma thyroid with metastasis to ectopic cervical thymus  

PubMed Central

Papillary carcinoma of thyroid is the most common type of thyroid neoplasm which is usually confined to the thyroid and tends to metastasize to regional lymph nodes. Distant metastasis occur in up to 15% of cases. Thymic metastasis from any malignant carcinoma is extremely rare with only four cases reported in medical literature. We report a case of papillary carcinoma of thyroid metastasizing to ectopic cervical thymus which has not been previously reported. PMID:21332990

2011-01-01

423

Ectopic Expression Reveals a Conserved PHYB Homolog in Soybean  

Microsoft Academic Search

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

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

2011-01-01

424

Transcriptome, Methylome and Genomic Variations Analysis of Ectopic Thyroid Glands  

Microsoft Academic Search

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

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

2010-01-01

425

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

426

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

427

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

PubMed Central

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

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

2014-01-01

428

Nitric oxide signaling contributes to ectopic orofacial neuropathic pain.  

PubMed

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

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

2013-12-01

429

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; Camőes, Isabel; Maciel, Joăo; Cabral Bastos, Pedro; Souto de Moura, Conceiçăo; Bettencourt, Paulo

2014-01-01

430

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

431

Early Pregnancy Loss  

MedlinePLUS

... Rh positive, this contact causes her to make antibodies against the Rh factor. These antibodies react against ... date of your next pregnancy is easier. Glossary Antibodies: Proteins in the blood produced in reaction to ...

432

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 ...

433

Anesthesia during Pregnancy  

MedlinePLUS

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

434

Pregnancy and Substance Abuse  

MedlinePLUS

... If you smoke, use alcohol or take illegal drugs, so does your unborn baby. First, don't ... Smoking during pregnancy passes nicotine and cancer-causing drugs to your baby. Smoke also keeps your baby ...

435

Asthma Medications and Pregnancy  

MedlinePLUS

... MD Medical Director, Health Initiatives View full profile Asthma and Pregnancy: Asthma Medications We would like to avoid all medicine ... make sure you are using it correctly. Other Asthma Related Medication Treatment Annual influenza vaccine (flu shot) ...

436

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. ...

437

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. ...

438

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 ...

439

HPV Vaccine and Pregnancy  

MedlinePLUS

... or visit us online at: www.OTISpregnancy.org . HPV Vaccine and Pregnancy This sheet talks about the ... advice from your health care provider. What is HPV? Human papillomavirus (HPV) is the most common infection ...

440

Healthy Weight during Pregnancy  

MedlinePLUS

... Training and Recovery Exercise Topics Fueling Your Workout Benefits of Physical Activity Exercise Nutrition Top Articles No Image Build Muscle - No ... January 2013 Tags Health Food Fitness Pregnancy Nutrition Exercise Prenatal ... of Physical Activity For Women Latest Content 1 ...

441

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 ...

442

Mercury and Pregnancy  

MedlinePLUS

... that contain high amounts of mercury. These include shark, swordfish, king mackerel and tilefish. If you need ... is mostly found in large fish, like swordfish, shark, king mackerel and tilefish. During pregnancy, don’t ...

443

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 ...

444

ERCP in Pregnancy  

PubMed Central

Background: Although rare, pancreaticobiliary disease during pregnancy can pose a serious risk to both the mother and fetus. Data regarding the relative safety of endoscopic retrograde cholangiopancreatography (ERCP) during pregnancy are sparse. Methods: We performed a retrospective review of 17 ERCP procedures performed at a single tertiary care referral center between January 2005 and April 2009. Records were reviewed for ERCP indication, endoscopic interventions, use and extent of fluoroscopy, postprocedure complications, and pregnancy outcomes including Apgar scores. Results: All procedures were performed without any maternal adverse events immediately or on follow-up. There were no signs of fetal distress during any of these cases, and there were no fetal complications noted upon delivery or at 30-day follow-up per chart review. Conclusion: Therapeutic ERCP during pregnancy appears to be safe when performed in experienced hands and with judicious use of fluoroscopy. PMID:20567530

Agha, Amir; Pinkas, Haim; Mamel, Jay; Brady, Patrick G.

2009-01-01

445

Seizure Disorders in Pregnancy  

MedlinePLUS

... mouth is not completely closed), heart defects, and neural tube defects . One reason why AEDs may be ... and left inside the uterus to prevent pregnancy. Neural Tube Defects: Birth defects that result from incomplete ...

446

Cosmetics and Pregnancy  

MedlinePLUS

... Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products Cosmetics Print this page Share this page E-mail this page Home Cosmetics Resources for You Consumers Cosmetics & Pregnancy FDA sometimes receives questions about the safe ...

447

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

448

Bleeding during Pregnancy  

MedlinePLUS

... fetus during pregnancy. If you have further questions, contact your obstetrician–gynecologist. FAQ038: Designed as an aid to patients, this document sets forth current information and opinions related to women’s health. The information ...

449

[Pregnancy and thyroid disorders].  

PubMed

Thyroid disorders are frequent among women, with a few specificities during pregnancy. Recent guidelines from the Endocrine Society concerning the management of thyroid disorders during pregnancy have been published, one year after the guidelines published by the American Thyroid Association. Iodine deficiency in France can increase the development of thyroid disorders during pregnancy. Hypothyroidism during pregnancy must be correctly substituted to avoid fetal complications. Maternal hyperthyroidism should be explored and monitored following a specific defined modality to discuss the necessity of a treatment and to prevent maternal and fetal complications. In case of thyroid nodes or cancer, the follow-up will not differ from non-pregnant women. However in most of cases, involvement of a multidisciplinay team might be necessary. PMID:25194220

Bricaire, L; Groussin, L

2015-03-01

450

Asthma and Pregnancy  

MedlinePLUS

... pregnancy, see the OTIS fact sheet about prednisone/prednisolone, albuterol, salmeterol, formoterol and inhaled corticosteroids. Can taking ... more information, see the OTISfact sheet about prednisone/prednisolone. If I have asthma, can I breastfeed my ...

451

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 ...

452

Metronidazole (Flagyl) and Pregnancy  

MedlinePLUS

... al. 1995. Safety of metronidazole in pregnancy: a meta-analysis. Am J Obstet Gynecol 172(21):525-529. ... T, et al. 1997. Is metronidazole teratogenic? A meta-analysis. Br J Clin Pharmacol 44:(2)179-182. ...

453

Lupus and Pregnancy  

MedlinePLUS

... activity, particularly during conception and early in pregnancy, increases the chance for these complications. Kidney disease and pre-existing high blood pressure are other risk factors for these complications. Rarely, lupus leads to blood ...

454

Pregnancy and Healthy Weight  

MedlinePLUS

... Selected Profiles & Interviews Selected biographies & science-focused interviews Multimedia Audio briefings, videos & podcasts related to NICHD research ... the News Spotlights Media Resources Selected Profiles & Interviews Multimedia Pregnancy & Healthy Weight Skip sharing on social media ...

455

Having a Healthy Pregnancy  

MedlinePLUS

... things during pregnancy, such as: certain types of fish, such as swordfish, canned tuna, and other fish that may be high in mercury (your doctor can help you decide which fish you can eat) foods that contain raw eggs, ...

456

Problems sleeping during pregnancy  

MedlinePLUS

... which is often worse at night. Stress and dreams. Many pregnant women worry about the baby or ... which can make it hard to sleep. Vivid dreams and nightmares are common during pregnancy. Dreaming and ...

457

Microcirculation in pregnancy.  

PubMed

The microcirculation, like all physiological systems undergoes modifications during the course of pregnancy. These changes aid the adaption to the new anatomical and physiological environment of pregnancy and ensure adequate oxygen supply to the fetus. Even though the microcirculation is believed to be involved in major pregnancy related pathologies, it remains poorly understood. The availability of safe and non-interventional technologies enabling scientists to study the intact microcirculation of the pregnant patient will hopefully expand our understanding. In this article we review the physiological changes occurring in the microcirculation during pregnancy and the role of the microcirculation in gestational related pathologies. We will also describe the available techniques for the measurement and evaluation of the microcirculation. Lastly we will highlight the possible fields in which these techniques could be utilized to help provide a clearer view of the microcirculation in the pregnant woman. PMID:24702490

Abdo, I; George, R B; Farrag, M; Cerny, V; Lehmann, C

2014-09-01

458

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

459

Recurrent Pregnancy Loss (RPL)  

MedlinePLUS

... miscarriages (the ones that happen in the first 3 months of pregnancy) are due to genetic abnormalities in the embryo or fetus. Normally, there are 46 chromosomes that contain the genes for normal development. Many ...

460

HIV and Pregnancy  

MedlinePLUS

... 2816 E-mail: contactus@aidsinfo.nih.gov Web: http://aidsinfo.nih.gov HIV and Pregnancy These fact ... are available on the AIDS info website at http://aidsinfo.nih.gov/guidelines. These fact sheets are ...

461

HIV and Pregnancy  

MedlinePLUS

... infection can be treated, but not cured. Taking anti-HIV drugs can help people with HIV infection stay healthy ... They include the following: • Take a combination of anti-HIV drugs during your pregnancy as prescribed. • Have your baby ...

462

[Portosystemic anastomosis during pregnancy].  

PubMed

There is discussed the surgical treatment of massive otherwise uncontrolable haemorrhage from oesophageal varices during advanced pregnancy. The authors have performed in the above situation a splenorenal shunt in a women suffering from the prehepatic portal hypertension during her sixth month of pregnancy. The pregnancy was maintained but an unviable child was born. The authors were able to find only 5 quotations from the references available to them dealing with 5 similar cases in women who delivered healthy babies thanks to a surgical intervention (5 times a portal systemic shunt, once a direct operation). The most important prevention of those exceptional surgical indications is the careful evaluation of all circumstances for a pregnancy in women with portal hypertension. PMID:1087522

Králík, J; Silhan, J; Reil, P; Skácel, J; Havelka, J

1976-01-01

463

Ultrasound in pregnancy (image)  

MedlinePLUS

The ultrasound has become a standard procedure used during pregnancy. It can demonstrate fetal growth and can detect increasing ... abnormalities, hydrocephalus, anencephaly, club feet, and other ... does not produce ionizing radiation and is considered ...

464

[A case of abdominal wall actinomycosis].  

PubMed

Actinomycosis is a chronic suppurative granulomatous infectious disease caused by actinomyces species that is characterized by formation of characteristic clumps called as sulfur granules. Abdominal actinomycosis is a rare disease and is often difficult to diagnose before operation. Abdominal actinomycosis infiltrating into the abdominal wall and adhering to the colon is even rarer. Most abdominal actinomycosis develops after operation, trauma or inflammatory bowel disease, and is also considered as an opportunistic infection in immunocompromised patient with underlying malignancy, diabetes mellitus, human immunodefidiency virus infection, etc. Actinomycosis is diagnosed based on histologic demonstration of sulfur granules in surgically resected specimen or pus, and treatment consists of long-term penicillin based antibiotics therapy with or without surgical resection. Herein, we report an unusual case of abdominal wall actinomycosis which developed in a patient after acupuncture and presented as abdominal wall mass that was first mistaken for abdominal wall invasion of diverticulum perforation. PMID:25896158

Kim, Kyung Hoon; Lee, Jin Soo; Cho, Hyeong Jun; Choi, Seung Bong; Cheung, Dae Young; Kim, Jin Il; Lee, In Kyu

2015-04-25

465

Combined method for fetal electrocardiogram extraction from noninvasive abdominal recordings.  

PubMed

Abdominal electrocardiogram (AECG) recording is a non-invasive method to assess fetal well-being during both pregnancy and delivery. However, AECG recording is contaminated by a series of physiological interferences which make difficult the extraction of morphological and temporal parameters of fetal ECG from the raw signals. In this work, it is proposed a combined method to extract the fetal ECG from AECG recording by removing the interferences on a cascade structure using a priori information about the signals nature. In this work, a total of 54 multichannel AECG recordings taken from 21 to 40 weeks of gestation were enrolled. Experimental results show that the proposed method outperforms conventional independent component analysis, and provides fetal heart rate detection in 80% of the cases. In addition it also permits to obtain fetal ECG morphology from AECG recordings. PMID:23365903

Ye-Lin, Y; Prats-Boluda, G; Alberola-Rubio, J; Garcia-Casado, J

2012-01-01

466

Acute asthma during pregnancy.  

PubMed Central

BACKGROUND: Acute asthma during pregnancy is potentially dangerous to the fetus. The aim of this study was to investigate the effect of an acute attack of asthma during pregnancy on the course of pregnancy or delivery, or the health of the newborn infant, and to identify undertreatment as a possible cause of the exacerbations. METHODS: Five hundred and four pregnant asthmatic subjects were prospectively followed and treated. The data on 47 patients with an attack of asthma during pregnancy were compared with those of 457 asthmatics with no recorded acute exacerbation and with 237 healthy parturients. RESULTS: Of 504 asthmatics, 177 patients were not initially treated with inhaled corticosteroids. Of these, 17% had an acute attack compared with only 4% of the 257 patients who had been on inhaled anti-inflammatory treatment from the start of pregnancy. There were no differences between the groups as to length of gestation, length of the third stage of labour, or amount of haemorrhage after delivery. No differences were observed between pregnancies with and without an exacerbation with regard to relative birth weight, incidence of malformations, hypoglycaemia, or need for phototherapy for jaundice during the neonatal period. CONCLUSIONS: Patients with inadequate inhaled anti-inflammatory treatment during pregnancy run a higher risk of suffering an acute attack of asthma than those treated with an anti-inflammatory agent. However, if the acute attack of asthma is relatively mild and promptly treated, it does not have a serious effect on the pregnancy, delivery, or the health of the newborn infant. PMID:8733495

Stenius-Aarniala, B. S.; Hedman, J.; Teramo, K. A.

1996-01-01

467

Hay fever in pregnancy.  

PubMed

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

Wiseberg, Max

2014-05-01

468

Urolithiasis and pregnancy.  

PubMed

The diagnosis of urolithiasis during pregnancy is common, even though no additional measures are required in asymptomatic cases. Renal colic or complications of urinary lithiasis occur more frequently during the last months of pregnancy, and there are several particularities for the diagnosis and treatment of this subset of women. The present manuscript aim to review the current knowledge concerning this subject and present authors personal experience. PMID:25317623

Korkes, Fernando; Rauen, Eduardo Costa; Heilberg, Ita Pfeferman

2014-01-01

469

Parathyroid disorders of pregnancy.  

PubMed

Diseases of the parathyroid gland are uncommon in women of childbearing age. However, total serum calcium is lower in normal pregnancy, but ionized serum calcium remains within normal limits. Serum parathyroid levels are slightly decreased in the second half of pregnancy. Primary hyperparathyroidism, if unrecognized, may increase maternal and fetal morbidity, which is related to the level of serum calcium. The most common cause is a single parathyroid adenoma, accounting for about 80% of cases. Maternal complications include acute pancreatitis, hypercalcemia crisis, and toxemia. An increased incidence of prematurity and neonatal hypocalcemia has been reported when maternal hypercalcemia is significantly elevated. Other causes of hypercalcemia are rare in pregnancy. Hypoparathyroidism is seldom seen in pregnancy; the most common cause is after surgical throidectomy. The doses of vitamin D and calcium do not change during pregnancy; however, hypercalcemia may develop in the postpartum period. Serum calcium should be determined at every trimester of pregnancy and at regular intervals after delivery, and in a significant number of patients, the dose of vitamin D should be reduced. Osteoporosis has been recognized most frequently in the last few years. It appears that those patients with a family history of osteoporosis and those on heparin therapy have a tendency to develop symptoms of the disease in pregnancy. Finally, lactation is not contraindicated in women with osteoporosis; although there is a slight decrease in bone density in the few months after delivery, this is a transient event and bone densitometry returns to prepregnancy levels in most women. Recent studies indicate that there is no need for calcium therapy during lactation with few exceptions, such as lactating adolescents, mothers nursing more than one child, and mothers with closely-spaced pregnancies. PMID:9880118

Mestman, J H

1998-12-01

470

Thecoma in pregnancy  

PubMed Central

A description is briefly given of a patient whose pregnancy was complicated by an ovarian thecoma which ruptured spontaneously. Eleven previously reported instances of the combination of thecoma and pregnancy are summarized. Although the present case appears to be the first in which the mother has survived rupture of the tumour, in view of the result to the child this can hardly be claimed as a triumph of obstetrics. ImagesFIG. 1FIG. 2FIG. 3 PMID:4347633

Gough, H. Martin; Walther, Garth L.

1973-01-01

471

Challenges of Twin Pregnancy  

PubMed Central

Family physicians have an important role in the diagnosis and management of twin pregnancies. Optimal antepartum management begins with early detection. Provision of patient education about the risks of the pregnancy is important. Intrapartum management is dependent on gestation age, placentation, fetal presentation, and fetal well-being. Anticipatory guidance and ongoing support should be provided for postpartum issues, such as breast-feeding and family adjustment. PMID:21229108

Wilson, Lynn M.; Hose, Patricia M.

1991-01-01

472

Frequency of nonallelic homologous recombination is correlated with length of homology: evidence that ectopic synapsis precedes ectopic crossing-over.  

PubMed

Genomic disorders constitute a class of diseases that are associated with DNA rearrangements resulting from region-specific genome instability, that is, genome architecture incites genome instability. Nonallelic homologous recombination (NAHR) or crossing-over in meiosis between sequences that are not in allelic positions (i.e., paralogous sequences) can result in recurrent deletions or duplications causing genomic disorders. Previous studies of NAHR have focused on description of the phenomenon, but it remains unclear how NAHR occurs during meiosis and what factors determine its frequency. Here we assembled two patient cohorts with reciprocal genomic disorders; deletion associated Smith-Magenis syndrome and duplication associated Potocki-Lupski syndrome. By assessing the full spectrum of rearrangement types from the two cohorts, we find that complex rearrangements (those with more than one breakpoint) are more prevalent in copy-number gains (17.7%) than in copy-number losses (2.3%); an observation that supports a role for replicative mechanisms in complex rearrangement formation. Interestingly, for NAHR-mediated recurrent rearrangements, we show that crossover frequency is positively associated with the flanking low-copy repeat (LCR) length and inversely influenced by the inter-LCR distance. To explain this, we propose that the probability of ectopic chromosome synapsis increases with increased LCR length, and that ectopic synapsis is a necessary precursor to ectopic crossing-over. PMID:21981782

Liu, Pengfei; Lacaria, Melanie; Zhang, Feng; Withers, Marjorie; Hastings, P J; Lupski, James R

2011-10-01

473

Corticosteroids and pregnancy.  

PubMed

Pregnancy results in major changes in the hypothalamo-pituitary-adrenal (HPA) axis, which in turn influence fetal growth and the timing of labor. From the beginning of the second trimester maternal cortisol secretion increases, and in late pregnancy the placenta, in large part mediated through corticotroph-releasing hormone, plays a crucial role in the regulation of the fetal HPA axis to ensure the synchronization of the various processes involved in parturition. Exposure of the fetus to excess glucocorticoid results in intrauterine growth failure and possibly "programs" the development of cardiovascular disease in adult life. Biochemical assessment of the HPA axis is complicated by the estrogen-induced elevation of circulating cortisol-binding globulin, resulting in misleadingly high circulating cortisol levels The hypercortisolemia of Cushing's syndrome causes infertility, but if pregnancy does occur it can result in increased morbidity and mortality in mother and fetus. However, the prospects of a successful pregnancy are greatly improved with control of hypercortisolemia by surgery and medical therapy with metyrapone. Hypoadrenalism can be difficult to diagnose during pregnancy but, once the diagnosis is made, with careful monitoring, dose adjustment as indicated, and parenteral cover for labor, a successful pregnancy should result. PMID:12536360

Trainer, Peter J

2002-11-01

474

Pregnancy with portal hypertension.  

PubMed

Even though pregnancy is rare with cirrhosis and advanced liver disease, but it may co-exist in the setting of non-cirrhotic portal hypertension as liver function is preserved but whenever encountered together is a complex clinical dilemma. Pregnancy in a patient with portal hypertension presents a special challenge to the obstetrician as so-called physiological hemodynamic changes associated with pregnancy, needed for meeting demands of the growing fetus, worsen the portal hypertension thereby putting mother at risk of potentially life-threatening complications like variceal hemorrhage. Risks of variceal bleed and hepatic decompensation increase many fold during pregnancy. Optimal management revolves round managing the portal hypertension and its complications. Thus management of such cases requires multi-speciality approach involving obstetricians experienced in dealing with high risk cases, hepatologists, anesthetists and neonatologists. With advancement in medical field, pregnancy is not contra-indicated in these women, as was previously believed. This article focuses on the different aspects of pregnancy with portal hypertension with special emphasis on specific cause wise treatment options to decrease the variceal bleed and hepatic decompensation. Based on extensive review of literature, management from pre-conceptional period to postpartum is outlined in order to have optimal maternal and perinatal outcomes. PMID:25755552

Aggarwal, Neelam; Negi, Neha; Aggarwal, Aakash; Bodh, Vijay; Dhiman, Radha K

2014-06-01

475

Pregnancy with Portal Hypertension  

PubMed Central

Even though pregnancy is rare with cirrhosis and advanced liver disease, but it may co-exist in the setting of non-cirrhotic portal hypertension as liver function is preserved but whenever encountered together is a complex clinical dilemma. Pregnancy in a patient with portal hypertension presents a special challenge to the obstetrician as so-called physiological hemodynamic changes associated with pregnancy, needed for meeting demands of the growing fetus, worsen the portal hypertension thereby putting mother at risk of potentially life-threatening complications like variceal hemorrhage. Risks of variceal bleed and hepatic decompensation increase many fold during pregnancy. Optimal management revolves round managing the portal hypertension and its complications. Thus management of such cases requires multi-speciality approach involving obstetricians experienced in dealing with high risk cases, hepatologists, anesthetists and neonatologists. With advancement in medical field, pregnancy is not contra-indicated in these women, as was previously believed. This article focuses on the different aspects of pregnancy with portal hypertension with special emphasis on specific cause wise treatment options to decrease the variceal bleed and hepatic decompensation. Based on extensive review of literature, management from pre-conceptional period to postpartum is outlined in order to have optimal maternal and perinatal outcomes. PMID:25755552

Aggarwal, Neelam; Negi, Neha; Aggarwal, Aakash; Bodh, Vijay; Dhiman, Radha K.

2014-01-01

476

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

477

Abdominal aortic aneurysms in children  

Microsoft Academic Search

Abdominal aortic aneurysms are rare in children. Causes include mycotic aneurysms, vasculitides (eg, Takayasu's arteritis), connective tissue diseases (eg, Marfan's syndrome, Ehlers-Danlos syndrome, and tuberous sclerosis) and traumatic false aneurysms. Four cases are described. Case 1 was a 12-year-old boy who presented with an acute unheralded rupture of the subdiaphragmatic aorta accompanied by lower limb paralysis and ischemia. Attempted repair

A. J. W. Millar; R. D. Gilbert; R. A. Brown; E. J. Immelman; D. A. Burkimsher; S. Cywes

1996-01-01

478

Radiology of blunt abdominal trauma.  

PubMed

Blunt abdominal trauma can produce injury to any of the intra-abdominal organs. While diagnostic studies may be necessary to help determine the most appropriate therapy, all these procedures take time, which in some instances can be better used to treat the patient actively. The condition of the patient and the clinical findings take precedence in the handling of the injured patient. Certain skeletal injuries are often a first clue and can help focus further investigations. Plain films and regular contrast examinations are adequate to evaluate most intra-abdominal injuries. When time is available, a variety of other radiologic techniques are available in most hospitals. Nuclear imaging is of considerable value in studying the liver, spleen, and kidneys. Thus far, ultrasound techniques have left much to be desired although theoretically of considerable potential. Angiography can be of great diagnostic and potentially of some therapeutic value. No diagnostic test beats a good history and careful examination. Radiologic studies, ideally, should be done to confirm a clinical suspicion, not just for the sake of "completeness." PMID:558659

Kurtzman, R S

1977-02-01

479

[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

480

Variation in Pregnancy Intendedness Across U.S. Women's Pregnancies.  

PubMed

How stable are women's pregnancy intentions across their reproductive lifespans? Are there demographic, social, or attitudinal characteristics that are associated with differing pregnancy intentions patterns? Patterns of intendedness across pregnancies were examined using a sample of 3,110 women ages 25-45 who have been pregnant at least twice from the National Survey of Fertility Barriers. Multinomial logistic regression analyses assessed associations between patterns of intentions and respondents' economic/social status, values and ideologies to determine if intentions are a stable characteristic or pregnancy-specific. The majority of women (60 %) reported varying intendedness across individual pregnancies, indicating that intendedness tends to be pregnancy-specific. Sociodemographic status as well as values and ideologies were significantly associated with pregnancy intendedness patterns. Compared to women who intended each pregnancy, women who were ambivalent, did not intend each pregnancy, or had intermittent intendedness were more likely to be single, younger, Black, report lower importance of motherhood and religiosity and were less likely to be Hispanic. A substantial proportion of women report the intendedness of their pregnancies varied between pregnancies. Research and policy addressing unintended pregnancies should consider that pregnancy intentions are not a static characteristic of most women. PMID:25260541

Shreffler, Karina M; Greil, Arthur L; Mitchell, Katherine Stamps; McQuillan, Julia

2015-05-01

481

Maternal cardiac metabolism in pregnancy  

PubMed Central

Pregnancy causes dramatic physiological changes in the expectant mother. The placenta, mostly foetal in origin, invades maternal uterine tissue early in pregnancy and unleashes a barrage of hormones and other factors. This foetal ‘invasion’ profoundly reprogrammes maternal physiology, affecting nearly every organ, including the heart and its metabolism. We briefly review here maternal systemic metabolic changes during pregnancy and cardiac metabolism in general. We then discuss changes in cardiac haemodynamic during pregnancy and review what is known about maternal cardiac metabolism during pregnancy. Lastly, we discuss cardiac diseases during pregnancy, including peripartum cardiomyopathy, and the potential contribution of aberrant cardiac metabolism to disease aetiology. PMID:24448314

Liu, Laura X.; Arany