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Ectopic Pregnancy

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21. Two Dose versus Single Dose of Methotrexate for Treatment of Ectopic Pregnancy: a Meta-Analysis. (PubMed)

Two Dose versus Single Dose of Methotrexate for Treatment of Ectopic Pregnancy: a Meta-Analysis. To compare the treatment success and failure rates, as well as side effects and surgery rates, between methotrexate protocols.PubMed, Embase, and the Cochrane library searched up to July 2018.Randomized controlled trials that compared women with ectopic pregnancies receiving the single-dose, two-dose, or multi-dose methotrexate protocols.Odds of treatment success, treatment failure, side effects (...) % CI, 1.01, 2.30). Compared to the single-dose protocol, the multi-dose protocol was associated with a nonsignificant reduction in treatment failure (OR, 0.56; 95% CI, 0.28, 1.13) and a higher chance of side effects (OR, 2.10; 95% CI, 1.24, 3.54). The odds of surgery for tubal rupture (OR, 1.62; 95% CI, 0.41, 6.49) and time to follow-up (OR, -1.3; 95% CI, -5.4, 2.7) were similar.The 2-dose methotrexate protocol is superior to the single-dose protocol for the treatment of ectopic pregnancy in terms

2019 American Journal of Obstetrics and Gynecology

22. Temporal trends in severe morbidity and mortality associated with ectopic pregnancy requiring hospitalisation in Washington State, USA: a population-based study. (PubMed)

Temporal trends in severe morbidity and mortality associated with ectopic pregnancy requiring hospitalisation in Washington State, USA: a population-based study. To examine temporal trend in maternal mortality/severe morbidity associated with hospitalisation due to ectopic pregnancy.A population-based observational study.All women hospitalised for ectopic pregnancy in Washington State, USA, 1987-2014 (n=20 418). The main composite outcome of severe morbidity/mortality included death, sepsis (...) , need for transfusion, hysterectomy and systemic or organ failure, identified by diagnostic and procedure codes from hospitalisation files. Severe morbidity/mortality due to ectopic pregnancy were expressed as incidence ratios among women of reproductive age (15-64 years) and among women hospitalised for ectopic pregnancy. Comparisons were made between 1987-1991 (reference) and 2010-2014 using ratios of incidence ratios (RR) and ratio differences (RD). The Cochran-Armitage test for trend assessed

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2019 BMJ open

23. Risk of ectopic pregnancy and tubal infertility following gonorrhoea and chlamydia infections. (PubMed)

Risk of ectopic pregnancy and tubal infertility following gonorrhoea and chlamydia infections. Gonorrhoea and chlamydia are important causes of pelvic inflammatory disease. Chlamydia also causes long-term sequelae, but the role of gonorrhoea is unclear. We followed 300,000 reproductive-aged women for 10 years for ectopic pregnancy and tubal infertility; our findings suggest that both infections confer similar increases in risk of these outcomes.© The Author(s) 2019. Published by Oxford

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2019 Clinical Infectious Diseases

24. Risk factors for ectopic pregnancy in a population of Cameroonian women: A case-control study. (PubMed)

Risk factors for ectopic pregnancy in a population of Cameroonian women: A case-control study. To identify the risk factors for ectopic pregnancy (EP) in a population of Cameroonian women.We performed a matched case-control study; 88 women with diagnosed EP (cases), and 176 women with first trimester intrauterine pregnancy (IUP) (controls), who underwent questionnaires. Odds Ratio (OR) and 95% confidence intervals (CIs) were calculated and adjusted for potential confounding factors via

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2018 PLoS ONE

25. The effect of morphological types of extrauterine ectopic pregnancies on the accuracy of pre-operative ultrasound diagnosis. (PubMed)

The effect of morphological types of extrauterine ectopic pregnancies on the accuracy of pre-operative ultrasound diagnosis. The aim of this study was to assess the overall accuracy of the transvaginal ultrasound scan (TVS) diagnosis of all types of extrauterine ectopic pregnancy (EUEP) in a large group of women who were managed surgically. We also examined the positive predictive value (PPV) of the different ultrasound morphological types of EUEP, using visual confirmation of ectopic pregnancy (...) presented with early pregnancy complications during the study period, including 1241 (4.7%, 95% CI 4.5-5.0) women who were diagnosed with an EUEP. Surgery was performed in 721 cases (58.1%, 95% CI 55.3-60.8) out of which 710 (98.5%, 95%CI 97.6% to 99.4%) had been diagnosed with an EUEP on a preoperative TVS. The remaining 11 women had severe pain and significant haemoperitoneum and were managed surgically on clinical grounds as an emergency, without an ectopic pregnancy having been identified

2019 Ultrasound in Obstetrics and Gynecology

26. Cervical Ectopic Pregnancy: A Rare Site of Implantation. (PubMed)

Cervical Ectopic Pregnancy: A Rare Site of Implantation. Cervical ectopic pregnancies are rare, comprising < 1% of ectopic pregnancies, and life threatening if there is a delay in treatment or a misdiagnosis.This case report describes a presentation of cervical ectopic pregnancy. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case report reviews nonsurgical and surgical treatment options for patients with cervical ectopic pregnancies.Copyright © 2019 Elsevier Inc. All rights reserved.

2019 Journal of Emergency Medicine

27. Chlamydia trachomatis and the Risk of Pelvic Inflammatory Disease, Ectopic Pregnancy, and Female Infertility: A Retrospective Cohort Study Among Primary Care Patients. (PubMed)

Chlamydia trachomatis and the Risk of Pelvic Inflammatory Disease, Ectopic Pregnancy, and Female Infertility: A Retrospective Cohort Study Among Primary Care Patients. We evaluated the risk of pelvic inflammatory disease (PID), ectopic pregnancy, and infertility in women with a previous Chlamydia trachomatis (CT) diagnosis compared with women who tested negative for CT and CT untested women, considering both targeted and incidental (ie, prescribed for another indication) use of CT-effective (...) antibiotics.This was a retrospective study of women aged 12-25 years at start of follow-up within the Clinical Practice Research Datalink GOLD database linked to index of multiple deprivation quintiles, 2000-2013. CT test status and antibiotic use were determined in a time-dependent manner. Risk of PID, ectopic pregnancy, or female infertility were evaluated using of Cox proportional hazard models.We studied 857 324 women, contributing 6 457 060 person-years. Compared with women who tested CT-negative, women

2019 Clinical Infectious Diseases

28. A decision support system for predicting the treatment of ectopic pregnancies. (PubMed)

A decision support system for predicting the treatment of ectopic pregnancies. Ectopic pregnancy is an important cause of morbidity and mortality worldwide. An early diagnosis, as well as the choice of the most suitable treatment for the patient is crucial to avoid possible complications. According to different factors an ectopic pregnancy must be treated from surgery, using a pharmacological treatment or following a conservative treatment. In this paper, a clinical decision support systems

2019 International journal of medical informatics

29. Unilateral live twin tubal ectopic pregnancy presenting at 12 weeks of gestation: A case report. (PubMed)

Unilateral live twin tubal ectopic pregnancy presenting at 12 weeks of gestation: A case report. Abdominal pain in pregnancy represents a demanding diagnostic challenge in the emergency department (ED) due to the extensive list of differential diagnoses to be considered, coupled with the possibility of each disease having nonclassical, atypical signs and symptoms, resultant from the patient's pregnant state. Additionally, emergency physicians (EPs) face limitations on investigative imaging (...) modalities because of the need to minimize fetal radiation exposure. EPs have to tackle this diagnostic challenge while performing a balancing act to maximize both maternal and fetal outcomes in a time-sensitive manner, becauser any delays in decision-making at the ED may threaten the safety of mother and child. Two common causes of abdominal pain in pregnancy presenting to the ED are acute appendicitis and ectopic pregnancy. The latter is almost always diagnosed by 10 weeks of gestation. Here, we report

2019 Medicine

30. Is There a Role for Hyperglycosylated hCG in the Diagnosis of Ectopic Pregnancy in Women with a Pregnancy of Unknown Location? (PubMed)

Is There a Role for Hyperglycosylated hCG in the Diagnosis of Ectopic Pregnancy in Women with a Pregnancy of Unknown Location? OBJECTIVE: To examine the potential use of hyperglycosylated human gonadotropin (hCG-H) in identifying ectopic pregnancies in pregnancies of unknown location (PULs) on ultrasound scan. STUDY DESIGN: This was a prospective observational study. An additional blood sample was taken from women whose initial transvaginal ultrasound scan showed none of the following: intact (...) intrauterine pregnancy, retained placental tissue, or ectopic pregnancy. Parallel sandwich ELISAs were performed using sheep monoclonal antibodies to the 12F6 epitope for detection of total hCG and to the 4D8 epitope for hCG-H detection, and an automated immunoassay technique was used for progesterone and serum β-hCG measurements. Patients were managed accord-ing to our standard clinical protocol. RESULTS: hCG-H was significantly higher in ectopic pregnancies (85.6 ng/mL) than in viable intrauterine

2017 Journal of Reproductive Medicine

31. Ruptured ectopic pregnancy with a negative urine pregnancy test (PubMed)

Ruptured ectopic pregnancy with a negative urine pregnancy test Ectopic pregnancy is commonly seen as a differential diagnosis of first-trimester vaginal bleeding. Often the diagnosis is made based on a combination of exam findings, transvaginal ultrasound, and a positive pregnancy test. Our case describes a patient with a history of ectopic pregnancy treated with methotrexate and serial human chorionic gonadotropin measurements that were decreasing appropriately. At the time of evaluation, her (...) urine pregnancy test was negative; however, she was confirmed to have a ruptured tubal ectopic pregnancy. This case highlights the variable presentation of ectopic pregnancies and the importance of combining exam findings with ultrasound and laboratory results.

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2017 Proceedings (Baylor University. Medical Center)

32. Clinical characteristics of persistent ectopic pregnancy after salpingostomy and influence on ongoing pregnancy (PubMed)

Clinical characteristics of persistent ectopic pregnancy after salpingostomy and influence on ongoing pregnancy The aim of this study was to assay the clinical characteristics of persistent ectopic pregnancy (PEP) and its influence on ongoing pregnancy.We retrospectively reviewed 2498 patients who received salpingostomies as primary management for ectopic pregnancies from January 2004 to December 2009, using medical records and telephone inquiries. Clinical characteristics of the 52 patients (...) monitored after surgery, which had declined by 28.31% on postoperative day (POD) 4, 40.22% on POD 7, 51.46% on POD 10 and 53.43% on POD 21. Repeat ectopic pregnancy (REP) tended to occur more frequently in PEP patients (PEP: 5 cases, 10.20%; non-PEP: 4 cases, 2.80%; P = 0.034). Multivariate analysis showed that pelvic adhesions and PEP were the strongest independent predictors of REP.Gestational age, mass size and pelvic adhesions were significantly correlated with PEP. PEP was an independent prognostic

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2017 The journal of obstetrics and gynaecology research

33. Recurrent ectopic pregnancy with heterotopic pregnancy in a patient of hypogonadotropic hypogonadism: a case report. (PubMed)

Recurrent ectopic pregnancy with heterotopic pregnancy in a patient of hypogonadotropic hypogonadism: a case report. Heterotopic pregnancy is the simultaneous occurrence of intrauterine and ectopic pregnancies. With an incidence reported to be between 1:8,000 and 1:30,000 pregnancies, heterotopic pregnancy is a rare entity. However, the increasing use of assisted reproductive techniques has contributed to the increasing incidence of heterotopic pregnancy during the past years.This is a rare (...) case of a hypogonadotropic hypogonadism in a patient with a heterotopic pregnancy six months after successful medical management of tubal ectopic pregnancy. The heterotopic pregnancy was managed expectantly with successful pregnancy outcome.Heterotopic pregnancy should always be considered, especially in patients with prior history of ectopic pregnancy and those undergoing assisted reproduction. Its treatment is a challenge as serial beta-hCG is not useful in diagnosis or follow-up, and medical

2017 Journal of Reproductive Medicine

34. Inexscreen as a screening test for ectopic pregnancy and miscarriage

Inexscreen as a screening test for ectopic pregnancy and miscarriage Inexscreen as a screening test for ectopic pregnancy and miscarriage Inexscreen as a screening test for ectopic pregnancy and miscarriage Malaysian Health Technology Assessment (MaHTAS) Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Malaysian Health Technology (...) Assessment (MaHTAS). Inexscreen as a screening test for ectopic pregnancy and miscarriage. Putrajaya: Malaysian Health Technology Assessment (MaHTAS). 2014 Authors' objectives To assess the safety, effectiveness (diagnostic accuracy) and cost-effectiveness of Inexscreen as a screening tool for ectopic pregnancy and miscarriage. Authors' conclusions There was limited retrievable fair level of evidence on the safety and effectiveness (diagnostic accuracy) of Inexscreen as a screening test for ectopic

2014 Health Technology Assessment (HTA) Database.

35. Aberrant expression of interleukin-6 and its receptor in Fallopian tubes bearing an ectopic pregnancy with and without tubal cytomegalovirus infection (PubMed)

Aberrant expression of interleukin-6 and its receptor in Fallopian tubes bearing an ectopic pregnancy with and without tubal cytomegalovirus infection Cytomegalovirus (CMV) has recently been suggested as a potential risk factor for the development of ectopic pregnancy (EP) following upper genital tract infection in women. However, little is known about its associated underlying pathogenic mechanisms. This was a prospective case-control study that measured the prevalence of CMV infection

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2016 Virusdisease

36. Randomised controlled trial: Salpingectomy for tubal ectopic pregnancy is appropriate in the presence of healthy-looking contralateral tube

Randomised controlled trial: Salpingectomy for tubal ectopic pregnancy is appropriate in the presence of healthy-looking contralateral tube Salpingectomy for tubal ectopic pregnancy is appropriate in the presence of healthy-looking contralateral tube | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log (...) in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Salpingectomy for tubal ectopic pregnancy is appropriate in the presence of healthy-looking contralateral tube Article Text Therapeutics

2014 Evidence-Based Medicine (Requires free registration)

37. Does this woman have an ectopic pregnancy? The rational clinical examination systematic review

Does this woman have an ectopic pregnancy? The rational clinical examination systematic review Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2013 DARE.

38. Demographic, lifestyle, and reproductive risk factors for ectopic pregnancy. (PubMed)

Demographic, lifestyle, and reproductive risk factors for ectopic pregnancy. To evaluate the relationship between demographic, lifestyle, and reproductive factors and the risk of ectopic pregnancy (EP).Prospective cohort.United States.Nurses' Health Study II cohort comprising 41,440 pregnancies from 22,356 women.Demographic, lifestyle, and reproductive factors self-reported in 1989 then updated every 2 years. Multivariable log-binomial regression models with generalized estimating equations (...) were used to estimate adjusted risk ratios (aRR).Ectopic pregnancy.Incident EP was reported in 411 (1.0%) pregnancies. Former and current smokers had 1.22 (95% confidence interval [CI], 0.97-1.55) and 1.73 (95% CI, 1.28-2.32) times, respectively, the risk of EP compared with never smokers. The risk of EP 10 years after quitting was similar to never smokers (aRR 0.90; 95% CI, 0.60-1.33). Women consuming ≥10 g/day of alcohol had 1.50 (95% CI, 1.08-2.09) times the risk of EP compared with never

2018 Fertility and Sterility

39. Intramural Ectopic Pregnancy Following Myomectomy (PubMed)

Intramural Ectopic Pregnancy Following Myomectomy Intramural pregnancy is a rare form of ectopic pregnancy with early diagnosis essential for prevention of severe hemorrhage and uterine rupture. We report a rare case of an intramural ectopic pregnancy at 12 weeks gestation in a woman 1 year post open myomectomy. Both transvaginal ultrasound and magnetic resonance imaging were utilized as diagnostic aids in this case. The rare nature of this clinical scenario and lack of guidelines

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2018 Journal of investigative medicine high impact case reports

40. ACOG Practice Bulletin No. 193 Summary: Tubal Ectopic Pregnancy. (PubMed)

ACOG Practice Bulletin No. 193 Summary: Tubal Ectopic Pregnancy. Ectopic pregnancy is defined as a pregnancy that occurs outside of the uterine cavity. The most common site of ectopic pregnancy is the fallopian tube. Most cases of tubal ectopic pregnancy that are detected early can be treated successfully either with minimally invasive surgery or with medical management using methotrexate. However, tubal ectopic pregnancy in an unstable patient is a medical emergency that requires prompt (...) surgical intervention. The purpose of this document is to review information on the current understanding of tubal ectopic pregnancy and to provide guidelines for timely diagnosis and management that are consistent with the best available scientific evidence.

2018 Obstetrics and Gynecology

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