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Ectopic Pregnancy

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61. An audit of the management of ectopic pregnancies in a district hospital, Gauteng, South Africa (PubMed)

An audit of the management of ectopic pregnancies in a district hospital, Gauteng, South Africa  Ectopic pregnancy (EP) is a life-threatening condition; at Odi Hospital, approximately 7-10 EPs are managed weekly. Our study is the first to assess the management of this life-threatening condition at Odi Hospital. This study aimed to determine the incidence of EP and to assess the profile of women who presented with EP at Odi District Hospital from 01 January 2010 to 31 December 2014. The study

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2018 African journal of primary health care & family medicine

62. MicroRNAs as Potential Serum Biomarkers for Early Detection of Ectopic Pregnancy (PubMed)

MicroRNAs as Potential Serum Biomarkers for Early Detection of Ectopic Pregnancy Diagnosis of ectopic pregnancy relies on both ultrasound findings and human chorionic gonadotropin (hCG) measurements but due to the need for serial tests, tubal rupture and death represent major maternal and fetal risks. Early detection of ectopic pregnancy is essential and thus a noninvasive diagnostic tool seems crucial for the prevention of adverse effects since studies suggest there is a specific relationship (...) between ectopic pregnancy and increasing microRNA factors. Human fluids in women with ectopic pregnancy reveal a particular change in comparison to healthy women. In addition to certain placental microRNAs circulating through plasma that present a specific concentration and serum profile, microRNAs seem to be possible biomarkers for the detection of pregnancy complications linked to placental pathologies. The aim of this study is to review current literature considering the expression levels

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2018 Cureus

63. Clinical significance of expression of hsa-mir-1247 and hsa-mir-1269a in ectopic pregnancy due to salpingitis (PubMed)

Clinical significance of expression of hsa-mir-1247 and hsa-mir-1269a in ectopic pregnancy due to salpingitis The clinical significance of hsa-mir-1247 and hsa-mir-1269a expression in ectopic pregnancy due to salpingitis was investigated. Eighty patients with ectopic pregnancy diagnosed by ultrasonography who were admitted to Jinan Maternity and Child Care Hospital from January 2012 to May 2012 were enrolled in this study. To the observation group were assigned 35 patients whose ectopic (...) pregnancy was due to salpingitis. The remaining 45 patients whose ectopic pregnancy was due to reasons other than endometriosis were assigned to the control group. Moreover, 32 healthy pregnant women were enrolled in this study at the same time as the healthy control group. Compared with the healthy control group, hsa-mir-1247 and hsa-mir-1269a were downregulated and upregulated, respectively, in patients with ectopic pregnancy (P<0.05). The difference was even more marked in patients with ectopic

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2018 Experimental and therapeutic medicine

64. Second Trimester Cervical Ectopic Pregnancy and Hemorrhage: A Case Report and Review of the Literature (PubMed)

Second Trimester Cervical Ectopic Pregnancy and Hemorrhage: A Case Report and Review of the Literature Cervical ectopic pregnancies are a rare occurrence in the United States. Here we present the interdisciplinary and conservative management approach to a cervical ectopic at an advanced gestational age. In addition, we review the surgical management of hemorrhage from cervical ectopic pregnancies, which is often catastrophic and life-threatening.

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2018 Case reports in obstetrics and gynecology

65. Successful diagnosis and treatment of early splenic ectopic pregnancy: A case report: Erratum (PubMed)

Successful diagnosis and treatment of early splenic ectopic pregnancy: A case report: Erratum 30142871 2018 11 14 1536-5964 97 34 2018 Aug Medicine Medicine (Baltimore) Successful diagnosis and treatment of early splenic ectopic pregnancy: A case report: Erratum. e12141 10.1097/MD.0000000000012141 eng Journal Article United States Medicine (Baltimore) 2985248R 0025-7974 2018 8 26 6 0 2018 8 26 6 0 2018 8 26 6 0 ppublish 30142871 10.1097/MD.0000000000012141 00005792-201808240-00123 PMC6113032

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2018 Medicine

66. Don’t cancel the surgery just yet! A case report of positive preoperative pregnancy test due to a soft tissue sarcoma production of ectopic beta human chorionic gonadotropin (PubMed)

Don’t cancel the surgery just yet! A case report of positive preoperative pregnancy test due to a soft tissue sarcoma production of ectopic beta human chorionic gonadotropin Soft tissue sarcomas are a rare group of mesenchymal malignancies which can range from low to high grade. These tumors have different clinical, radiographic, and histopathological characteristics. Beta human chorionic gonadotropin is a naturally secreted hormone by placental syncytiotrophoblast cells during pregnancy (...) . On very rare occasions, sarcomas can develop the ability to ectopically produce human chorionic gonadotropin. Very few cases exist in the literature of soft tissue sarcomas expressing this hormone. We report the case of a 55-year-old female who presented with a posterior thigh soft tissue sarcoma who on the day of surgical resection was found to have an unusually elevated serum human chorionic gonadotropin. Positive immunohistochemical staining of the resected mass confirmed the sarcoma as the source

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2018 Rare tumors

67. Successful Procedure in Conservative Management of Interstitial (Cornual) Ectopic Pregnancy (PubMed)

Successful Procedure in Conservative Management of Interstitial (Cornual) Ectopic Pregnancy A 35-year-old woman presented with spotting and lower abdominal pain. Follow-up sonography was suggestive of interstitial ectopic pregnancy. Laparoscopic cornuostomy was carried out. Before incision, diluted vasopressin was injected around the site of interstitial pregnancy. Removal of the conceptual tissues was conducted smoothly through a 1.5 cm incision. The overall blood loss was 50 mL. The operative (...) time was 50 min, and there were no intraoperative complications. We successfully performed laparoscopic cornuostomy, which was followed by an unremarkable postoperative course. Laparoscopic surgery is a safe and effective minimally invasive surgical intervention for interstitial ectopic pregnancy if performed by the experienced surgeon. Local vasopressin injection is a good alternative for bleeding control in conservative laparoscopic surgery.

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2018 Gynecology and Minimally Invasive Therapy

68. Retroperitoneal Ectopic Pregnancy. (PubMed)

Retroperitoneal Ectopic Pregnancy. Retroperitoneal ectopic pregnancies are rare and have a tendency to implant along major vessels of the abdomen and pelvis. Clinical manifestations can vary from no symptoms to hypovolemic shock and death.A 30-year-old woman presented in hypovolemic shock with left flank and abdominal pain after attempting to medically terminate her first-trimester pregnancy. Intraoperative findings revealed normal pelvic organs with a massive retroperitoneal hematoma (...) containing chorionic villi confirmed on histopathology.In a woman with a pregnancy of unknown location presenting with worsening flank pain, a retroperitoneal ectopic pregnancy must be considered. Prompt diagnosis and management in a low-resource setting presents additional challenges.

2018 Obstetrics and Gynecology

69. Pelvic Chlamydial Infection Predisposes to Ectopic Pregnancy by Upregulating Integrin β1 to Promote Embryo-tubal Attachment (PubMed)

Pelvic Chlamydial Infection Predisposes to Ectopic Pregnancy by Upregulating Integrin β1 to Promote Embryo-tubal Attachment Tubal ectopic pregnancies are a leading cause of global maternal morbidity and mortality. Previous infection with Chlamydia trachomatis is a major risk factor for tubal embryo implantation but the biological mechanism behind this association is unclear. Successful intra-uterine embryo implantation is associated with increased expression of endometrial "receptivity (...) increased OE-E6/E7 cell ITGB1 expression and promoted trophoblast attachment to OE-E6/E7 cells which was negated by anti-ITGB1-antibody. We demonstrate that infection with C. trachomatis increases tubal ITGB1 expression, predisposing to tubal embryo attachment and ectopic pregnancy.Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

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2018 EBioMedicine

70. Association between Prior Chlamydia trachomatis Infection and Ectopic Pregnancy at a Tertiary Care Hospital in South Western Uganda (PubMed)

Association between Prior Chlamydia trachomatis Infection and Ectopic Pregnancy at a Tertiary Care Hospital in South Western Uganda Increase in the number of ectopic pregnancy is attributed to increase in the incidence of pelvic infections. Chlamydia trachomatis is responsible for most of the sexually transmitted bacterial infections. If undetected and untreated, the infection can ascend to the upper genital tract and cause pelvic inflammatory disease (PID) and related sequelae (ectopic (...) pregnancy and tubal factor infertility).To determine the association between prior Chlamydia trachomatis infection and ectopic pregnancy at Mbarara Regional Referral Hospital (MRRH).This was an unmatched case-control study carried out at MRRH involving 25 cases and 76 controls. Serological evidence of prior chlamydial infection was determined by testing for the presence of Chlamydia immunoglobulin G antibodies in their blood. Logistic regression was used to determine the association between prior

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2018 Obstetrics and gynecology international

71. Ectopic pregnancy incidence in the Republic of Korea in 2009–2015: A population-based cross-sectional study (PubMed)

Ectopic pregnancy incidence in the Republic of Korea in 2009–2015: A population-based cross-sectional study We estimated the incidence of ectopic pregnancy (EP) and the success rate of expectant management of EP in South Korea. We analyzed data from 2009 to 2015 using the Health Insurance Review and Assessment Service National Inpatient Sample (HIRA-NIS) database. EP was identified by diagnostic codes, and strict EP was identified by both diagnostic codes and treatment codes. From 2009 (...) to 2015, 369,701 cases of EP, abortion, or delivery were extracted from a total of 4,476,495 women. Of the total pregnancies, 8,556 cases were EPs. The incidence of EP was 34.1 ± 0.7 per 1,000 pregnancies and the incidence of strict EP was 17.3 ± 0.3 per 1,000 pregnancies. Among women aged 25-44 years, age was associated with a higher incidence of EP (odds ratio [OR]: 1.13; 95% confidence interval [CI]: 1.06, 1.19; P < 0.01). The incidence rates of EP (OR: 0.99; 95% CI: 0.97, 1.01; P = 0.51) did

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2018 Scientific reports

72. A cohort of women with ectopic pregnancy: challenges in diagnosis and management in a rural hospital in a low-income country. (PubMed)

A cohort of women with ectopic pregnancy: challenges in diagnosis and management in a rural hospital in a low-income country. Ectopic pregnancy (EP) is a serious complication of early pregnancy. In low-income countries diagnosis of EP is difficult and it is a major contributor to maternal mortality. We aimed to assess and improve the diagnostic process of women with EP.We conducted a retrospective medical records study of all women with confirmed EP in Ndala Hospital from 2010 to 2012. We used (...) data on demographics, symptoms, diagnostic procedures, surgical findings, treatment and post-operative status.Six thousand six hundred sixty-two women gave birth in the hospital, and 88 women were diagnosed with EP (incidence 1.3%). Thirty-nine percent of women did not report to be pregnant or to have a history of amenorrhea. On admission in Ndala hospital, a diagnosis of 'suspected EP' was made in less than half (47%) of the cases. Most women had a urine pregnancy test done (sensitivity of 98

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2018 BMC Pregnancy and Childbirth

73. Successful diagnosis and treatment of early splenic ectopic pregnancy: A case report. (PubMed)

Successful diagnosis and treatment of early splenic ectopic pregnancy: A case report. Splenic ectopic pregnancy (SEP), a special abdominal pregnancy, is extremely rare but carries a high risk of potentially uncontrollable, life-threatening intraperitoneal bleeding at early gestation, which is equivalent to the spontaneous rupture of the spleen. Therefore, early diagnosis of SEP is crucial and may avoid life-threatening situation.A 29-year-old G3P2 woman presented with 50 days of amenorrhea (...) . The patient discharged with no complications and normal 1-month follow-up.It highlights that fully understanding of the knowledge about abdominal pregnancy, especially splenic pregnancy, and early imaging study with ultrasonography could reduce or avoid the misdiagnosis and miss-diagnosis of SEP.

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2018 Medicine

74. A multi-centre, double-blind, placebo-controlled, randomised trial of combination methotrexate and gefitinib versus methotrexate alone to treat tubal ectopic pregnancies (GEM3): trial protocol (PubMed)

A multi-centre, double-blind, placebo-controlled, randomised trial of combination methotrexate and gefitinib versus methotrexate alone to treat tubal ectopic pregnancies (GEM3): trial protocol Tubal ectopic pregnancy (tEP) is the most common life-threatening condition in gynaecology. Treatment options include surgery and medical management. Stable women with tEPs with pre-treatment serum human chorionic gonadotrophin (hCG) levels < 1000 IU/L respond well to outpatient medical treatment

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2018 Trials Controlled trial quality: predicted high

75. Uterine artery embolization combined with local infusion of methotrexate and 5- fluorouracil in treating ectopic pregnancy: A CONSORT-compliant article. (PubMed)

Uterine artery embolization combined with local infusion of methotrexate and 5- fluorouracil in treating ectopic pregnancy: A CONSORT-compliant article. To compare the efficiency and safety of uterine artery embolization (UAE) combined with local infusion of methotrexate (MTX) or MTX and 5-fluorouracil (5-FU) in the treatment of ectopic pregnancy (EP).One hundred women with EP were prospectively enrolled from December 2012 to February 2015 and randomly allocated into 2 groups. One group

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2018 Medicine Controlled trial quality: uncertain

76. Feasibility of single-incision laparoscopy for ruptured ectopic pregnancies with hemoperitoneum. (PubMed)

Feasibility of single-incision laparoscopy for ruptured ectopic pregnancies with hemoperitoneum. The aim of this study was to compare single-incision laparoscopic surgery (SILS) and conventional laparoscopy in ectopic pregnancies accompanied by severe hemoperitoneum.The main outcome measures were duration of surgery, intraoperative bleeding quantity, complications, post-operative pain scores, additional analgesic requirements, and length of hospital stay.A total of 53 women, 28 (...) at the sixth postoperative hour was lower in the SILS group. This effect was not observed at 12 and 24 hours.SILS appears to be effective and safe for the treatment of ruptured ectopic pregnancies accompanied by hemoperitoneum.

2018 Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy

77. A Ruptured Ectopic Pregnancy Presenting with a Negative Urine Pregnancy Test (PubMed)

A Ruptured Ectopic Pregnancy Presenting with a Negative Urine Pregnancy Test A negative urine pregnancy test in the emergency department traditionally excludes the diagnosis of pregnancy. We report a rare case of ruptured ectopic pregnancy in a patient with a negative urine pregnancy test but with a serum beta-human chorionic gonadotropin (β-hCG) of 10 mIU/mL. The patient developed hemoperitoneum and required laparoscopy by Obstetrics and Gynecology (OB/Gyn). This case highlights (...) the fallibility of the urine pregnancy test in diagnosing early pregnancy.

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2016 Case Reports in Emergency Medicine

78. Pre-pregnancy and Early Prenatal Care are Associated with Lower Risk of Ectopic Pregnancy Complications in the Medicaid Population: 2004-08. (PubMed)

Pre-pregnancy and Early Prenatal Care are Associated with Lower Risk of Ectopic Pregnancy Complications in the Medicaid Population: 2004-08. Ectopic pregnancy causes significant maternal morbidity and mortality. Complications are more common among women with Medicaid or no insurance compared to those with private insurance. It is unknown whether preventive care prior to pregnancy and prenatal care, which are covered by Medicaid, would decrease complications if they were more fully (...) utilised.Medicaid claims were used to identify a clinical cohort of women who experienced an ectopic pregnancy during 2004-08 among all female Medicaid enrolees from a large 14-state population, ages 15-44. Diagnosis and procedure codes were used to identify ectopic pregnancies and associated complications. The primary outcomes were complications associated with ectopic pregnancy: blood transfusion, sterilisation, or hospitalisation with length of stay greater than 2 days. Independent variables were

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2016 Paediatric and perinatal epidemiology

79. Can risk factors, clinical history and symptoms be used to predict risk of ectopic pregnancy in women attending an early pregnancy assessment unit? (PubMed)

Can risk factors, clinical history and symptoms be used to predict risk of ectopic pregnancy in women attending an early pregnancy assessment unit? To examine whether risk factors and symptoms may be used to predict the likelihood of ectopic pregnancy (EP) in women attending early pregnancy assessment units in the UK.This was an observational cohort study of pregnant women under 12 weeks' gestation who were recruited from three London university hospitals between August 2012 and April 2013. One (...) hospital continued recruitment between January and June 2015. A standardized information sheet incorporating patient demographics, medical history and symptoms was completed by patients and confirmed by examining clinicians. The outcome measure was final pregnancy location.There were 1320 eligible patients included in the analysis, with a total of 72 EPs (rate of 6%). Pelvic pain and diarrhea > three times in the previous 24 h were independent symptoms that increased the risk of EP, with relative risks

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2016 Ultrasound in Obstetrics and Gynecology

80. Diagnostic Methods of Ectopic Pregnancy and Early Pregnancy Loss: a Review of the Literature (PubMed)

Diagnostic Methods of Ectopic Pregnancy and Early Pregnancy Loss: a Review of the Literature This review article presents recent evidence on early pregnancy loss and ectopic pregnancy. In the light of recent evidence, the β-hCG discriminatory zone may be extended in clinically stable cases without evidence of bleeding. A possible cut-off is 4300 mIU/ml, which corresponds to when a sonographer should detect an intrauterine pregnancy. Embryonic demise can be confirmed when a transvaginal (...) ultrasound finding shows no heartbeat in an embryo of more than 7 mm CRL, no embryo in a gestational sac having a mean sac diameter of more than 25 mm, or no appearance of an embryo within 7-10 days after the primary examination. These are considered definitive signs of embryonic demise. Suggestive signs of embryonic demise require closer monitoring of the pregnancy.

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2016 Geburtshilfe Und Frauenheilkunde

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