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Ectopic Pregnancy

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82. Molar Pregnancy Presents as Tubal Ectopic Pregnancy: A Rare Case Report (PubMed)

Molar Pregnancy Presents as Tubal Ectopic Pregnancy: A Rare Case Report The incidence of hydatidiform mole is 1 per 1000 pregnancies. The occurrence of hydatidiform mole in ruptured tubal pregnancy is very rare. We report an unusual case of molar pregnancy in the right fallopian tube which presented as an adherent adnexal mass. The present case conveys the importance of histological examination of products of conception which helps the pathologist to provide an appropriate diagnosis, thereby

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2016 Journal of clinical and diagnostic research : JCDR

83. Complicated abdominal pregnancy with placenta feeding off sacral plexus and subsequent multiple ectopic pregnancies during a 4-year follow-up: a case report (PubMed)

Complicated abdominal pregnancy with placenta feeding off sacral plexus and subsequent multiple ectopic pregnancies during a 4-year follow-up: a case report Abdominal pregnancy (pregnancy in the peritoneal cavity) is a very rare and serious type of extrauterine gestation that accounts for approximately 1.4% of all ectopic pregnancies. It also represents one of the few times an ectopic pregnancy can be carried to term. Early strategic diagnosis and management decisions can make a critical (...) tenderness and no blood in the vaginal vault. Laboratory findings corresponded to an increased level of beta human chorionic gonadotropin; magnetic resonance imaging confirmed an abdominal pregnancy. She underwent feticide, administration of methotrexate and a laparotomy was done which was immediately deferred due to perceived increased bleeding risk. She was found to have an intra-abdominal ectopic pregnancy with the placenta attached to her omentum, cul-de-sac and rectosigmoid, with unusual

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2016 Journal of medical case reports

84. Retroperitoneal ectopic pregnancy: a case report and review of the literature. (PubMed)

Retroperitoneal ectopic pregnancy: a case report and review of the literature. Retroperitoneal ectopic pregnancy (REP) is an extremely rare type of ectopic pregnancy, with a total of less than 20 cases reported in the English literature. However, failure to recognize REP may result in severe consequences.We report a case of 32-year-old woman with REP. She had amenorrhea, left lower abdominal pain, but no vaginal bleeding. Her urine human chorionic gonadotropin (HCG) test was positive and blood (...) broad ligament. The patient was diagnosed of having REP with the gestational tissues covered by the peritoneum. The REP was removed by laparoscopic surgery. Bleeding was stopped by bipolar coagulation and absorbable hemostatic cellulose. The patient recovered smoothly and was discharged on the next day after surgery. Her blood HCG returned to normal range 29 days after surgery.REP is very rare, but in any suspected case of ectopic pregnancy, caution must be paid to find signs of REP when the common

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2017 BMC Pregnancy and Childbirth

85. New Evidence to Guide Ectopic Pregnancy Diagnosis and Management. (PubMed)

New Evidence to Guide Ectopic Pregnancy Diagnosis and Management. Ectopic pregnancy is a leading source of morbidity and mortality in pregnancy, accounting for 1% to 2% of all pregnancies. Timely diagnosis and management of these abnormal gestations are vital to patient safety.The objective of this study was to describe recent evidence in the risk factors, diagnosis, and management of ectopic pregnancy.Comprehensive review of the published literature.Recent literature describes newly identified (...) risk factors for ectopic pregnancy, particularly those specific to assisted reproduction. Furthermore, evidence mounts for the utility of endometrial sampling for the diagnosis of pregnancy location, allowing a significant proportion of women to avoid methotrexate by diagnosing failing intrauterine pregnancies instead. Finally, recent, high-level evidence supports (in women with normal contralateral fallopian tubes) the equivalence of salpingectomy and salpingostomy regarding rates of subsequent

2017 Obstetrical & Gynecological Survey

86. A systematic review of ectopic pregnancy after hysterectomy. (PubMed)

A systematic review of ectopic pregnancy after hysterectomy. An ectopic pregnancy after hysterectomy is a rare but potentially life-threatening event. Women with this condition might not be appropriately investigated, resulting in delays in diagnosis and treatment.To characterize cases of ectopic pregnancy occurring after hysterectomy.PubMed, Embase, Scopus, and Web of Science were searched using the terms "pregnancy, abdominal" or "pregnancy, tubal" or "pregnancy, ectopic" and "hysterectomy (...) in a remaining fallopian tube was common. Most patients were managed surgically.A high index of suspicion and a low threshold for performing a β-hCG pregnancy test is recommended in all women presenting with clinical symptoms of ectopic pregnancy, regardless of the hysterectomy status. This could lead to earlier diagnosis and fewer complications.© 2017 International Federation of Gynecology and Obstetrics.

2017 International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

87. Multiple-dose and double-dose versus single-dose administration of methotrexate for the treatment of ectopic pregnancy: a systematic review and meta-analysis. (PubMed)

Multiple-dose and double-dose versus single-dose administration of methotrexate for the treatment of ectopic pregnancy: a systematic review and meta-analysis. In this systematic review and meta-analysis, the effectiveness and safety among different dosage of methotrexate protocols for the treatment of unruptured tubal ectopic pregnancy was evaluated. Six studies of randomized contorlled trials were identified through searches conducted on PubMed, Embase and Cochrane Library between January 1974

2017 Reproductive biomedicine online

88. Repeat acute abdomen and hemoperitoneum during the same pregnancy due to a ruptured ectopic treated by salpingostomy. (PubMed)

Repeat acute abdomen and hemoperitoneum during the same pregnancy due to a ruptured ectopic treated by salpingostomy. A leading cause of maternal mortality in the first trimester is hemorrhage due to a ruptured ectopic pregnancy. With the advent of tube salvage surgery, ectopic pregnancies can be removed while ensuring hemostasis and preserving the integrity of the fallopian tube. A major drawback of tube salvage surgery is the significant risk of persistent trophoblastic tissue being left (...) behind. We report a case of a 30year old female who presented to the ED with acute abdomen and hemoperitoneum due to a ruptured ectopic pregnancy. She was treated with salpingostomy and the pathologic report confirmed removal of the ectopic pregnancy. After an initially uneventful post-operative recovery, she presented to the ED 27days later with signs of acute abdomen and hemoperitoneum. Surgical intervention confirmed a ruptured ectopic pregnancy in the same site as previous, and salpingectomy

2017 American Journal of Emergency Medicine

89. Ectopic Pregnancy-ClinicoRadiological Approach

Ectopic Pregnancy-ClinicoRadiological Approach Ectopic Pregnancy-ClinicoRadiological Approach - Sumer's Radiology Blog Top Ad unit 728 × 90 Radiology News radiology Ectopic Pregnancy-ClinicoRadiological Approach Ectopic Pregnancy-ClinicoRadiological Approach , Sumer Sethi About Dr. Sumer Sethi Number of Entries : 35 Unique blend of academic excellence and entrepreneurship, heading leading firms in India- Teleradiology Providers, pioneering company providing teleradiology services and DAMS

2017 Sumer's Radiology Blog

90. Reduced Ectopic Pregnancy Rate on Day 5 Embryo Transfer Compared with Day 3: A Meta-Analysis. (PubMed)

Reduced Ectopic Pregnancy Rate on Day 5 Embryo Transfer Compared with Day 3: A Meta-Analysis. To compare the risk of ectopic pregnancy (EP) after embryo transfer on day 3(D3-ET) and day 5(D5-ET).Meta-analysis.Women with pregnancy resulting from in vitro undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).Twenty-two studies were identified through research conducted using the PubMed, Embase, and Cochrane databases and ClinicalTrials.gov. All studies were conducted (...) prior to October 2016. Adding the reproductive data from our center, a total of 143 643 pregnancies were reviewed(D3-ET: n = 62027,D5-ET:n = 81616). A lower EP rate was found in women undergoing D5-ET than in those undergoing D3-ET [relative risk (RR), 0.67;95% confidence interval (CI), 0.54-0.85;143643 pregnancies in 23 studies; I2 = 67%]. These results were validated in subgroups of fresh embryo-transfer (Fre-ET) cycles [RR, 0.78; 95%CI, 0.69-0.88; 91 871 pregnancies in 21 studies; I2 = 29

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2017 PloS one

91. Ectopic pregnancy: exploration of its global research architecture using density-equalising mapping and socioeconomic benchmarks. (PubMed)

Ectopic pregnancy: exploration of its global research architecture using density-equalising mapping and socioeconomic benchmarks. About 2% of all pregnancies are complicated by the implantation of the zygote outside the uterine cavity and termed ectopic pregnancy. Whereas a multitude of guidelines exists and related research is constantly growing, no thorough assessment of the global research architecture has been performed yet. Hence, we aim to assess the associated scientific activities (...) in relation to geographical and chronological developments, existing research networks and socioeconomic parameters.Retrospective, descriptive study.On the basis of the NewQIS platform, scientometric methods were combined with novel visualising techniques such as density-equalising mapping to assess the scientific output on ectopic pregnancy. Using the Web of Science, we identified all related entries from 1900 to 2012.8040 publications were analysed. The USA and the UK were dominating the field in regard

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2017 BMJ open

92. How to Measure Size of Tubal Ectopic Pregnancy on Ultrasound Scan? (PubMed)

How to Measure Size of Tubal Ectopic Pregnancy on Ultrasound Scan? To identify the preoperative ultrasound parameters for assessing the size of tubal ectopic pregnancy that correlate best with findings at surgery.This was a prospective study of all women attending our center who had a conclusive transvaginal ultrasound diagnosis of tubal ectopic pregnancy over a 10-month period. In each case, the total size of the ectopic pregnancy was measured by placing the calipers on the outer edges (...) of the visible trophoblastic tissue. In ectopic pregnancies presenting with a well-defined gestational sac, the size of the celomic (chorionic) cavity was also measured using the inner borders of the trophoblastic ring as reference points. In women with signs of intra-abdominal bleeding, the size of the hematosalpinx and/or hemoperitoneum was measured. Surgeons were blinded to the ultrasound measurements and were asked to estimate the size of the ectopic pregnancy and the amount of hemoperitoneum

2017 Ultrasound in Obstetrics and Gynecology

93. Delayed Detection of Spontaneous Bilateral Tubal Ectopic Pregnancies After Methotrexate Treatment. (PubMed)

Delayed Detection of Spontaneous Bilateral Tubal Ectopic Pregnancies After Methotrexate Treatment. Bilateral tubal ectopic pregnancies are a rare subset of ectopic pregnancy that can pose a diagnostic dilemma for clinicians. There is no distinct clinical presentation for bilateral tubal ectopic pregnancies, although they are typically associated with assistive reproductive techniques. In addition, there is no single diagnostic feature to help clinicians delineate bilateral tubal ectopic (...) pregnancies from other types of ectopic pregnancy prior to passing the discriminatory zone (such as heterotopic pregnancy or twin ectopic [two gestational sacs in one tube]). Diagnosis is typically made via direct visualization intraoperatively and therefore treatment is usually surgical.We present a case of spontaneous bilateral tubal ectopic pregnancies diagnosed 7 days apart via transvaginal ultrasound. The patient presented to the emergency department with pelvic pain on the contralateral side of her

2017 Journal of Emergency Medicine

94. Practice Bulletin No. 191: Tubal Ectopic Pregnancy. (PubMed)

Practice Bulletin No. 191: 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.

2017 Obstetrics and Gynecology

95. Emergency Medicine Myths: Ectopic Pregnancy Evaluation, Risk Factors, and Presentation. (PubMed)

Emergency Medicine Myths: Ectopic Pregnancy Evaluation, Risk Factors, and Presentation. Ectopic pregnancy (EP) is an important cause of morbidity and mortality in females of reproductive age. Proper diagnosis and treatment are critical, as complications such as rupture, hemorrhagic shock, and even death can occur.EP is a condition emergency physicians are trained to detect, yet there are multiple myths concerning its evaluation and diagnosis. This article reviews several of these myths in order (...) may have positive ultrasound findings with serum β-hCG levels under a defined discriminatory zone (DZ). On the other hand, some patients with an early viable intrauterine pregnancy may have no visible findings on initial ultrasound, but have serum β-hCG (quantitative) levels well above the DZ. Although rare, EP has even been demonstrated in women with negative urine β-hCG tests or low serum β-hCG levels.While EP may be a challenging diagnosis, understanding the myths surrounding EP may help

2017 Journal of Emergency Medicine

96. Expectant management of caesarean scar ectopic pregnancy: a systematic review. (PubMed)

Expectant management of caesarean scar ectopic pregnancy: a systematic review. The purpose of this review is to systematically review all the reported cases and case series of caesarean scar pregnancy (CSP) managed expectantly without any intervention in order to understand the outcomes of pregnancy which will guide clinicians and patients in making treatment choices.An electronic search on PubMed, EMBASE and Cochrane databases and a manual search from references of the articles were performed (...) . Studies were selected based on inclusion and exclusion criteria. Data were extracted for various outcomes of pregnancy and the quality of the reports was assessed using a modified Delphi technique.A total of 56 cases of CSP from 11 reports were included in the review, including 44 cases with foetal cardiac activity. Live births were achieved in 73% of cases with a quarter of them born before 34 weeks. Hysterectomy rates were 70%. In 12/44 (27%) of cases pregnancies were lost due to complications

2017 Journal of perinatal medicine

97. Comparison of management regimens following ultrasound diagnosis of nontubal ectopic pregnancies: a retrospective cohort study. (PubMed)

Comparison of management regimens following ultrasound diagnosis of nontubal ectopic pregnancies: a retrospective cohort study. To review management options for nontubal ectopic pregnancies.Retrospective cohort study.Tertiary hospital in Melbourne, Australia.A total of 100 nontubal pregnancies: 1 abdominal, 32 caesarean scar, 14 cervical, 41 cornual-interstitial, 12 ovarian.Cases were classified according to ectopic site. Management categories were medical, surgical, combination or expectant (...) interventions.Minimally invasive approaches were found to be safe and effective treatment for women desiring to conserve fertility. Ultrasound-guided intra-sac injection and laparoscopic ectopic removal procedures aimed at preserving reproductive organs should be included as minimally invasive primary management tools in addition to the well-recognised option of systemic methotrexate.Nontubal ectopics: minimally invasive procedures a safe alternative to surgery in selected cases.© 2017 Royal College of Obstetricians

2017 BJOG

98. Comparison of ectopic pregnancy risk among transfers of embryos vitrified on day 3, day 5, and day 6. (PubMed)

Comparison of ectopic pregnancy risk among transfers of embryos vitrified on day 3, day 5, and day 6. To compare ectopic pregnancy risk among transfers of embryos vitrified on day 3, day 5, and day 6.Retrospective cohort study.Academic tertiary-care medical center.A total of 10,736 pregnancies after 23,730 frozen-thawed embryo transfer (FET) cycles of in vitro fertilization/intracytoplasmic sperm injection from March 2003 to May 2015.The ectopic pregnancy rate was compared among pregnancies (...) resulting from transfers of embryos vitrified on day 3, day 5, and day 6. Generalized estimation equation regression models were used to calculate unadjusted and adjusted odds ratios and 95% confidence intervals for the association between ectopic pregnancy and selected patient and treatment characteristics. We studied this association in both the group that achieved pregnancy and the group that underwent an FET cycle.Odds of ectopic pregnancy.The overall rate of ectopic pregnancy was 2.8% (304/10,736

2017 Fertility and Sterility

99. Ectopic pregnancy in women with inflammatory bowel disease - a 22 year nationwide cohort study. (PubMed)

Ectopic pregnancy in women with inflammatory bowel disease - a 22 year nationwide cohort study. Few data are available on adverse events of pregnancy in women with inflammatory bowel diseases (IBD), such as ectopic pregnancy. We assessed the risk of ectopic pregnancy in pregnancies of women in Denmark with IBD compared with those without IBD over a 22-year period. We also examined the disease-specific risks of ectopic pregnancies in pregnancies of women with ulcerative colitis (UC) or Crohn's (...) disease (CD) who underwent IBD-related surgical procedures.We performed a retrospective study of all women of child-bearing age (ages, 15-50 y) registered in the Danish National Patient Registry with at least 1 pregnancy during the period from January 1994 through December 31, 2015. We collected data on all women with an ectopic pregnancy, hydatidiform mole, miscarriages (spontaneous and other abortions, including abnormal pregnancy products, missed abortion, and pregnancy without a fetus), induced

2017 Clinical Gastroenterology and Hepatology

100. Impact of hysterosalpingography after operative treatment for ectopic pregnancy in Taiwan: A 16-year Nationwide Population-Based Analysis. (PubMed)

Impact of hysterosalpingography after operative treatment for ectopic pregnancy in Taiwan: A 16-year Nationwide Population-Based Analysis. By retrieving records from Taiwan's National Health Insurance (NHI) system's database, the current study aimed to investigate the impacts of hysterosalpingography (HSG) to patients after ectopic pregnancy (EP) operations in Taiwan.In this retrospective cohort study, insurance claims data from 1997 to 2013, derived from a cohort of 1 million people randomly (...) sampled to represent all NHI beneficiaries, were analyzed. Patients after ectopic pregnancy (EP) operations were identified via the inclusion of the corresponding NHI procedure codes. We further divided the patients into 2 groups by whether received subsequent HSG, EP-HSG, and EP-no-HSG. Patients with history of previous pregnancies (PP) and subsequent HSG were grouped as PP-HSG. We sought to evaluate the following pregnancies (FP) rate, interval to FP in EP-HSG compared with that in EP-no-HSG, and PP

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2017 Medicine

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