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Ectopic Pregnancy

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141. Overview of pregnancy complications

Overview of pregnancy complications Overview of pregnancy complications - Summary of relevant conditions | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Overview of pregnancy complications Last reviewed: February 2019 Last updated: September 2018 Introduction Complications in pregnancy can result from conditions that are specifically linked to the pregnant state as well as conditions that commonly arise or occur incidentally in women who are pregnant (...) need for folate. Complications include neural tube defects, spontaneous abortion, and placental abruption. Goh YI, Koren G. Folic acid in pregnancy and fetal outcomes. J Obstet Gynaecol. 2008;28:3-13. http://www.ncbi.nlm.nih.gov/pubmed/18259891?tool=bestpractice.com In pregnant women, iron deficiency anaemia is defined as haemoglobin below 110 g/L (<11 g/dL). Goddard AF, James MW, McIntyre AS, et al; British Society of Gastroenterology. Guidelines for the management of iron deficiency anaemia. Gut

2018 BMJ Best Practice

142. Assessment of abdominal pain in pregnancy

not only to pregnancy-specific causes or gynaecological conditions, but to many other diseases whose symptoms and signs may be altered significantly by the pregnant state. This is particularly true from the late second trimester onwards. Evaluation is based on 2 patients: the mother and the fetus. The potential adverse effects of anaesthesia, drugs, and radiation on the fetus often complicate the traditional diagnostic approach. As a result, the presence of the fetus may lead to delayed intervention (...) or invasive diagnostic tests. Furthermore, there is a general reluctance to operate unnecessarily on a gravid patient. The acute abdomen in pregnancy remains a diagnostic dilemma. As pregnancy stretches the anterior abdominal wall, the resulting peritoneal signs are often different from what is expected in the non-pregnant patient owing to lack of contact with the underlying inflammation. In addition, the clinical picture may be distorted by the uterus obstructing the movement of the omentum to the area

2018 BMJ Best Practice

143. Managing the disposal of pregnancy remains Full Text available with Trip Pro

the 24th week of gestation. This will include following an ectopic pregnancy, early intrauterine fetal death, miscarriage, or a medically or surgically induced termination of pregnancy. Publication date: December 2018 Review date: December 2022. The Nine Quality Standards This publication has met the nine quality standards of the quality framework for RCN professional publications. For more information, or to request further details on how the nine quality standards have been met in relation (...) disposal of pregnancy remains, where the pregnancy has ended before the 24th week of gestation. This will include following an ectopic pregnancy, early intrauterine fetal death, miscarriage, or a medically or surgically induced termination of pregnancy. This guidance does not refer to the disposal of embryos created in vitro (for fertility treatment or embryo research), a process which is regulated by the Human Fertilisation and Embryology Authority (HFEA). Neither does it apply to care following

2018 Royal College of Nursing

144. Management of Cardiovascular Diseases during Pregnancy Full Text available with Trip Pro

dissection, and myocardial infarction (MI) were the most common causes of maternal death in the UK over the period 2006–08. Knowledge of the risks associated with CVDs during pregnancy and their management in pregnant women who suffer from serious pre-existing conditions is of pivotal importance for advising patients before pregnancy. Since all measures concern not only the mother but the foetus as well, the optimum treatment of both must be targeted. A therapy favourable for the mother can be associated (...) disease Expert centre for pregnancy and cardiac disease mWHO I mWHO II mWHO II – III mWHO III mWHO IV Diagnosis (if otherwise well and uncomplicated) Small or mild – pulmonary stenosis – patent ductus arteriosus – mitral valve prolapse Successfully repaired simple lesions (atrial or ventricular septal defect, patent ductus arteriosus, anomalous pulmonary venous drainage) Atrial or ventricular ectopic beats, isolated Unoperated atrial or ventricular septal defect Repaired tetralogy of Fallot Most

2018 European Society of Cardiology

145. Pregnancy

have questions please contact us via jon.brassey@tripdatabase.com Top results for pregnancy 1. Oral anti-diabetic agents for women with established diabetes/impaired glucose tolerance or previous gestational diabetes planning pregnancy , or pregnant women with pre-existing diabetes. BACKGROUND: While most guidance recommends the use of insulin in women whose pregnancies are affected by pre-existing diabetes, oral anti-diabetic agents may be more acceptable to women. The effects of these oral anti (...) -diabetic agents on maternal and infant health outcomes need to be established in pregnant (...) women with pre-existing diabetes or impaired glucose tolerance, as well as in women with previous gestational diabetes mellitus preconceptionally or during a subsequent pregnancy . OBJECTIVES: To investigate the effects of oral anti-diabetic agents in women with established diabetes, impaired glucose tolerance or previous gestational diabetes who are planning a pregnancy , or pregnant women with pre-existing

2018 Trip Latest and Greatest

146. Diagnostic Biomarkers for Predicting Adverse Early Pregnancy Outcomes Full Text available with Trip Pro

‐diagnostic. However, a single measurement of maternal serum β‐hCG is of limited value due to the wide range of levels in normal early pregnancy. As a result, it has not been possible to define a cut‐off level below which a miscarriage could be reliably diagnosed. It had been proposed that in women for whom an intrauterine pregnancy cannot be confirmed during TVS, a single measurement of serum β‐hCG above 1000–2000 IU/l could be indicative of an ectopic pregnancy. However, it has since been shown (...) that in as many as 78% of women with ectopic pregnancies visible on ultrasound, serum β‐hCG values were below 1000 IU/l. , By contrast, in a number of women with normal intrauterine pregnancies, the pregnancy could not be detected on ultrasound despite initial serum β‐hCG levels greater than 1000 IU/l. This scenario is most likely to occur in women with multiple pregnancies. Noncritical adoption of β‐hCG cut‐off levels in these cases could lead to unintended medical or surgical termination of wanted

2018 Royal College of Obstetricians and Gynaecologists

147. Protocol for a systematic review on the frequencies of each type of adverse event (AE) of systemic single-dose methotrexate treatment compared to placebo or other doses and routes, for ectopic pregnancy and persistent pregnancy of unknown location (PUL)

Protocol for a systematic review on the frequencies of each type of adverse event (AE) of systemic single-dose methotrexate treatment compared to placebo or other doses and routes, for ectopic pregnancy and persistent pregnancy of unknown location (PUL) Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content

2017 PROSPERO

148. Is a Self-Assessed Questionnaire Useful for the Diagnosis of Ectopic Pregnancy in Hospitalized Patients? Full Text available with Trip Pro

Is a Self-Assessed Questionnaire Useful for the Diagnosis of Ectopic Pregnancy in Hospitalized Patients? Delayed diagnosis of ectopic pregnancy (EP) is responsible for maternal morbidity and mortality. Our objective was to develop and validate decision rules for the diagnosis of EP, in patients in their first trimester of pregnancy with symptoms, based solely on a self-assessment questionnaire.From September 2006 to March 2008, 574 patients, who have consulted for acute pelvic pain (...) independently and significantly (p<0.05) associated with EP: no frequent need to change sanitary towels (aDOR = 6.1; 95% CI [2.1-17.8]), duration of bleeding > 24 hours (aDOR = 4,3; 95% CI [1,7-11,0]), pain during coughing (aDOR = 3.1; CI 95% [1,4-6,7]), brown discharge (aDOR = 3.0; 95% CI [1.3-7.1]) and unilateral pelvic pain (aDOR = 2.7; 95% CI [1.3-5.9]). The SAQ-GE ectopic pregnancy score was based on these five criteria with values ranging from 0 to 100. The low-risk group of EP (score<25) had

2016 PLoS ONE

149. Termination of pregnancy

attention · Signs of infection include fever, lethargy, offensive vaginal discharge, excessive pain Ectopic pregnancy · There may be a possibility of ectopic pregnancy – especially if the pregnancy site was not confirmed by ultrasound scan before the procedure · If there is increasing pain and/or a reoccurrence of vaginal bleeding seek medical assistance Breast discomfort · Can persist for two weeks (especially after mid trimester terminations) · Lactation can occur (at later gestations) · Advise (...) Termination of pregnancy Maternity and Neonatal C linical G uideline Queensland Health Termination of pregnancy Queensland Clinical Guideline: Termination of pregnancy Refer to online version, destroy printed copies after use Page 2 of 32 Document title: Termination of pregnancy Publication date: April 2013 Document number: MN13.21-V3-R19 Document supplement: The document supplement is integral to and should be read in conjunction with this guideline. Amendments: Full version history

2019 Queensland Health

150. Ectopic Pregnancy in Uncommon Implantation Sites: Intramural Pregnancy and Rudimentary Horn Pregnancy Full Text available with Trip Pro

Ectopic Pregnancy in Uncommon Implantation Sites: Intramural Pregnancy and Rudimentary Horn Pregnancy Ectopic pregnancy is commonly located in the fallopian tube. Nevertheless, two unusual types of ectopic pregnancy, intramural pregnancy and rudimentary horn pregnancy, seriously threaten maternal life. The diagnosis and treatment of these unusual implantation sites present a clinical challenge. In this study, we illustrated the two unusual types of ectopic pregnancy and summarized the current

2015 Case reports in obstetrics and gynecology

151. Management of Pregnancy

that arise during pregnancy, such as ectopic pregnancy, may require immediate attention while others are more chronic. Regardless of the type of complication, each requires the appropriate level of medical support, which may vary depending on the pregnant woman’s current environment. Once a woman has delivered her baby, she may struggle with breastfeeding in the context of VA/DoD Clinical Practice Guideline for the Management of Pregnancy March 2018 Page 8 of 147 unpredictable and demanding work (...) Health System,” by facilitating the development of clinical practice guidelines (CPGs) for the VA and DoD populations.[ ] This CPG is intended to provide healthcare providers with a framework by which to evaluate, treat, and manage the individual needs and preferences of pregnant women, thereby leading to improved clinical outcomes. 1 In 2009, the VA and DoD published a CPG for the Management of Pregnancy (2009 Pregnancy CPG), which was based on evidence reviewed through December 2007. Since

2018 VA/DoD Clinical Practice Guidelines

152. CRACKCast E177 – Acute Complications of Pregnancy

check out EM Cases Rapid Reviews Videos on Shownotes – Key Points You know a chapter is gargantuan when the summary points are two pages long….so here we go. We’ll cover the key, key concepts Ectopic pregnancy Bleeding in late pregnancy Hypertension in pregnancy AF Embolism Rh immunization Abd pain in pregnancy N/V in pregnancy VTE in pregnancy Vaginal and UTIs Thyroid disease Ectopic Pregnancy An ectopic pregnancy can masquerade as a threatened miscarriage in the early stages of pregnancy (...) and should always be considered in the differential diagnosis. The history and physical examination of the patient with ectopic pregnancy are insensitive and nonspecific, pelvic ultrasonography and serum hCG levels are essential to locate the pregnancy in any patient who has abdominal pain or vaginal bleeding and a positive pregnancy test result. Bleeding in Late Pregnancy Bleeding during the second trimester (14–24 weeks) is not benign and is associated with a 33% risk of fetal loss. Management

2018 CandiEM

153. Early Pregnancy Loss

risk factors thought to be associated with early pregnancy loss is beyond the scope of this docu- ment and is covered in more detail in other publications (6, 7). Clinical Considerations and Recommendations < What findings can be used to confirm a diagnosis of early pregnancy loss? Common symptoms of early pregnancy loss, such as vaginal bleeding and uterine cramping, also are common in normal gestation, ectopic pregnancy, and molar preg- nancy. Before initiating treatment, it is important (...) to be associated with early pregnancy loss but should not be used to make a defini- tive diagnosis (17). These findings warrant further eval- uation in 7–10 days (14). In cases in which an intrauterine gestation cannot be identified with reasonable certainty, serial serum b-hCG measurements and ultrasound examinations may be required before treatment to rule out the possibility of an ectopic pregnancy. A detailed description of the rec- ommended approach to ectopic pregnancy diagnosis and management

2018 American College of Obstetricians and Gynecologists

154. Maternal, pregnancy and neonatal outcomes following IVF pregnancies

of ectopic pregnancy after ART 37 Table 3b: Risk factors for ectopic pregnancy in ART 38 Table 4a: Pregnancy loss after ART incidence 41 Table 4b: Risk factors for pregnancy loss after ART 42 Table 5a: Incidence of antepartum haemorrhage in ART pregnancies 48 Table 5b: Risk factors for antepartum haemorrhage in ART pregnancies 50 Table 6a: Incidence of hypertensive disorders in ART pregnancies 52 5 MATERNAL, PREGNANCY AND NEONATAL OUTCOMES FOLLOWING IVF: A RAPID REVIEW | SAX INSTITUTE Table 6b: Risk (...) matrix of all studies is presented in the Appendix to this report. Outcomes 1. What is the evidence regarding the effect of ART on pregnancy outcomes and the maternal or treatment factors that may alter this effect? 1.1. Ectopic pregnancy 1.1.1. Is the incidence different between ART and naturally conceived pregnancies? Whether the incidence of ectopic pregnancy after ART is higher or lower when compared with spontaneously conceived cycles in subfertile patients has been evaluated in one recently

2015 Sax Institute Evidence Check

155. Pre-pregnancy and Early Prenatal Care are Associated with Lower Risk of Ectopic Pregnancy Complications in the Medicaid Population: 2004-08. Full Text available with Trip Pro

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

2016 Paediatric and perinatal epidemiology

157. Trends in ectopic pregnancy rates following assisted reproductive technologies in the UK: a 12-year nationwide analysis including 160 000 pregnancies. Full Text available with Trip Pro

Trends in ectopic pregnancy rates following assisted reproductive technologies in the UK: a 12-year nationwide analysis including 160 000 pregnancies. Have the advancement of assisted reproductive technologies (ART) and changes in the incidence of specific causes of infertility-altered ectopic pregnancy (EP) rates following ART over time in the UK?EP rates in the UK following IVF/ICSI have progressively decreased, and this appears to be associated with a reduction in the incidence of tubal (...) factor infertility and the increased use of both a lower number of embryos transferred and extended embryo culture.Historically, EP rates following ART are known to have increased over time. However, the impact of progress in ART procedures and changes in both policy and the incidence of specific causes of infertility on the overall EP rate in the UK has yet to be studied.A population-based retrospective analysis was carried out on all pregnancies following ART cycles carried out in the UK between

2016 Human Reproduction

158. Molar Pregnancy Presents as Tubal Ectopic Pregnancy: A Rare Case Report Full Text available with Trip Pro

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

2016 Journal of clinical and diagnostic research : JCDR

159. A Ruptured Ectopic Pregnancy Presenting with a Negative Urine Pregnancy Test Full Text available with Trip Pro

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.

2016 Case Reports in Emergency Medicine

160. Diagnostic Methods of Ectopic Pregnancy and Early Pregnancy Loss: a Review of the Literature Full Text available with Trip Pro

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.

2016 Geburtshilfe Und Frauenheilkunde

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