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Ectopic Pregnancy

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161. Complicated abdominal pregnancy with placenta feeding off sacral plexus and subsequent multiple ectopic pregnancies during a 4-year follow-up: a case report Full Text available with Trip Pro

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

2016 Journal of medical case reports

162. Quantitative analysis of hormones and inflammatory cytokines in Chlamydia trachomatis-infected women with tubal ectopic pregnancy and early intrauterine pregnancy Full Text available with Trip Pro

Quantitative analysis of hormones and inflammatory cytokines in Chlamydia trachomatis-infected women with tubal ectopic pregnancy and early intrauterine pregnancy In this data, non-pregnant women during the menstrual cycle, women with normal intrauterine pregnancy (IUP), and women with tubal ectopic pregnancy (EP) after informed consent were included. The serum levels of 17β-estradiol, progesterone, testosterone, beta-human chorionic gonadotropin, interleukin (IL)-1β, IL-4, IL-6, IL-7, IL-8, IL (...) -pregnant conditions regardless of C. trachomatis infection.

2015 Data in brief

163. The value of ratio of hCG, progesterone in local blood of pregnancy location versus venous blood in the diagnosis of ectopic pregnancy Full Text available with Trip Pro

The value of ratio of hCG, progesterone in local blood of pregnancy location versus venous blood in the diagnosis of ectopic pregnancy The aim of this study is to combine the ratios of venous serum/colporrhagia and hemoperitoneum/venous serum of human chorionic gonadotropin (hCG) and Progesterone (P) to generate and evaluate a new method to improve the prognosis of Ectopic pregnancy (EP).For patients with curettage procedure, curettage material and venous blood were obtained at the same time

2015 International journal of clinical and experimental medicine

164. Randomized comparison of health-related quality of life in women with ectopic pregnancy or pregnancy of unknown location treated with systemic methotrexate or expectant management. (Abstract)

Randomized comparison of health-related quality of life in women with ectopic pregnancy or pregnancy of unknown location treated with systemic methotrexate or expectant management. To study the impact on health-related quality of life (HRQoL) of treatment with systemic methotrexate (MTX) or expectant management in women with ectopic pregnancy or pregnancy of unknown location (PUL) with low and plateauing serum hCG concentrations.HRQoL was assessed alongside a randomized clinical trial (RCT (...) ) with the use of standard self-administered psychometric measure questionnaires.All women who participated in the multicenter RCT comparing treatment with systemic MTX to expectant management in women with ectopic pregnancy or persisting PUL were eligible for the HRQoL measurements.HRQoL measures of three standardized questionnaires (SF-36, RSCL, HADS).Data were available for 64 of 73 women (78%) randomized in the RCT. We found no difference in HRQoL between the two treatment groups. The need for additional

2015 European journal of obstetrics, gynecology, and reproductive biology Controlled trial quality: uncertain

165. Pregnancy-associated microRNAs in plasma as potential molecular markers of ectopic pregnancy. (Abstract)

Pregnancy-associated microRNAs in plasma as potential molecular markers of ectopic pregnancy. To investigate cell-free pregnancy-associated microRNAs as molecular markers for the diagnosis of ectopic pregnancy.Laboratory study using human plasma samples.Research unit in a university hospital.Plasma samples from 18 women with ectopic pregnancies (EP group), 12 women with spontaneous abortion (SA group), and 26 normal women with singleton pregnancies (NP group).Total RNAs containing small RNA (...) from SA, yielding an area under the curve of 0.7454 (95% confidence interval, 0.5558-0.9349).Cell-free pregnancy-associated microRNAs have potential as molecular markers of ectopic pregnancy.Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

2015 Fertility and Sterility

166. Ectopic pregnancy rate increases with the number of retrieved oocytes in autologous in vitro fertilization with non-tubal infertility but not donor/recipient cycles: an analysis of 109,140 clinical pregnancies from the Society for Assisted Reproductive Te (Abstract)

Ectopic pregnancy rate increases with the number of retrieved oocytes in autologous in vitro fertilization with non-tubal infertility but not donor/recipient cycles: an analysis of 109,140 clinical pregnancies from the Society for Assisted Reproductive Te To study the impact of controlled ovarian stimulation on ectopic pregnancy (EP) rate as a function of the number of oocytes retrieved, using donor IVF cycles as a control.Retrospective cohort study using a large national database.Not (...) applicable.Data from 109,140 cycles from the 2008-2010 SART registry, including 91,504 autologous cycles and 17,636 donor cycles in patients with non-tubal infertility.Varying amounts of oocytes retrieved in autologous and donor IVF.Ectopic pregnancy rates.In autologous cycles, the EP rate significantly increased as oocyte yield increased. This association was not found in oocyte recipients.In autologous IVF cycles, increasing oocyte yield is correlated with a significantly increased EP rate. This association

2015 Fertility and Sterility

167. 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

168. Can Mean Platelet Volume and Platelet Distrubition Width be Possible Markers for Ectopic Pregnancy and Tubal Rupture? (MPV and PDW in Ectopic Pregnancy) Full Text available with Trip Pro

Can Mean Platelet Volume and Platelet Distrubition Width be Possible Markers for Ectopic Pregnancy and Tubal Rupture? (MPV and PDW in Ectopic Pregnancy) 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.This retrospective evaluation of 153 tubal EP patients (39 ruptured and 114 non-ruptured) admitted to our clinic (...) significantly lower in ruptured EP compared to non-ruptured ectopic pregnancies and control groups (p=0.005).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

2014 Pakistan Journal Of Medical Sciences

169. Cornual ectopic pregnancy: an example of the overdiagnosis of molar ectopic pregnancy: a case report. (Abstract)

Cornual ectopic pregnancy: an example of the overdiagnosis of molar ectopic pregnancy: a case report. Molar ectopic pregnancies are rare. A literature search revealed that molar ectopic pregnancies are overdiagnosed.A 25-year-old, G5P3013, African American woman presented to a com- munity hospital with sudden onset of sharp, stabbing, low abdominal pain and nausea and vomiting. Quantitative hCG was 6,644 mIU/mL and ultrasound demonstrated increased vascularity and a hypoechoic, partially (...) tubular collection in the left adnexa concerning for ectopic pregnancy. Laparoscopy revealed a small amount of blood and a slight bulge in the left uterine cornu, which ruptured during blunt exploration. Laparotomy revealed the ruptured left uterine cornu with tissue protruding. A wedge resection of the cornu was performed. The pathologic findings from the cornual resection were consistent with a complete mole. Immunohistochemical staining was performed using p57 analysis 1.5 years later

2014 Journal of Reproductive Medicine

170. Flowchart: Stable intrauterine non-viable pregnancy

of menstruation • Contraception • Follow-up arrangements General care considerations • Review POC histopathology • If indicated, recommend RhD-Ig • Analgesia as required • Communicate information to other care providers (e.g. GP) If medical or expectant: • Discuss options for continued expectant or medical or surgical: o At the woman’s request o If ongoing symptoms o If clinical concerns Consider the woman’s psychological needs and offer access to support Clinical presentation • Ectopic pregnancy excluded (...) Flowchart: Stable intrauterine non-viable pregnancy Queensland Health State of Queensland (Queensland Health) 2017 http://creativecommons.org/licenses/by-nc-nd/3.0/au/deed.en Queensland Clinical Guidelines, Guidelines@health.qld.gov.au Queensland Clinical Guidelines www.health.qld.gov.au/qcg Stable intrauterine non-viable pregnancy Expectant Indications • Woman’s preference • Incomplete miscarriage Contraindications • Haemodynamic instability • Suspected GTD • IUD (must be removed) • Risk

2017 Queensland Health

171. Flowchart: Assessment of suspected early pregnancy loss

as indicated • STI screen as indicated Ectopic pregnancy Refer to flowchart: Ectopic pregnancy Confirm pregnancy location Intrauterine pregnancy (IUP) PUL • Specialist review and follow-up essential • Serial ß-hCG • Serial TVS Refer to flowchart: Assessment of location and viability in suspected early pregnancy loss Pregnancy viable? Individualise pregnancy care Clinical presentation • Pregnancy : greater than, <: less than (...) Flowchart: Assessment of suspected early pregnancy loss Queensland Health State of Queensland (Queensland Health) 2017 http://creativecommons.org/licenses/by-nc-nd/3.0/au/deed.en Queensland Clinical Guidelines, Guidelines@health.qld.gov.au Queensland Clinical Guidelines www.health.qld.gov.au/qcg Assessment of suspected early pregnancy loss Haemodynamically stable? Assessment • History • Confirm pregnancy • Physical Exam • Serial ß-hCG • USS (TVS preferred) • FBC and blood group • MSU

2017 Queensland Health

172. Early pregnancy loss

area, level of education and age ? compared with pregnant controls only Refer to online version, destroy printed copies after use Page 15 of 39 Queensland Clinical Guideline: Early pregnancy loss 4.2 Expectant management of ectopic pregnancy Expectant management is an option for selected women. Clear criteria for selection have not been well defined. 26 Table 10. Expectant management of ectopic pregnancy Aspect Consideration Context • Among selected cases (early gestation, with ß-hCG values below (...) , Brisbane Qld 4001, email ip_officer@health.qld.gov.au, phone (07) 3234 1479. Refer to online version, destroy printed copies after use Page 2 of 39 Queensland Clinical Guideline: Early pregnancy loss Flow Chart: Assessment of suspected early pregnancy loss Haemodynamically stable? Assessment • History • Confirm pregnancy • Physical Exam • Serial ß-hCG • USS (TVS preferred) • FBC and blood group • MSU as indicated • STI screen as indicated Ectopic pregnancy Refer to flowchart: Ectopic pregnancy Confirm

2017 Queensland Health

173. Guideline Supplement: Early pregnancy loss

printed copies after use Page 5 of 16 Queensland Clinical Guideline Supplement: Early pregnancy loss 2.4.1 Keywords The following list of keywords was used in combination in the basic search strategy. Other keywords may have been used for specific aspects of the guideline. Key word/phrase Synonyms/Subject heading/Mesh term Early pregnancy loss “pregnancy loss” OR miscarriage OR ectopic OR “ectopic pregnancy” OR “threatened abortion” OR “threatened miscarriage” OR “missed abortion” OR “missed (...) and private maternity facilities. It can be downloaded in Portable Document Format (PDF) from www.health.qld.gov.au/qcg 5.1 Guideline resources The following guideline components are provided on the website as separate resources: • Flowchart: assessment of suspected early pregnancy loss • Education presentation: Early pregnancy loss • Knowledge assessment: Early pregnancy loss • Patient information: o Ectopic pregnancy o Pain and bleeding in early pregnancy o RhD negative in pregnancy 5.2 Suggested

2017 Queensland Health

174. Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association Full Text available with Trip Pro

and carry a pregnancy to term will present little problem. However, for those with complex CHD, pregnancy may be associated with an increased risk compared with women with milder forms of CHD, regardless of whether they are clinically stable at the time of conception. This document provides an overview of the management of the patient with complex CHD who becomes pregnant. Defining the Population Simple CHD lesions include mild pulmonary valve stenosis, a small, uncomplicated atrial septal defect (...) changes in blood volume. Reprinted with permission from Longo et al. Copyright © 1983, American Physiological Society. B-Type Natriuretic Peptide The median level of B-type natriuretic peptide (BNP) in normal pregnant woman is about twice that of nonpregnant control subjects, rising early in pregnancy and remaining high throughout gestation until ≈72 hours after delivery. , Adverse maternal cardiac events have been associated with high BNP concentrations (>100 pg/mL), but its use as a negative

2017 American Heart Association

175. Smoking Cessation During Pregnancy

element in prenatal smoking cessation. An office-based protocol that systematically identifies pregnant women who smoke and offers treatment or referral has been proved to increase quit rates. A short counseling session with pregnancy-specific educational materials and a referral to the smokers' quit line is an effective smoking cessation strategy. The 5A's is an office-based intervention developed to be used under the guidance of trained practitioners to help pregnant women quit smoking. Knowledge (...) States have led to a decrease in smoking by pregnant women and nonpregnant women of reproductive age ( ). Pregnancy appears to motivate women to stop smoking; 46% of prepregnancy smokers quit smoking directly before or during pregnancy (1). Although the rate of reported smoking during pregnancy has decreased from 18.4% in 1990 to 13.2% overall in 2006, for some populations, such as adolescent females and less educated non-Hispanic white and American Indian women, the decrease was less dramatic

2017 American College of Obstetricians and Gynecologists

176. Guidelines for the Use of Laparoscopy during Pregnancy

Stefanidis Preamble Surgical interventions during pregnancy should minimize fetal risk without compromising the safety of the mother. Favorable outcomes for the pregnant woman and fetus depend on accurate and timely diagnosis with prompt intervention. Surgeons must be aware of data regarding differences in techniques used for pregnant patients to optimize outcomes. This document provides specific recommendations and guidelines to assist physicians in the diagnostic work-up and treatment of surgical (...) ultrasound, CT, and/or MRI. A risk-benefit discussion with the patient should occur prior to any diagnostic study. Ultrasound Guideline 1: Ultrasound imaging during pregnancy is safe and effective in identifying the etiology of acute abdominal pain in many patients and should be the initial imaging test of choice (+++; Strong). Abdominal pain in the pregnant patient can be separated into gynecologic and non-gynecologic causes. When radiographic studies are required to establish a diagnosis, ultrasound

2017 Society of American Gastrointestinal and Endoscopic Surgeons

177. Vaginal Hysterectomy for Treatment of Cervical Ectopic Pregnancy. (Abstract)

Vaginal Hysterectomy for Treatment of Cervical Ectopic Pregnancy. Cervical ectopic pregnancy can lead to catastrophic hemorrhage, and may be managed conservatively with intra-amniotic methotrexate (MTX), systemic MTX, or both; surgical evacuation with or without balloon tamponade; and uterine artery embolization. However, some patients require hysterectomy, which has traditionally been performed abdominally.A 39-year-old parous woman was diagnosed with cervical ectopic pregnancy at an estimated (...) for treatment of cervical ectopic pregnancy in patients who have completed childbearing and for whom conservative treatment has failed.

2016 Obstetrics and Gynecology

178. Single dose systemic methotrexate versus expectant management for treatment of tubal ectopic pregnancy: A placebo-controlled randomised trial. Full Text available with Trip Pro

Single dose systemic methotrexate versus expectant management for treatment of tubal ectopic pregnancy: A placebo-controlled randomised trial. Methotrexate is used routinely worldwide for the medical treatment of clinically stable women with a tubal ectopic pregnancy. This is despite the lack of robust evidence to show its superior effectiveness over expectant management. The aim of our multicenter randomized controlled trial was to compare success rates of methotrexate against placebo (...) for the conservative treatment of tubal ectopic pregnancy.This study took place in two early-pregnancy units in the UK between August 2005 and June 2014. Inclusion criteria were clinically stable women with a conclusive ultrasound diagnosis of a tubal ectopic pregnancy, presenting with a low serum beta human chorionic gonadotropin (β-hCG) level of < 1500 IU/L. Women were assigned randomly to a single systemic injection of either 50 mg/m2 methotrexate or placebo. The primary outcome was a binary indicator

2016 Ultrasound in Obstetrics and Gynecology Controlled trial quality: predicted high

179. IMELDA transvaginal approach to ectopic pregnancy: diagnosis by transvaginal hydrolaparoscopy and treatment by transvaginal natural orifice transluminal endoscopic surgery. Full Text available with Trip Pro

IMELDA transvaginal approach to ectopic pregnancy: diagnosis by transvaginal hydrolaparoscopy and treatment by transvaginal natural orifice transluminal endoscopic surgery. To demonstrate a new minimally invasive approach for the diagnosis and treatment of ectopic pregnancy.Stepwise explanation of the technique using original video footage.Hospital.Since 2014, 15 patients were treated transvaginally for ectopic pregnancy and pregnancy of unknown location (PUL).In case of a diagnosis of ectopic (...) pregnancy on ultrasound, a 2.5-cm colpotomy is made under general anesthesia, and the ectopic pregnancy is treated by transvaginal natural orifice transluminal endoscopic surgery (vNOTES) salpingectomy or salpingostomy. In case of a PUL on ultrasound, transvaginal hydrolaparoscopy (TVHL), an established technique for fertility exploration under local or general anesthesia, is used to investigate. If a tubal pregnancy is confirmed on TVHL, the colpotomy is extended to a 2.5-cm incision, and the ectopic

2016 Fertility and Sterility

180. Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: a prospective cohort study. Full Text available with Trip Pro

Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: a prospective cohort study. This is a pilot study to investigate the type and severity of emotional distress in women after early pregnancy loss (EPL), compared with a control group with ongoing pregnancies. The secondary aim was to assess whether miscarriage or ectopic pregnancy impacted differently on the type and severity of psychological morbidity.This was a prospective survey study. Consecutive women (...) and depression. There was little difference in type or severity of distress following ectopic pregnancy or miscarriage.We have shown a large number of women having experienced a miscarriage or ectopic pregnancy fulfil the diagnostic criteria for probable PTSD. Many suffer from moderate-to-severe anxiety, and a lesser number depression. Psychological morbidity, and in particular PTSD symptoms, persists at least 3 months following pregnancy loss.Published by the BMJ Publishing Group Limited. For permission

2016 BMJ open

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