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Ectopic Pregnancy

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161. IMELDA transvaginal approach to ectopic pregnancy: diagnosis by transvaginal hydrolaparoscopy and treatment by transvaginal natural orifice transluminal endoscopic surgery. (PubMed)

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

162. Ectopic pregnancy following in vitro fertilization: meta-analysis and single-center experience during 6 years. (PubMed)

Ectopic pregnancy following in vitro fertilization: meta-analysis and single-center experience during 6 years. Ectopic pregnancy (EP) has been reported to occur in 1.4-5.4% of all clinical pregnancies resulting from in vitro fertilization (IVF) and embryo transfer (ET). Data on factors associated with abnormal embryo implantation following assisted conception are limited.A systematic review and meta-analysis was performed to determine whether there is an association between the day (cleavage (...) -stage, D3, versus blastocyst, D5) or the type (fresh versus frozen/thawed) of ET and EP rate. Risk factors for EP were evaluated in a retrospective study of 1194 women, who achieved pregnancy at our IVF unit between 2010 and 2016.Sixteen papers were considered for the meta-analysis. EP rate did not differ between D3 and D5 fresh ET groups (RR = 0.99, 95%CI: 0.76-1.30) and was higher after fresh versus frozen ET (RR = 1.56, 95%CI: 1.25-1.95). At our clinic, 21 (1.76%) pregnancies were documented

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2016 Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology

163. Abdominal ectopic pregnancy after in vitro fertilization and single embryo transfer: a case report and systematic review. (PubMed)

Abdominal ectopic pregnancy after in vitro fertilization and single embryo transfer: a case report and systematic review. Ectopic pregnancy is the leading cause of maternal morbidity and mortality during the first trimester and the incidence increases dramatically with assisted-reproductive technology (ART), occurring in approximately 1.5-2.1 % of patients undergoing in-vitro fertilization (IVF). Abdominal ectopic pregnancy is a rare yet clinically significant form of ectopic pregnancy due (...) to potentially high maternal morbidity. While risk factors for ectopic pregnancy after IVF have been studied, very little is known about risk factors specific for abdominal ectopic pregnancy. We present a case of a 30 year-old woman who had an abdominal ectopic pregnancy following IVF and elective single embryo transfer, which was diagnosed and managed by laparoscopy. We performed a systematic literature search to identify case reports of abdominal or heterotopic abdominal ectopic pregnancies after IVF

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2016 Reproductive biology and endocrinology : RB&E

164. Twin Cesarean Scar Ectopic Pregnancy Treated with Systemic and Local Methotrexate. (PubMed)

Twin Cesarean Scar Ectopic Pregnancy Treated with Systemic and Local Methotrexate. 27640939 2018 01 26 2018 01 26 1097-6868 216 1 2017 01 American journal of obstetrics and gynecology Am. J. Obstet. Gynecol. Twin cesarean scar ectopic pregnancy treated with systemic and local methotrexate. 77.e1-77.e2 S0002-9378(16)30787-6 10.1016/j.ajog.2016.09.080 Bringley Johanna J Department of Obstetrics and Gynecology, Albany Medical Center, Albany, NY. Denefrio Cassandra C Department of Obstetrics (...) Methotrexate administration & dosage Postoperative Complications diagnostic imaging drug therapy Pregnancy Pregnancy, Ectopic diagnostic imaging drug therapy etiology Ultrasonography, Prenatal 2016 08 12 2016 09 05 2016 09 07 2016 10 30 6 0 2018 1 27 6 0 2016 9 20 6 0 ppublish 27640939 S0002-9378(16)30787-6 10.1016/j.ajog.2016.09.080

2016 American Journal of Obstetrics and Gynecology

165. Systematic review: What is the best first-line approach for cesarean section ectopic pregnancy? (PubMed)

Systematic review: What is the best first-line approach for cesarean section ectopic pregnancy? This systematic review aims to analyze the case reports, case series, or clinical studies describing the women with cesarean scar ectopic pregnancy (CSEP), and thus, to determine the efficacy and safety of different primary treatment modalities in the management of CSEP. A thorough search of electronic databases showed that 274 articles on CSEP were published between January 1978 and April 2014 (...) , and hysterotomy, respectively. The ability to achieve a subsequent term pregnancy is related to successful systemic methotrexate treatment (p = 0.001) or hysterotomy (p = 0.009). Future term pregnancy was significantly more frequent in the hysterotomy group (p = 0.001). Hysteroscopy and laparoscopic hysterotomy are safe and efficient surgical procedures that can be adopted as primary treatment modalities for CSEP. Uterine artery embolization should be reserved for cases with significant bleeding and/or a high

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2016 Taiwanese journal of obstetrics & gynecology

166. Risk factors for ectopic pregnancy in assisted reproductive technology: a 6-year, single-center study. (PubMed)

Risk factors for ectopic pregnancy in assisted reproductive technology: a 6-year, single-center study. To explore factors affecting the incidence of ectopic pregnancy (EP) in assisted reproductive technology (ART).A retrospective cohort study on the incidence of EPs in IVF/intracytoplasmic sperm injection (ICSI) and IUI cycles from June 2009 to August 2015. Age of patients, tubal factor infertility, type of cycle (fresh or thawed), embryo being transferred (cleavage embryo or blastocyst (...) ), and number of embryos transferred were analyzed to explore their relationship with the incidence of EP.Teaching hospital.A total of 18,432 pregnancies resulting from ART treatment were retrospectively analyzed.None.Ectopic pregnancy rate.For IVF/ICSI cycles, the incidence of EP was different between cycles transferred with cleavage embryo and blastocyst (3.45% vs. 2.47%). In multivariate logistic regression analysis, tubal infertility was associated with EP (adjusted odds ratio 1.716, 95% confidence

2016 Fertility and Sterility

167. GnRH and GnRH receptor are expressed at tubal ectopic pregnancy implantation sites. (PubMed)

GnRH and GnRH receptor are expressed at tubal ectopic pregnancy implantation sites. To investigate whether gonadotropin-releasing hormone (GnRH) and GnRH receptor (GnRHR) are expressed at tubal ectopic pregnancy sites, and to study the potential role of GnRH signaling in regulating immortalized human trophoblast cell viability.Immunohistochemical and experimental studies.Academic research laboratory.Fallopian tube implantation sites (n = 25) were collected from women with ectopic pregnancy (...) are expressed in trophoblast cell populations and fallopian tube epithelium at tubal ectopic pregnancy sites. GnRH increases BeWo cell viability, an effect mediated by the GnRHR. Further work is required to investigate the potential role of GnRH signaling in ectopic pregnancy.Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

2016 Fertility and Sterility

168. Risk factors for recurrent ectopic pregnancy: a case-control study. (PubMed)

Risk factors for recurrent ectopic pregnancy: a case-control study. To study the risk factors for recurrent ectopic pregnancy (REP).A retrospective case-control study.A university medical centre.554 women with a history of ectopic pregnancy (EP) were included. Among them were 181 women with current EP, 184 women with current intrauterine pregnancy (IUP) and 189 nonpregnant women (NonP).The three groups were matched at a ratio of 1:1 with respect to current age, age of initial EP and gestational

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2016 BJOG

169. Is the type of gonadotropin-releasing hormone suppression protocol for ovarian hyperstimulation associated with ectopic pregnancy in fresh autologous cycles for in vitro fertilization? (PubMed)

Is the type of gonadotropin-releasing hormone suppression protocol for ovarian hyperstimulation associated with ectopic pregnancy in fresh autologous cycles for in vitro fertilization? To evaluate the association between different ovarian hyperstimulation protocols and ectopic pregnancy (EP) in in vitro fertilization (IVF) cycles in fresh autologous embryo transfer cycles in the United States between 2008 and 2011 as reported to the Society of Assisted Reproductive Technology (SART).Historical (...) cohort study.Not applicable.None.None.All autologous cycles that resulted in a clinical pregnancy after a fresh, intrauterine embryo transfer and described characteristics of cycles according to protocol were included: luteal GnRH agonist, GnRH agonist flare, or GnRH antagonist. Multivariate logistic regression was conducted to investigate the association between type of protocol and EP.Among 136,605 clinical pregnancies, 2,645 (1.94%) were EP. Ectopic pregnancy was more frequent with GnRH antagonist

2016 Fertility and Sterility

170. Bilateral Simultaneous Tubal Ectopic Pregnancy: A Case Report, Review of Literature and a Proposed Management Algorithm (PubMed)

Bilateral Simultaneous Tubal Ectopic Pregnancy: A Case Report, Review of Literature and a Proposed Management Algorithm Bilateral simultaneous Tubal Ectopic Pregnancy (BTP) is the rarest form of ectopic pregnancy. The incidence is higher in women undergoing assisted reproductive techniques or ovulation induction. The clinical presentation is unpredictable and there are no unique features to distinguish it from unilateral ectopic pregnancy. BTP continues to be a clinician's dilemma as pre (...) -operative diagnosis is difficult and is commonly made during surgery. Treatment options are varied depending on site of ectopic pregnancy, extent of tubal damage and requirement of future fertility. We report a case of BTP which was diagnosed during surgery and propose an algorithm for management of such patients.

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2016 Journal of clinical and diagnostic research : JCDR

171. Ectopic pregnancy risk factors for ART patients undergoing the GnRH antagonist protocol: a retrospective study (PubMed)

Ectopic pregnancy risk factors for ART patients undergoing the GnRH antagonist protocol: a retrospective study In-vitro fertilization is a known risk factor for ectopic pregnancies. We sought to establish the risk factors for ectopic pregnancy in GnRH antagonist cycles examining patient and stimulation parameters with an emphasis on ovulation trigger.We conducted a retrospective, cohort study of 343 patients undergoing 380 assisted reproductive technology (ART) cycles with the GnRH antagonist (...) protocol and achieving a clinical pregnancy from November 2010 through December 2015.Significant risk factors for ectopic pregnancy in the univariate analysis included prior Cesarean section (CS), endometriosis, mechanical factor infertility, longer stimulation, elevated estradiol and progesterone levels, GnRH agonist trigger, higher number of oocytes aspirated, and insemination technique. Independent risk factors for ectopic pregnancy in the multivariate analysis included GnRH agonist trigger, higher

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2016 Reproductive biology and endocrinology : RB&E

172. Methotrexate-induced pancytopenia in a patient with ectopic pregnancy (PubMed)

Methotrexate-induced pancytopenia in a patient with ectopic pregnancy 29593825 2018 11 14 1734-1922 14 2 2018 Mar Archives of medical science : AMS Arch Med Sci Methotrexate-induced pancytopenia in a patient with ectopic pregnancy. 475-476 10.5114/aoms.2016.58844 Shao Shih-Chieh SC Department of Pharmacy, Chang Gung Memorial Hospital, Keelung, Taiwan. Yang Yea-Huei Kao YK School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung

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2016 Archives of medical science : AMS

173. Spontaneous Bilateral Tubal Ectopic Pregnancy: Incidental Finding During Laparoscopy – Brief Report and Review of Literature (PubMed)

Spontaneous Bilateral Tubal Ectopic Pregnancy: Incidental Finding During Laparoscopy – Brief Report and Review of Literature Objective: Bilateral tubal ectopic pregnancies are rare; the reported incidence is only 1 in 200 000 pregnancies. Detecting bilateral tubal ectopic pregnancy is urgent because of the associated morbidity and mortality. The appropriate fertility-preserving surgery must also be considered, as preservation of both tubes is presumed to offer better fertility prospects. Case (...) Report: A 39-year-old gravida 2, para 1 presented with vaginal bleeding at 8 + 4 weeks of gestation. An approximately 18 mm adnexal mass in the right fallopian tube was detected on ultrasound. Laparoscopy was performed because ectopic pregnancy was suspected. This suspicion was confirmed during laparoscopy; the right fallopian tube was found to contain a mass measuring 20 mm in the isthmic part. Ultrasound of the left fallopian tube also showed a mass in the ampullary region (diameter: 10 mm), also

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2016 Geburtshilfe Und Frauenheilkunde

174. Recurrent ectopic pregnancy as a unique clinical sub group: a case control study (PubMed)

Recurrent ectopic pregnancy as a unique clinical sub group: a case control study Women with recurrent ectopic pregnancy (EP) represent a unique cohort of patients in whom diagnostic expertise is paramount. We determined whether recurrent EP is associated with significant differences in patient demographics, clinical presentation, risk factors and surgical findings when compared with primary EP.A retrospective case-control study of all EPs diagnosed from 2003 to 2014, at Whipps Cross University (...) . 3.5 %, p < 0.05 and 53.8 vs. 14 %, p < 0.05). At surgery, primary EPs had a significantly greater volume of hemoperitoneum (592 ± 850 vs. 249 ± 391 ml, p < 0.05), whereas recurrent EPs were significantly more likely to have contralateral pathology (31.1 vs. 9.8 %, p < 0.05). Regression analysis showed that the parameters of age, gestational age at presentation, first βHCG level, positive history of previous tubal surgery and previous ectopic pregnancy differ in women at risk of a recurrent EP when

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2016 SpringerPlus

175. Cervical Ectopic Pregnancy: A Clinician’s Dilemma (PubMed)

Cervical Ectopic Pregnancy: A Clinician’s Dilemma 27803524 2018 11 13 0971-9202 66 Suppl 2 2016 10 Journal of obstetrics and gynaecology of India J Obstet Gynaecol India Cervical Ectopic Pregnancy: A Clinician's Dilemma. 617-619 Vora Priyanka H PH Department of Obstetrics and Gynaecology, Nowrosjee Wadia Maternity Hospital, Parel, Mumbai, Maharashtra 400014 India ; 274, Shakti Nivas, First Floor, Block No 6, Deodhar Road, Matunga (C.R.), Mumbai, 400019 India. Jassawalla M J MJ Department (...) of Obstetrics and Gynaecology, Nowrosjee Wadia Maternity Hospital, Parel, Mumbai, Maharashtra 400014 India. Bhalerao Sarita S Department of Obstetrics and Gynaecology, Nowrosjee Wadia Maternity Hospital, Parel, Mumbai, Maharashtra 400014 India. Nadkarni Trupti T Department of Obstetrics and Gynaecology, Nowrosjee Wadia Maternity Hospital, Parel, Mumbai, Maharashtra 400014 India. eng Journal Article 2016 04 06 India J Obstet Gynaecol India 0374763 0975-6434 Cervical ectopic Uterine artery embolization None

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2016 Journal of obstetrics and gynaecology of India

176. Primary Ovarian Monochorionic Twin Ectopic Pregnancy. A Case Report. (PubMed)

Primary Ovarian Monochorionic Twin Ectopic Pregnancy. A Case Report. Primary ovarian pregnancy is a rare form of ectopic gestation and one that is often diagnosed only at the time of surgery.A 17-year-old primi- gravid woman presented to our clinic with lower abdom- inal pain, vaginal bleeding, and missed period. Trans- vaginal sonography revealed an empty uterus, normal- looking right fallopian tubes, and the presence of a gestational sac containing 2 yolk sacs and 2 embryos with cardiac (...) activity on the right ovary. Methotrexate therapy failed and the patient was successfully treated with laparoscopic enucleation of the ectopic pregnancy mass.Surgery is the primary treatment modality of choice in twin ovarian pregnancy. Therefore, the differential diagnosis of ovarian pregnancy is of great importance in order to plan immediate surgery and save the patient from unnecessary medical treatment, and thus preserving future fertility.

2016 Journal of Reproductive Medicine

177. Ectopic Pregnancy

Ectopic Pregnancy Ectopic Pregnancy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Ectopic Pregnancy Ectopic Pregnancy Aka: Ectopic (...) Pregnancy , Tubal Pregnancy From Related Chapters II. Definition Implantation of fertilized ovum outside of the III. Epidemiology : 2% of all pregnancies Second most common cause of maternal mortality Accounts for 6% of maternal deaths (as high as 10-15% of maternal deaths in past) Case fatality rate: 3.8 deaths per 10,000 ectopics IV. Risk Factors Highest risk factors Prior tubal surgery ( 21.0) Sterilization such as ( 9.3) Prior Ectopic Pregnancy ( 8.3, represents 11% of cases) (IUD) ( 5.0, represents

2018 FP Notebook

178. Ectopic Pregnancy After Plan B Emergency Contraceptive Use. (PubMed)

Ectopic Pregnancy After Plan B Emergency Contraceptive Use. Pregnancy outcomes after emergency contraceptive use has been debated over time, but review of the literature includes mechanisms by which these medications may increase the chance of an ectopic pregnancy. Such cases are infrequently reported, and many emergency providers may not readily consider this possibility when treating patients.This is a case presentation of ectopic pregnancy in a patient who had recently used Plan B (...) of levonorgestrel use and the incidence of ectopic pregnancies. The mechanism of action of this emergency contraceptive is addressed, and though no definite causal relationship is known between levonorgestrel and ectopic pregnancies, there is a pharmacologic explanation for how this event may occur after use of this medication. Ultimately, the emergency provider will be reminded of the importance of educating the patient on the possible outcomes after its use, including failure of an emergency contraceptive

2016 Journal of Emergency Medicine

179. Surgical treatment of Cesarean scar ectopic pregnancy: Efficacy and safety of ultrasound-guided suction curettage. (PubMed)

Surgical treatment of Cesarean scar ectopic pregnancy: Efficacy and safety of ultrasound-guided suction curettage. To assess the efficacy of ultrasound-guided suction curettage for management of pregnancies implanted into the lower uterine segment Cesarean section scar.This was a retrospective study including women diagnosed with Cesarean section scar pregnancy at two large tertiary referral early pregnancy units between 1997 and 2014. Surgical evacuation was offered to selected women (...) presenting in the first trimester ≤ 14 weeks' gestation. All procedures were performed transcervically under ultrasound guidance using suction curettage. A modified Shirodkar cervical suture was used in women who required additional measures to secure hemostasis.A total of 232 women with Cesarean section scar pregnancy were seen at the referral units; 191/232 (82.3%) women were treated surgically. The median intraoperative blood loss was 100 mL (range, 10-3000 mL); 9/191 (4.7% (95% CI, 1.7-7.7%)) women

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2016 Ultrasound in Obstetrics and Gynecology

180. Laparoscopic tube-preserving surgical procedures for ectopic tubal pregnancy (PubMed)

Laparoscopic tube-preserving surgical procedures for ectopic tubal pregnancy To present our experience with laparoscopic tube-preserving surgery for ectopic tubal pregnancy and evaluate its feasibility and efficacy.This was a prospective study of 57 consecutive patients with ectopic tubal pregnancies undergoing laparoscopic tube-preserving procedures including salpingotomy, salpingostomy, segmental resection and reanastomosis, and fimbrial milking. The outcome measures were treatment success (...) gonadotropin resolution time of 18.3±5.9 days, no persistent trophoblast or postoperative complications occurred. A tubal patency test using hysterosalpingography was performed in 15 cases at 3 months postoperatively. Among these, the homolateral tubal patency rate was 75% (11 of 15) and the contralateral patency rate was 80% (12 of 15).Tube-preserving surgery is a feasible and safe treatment option for ectopic tubal pregnancy. However, considering that the optimal goal of tube-preserving surgical

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2016 Obstetrics & gynecology science

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