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Sample records for repeat ectopic pregnancy

  1. Ectopic Pregnancy

    Science.gov (United States)

    ... woman is pregnant. If you have an ectopic pregnancy, the fertilized egg grows in the wrong place, ... tubes. The result is usually a miscarriage. Ectopic pregnancy can be a medical emergency if it ruptures. ...

  2. Ectopic Pregnancy

    Science.gov (United States)

    ... Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & ... low blood pressure (also caused by blood loss) lower back pain continue What Causes an Ectopic Pregnancy? An ectopic ...

  3. Ectopic pregnancy (image)

    Science.gov (United States)

    An ectopic pregnancy is one in which the fertilized egg implants in tissue outside of the uterus and the placenta ... common site is within a Fallopian tube, however, ectopic pregnancies can occur in the ovary, the abdomen, and ...

  4. Scar Ectopic Pregnancy.

    Science.gov (United States)

    Patel, Madhuri Arvind

    2015-12-01

    Scar ectopic pregnancy is the rarest form of ectopic pregnancy and has been increasingly diagnosed all over the world. This is a life-threatening form of abnormal implantation of embryo within the myometrium and fibrous tissues in a previous scar on the uterus, especially following caesarean section. With the increasing rate of caesarean section, there is a substantial increase in this condition with better understanding of this disease. The early and accurate diagnosis with timely management can prevent pregnancy complications such as haemorrhage, uterine rupture and can preserve fertility.

  5. Repeat acute abdomen and hemoperitoneum during the same pregnancy due to a ruptured ectopic treated by salpingostomy.

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    Canelas, Caroline M; Shih, Richard D; Clayton, Lisa M; Giroski, Laura J; Alter, Scott M; Feinstein, Stacey; Learman, Lee A

    2017-06-01

    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 was performed, after which the patient recovered without complications. The increased risk of persistent trophoblastic tissue associated with tube salvage surgery can lead to subsequent reoperation for tubal rupture. Patients undergoing these procedures should be closely monitored in the following weeks and undergo serial β-hCG testing in order to confirm successful removal of the ectopic. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Non-tubal ectopic pregnancy.

    Science.gov (United States)

    Parker, Victoria Louise; Srinivas, M

    2016-07-01

    11 per 1000 pregnancies are ectopic (NICE Guidelines, 2012) with 95 % of ectopic pregnancies being tubal in origin, and 80 % of these occurring within the ampulla (The Ectopic Pregnancy Trust). 5% therefore are non-tubal. In this review we aim to collate literature relevant to non-tubal ectopic pregnancy. Literature regarding cornual, ovarian, abdominal, interstitial, cervical and Caesarean scar ectopic pregnancy was reviewed using EMBASE and Medline databases. Non-tubal ectopic pregnancies are often overlooked, diagnosed late and are associated with higher maternal morbidity and mortality. Ultrasound remains the mainstay of diagnosis in corroboration with clinical features. Management may include medical treatment with methotrexate, surgery or expectancy. There is also an increasing interest in the use of minimally invasive radiological approaches. Non-tubal ectopic pregnancy is a rare but potentially life-threatening and often misdiagnosed condition. This is particularly pertinent for Caesarean scar ectopic pregnancies, the prevalence of which is increasing due to the rising proportion of women having Caesarean sections (Litwicka and Greco, 2011). Practitioners should be aware of non-tubal pregnancies to aid more efficient diagnosis, optimise management and increase patient safety.

  7. [Early diagnosis of ectopic pregnancy].

    Science.gov (United States)

    Belics, Zoran; Gérecz, Balázs; Csákány, M György

    2014-07-20

    Ectopic pregnancy is a high-risk condition that occurs in 2% of reported pregnancies. This percentage is fivefold higher than that registered in the 1970s. Since 1970 there has been a two-fold increase in the ratio of ectopic pregnancies to all reported pregnancies in Hungary and in 2012 7.4 ectopic pregnancies per thousand registered pregnancies were reported. Recently, the majority (80%) of cases can be diagnosed in early stage, and the related mortality objectively decreased in the past few decades to 3.8/10,000 ectopic pregnancies. If a woman with positive pregnancy test has abdominal pain and/or vaginal bleeding the physician should perform a work-up to safely exclude the possibility of ectopic pregnancy. The basis of diagnosis is ultrasonography, especially vaginal ultrasound examination and measurement of the β-subunit of human chorionic gonadotropin. The ultrasound diagnosis is based on the visualization of an ectopic mass rather than the inability to visualize an intrauterine pregnancy. In some questionable cases the diagnostic uterine curettage or laparoscopy may be useful. The actuality of this topic is justified by practical difficulties in obtaining correct diagnosis, especially in the early gestational time.

  8. Clinical study of ectopic pregnancy.

    Science.gov (United States)

    Chhabra, S; Aher, K; Jaiswal, M

    1992-01-01

    Ectopic pregnancy remains a leading cause of maternal mortality and accounts for a sizeable proportion of infertility and ectopic recurrence. The possibility that a woman is experiencing an ectopic pregnancy must be considered when evaluating a woman, especially a sterilized woman, who has a possible pregnancy, amenorrhea, abdominal pain, or abnormal bleeding; studies have found that one in six pregnancies occurring after tubal sterilization are ectopic. The authors present a clinical study of 82 cases of ectopic pregnancy admitted to the department of Obstetrics and Gynecology of Mahatma Gandhi Institute of Medical Sciences, Sevagram. Cases of ectopic pregnancy represent 0.99% of total obstetric admissions, of whom 69.51% were diagnosed as such on admission. 40.24% of the women were older than 30 years, while 34.14% were elderly beyond third parity. 70.73% of the women presented before missing their second period. Patients presented with multiple complaints, but the most common was abdominal pain reported by 61.70%. 78.04% were admitted with an acute abdomen, but shock was present in only 7.14% of cases. The main surgical treatment modality was salpingectomy among 59.75%. There was no maternal mortality through postoperative morbidity in the form of paralytic ileus, although fever did occur in some women.

  9. CLINICAL STUDY OF ECTOPIC PREGNANCY

    Directory of Open Access Journals (Sweden)

    Swami

    2015-10-01

    Full Text Available An ectopic pregnancy is one in which fertilized ovum is implanted at the site other than normal uterine cavity.[1] Incidence of ectopic pregnancy is 1:160 deliveries.[2] Clinical presentation is variable from acute to chronic type. Due to its varied clinical presentation ectopic pregnancy poses great diagnostic difficulty both to obstetrician, physician and surgeons.[3] OBJECTIVE: To find out incidence in our study population and to evaluate symptomatically and clinical presentation in these patients. MATERIALS AND METHODS: Retrospective study of 34 ectopic pregnancies admitted and treated in Medical College hospital, Ujjain from 2010 to 2015 are included in the study. RESULTS: The incidence of ectopic pregnancy is more between the age group of 21-30years (73.52% and in Multigravida 64.71%. Infertility and previous tubal surgery are the high risk factors for tubal pregnancy. Pain in abdomen was present in all 34 cases, amenorrhea in 97.05% and bleeding per vagina in 76.47% cases. Syncopal attacks, vomiting were detected in 14.70% cases. Acute ectopic pregnancy was detected in 14.71% and chronic in 85.29% cases. 82.35% cases presented with adnexal mass, 79.41% with cervical motion tenderness, 50% with pallor, 32.35% with abdominal lump and tenderness and 11.76% with fullness in POD. CONCLUSION: Ectopic pregnancy is leading cause of maternal mortality in first trimester. In spite of advanced diagnostic techniques. It poses great diagnostic difficulties due to varied signs and symptoms. Previous tubal surgery pelvic inflammatory disease and infertility are the risk factors of tubal pregnancy.

  10. Clinical Analysis of 87 Examples Repeated Ectopic Pregnancy LI Yuanqin. Chengdu Tianda Sterlity Hospital.%重复性异位妊娠87例分析

    Institute of Scientific and Technical Information of China (English)

    刘媛琴

    2013-01-01

    Objective: Analyze the risk factors of Repeated Ectopic Pregnancy (REP), raise the consciousness of REP and take precautions against REP. Methods: A retrospective analysis about relations between treatment of first-time ectopic pregnancy and the position of REP was performed on the clinical data in the Peking University People’s Hospital and folow-up of 87 cases (Observation Group) of REP patients since 2007Compare contemporaneous 570 first-time REP patients (control group) who have surgical therapies with those cases showing above and find the relationship between morbidity of repeated ectopic pregnancy and, the anamnesis, the condition of pelvic cavities and so forth. Results: Among the 87 cases, 52 cases (59.8﹪ of total cases) occurred after first-time ectopic pregnancy expectant treatment, including 32 cases of ipsilateral REP and 20 cases of contralateral REP; 35 (40.2﹪) cases occurred after tubal resection, including 2 cases of ipsilateral REP and 33 cases of contralateral REP. The difference between these two groups is obvious (p<0.01). In comparison with the control group, observation group results in a significantly higher morbidity of repeated ectopic and has more risk to develop pelvic adhesion, endometriosis and contralateral tubal pathology (p<0.05). Conclusion: Treatment of first-time ectopic pregnancy is relevant to REP and the position of ectopic pregnancy. And, pelvic operation history, pelvic adhesion, endometriosis and contralateral tubal pathology are al risk factors of morbidity of repeated ectopic pregnancy.%  目的分析重复性异位妊娠(REP)的高危因素,提高对REP的认识及预防REP的发生.方法采用回顾分析方法,对北大人民医院5年来手术治疗的87例REP患者(观察组)的首次异位妊娠的治疗方法与REP部位进行了回顾性分析,并与同期收治的570例手术治疗的初次异位妊娠患者(对照组)的临床数据为对照,观察两组患者盆腔情况、既往病

  11. Heterochronic bilateral ectopic pregnancy after ovulation induction.

    Science.gov (United States)

    Zhu, Bo; Xu, Gu-feng; Liu, Yi-feng; Qu, Fan; Yao, Wei-miao; Zhu, Yi-min; Gao, Hui-juan; Zhang, Dan

    2014-08-01

    Ectopic pregnancy is identified with the widely-applied assisted reproductive technology (ART). Bilateral ectopic pregnancy is a rare form of ectopic pregnancy which is difficult to be diagnosed at the pre-operation stage. In this paper, we presented an unusual case of heterochronic bilateral ectopic pregnancy after stimulated intrauterine insemination (IUI), where there has been a delay of 22 d between the diagnoses of the two ectopic pregnancies. Literature was reviewed on the occurrence of bilateral ectopic pregnancy during the past four years in the MEDLINE database. We found 16 cases of bilateral ectopic pregnancy reported since 2008, and analyzed the characteristics of those cases of bilateral ectopic pregnancy. We emphasize that ovulation induction and other ARTs may increase the risk of bilateral ectopic pregnancy. Because of the difficulty in identification of bilateral ectopic pregnancy by ultrasonography, the clinician should be aware that the treatment of one ectopic pregnancy does not preclude the occurrence of a second ectopic pregnancy in the same patient and should pay attention to the intra-operation inspection of both side fallopian tubes in any ectopic pregnancy case.

  12. Etiologic Factors and Prevention of Repeated Ectopic Pregnancy%重复异位妊娠的发生与防治

    Institute of Scientific and Technical Information of China (English)

    孙莉; 赵郡; 张蕾

    2012-01-01

    Objective To explore etiologic factors and preventive measures of repeated ectopic pregnancy (REP) in order to improve the therapeutic measures. Methods Clinical data and therapeutic method of 41 patients with repeated ectopic pregnancy and 40 patients with the first time ectopic pregnancy (EP) during September 2009 and September 2011 were retrospectively analyzed. Results Comparison of two groups of pregnant difference was statistically signicant (P < 0.01). Among 41 patients with repeated ectopic pregnancy there were 26 patients (63.4% ) who experienced REP within two years. Those EP patients who underwent surgery or pharmacothera-py at the first time had a higher incidence rate of REP than those who underwent salpingectomy(P <0.01). Risk factors of repeated ectopic pregnancy included inflammation of the tube and pelvic adhesion (OR =48.14, P =0.006) , the history of pelvic and uterine operation (OR =41.32, P =0.042), no or occasional use of contraception pills (OR = 13.78, P =0.002) and tube rupture at first ectopic pregnancy (OR =5. 16, P =0.022); the protective factors included salpingectomy and oviductus lateralis sterilization operation (OR = 0. 05, P = 0.002), extended use of oral contraception pills (OR=0.13, P = 0.046) and duration of amenorrheal at first ectopic pregnancy for less than 45 days (OR =0.97, P =0.036). Conclusion The trauma of the tube, acute or chronic pelvic inflammatory disease and pelvic adhesion are the primary risk factors of repeated ectopic pregnancy. Intensive clinical measures should be taken to cure the primary disease of the patients with EP, who must be closely followed up and be given guidance in contraception and pregnancy.%目的 探讨重复异位妊娠(repeated ectopic pregnancy,REP)的发生特点,并提出预防和治疗措施.方法 回顾性分析2009年9月-2011年9月我院收治的41例REP(观察组)与同期40例首次异位妊娠(ectopic pregnancy,EP)(对照组)的临床资料及治疗方法,并进行REP影

  13. Clinical audit of ectopic pregnancy.

    Science.gov (United States)

    Hamid, Alaa Aldin Abdel; Yousry, Almraghy; El Radi, Safwat Abd; Shabaan, Omar Mamdouh; Mazen, Elzahry; Nabil, Halal

    2017-03-01

    The aim of this study was to determine the risk factors of ectopic pregnancy in cases presented to the Woman's Health Hospital (WHH) in Assuit University, and to perform clinical audit on strategies for management of ectopic pregnancy in the WHH. This descriptive hospital based study was conducted at the Woman's Health Hospital (WHH) of Assuit University (Egypt). There were 210 patients who were admitted to the WHH with the diagnosis of ectopic pregnancy in the period between February 1, 2015 through the end of October 2015. Data were analyzed by SPSS version 21, using descriptive statistics, Mann-Whitney U test, and Chi square. Ectopic pregnancy affects woman in the reproductive age. There are many risk factors that increase the chance of its occurrence; however, it may also occur in the absence of any risk factors (14.0%). Internal VD (72.5%) is the most frequent risk factor; other risk factors include history of abortion, previous CS, ovulation induction, history of infertility, or previous history of EP. Clinical audit is an important item of any adequate health care. As regards to the clinical audit of EP management, we are not adhering to the guidelines.

  14. Different Sonographic Faces of Ectopic Pregnancy

    Science.gov (United States)

    Chanana, Charu; Gupta, Nishant; Bansal, Itisha; Hooda, Kusum; Sharma, Pranav; Gupta, Mohit; Gandhi, Darshan; Kumar, Yogesh

    2017-01-01

    Vaginal bleeding in the first trimester has wide differential diagnoses, the most common being a normal early intrauterine pregnancy, with other potential causes including spontaneous abortion and ectopic pregnancy. The incidence of ectopic pregnancy is approximately 2% of all reported pregnancies and is one of the leading causes of maternal mortality worldwide. Clinical signs and symptoms of ectopic pregnancy are often nonspecific. History of pelvic pain with bleeding and positive β-human chorionic gonadotropin should raise the possibility of ectopic pregnancy. Knowledge of the different locations of ectopic pregnancy is of utmost importance, in which ultrasound imaging plays a crucial role. This pictorial essay depicts sonographic findings and essential pitfalls in diagnosing ectopic pregnancy.

  15. Different Sonographic Faces of Ectopic Pregnancy

    Directory of Open Access Journals (Sweden)

    Charu Chanana

    2017-01-01

    Full Text Available Vaginal bleeding in the first trimester has wide differential diagnoses, the most common being a normal early intrauterine pregnancy, with other potential causes including spontaneous abortion and ectopic pregnancy. The incidence of ectopic pregnancy is approximately 2% of all reported pregnancies and is one of the leading causes of maternal mortality worldwide. Clinical signs and symptoms of ectopic pregnancy are often nonspecific. History of pelvic pain with bleeding and positive β-human chorionic gonadotropin should raise the possibility of ectopic pregnancy. Knowledge of the different locations of ectopic pregnancy is of utmost importance, in which ultrasound imaging plays a crucial role. This pictorial essay depicts sonographic findings and essential pitfalls in diagnosing ectopic pregnancy.

  16. Different Sonographic Faces of Ectopic Pregnancy.

    Science.gov (United States)

    Chanana, Charu; Gupta, Nishant; Bansal, Itisha; Hooda, Kusum; Sharma, Pranav; Gupta, Mohit; Gandhi, Darshan; Kumar, Yogesh

    2017-01-01

    Vaginal bleeding in the first trimester has wide differential diagnoses, the most common being a normal early intrauterine pregnancy, with other potential causes including spontaneous abortion and ectopic pregnancy. The incidence of ectopic pregnancy is approximately 2% of all reported pregnancies and is one of the leading causes of maternal mortality worldwide. Clinical signs and symptoms of ectopic pregnancy are often nonspecific. History of pelvic pain with bleeding and positive β-human chorionic gonadotropin should raise the possibility of ectopic pregnancy. Knowledge of the different locations of ectopic pregnancy is of utmost importance, in which ultrasound imaging plays a crucial role. This pictorial essay depicts sonographic findings and essential pitfalls in diagnosing ectopic pregnancy.

  17. Molar Pregnancy Presents as Tubal Ectopic Pregnancy

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    Fatemeh Davari Tanha

    2011-01-01

    Full Text Available Hydatidiform moles are abnormal gestations characterized by the presence of hydropic changesaffecting some or all of the placental villi. Hydatidiform moles arise as a result of the fertilizationof an abnormal ovum. In this report, the patient was a 29 year old Asian woman who had inductionof ovulation with letrozol. Since the majority of molar gestations arise within the uterine cavitythus the occurrence of a hydatidiform mole within ectopic gestational tissue is rare. It is importantto differentiate a hydatidiform mole from a conventional ectopic pregnancy, particularly in infertilewomen who have a history of ovulation induction.

  18. Epidemiology of Ectopic Pregnancy in Hamadan Province

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    Fatemeh Shobeiri

    2012-04-01

    Full Text Available Background: The blastocyst implantation in any place other than uterus cavity endometrium is called ectopic pregnancy. The prevalence of ectopic pregnancy is different in various countries. This study has been conducted to investigate the epidemiology of ectopic pregnancy in Hamadan province during 2000-2010.Materials and Methods: The present study is a retrospective descriptive study. The data on 872 ectopic pregnancies were extracted by questionnaires from the files in the records department of hospitals and delivery centers in Hamadan province during 2000-2010. Data were analyzed using descriptive statistics and the obtained data were analyzed using SPSS-16 software.Results: The frequency of ectopic pregnancy in Hamadan province during 2000-2010 was averagely 2.6 per 1000 pregnancies. Tubal pregnancy with 95.2% is the most prevalent type of ectopic pregnancy most of which had occurred in the right tube (52.4%. Most ectopic pregnancies (52.2% were in the age group of 25-34.Conclusion: The prevalence of ectopic pregnancy in Hamadan province during the mentioned years has been 2.6 in 1000 pregnancies, which is lower compared to many existing data. However, the prevalence of ectopic pregnancy in this province has increased over time, so that it has become 3.3 times as much from 2000-2010.

  19. Ectopic Pregnancy%异位妊娠

    Institute of Scientific and Technical Information of China (English)

    项翠莲

    2014-01-01

    Where fecundity implantation in the uterus outside the body cavity development, known as ectopic pregnancy, commonly known as "ectopic pregnancy." There was no medicine in ancient ectopic pregnancy nonaggressive records, but in the "pregnancy pain", "by the leak," "Zheng Jia" and other syndromes have similar symptoms described. Ectopic pregnancy, including ectopic pregnancy, ovarian pregnancy, abdominal pregnancy, broad ligament pregnancy, cervical pregnancy and uterine rudimentary horn pregnancy. Ectopic pregnancy is confined outside the uterus, excluding cervical pregnancy and uterine rudimentary horn pregnancy. Therefore, ectopic pregnancy broader meaning.%凡孕卵在子宫体腔以外着床发育,称为异位妊娠,俗称"宫外孕"。中医学古籍中未见有异位妊娠的病名记载,但在"妊娠腹痛"、"经漏"、"癥瘕"等病证中有类似症状的描述。异位妊娠包括输卵管妊娠、卵巢妊娠、腹腔妊娠、阔韧带妊娠、宫颈妊娠以及子宫残角妊娠。宫外孕则仅指子宫以外的妊娠,不包括宫颈妊娠和子宫残角妊娠。因此异位妊娠含义更广。

  20. Ovarian Ectopic Pregnancy: a Rare Case Report

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    N Lotfian

    2017-02-01

    Full Text Available Background and aim: Ovarian pregnancy is an uncommon form of ectopic pregnancy which usually diagnosed so late. The aim of this study is to report a case of ovarian ectopic pregnancy Case presentation: A 19 years old woman, with a history of polycystic ovary, first pregnancy, gestation age 9 weeks and 4 days, visited the doctor. She was complaining of severe abdomen pain and vaginal spotting and she was bedridden because of threatened miscarriage. She had discharged from hospital with progesterone suppository prescription. Requesting a transvaginal ultrasound and heterogeneous echogenic mass (size18×8/5 was shown near the left ovary. It was shown as ectopic pregnancy. The patient was hospitalized by ectopic pregnancy in ovary diagnosis and she was treated by methotrexate. Conclusion: In pregnant women that complain of bleeding and spotting in early pregnancy, in addition to threatened abortion, ectopic pregnancy should exist even in the absence of clinical symptoms, should be considered.

  1. MR features of ectopic pregnancy

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    Tamai, Ken; Togashi, Kaori [Kyoto University, Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto (Japan); Koyama, Takashi [Kyoto University Hospital, Department of Radiology, Kyoto (Japan)

    2007-12-15

    Ectopic pregnancy (EP), in which a fertilized ovum implants outside the uterine cavity, is the leading cause of pregnancy-related death in the first trimester. EP is usually suspected by a positive pregnancy test and an empty uterus on transvaginal sonography (TVS). Although TVS is the initial modality of choice, it may occasionally fail to demonstrate the implantation site. When TVS findings are indeterminate, magnetic resonance imaging (MRI) may provide better delineation of the focus of EP owing to its excellent tissue contrast. The key MRI features of EP include gestational sac (GS)-like structures that typically appear as a cystic sac-like structure, frequently associated with surrounding acute hematoma of distinct low intensity on T2-weighted images. In tubal pregnancy, an enhanced tubal wall on postcontrast images may be another diagnostic finding. Ruptured EP is inevitably associated with acute hematoma outside these structures. In intrauterine EP, recognition of the relationship between GS-like structure and the myometrium can aid in differentiating from normal pregnancy. Diagnostic pitfalls include heterotopic pregnancy, decidual changes in endometrial cyst and theca lutein cysts mimicking GS-like structures. Knowledge of a spectrum of clinical and MRI features of EP is essential for establishing an accurate diagnosis and determining appropriate management. (orig.)

  2. Revisiting Ectopic Pregnancy: A Pictorial Essay

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    Artemis Petrides

    2014-01-01

    Full Text Available Ectopic pregnancies occur in approximately 1.4% of all pregnancies and account for 15% of pregnancy-related deaths. Considering the high degree of mortality, recognizing an ectopic pregnancy is important. Signs and symptoms of an ectopic pregnancy are nonspecific and include pain, vaginal bleeding, and an adnexal mass. Therefore, imaging can play a critical role in diagnosis. There are different types of ectopic pregnancies, which are tubal, cornual, cesarean scar, cervical, heterotopic, abdominal, and ovarian. Initial imaging evaluation of pregnant patients with pelvic symptoms is by ultrasonography, transabdominal, transvaginal or both. We review the sonographic appearance of different types of ectopic pregnancies that will aid in accurate and prompt diagnosis.

  3. Optimising the diagnosis of ectopic pregnancy.

    Science.gov (United States)

    Berry, Janet; Davey, Mark; Hon, Mei-See; Behrens, Renée

    2016-05-01

    This retrospective cohort study reviewed the diagnosis of all ectopic pregnancies within a district general hospital over a 5-year period after the establishment of a dedicated Early Pregnancy Assessment Unit (EPAU). Of 215 ectopic pregnancies identified, notes were available for 208 (97%). Two-hundred and two cases were determined to have been diagnosed and managed as ectopic pregnancies. Six cases were excluded as they were pregnancies of unknown location managed as such. Overall, 91% were diagnosed by ultrasound scan, 5% were diagnosed clinically and 3% were diagnosed on serial human chorionic gonadotrophin (hCG) levels. This study found that the introduction of a dedicated, multi-professional, EPAU with a stable workforce improved ultrasound visualisation of ectopic pregnancies at first ultrasound scan from 22% prior to its commencement, to 61% over this period. The improvement in positive scan diagnosis of ectopic pregnancy was associated with a reduction in negative laparoscopy rate from 13% to 6%.

  4. [Conservative treatment of ectopic pregnancy].

    Science.gov (United States)

    Odland, J O; Maltau, J M; Tollan, A

    1991-01-30

    During the last decades the incidence of ectopic pregnancy has been steadily rising. The chosen therapy has usually been unilateral salpingectomy. Recently, different conservative (tube-preserving) treatment-modalities have been introduced in clinical practice. We have tried conservative treatment by local injection of prostaglandin F2a (total dose 2-4 mg) directly into the tubal pregnancy and, if feasible, also into the corpus luteum graviditate. The treatment was successful in 13 out of 16 patients. In one patient laparotomia was performed because of pain, and revealed a haematoma in fossa Douglasi. Reinjection of prostaglandin was necessary in one patient because of rising HCG titres. One patient was hospitalized for four days because of nausea and pain. The treatment was otherwise successful. The method may be useful as a non-surgical alternative in haemodynamically stable patients without tubal rupture. Further studies are needed to evaluate the outcome in terms of future fertility.

  5. Ruptured ectopic pregnancy with a negative urine pregnancy test.

    Science.gov (United States)

    Hughes, Mallory; Lupo, Andrew; Browning, Adrianne

    2017-01-01

    Ectopic pregnancy is commonly seen as a differential diagnosis of first-trimester vaginal bleeding. Often the diagnosis is made based on a combination of exam findings, transvaginal ultrasound, and a positive pregnancy test. Our case describes a patient with a history of ectopic pregnancy treated with methotrexate and serial human chorionic gonadotropin measurements that were decreasing appropriately. At the time of evaluation, her urine pregnancy test was negative; however, she was confirmed to have a ruptured tubal ectopic pregnancy. This case highlights the variable presentation of ectopic pregnancies and the importance of combining exam findings with ultrasound and laboratory results.

  6. What Is the Risk for a Second Ectopic Pregnancy?

    Science.gov (United States)

    ... Old What Is the Risk for a Second Ectopic Pregnancy? KidsHealth > For Parents > What Is the Risk for ... TOPIC Medical Care During Pregnancy Pregnancy & Newborn Center Pregnancy Precautions: FAQs Ectopic Pregnancy Contact Us Print Resources Send to a ...

  7. Concurrent bilateral ectopic pregnancy: a rarity

    Directory of Open Access Journals (Sweden)

    Prabhleen Kaur

    2015-08-01

    Full Text Available Bilateral ectopic pregnancy is a rare twin gestation with only a few cases reported in the literature. We report a 30 year old woman without any high risk factor for ectopic pregnancy, who had concurrent bilateral ectopic pregnancy. A 30 year old female presented to the Gynecology emergency department complaining of vaginal bleeding and abdominal pain. The presumptive diagnosis of ruptured left sided ectopic pregnancy was made on basis of clinical findings and ultrasound finings. An emergency laparotomy was done revealed a hemoperitoneum of 1.5 liters, a ruptured left tubal pregnancy with active bleeding and right tubal un-ruptured ectopic was found. A bilateral salpingectomy was performed. Histopathology confirmed presence of chorionic villi in both tubes. In theory, laparoscopic salpingostomy is the best surgical approach in bilateral tubal pregnancy. However, bilateral salpingectomy may be necessary when both tubes are extensively damaged or are actively bleeding. Successful pregnancies have been reported after conservative surgical treatment of bilateral ectopic, but the risk of recurrence is high. Our decision for an emergency laparotomy followed by bilateral salpingectomy was based on the fact that the patient presented with acute abdomen and was haemodynamically unstable and there was extensive bilateral tubal damage. As the incidence of ectopic pregnancies is increasing concurrently with the incidences of pelvic inflammatory disease and use of assisted fertility techniques; it may be that these and ldquo;rare ectopics and rdquo; will become less uncommon. [Int J Reprod Contracept Obstet Gynecol 2015; 4(4.000: 1197-1199

  8. Diagnosis and management of ectopic pregnancy.

    Science.gov (United States)

    Barash, Joshua H; Buchanan, Edward M; Hillson, Christina

    2014-07-01

    Ectopic pregnancy affects 1% to 2% of all pregnancies and is responsible for 9% of pregnancy-related deaths in the United States. When a pregnant patient presents with first-trimester bleeding or abdominal pain, physicians should consider ectopic pregnancy as a possible cause. The patient history, physical examination, and imaging with transvaginal ultrasonography can usually confirm the diagnosis. When ultrasonography does not clearly identify the pregnancy location, the physician must determine whether the pregnancy is intrauterine (either viable or failing) or ectopic. Use of the beta subunit of human chorionic gonadotropin (ß-hCG) discriminatory level, the ß-hCG value above which an intrauterine pregnancy should be visualized by transvaginal ultrasonography, may be helpful. Failure to visualize an intrauterine pregnancy when ß-hCG is above the discriminatory level suggests ectopic pregnancy. In addition to single measurements of ß-hCG levels, serial levels can be monitored to detect changes. ß-hCG values in approximately 99% of viable intrauterine pregnancies increase by about 50% in 48 hours. The remaining 1% of patients have a slower rate of increase; these patients may have pregnancies that are misdiagnosed as nonviable intrauterine or ectopic. After an ectopic pregnancy has been confirmed, treatment options include medical, surgical, or expectant management. For patients who are medically unstable or experiencing life-threatening hemorrhage, a surgical approach is indicated. For others, management should be based on patient preference after discussion of the risks, benefits, and monitoring requirements of all approaches.

  9. Ovarian ectopic pregnancy- a case report

    Directory of Open Access Journals (Sweden)

    Hiremath PB, Nidhi Bansal, SPArunkumar, Lavanya M, Sandhya Panjeta Gulia, Premaleela KGM, Reshma Hiremath

    2014-11-01

    Full Text Available Ectopic pregnancy (implantation anywhere outside the normal uterine cavity is the most common pregnancy complication leading to mortality. In the era of artificial reproductive techniques and liberated life style, ectopic pregnancy is not rare. However, ovarian pregnancy is an uncommonly encountered variety of ectopic pregnancy, and a definitive preoperative diagnosis is very challenging. Intraoperative findings and histopathology usually provide the final diagnosis. High serum beta human chorionic gonadotrophin levels, lack of an intrauterine gestational sac, tubo ovarian mass on ultrasonography (USG, patient’s risk factors, in addition to the Spiegelberg’s criteria gives a high probability of ovarian pregnancy. Management with surgical approach is required in all cases. We have made an attempt to present a case of ovarian pregnancy, consistent with Spiegelberg’s criteria. Our case demonstrates the difficulty in preoperative and intra operative diagnosis of ovarian ectopic, the final confirmation has been made by histopathology.

  10. 43例重复异位妊娠发病相关因素分析%Analysis of the Relative Factors of the Onset of Repeated Ectopic Pregnancy

    Institute of Scientific and Technical Information of China (English)

    莫培培

    2011-01-01

    Objective To determine the relative factors of the onset of repeated ectopic pregnancy ( REP ).Methods In this paper,the clinical data of 43 cases with REP, the relationship between the treatment methods of the initial treatment of ectopic pregnancy ( EP )and the location of repeat ectopic pregnancy,the treatment of REP were analysed retrospectively.Results The incidence rate of REP was 13.56% ( 43/317 ).Every cases had chronic pelvic inflammatory disease history, and 37 cases had infertility history.38 cases had miscarriage history.Most REP happened in the last three years from the first time of ectopic pregnancy happened.The initial treatment and pelvic inflammation have influence on EP.Conclusion The risk factors of onset of REP involves several aspects as follows :repeated miscarriages, pelvic inflammation and infertility,etc.The initial treatment of ectopic pregnancy closely related to REP.%目的分析重复异位妊娠(REP)的发病相关因素.方法回顾性分析43例REP患者的临床资料,首次异位妊娠(EP)的治疗方法与REP发生部位的关系及REP的治疗情况.结果 REP的发生率为13.56%,所有患者都有盆腔炎史,37例有不孕症病史;既往有流产或宫腔操作史38例.多发生在距上次EP发生3年内,与首次EP的治疗方式有关,盆腔炎对REP有影响.结论 REP的发病相关因素是多方面的,反复流产、盆腔炎和不孕症是常见因素,与首次EP的治疗方式密切相关.

  11. Sigmoid Microinvasion by an Ectopic Pregnancy.

    Science.gov (United States)

    Paquette, Joalee; Leboeuf, Mathieu; Gorak-Savard, Émilie

    2016-11-01

    Approximately 2.1% to 8.6% of all pregnancies after IVF with embryo transfer have been reported to be ectopic. In this report, we present a case of presumed intestinal microperforation caused by an ectopic pregnancy following IVF. A 29-year-old woman presented with rectal bleeding. She had previously been treated for an ectopic pregnancy for which she had received two doses of methotrexate. Colonoscopy and abdominal CT angiography were performed and showed that the ectopic pregnancy was attached to the sigmoid colon. Surgery was performed to remove the ectopic pregnancy. Because intestinal microperforations were suspected, the patient received intravenous antibiotic therapy during her hospitalization. In cases of intestinal bleeding, clinicians should consider the possibility of intestinal involvement of an ectopic pregnancy, even if the response to treatment for the ectopic pregnancy has been appropriate. Copyright © 2016 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

  12. Endometrium implantation and ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    LIU Yixun

    2004-01-01

    Embryo in uterine implantation is a complex and multifactor-related process and is a downstream and ideal point for woman fertility control.Understanding the cellular and molecular mechanism of implantation is a prerequisite for development of anti-implantation contraceptives.In spite of considerable accumulation of information from the laboratory animals that has been achieved,it is difficult to generate such information in human due to ethical restriction and experimental limitation,and the present knowledge for understanding the definitive mechanisms which control these events remains elusive.Embryo implantation can also occur outside uterus.Some women with abdominal pregnancies could successfully complete the processes of gestation and bear normal babies,implying that implantation itself may be not an endometrium-specific process.Reproductive biologists should cooperate with gynecologists to further comparatively study the molecular and cellular mechanisms of implantation normally occurring in endometrium and abnormally appearing outside uterine cavity.Such collaborative studies may generate new important information for developing anti-implantation contraceptive and for techniques of accurate diagnosis of ectopic pregnancy.A specially designed GnRH-2 analog and a combination use of Iow dose RU486 and gossypol as anti-implantation contraceptives have been suggested.

  13. Molecular diagnostics and therapeutics for ectopic pregnancy.

    Science.gov (United States)

    Tong, Stephen; Skubisz, Monika M; Horne, Andrew W

    2015-02-01

    Ectopic pregnancies are a serious gynaecological emergency that can be fatal. As such, prompt diagnosis and safe timely treatment is essential. Here, we review the literature on the development of molecularly targeted diagnostics and therapeutics for ectopic pregnancy. A blood-based biomarker that accurately identifies an ectopic pregnancy could be used to offer early diagnostic certainty in cases where ultrasound cannot determine the location of the embryo ('a pregnancy of unknown location'). Molecules examined so far can be broadly grouped into biological themes of relevance to reproduction: (i) Fallopian tube (dys)function, (ii) embryo/trophoblast growth, (iii) corpus luteum function, (iv) inflammation, (v) uterine function and (vi) angiogenesis. While a sensitive and specific biomarker for ectopic pregnancy has yet to be identified, it is possible that improvements in platform technologies or a multi-modal biomarker approach may yield an accurate diagnostic biomarker test. Furthermore, with the advent of better imaging technology, the need for a blood-based biomarker test may be superseded by improvements in ultrasound or magnetic resonance imaging technology. There have been some recent preclinical studies describing molecularly targeted therapeutic approaches for ectopic pregnancy. Notably, bench-to-bedside studies have examined the use of combination gefitinib (orally available epidermal growth factor receptor inhibitor) and methotrexate. Preclinical studies suggest that combination gefitinib and methotrexate is highly effective in inducing placental cell death, and is significantly more effective than methotrexate alone. In early human trials, encouraging preliminary efficacy data have shown that combination gefitinib and methotrexate can rapidly resolve tubal ectopic pregnancies, and large extra-tubal ectopic pregnancies. If a large clinical randomized controlled trial confirms these findings, combination gefitinib and methotrexate could become a new

  14. Disparities in the management of ectopic pregnancy.

    Science.gov (United States)

    Hsu, Jennifer Y; Chen, Ling; Gumer, Arielle R; Tergas, Ana I; Hou, June Y; Burke, William M; Ananth, Cande V; Hershman, Dawn L; Wright, Jason D

    2017-07-01

    Ectopic pregnancy is common among young women. Treatment can consist of either surgery with salpingectomy or salpingostomy or medical management with methotrexate. In addition to acute complications, treatment of ectopic pregnancy can result in long-term sequelae that include decreased fertility. Little is known about the patterns of care and predictors of treatment in women with ectopic pregnancy. Similarly, data on outcomes for various treatments are limited. We examined the patterns of care and outcomes for women with ectopic pregnancy. Specifically, we examined predictors of medical (vs surgical) management of ectopic pregnancy and tubal conservation (salpingostomy vs salpingectomy) among women who underwent surgery. The Perspective database was used to identify women with a diagnosis of tubal ectopic pregnancy treated from 2006-2015. Perspective is an all-payer database that collects data on patients at hospitals from throughout the United States. Women were classified as having undergone medical treatment, if they received methotrexate, and surgical treatment, if treatment consisted of salpingostomy or salpingectomy. Multivariable models were developed to examine predictors of medical treatment and of tubal conserving salpingostomy among women who were treated surgically. Among the 62,588 women, 49,090 women (78.4%) were treated surgically, and 13,498 women (21.6%) received methotrexate. Use of methotrexate increased from 14.5% in 2006 to 27.3% by 2015 (Pectopic pregnancy. There are significant race- and insurance-related disparities associated with treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. A clinical study of ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Shanti Sri Asuri

    2016-11-01

    Conclusions: The early diagnosis of an ectopic pregnancy is one of the greatest challenges for a physician. It requires a high index of suspicion to diagnose an ectopic pregnancy. The importance of an early diagnosis lies in the fact that the lady can be offered a conservative line of management which can definitely have a beneficial effect on her reproductive career. [Int J Reprod Contracept Obstet Gynecol 2016; 5(11.000: 3750-3753

  16. Ectopic Pregnancy in Uncommon Implantation Sites: Intramural Pregnancy and Rudimentary Horn Pregnancy

    OpenAIRE

    Yi Wang; Fan Yu; Li-Qin Zeng

    2015-01-01

    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 data regarding diagnosis and optimal treatment from our experience.

  17. ANALYSIS OF RISK FACTORS ECTOPIC PREGNANCY

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    Budi Santoso

    2017-04-01

    Full Text Available Introduction: Ectopic pregnancy is a pregnancy with extrauterine implantation. This situation is gynecologic emergency that contributes to maternal mortality. Therefore, early recognition, based on identification of the causes of ectopic pregnancy risk factors, is needed. Methods: The design descriptive observational. The samples were pregnant women who had ectopic pregnancy at Maternity Room, Emergency Unit, Dr. Soetomo Hospital, Surabaya, from 1 July 2008 to 1 July 2010. Sampling technique was total sampling using medical records. Result: Patients with ectopic pregnancy were 99 individuals out of 2090 pregnant women who searched for treatment in Dr. Soetomo Hospital. However, only 29 patients were accompanied with traceable risk factors. Discussion:. Most ectopic pregnancies were in the age group of 26-30 years, comprising 32 patients (32.32%, then in age groups of 31–35 years as many as 25 patients (25.25%, 18 patients in age group 21–25 years (18.18%, 17 patients in age group 36–40 years (17.17%, 4 patients in age group 41 years and more (4.04%, and the least was in age group of 16–20 years with 3 patients (3.03%. A total of 12 patients with ectopic pregnancy (41.38% had experience of abortion and 6 patients (20.69% each in groups of patients with ectopic pregnancy who used family planning, in those who used family planning as well as ectopic pregnancy patients with history of surgery. There were 2 patients (6.90% of the group of patients ectopic pregnancy who had history of surgery and history of abortion. The incidence rate of ectopic pregnancy was 4.73%, mostly in the second gravidity (34.34%, whereas the nulliparous have the highest prevalence of 39.39%. Acquired risk factors, i.e. history of operations was 10.34%, patients with family planning 20.69%, patients with history of abortion 41.38%, patients with history of abortion and operation 6.90% patients with family and history of abortion was 20.69%.

  18. Fragmentation of Care in Ectopic Pregnancy.

    Science.gov (United States)

    Stulberg, Debra B; Dahlquist, Irma; Jarosch, Christina; Lindau, Stacy T

    2016-05-01

    Ectopic pregnancy is an important cause of maternal morbidity and mortality. Women who experience fragmented care may undergo unnecessary delays to diagnosis and treatment. Based on ectopic pregnancy cases observed in clinical practice that raised our concern about fragmentation of care, we designed an exploratory study to describe the number, characteristics, and outcomes of fragmented care among patients with ectopic pregnancy at one urban academic hospital. Chart review with descriptive statistics. Fragmented care was defined as a patient being evaluated at an outside facility for possible ectopic pregnancy and transferred, referred, or discharged before receiving care at the study institution. Of 191 women seen for possible or definite ectopic pregnancy during the study period, 42 (22 %) met the study definition of fragmented care. The study was under-powered to observe statistically significant differences across groups, but we found concerning, non-significant trends: patients with fragmented care were more likely to be Medicaid recipients (65.9 vs. 58.8 %) and to experience a complication (23.8 vs. 18.1 %) compared to those with non-fragmented care. Most patients (n = 37) received no identifiable treatment prior to transfer and arrived to the study hospital with no communication to the receiving hospital from the outside provider (n = 34). Nine patients (21 %) presented with ruptured ectopic pregnancies. The fragmentation we observed in our study may contribute to previously identified socio-economic disparities in ectopic pregnancy outcomes. If future research confirms these findings, health information exchanges and regional coordination of care may be important strategies for reducing maternal mortality.

  19. [Clinical and ultrasonographic data in ectopic pregnancy].

    Science.gov (United States)

    Romero Gutierrez, G; Patiño Segura, A; Pulido Ochoa, J J; Valadéz Ortega, A

    1994-06-01

    In order to evaluate the clinical and sonographic findings in 60 patients with ectopic pregnancy confirmed at laparotomy, we carried out a prospective study at the Hospital de Gineco-Obstetricia del Centro Médico León, Instituto Mexicano del Seguro Social. The patients were 28.17 years old, average. The ectopic pregnancy was more common in multiparous women (80%) than in nuliparous ones. The obstetric risk factors more frequent were abortion (26.6%) and use of intrauterine device (23.3%). The clinical sign reported most common was pelvic pain, referred in 48 patients (80%). Hemodynamic changes were detected in 21.6% of the cases. The ultrasound findings were seen in most of the patients and heterogeneous adnexal mass was observed in 91.6% of them, moreover intraperitoneal fluid was reported in 61.6% of the patients with ectopic pregnancy. The heterogeneous adnexal mass had a direct relationship with the diagnosis of ectopic pregnancy and had a correlation coefficient value R = 0.99 (P < 0.01). The ultrasonographic findings seen with transvaginal technique were similar than those obtained through transabdominal procedure. We conclude that ultrasonography has a definite role in improving the diagnosis of ectopic pregnancy.

  20. Recurrent ectopic pregnancy after ipsilateral partial salpingectomy: a case report.

    Science.gov (United States)

    Lee, D H

    2015-01-01

    Ectopic pregnancy is associated with maternal morbidity and mortality during early pregnancy. Ectopic pregnancy occurs in approximately 2% of all pregnancies, and the risk of ectopic pregnancy is increased by eight-fold in women with a history of eopic pregnancy. However, recurrent ectopic pregnancy after ipsilateral partial salpingectomy is quite rare. The authors experienced a case of recurrent ectopic pregnancy in the distal remnant after right partial salpingectomy. In this case report, they discuss this unusual case and provide a brief review of the literature.

  1. Twin tubal pregnancy: A large unruptured ectopic pregnancy.

    Science.gov (United States)

    Goswami, Deepti; Agrawal, Nidhi; Arora, Vrinda

    2015-11-01

    Twin ectopic pregnancy is a rare occurrence, with an estimated incidence of 1 in 20 000 spontaneous pregnancies. We describe a case of unilateral twin ectopic pregnancy in which the gravid fallopian tube showed no signs of tubal rupture despite marked tubal distension. A 25-year-old woman presented with clinical features suggestive of large right-sided tubal ectopic pregnancy. Serum β-human chorionic gonadotropin was 10 800 IU/mL. Laparotomy revealed markedly distended right fallopian tube. There was no hemoperitoneum. The tube contained twin gestational sacs. The crown-rump length of the embryos was 2 cm. The ectopic gestation was thus unique, in that despite marked tubal distension, the trophoblastic invasion was not significant to cause tubal rupture. There may be a role for medical management based on individual gestational sac size in selected cases of twin tubal pregnancy in which there is no evidence of hemoperitoneum.

  2. Ectopic pregnancy after levonorgestrel emergency contraception

    Directory of Open Access Journals (Sweden)

    Ahmet Karatas

    2013-08-01

    Full Text Available Levonorgestrel Emergency Contraception (LNG-EC is the safest and the most commonly used oral regimen that can be used after an unprotected intercourse. Although it is highly effective, failures can occur especially if it is used in the peri /or postovulatory period. It can not inhibit ovulation if used in these periods and the altered tubal motility together with the ciliary dysfunction can prevent the transfer of the fertilized ovum from the fallopian tube to the endometrial cavity, causing an ectopic pregnancy, which is one of the important concerns after failed LNG-EC. This risk was reported not to be higher than the risk of ectopic pregnancy observed in the general population, but the users of this medication should still warned about this risk. Here we report a case of ectopic pregnancy from Turkey after midcyclic use and failure of LNG-EC. [Int J Reprod Contracept Obstet Gynecol 2013; 2(4.000: 749-750

  3. Laparoscopic Resection of Cesarean Scar Ectopic Pregnancy.

    Science.gov (United States)

    Ades, Alex; Parghi, Sneha

    To demonstrate a technique for the laparoscopic surgical management of cesarean section scar ectopic pregnancy. Step-by-step presentation of the procedure using video (Canadian Task Force classification III). Cesarean section scar ectopic pregnancy is a rare form of ectopic pregnancy with an incidence ranging from 1:1800 to 1:2216. Over the last decade, the incidence seems to be on the rise with increasing rates of cesarean deliveries and early use of Doppler ultrasound. These pregnancies can lead to life-threatening hemorrhage, uterine rupture, and hysterectomy if not managed promptly. Local or systemic methotrexate therapy has been used successfully but can result in prolonged hospitalization, requires long-term follow-up, and in some cases treatment can fail. In the hands of a trained operator, laparoscopic resection can be performed to manage this type of pregnancy. Consent was obtained from the patient, and exemption was granted from the local Internal Review Board (The Womens' Hospital, Parkville). In this video we describe our technique for laparoscopic management of a cesarean scar ectopic pregnancy. We present the case of a 34-year-old G4P2T1 with the finding of a live 8-week pregnancy embedded in the cesarean section scar. The patient had undergone 2 previous uncomplicated cesarean sections at term. On presentation her β-human chorionic gonadotropin (β-hCG) level was 52 405 IU/L. She was initially managed with an intragestational sac injection of potassium chloride and methotrexate, followed by 4 doses of intramuscular methotrexate. Despite these conservative measures, the level of β-hCG did not adequately fall and an ultrasound showed a persistent 4-cm mass. A decision was made to proceed with surgical treatment in the form of a laparoscopic resection of the ectopic pregnancy. The surgery was uneventful, and the patient was discharged home within 24 hours of her procedure. Her serial β-hCG levels were followed until complete resolution

  4. A RARE CASE OF CERVICAL ECTOPIC PREGNANCY

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    Rajalekshmi

    2015-07-01

    Full Text Available A 30 year s old nulligravida woman presented with bleeding PV for 5 days and lower abdominal pain for 3 days. Her urine pregnan c y test was positive. Speculum and per vaginal examination revealed open cervix with fleshy mass protruding through the cervix. Ultrasound showed normal, empty uterine cavity with mixed echogenic c ontents in the cervix. Emergency dilatation and evacuation was done. Histopathological examination revealed products of conception. All these factors confirmed it to be cervical ectopic pregnancy. In this case report we discuss the diagnosis and management of a rare case of cervical ectopic pregnancy encountered in our hospital.

  5. Molar tubal ectopic pregnancy: Report of two cases.

    Science.gov (United States)

    Mbarki, Chaouki; Jerbi, Emna; Hsayaoui, Najeh; Zouari, Fatma; Ben Brahim, Ehsen; Oueslati, Hedhili

    2015-06-01

    Ectopic molar pregnancy is a rare occurrence and consequently not often considered as a diagnostic possibility. We report two cases of molar hydatidiform tubal pregnancy. Diagnosis of ectopic pregnancy was confirmed on clinical biological and sonographic investigations. Diagnosis of molar pregnancy was done on histopathology. The clinical course was favorable for both patients. Although rare, molar changes can occur at any site of an ectopic pregnancy. Clinical diagnosis of a molar pregnancy is difficult but histopathology is the gold standard for diagnosis.

  6. Imaging Unusual Pregnancy Implantations: Rare Ectopic Pregnancies and More.

    Science.gov (United States)

    Dibble, Elizabeth H; Lourenco, Ana P

    2016-12-01

    The purpose of this article is to review key clinical issues and imaging features of unusual pregnancy implantations. Examples from different imaging modalities are provided to increase interpreting physicians' familiarity with the appearance and potential complications of unusual ectopic, cesarean scar, heterotopic, and rudimentary horn pregnancies. Abnormal pregnancy implantations are life-threatening. Interpreting physicians' familiarity with the appearance of unusual pregnancy implantations is critical for early identification and initiation of appropriate therapy.

  7. [Laparoscopic surgery in ectopic pregnancy].

    Science.gov (United States)

    Rachev, E; Novachkov, V

    1995-01-01

    The authors present two cases of women with unruptured tubal pregnancies who were treated by methods of laparoscopic surgery. A salpingotomy as well as an aspiration of the pregnancy was performed. The operations reported are the first in gynaecological practice in Bulgaria and the operative technique is described.

  8. A pragmatic and evidence-based management of ectopic pregnancy.

    Science.gov (United States)

    Oron, Galia; Tulandi, Togas

    2013-01-01

    The incidence of ectopic pregnancy is approximately 2% of all pregnancies, and it remains the leading cause of death in early pregnancy. Over 95% of ectopic pregnancies are tubal pregnancies, and the remainders are nontubal pregnancies. The highest risk factor for ectopic pregnancy is a previous tubal pregnancy followed by previous tubal surgery, tubal sterilization, tubal pathology, and current intrauterine device use. The apparent increase in the incidence of nontubal ectopic pregnancy including heterotopic pregnancy may be attributed to the increasing number of pregnancies because of in vitro fertilization treatment. In most cases, an ectopic pregnancy can be treated medically with a single dose of methotrexate. Surgical treatment is still needed in women who are hemodynamically unstable and in those who do not fulfill the criteria for methotrexate treatment. Usually surgical treatment can be performed by laparoscopy and in some cases by hysteroscopy. Laparotomy is rarely needed even in women with intraperitoneal bleeding.

  9. Intramural ectopic pregnancy: a case and review of the literature.

    Science.gov (United States)

    Kirk, Emma; McDonald, Katie; Rees, Julia; Govind, Abha

    2013-06-01

    An intramural ectopic is a rare type of ectopic pregnancy in which the gestational sac is implanted within the myometrium, separate from the endometrial cavity and Fallopian tubes. There are only 53 cases in the published literature. We report a case of intramural ectopic pregnancy treated surgically and review the published data on this rare type of ectopic pregnancy, with respect to aetiology, diagnosis and management. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  10. Impact of ectopic pregnancy for reproductive prognosis in next generation.

    Science.gov (United States)

    Kårhus, Line Lund; Egerup, Pia; Skovlund, Charlotte Wessel; Lidegaard, Øjvind

    2014-04-01

    The impact of an ectopic pregnancy in the next generation is unknown. Our aim was to compare reproductive outcomes in daughters of women with and without ectopic pregnancy. Designed as a historical prospective controlled cohort study with data collected in four Danish registries from 1977-2009, women with ectopic pregnancy during 1977-1982 were age-matched to women without ectopic pregnancy. Daughters of these two cohorts were followed until 2009. We compared 5126 daughters of women with ectopic pregnancy with 19 928 daughters of women without ectopic pregnancy. The daughters of women with ectopic pregnancy had a 1.5-fold (95% confidence interval 1.2-1.9) increased risk of ectopic pregnancy, while for deliveries this was 1.0 (1.0-1.1), for miscarriages 1.1 (1.0-1.2), and for induced abortions 1.3 (1.2-1.4). Daughters of mothers with ectopic pregnancy have a 50% higher risk of ectopic pregnancy than daughters of women without an ectopic pregnancy, but a normal delivery rate.

  11. Dreams of my daughter: an ectopic pregnancy.

    Science.gov (United States)

    Lahman, Maria K E

    2009-02-01

    Autoethnographic narrative, personal journal excerpts, and artifacts were employed to narrate the story of my ectopic pregnancy and experiences with the medical field. The name "Doctor" is invoked as a way of objectifying yet protecting the anonymity of the doctor who objectified and did not protect me. A methodological discussion of the following tensions in autoethnography is presented: intimacy/professionality, art/science, showing/explaining.

  12. Two Cases of Primary Ectopic Ovarian Pregnancy

    Directory of Open Access Journals (Sweden)

    Sonia Gon

    2011-04-01

    Full Text Available Primary ovarian pregnancy is one of the rarest varieties of ectopic pregnancies. Patients frequently present with abdominal pain and menstrual irregularities. Intrauterine devices have evolved as probable risk factors. Preoperative diagnosis is challenging but transvaginal sonography has often been helpful. A diagnostic delay may lead to rupture, secondary implantation or operative difficulties. Therefore, awareness of this rare condition is important in reducing the associated risks. Here, we report two cases of primary ovarian pregnancies presenting with acute abdominal pain. Transabdominal ultrasonography failed to hint at ovarian pregnancy in one, while transvaginal sonography aided in the correct diagnosis of the other. Both cases were confirmed by histopathological examinations and were successfully managed by surgery.

  13. [Abdominal ectopic pregnancy. A case report and literature review].

    Science.gov (United States)

    Puch-Ceballos, Eduardo Erik; Vázquez-Castro, Rosbel; Osorio-Pérez, Ana Isabel; Ramos-Ayala, Montserrat; Villarreal-Sosa, Conrado Otoniel; Ruvalcaba-Rivera, Everardo

    2015-07-01

    Abdominal ectopic pregnancy is an extremely rare entity, which represents 1% of all ectopic pregnancies and is associated with high maternal and fetal morbidity and mortality. The maternal mortality risk of an abdominal ectopic pregnancy is seven to eight times greater than the risk of a tubal ectopic pregnancy and is 90 times greater than the risk of intrauterine pregnancy. This is a disease of difficult diagnosis that often takes place late. We report the case of a patient with an abdominal ectopic pregnancy, which was diagnosed by abdominal ultrasound in the second trimester; the patient was suc- cessfully treated with exploratory laparotomy with complete removal of the fetus and placenta. We provide a review of the literature on the risk factors for abdominal ectopic pregnancy, diagnostic tests and therapeutic options.

  14. Spontaneous live recurrent ectopic pregnancy after ipsilateral partial salpingectomy leading to tubal rupture.

    Science.gov (United States)

    Abraham, Cynthia; Seethappan, Vanitha

    2015-01-01

    Ectopic pregnancy accounts for 1-2% of all pregnancies in the United States. The most common site of implantation for an ectopic pregnancy is the fallopian tube. We present the first case describing a recurrent ectopic pregnancy with a fetal heartbeat after ipsilateral salpingectomy that led to tubal rupture. The patient presented with abdominal pain approximately six weeks after her last menstrual period. Seven years prior to presentation, a laparoscopic partial right salpingectomy had been performed for a tubal ectopic pregnancy. Physical exam was significant for diffuse abdominal tenderness and guarding. Ultrasonography revealed a right tubal pregnancy with a fetal pole and a fetal heart rate that was calculated to be 108 beats per minute. Free fluid was also noted. 1.5l of hemoperitoneum was subsequently evacuated and the right fallopian tube remnant with the ectopic pregnancy was removed. Pathology of the tubal remnant showed immature chorionic villi and fetal parts. The mechanism by which a recurrent ectopic pregnancy after ipsilateral salpingectomy occurs is unclear, but is theorized to be secondary to contralateral fertilization and/or tubal recanalization that may occur due to inadequate diathermy. Physicians should be aware that ectopic pregnancies may not only occur repeatedly but may also present a typically. We recommend when performing a salpingectomy that efforts be undertaken to minimize the length of the tubal remnant and to assure adequate coagulation of tissue so as to reduce the risk of recurrence. Copyright © 2015. Published by Elsevier Ltd.

  15. Current knowledge of the aetiology of human tubal ectopic pregnancy

    Science.gov (United States)

    Shaw, J.L.V.; Dey, S.K.; Critchley, H.O.D.; Horne, A.W.

    2010-01-01

    BACKGROUND An ectopic pregnancy is a pregnancy which occurs outside of the uterine cavity, and over 98% implant in the Fallopian tube. Tubal ectopic pregnancy remains the most common cause of maternal mortality in the first trimester of pregnancy. The epidemiological risk factors for tubal ectopic pregnancy are well established and include: tubal damage as a result of surgery or infection (particularly Chlamydia trachomatis), smoking and in vitro fertilization. This review appraises the data to date researching the aetiology of tubal ectopic pregnancy. METHODS Scientific literature was searched for studies investigating the underlying aetiology of tubal ectopic pregnancy. RESULTS Existing data addressing the underlying cause of tubal ectopic pregnancy are mostly descriptive. There are currently few good animal models of tubal ectopic pregnancy. There are limited data explaining the link between risk factors and tubal implantation. CONCLUSIONS Current evidence supports the hypothesis that tubal ectopic pregnancy is caused by a combination of retention of the embryo within the Fallopian tube due to impaired embryo-tubal transport and alterations in the tubal environment allowing early implantation to occur. Future studies are needed that address the functional consequences of infection and smoking on Fallopian tube physiology. A greater understanding of the aetiology of tubal ectopic pregnancy is critical for the development of improved preventative measures, the advancement of diagnostic screening methods and the development of novel treatments. PMID:20071358

  16. The Clinical and Ultrasonic Study of Clinically Suspected Ectopic Pregnancy: Laying Emphasis on 15 proven Ectopic Pregnancies

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    Byun, Myung Ho; Chung, Yung Sun [Chonnam National University College of Medicine, Gwangju (Korea, Republic of)

    2010-05-15

    Ectopic preganacies are unsuccessful pregnancies that result from implantation of fertilized ovum occurring in an aberrant area. Aside from an emergency case, the early diagnosis of ectopic pregnancy is very difficult particularly in a case with insidious onset and mild clinical manifestations. Early diagnosis not only reduces the danger, but also simplifies the management of ectopic pregnancy. Ultrasonography has been an indispensable diagnostic tool in Obstetrics and Gynecology. In the authors' experience, clinical suspected ectopic pregnancy was one of the common indications for performing ultrasonography. Since Kobayashi at al. reported the appearances of ectopic pregnancy utilizing bistable B-scan ultrasonography, the ultrasonic findings of ectopic pregnancy have been reported by many authors. But, its accuracy and reliability in the diagnosis of ectopic pregnancy are still open to controversy. The authors studied 65 cases of clinically suspected ectopic pregnancy with Picker 80 L gray scale ultrasonography from Aug. 1982 to June. 1983. There were 29 confirmed cases, of which 15 were proved to have ectopic pregnancy and 14 were proved to have diseases other than ectopic pregnancy by surgical and histopathological study or by laparoscopy and follow up study. 29 confirmed cases were reviewed. The results were as follows: 1. Among 15 ectopic pregnancies, there were 12 ampullary pregnancies, 2 isthmic pregnancies and 1 interstitial pregnancy. Among 14 cases of no ectopic pregnancy, there were 5 intrauterine pregnancies, 3 myoma uteri, 2 P.I.D., and 1 case of dermoid cyst, cystic teratoma, H-mole and tubal hematoma due to previous tuball ligation, respectively. 2. The age distribution of ectopic pregnancy was from 22 to 41 years. The common clinical manifestations of ectopic pregnancy were lower abdominal pain (73.3%), vaginal spotting or bleeding (73.3%) and amenorrhea (66.7%). 3. Positive result of urine immunologic pregnancy test was 28.6% in ectopic

  17. Non-invasive diagnosis and management of ectopic pregnancy

    NARCIS (Netherlands)

    van Mello, N.M.

    2013-01-01

    The work presented in this thesis begins with a focus on non-invasive diagnostic methods for ectopic pregnancy. The heterogeneity found in studies on diagnostic tests for ectopic pregnancy has led to an international recommendation on uniform definitions of early pregnancy complications. Hereafter,

  18. Non-invasive diagnosis and management of ectopic pregnancy

    NARCIS (Netherlands)

    van Mello, N.M.

    2013-01-01

    The work presented in this thesis begins with a focus on non-invasive diagnostic methods for ectopic pregnancy. The heterogeneity found in studies on diagnostic tests for ectopic pregnancy has led to an international recommendation on uniform definitions of early pregnancy complications. Hereafter,

  19. Diagnosis and management of intramural ectopic pregnancy.

    Science.gov (United States)

    Bannon, Kimberly; Fernandez, Carlos; Rojas, David; Levine, Elliot M; Locher, Stephen

    2013-01-01

    Intramural pregnancy, a gestation completely surrounded by the myometrium located within the uterine wall with separation from the uterine cavity, is an extremely unusual form of pregnancy. Complications resulting from intramural pregnancy include inevitable uterine rupture with resultant hemorrhage and possible hysterectomy if diagnosis is not made early and treatment is not initiated. An asymptomatic patient was initially diagnosed with a missed abortion at approximately 6 weeks of gestation after a routine ultrasound. Suction curettage was performed approximately 1 month after the initial diagnosis. The pathology specimen failed to reveal placental villi. Ultimately, the diagnosis of intramural pregnancy was made via ultrasound and a computed tomography scan. She was treated with a single dose of systemically administered methotrexate. Over a period of 4 months, β-human chorionic gonadotropin levels trended downward; however, the intramural pregnancy failed to resolve completely, and a persistent mass remained. The intramural pregnancy was removed using the da Vinci laparoscopic procedure (Intuitive Surgical, Sunnyvale, CA). If the diagnosis of intramural ectopic pregnancy is made sufficiently early, conservative measures can be taken, which can preserve a patient's future fertility.

  20. Key Concepts in Pregnancy of Unknown Location: Identifying Ectopic Pregnancy and Providing Patient-Centered Care.

    Science.gov (United States)

    Fields, Loren; Hathaway, Alison

    2017-03-01

    Pregnancy of unknown location (PUL) is a descriptive term for when a woman with a positive pregnancy test has a transvaginal ultrasound that cannot determine the site of the pregnancy. While the majority of women with PUL are subsequently diagnosed with a spontaneous abortion or viable intrauterine pregnancy, 7% to 20% of these women have an ectopic pregnancy. The potential for morbidity and mortality related to an ectopic pregnancy means that considerable care is necessary in the evaluation and management of women with PUL. In some cases, the location of the pregnancy is never determined and the PUL is categorized as resolving or persisting. Evidence suggests expectant management is a safe and effective approach for most women with PUL and should be the mainstay of care. However, in the case of persisting PUL, continued concern for ectopic pregnancy remains. Strategies for deciding when to intervene when a woman has a PUL are reviewed. A variety of clinical tools, including serum beta human chorionic gonadotropin (β-hCG), repeat ultrasonography, dilation and curettage (D&C), and empiric methotrexate therapy are discussed. Finally, a proposal is made that women with persisting PUL can be presented with the option of choosing expectant management, diagnostic D&C, or empiric methotrexate treatment. © 2016 by the American College of Nurse-Midwives.

  1. Cervical Ectopic Pregnancy following Assisted Reproductive Technology: A Case Report

    Directory of Open Access Journals (Sweden)

    Firoozeh Ahmadi

    2012-01-01

    Full Text Available Cervical ectopic pregnancy (EP is an infrequent, life-threatening form of ectopic gestationpregnancy that implants within the endocervical canal. With the increase in use of assistedreproductive technology (ART worldwide and more liberal use of transvaginal sonography (TVSduring early pregnancy, more cases of cervical ectopic pregnancy are being diagnosed. Earlydiagnosis of this condition by using ultrasound imaging allows for prevention of maternal morbiditydue to hemorrhage and leads to conservative management of this condition.We present the case ofa 38-year old woman (gravida 1, para 0 who was found to have acervical ectopic pregnancy at sixweeks of gestation.

  2. Improved fertility following conservative surgical treatment of ectopic pregnancy

    DEFF Research Database (Denmark)

    Bangsgaard, Nannie; Lund, Claus Otto; Ottesen, Bent;

    2003-01-01

    OBJECTIVE: To evaluate fertility after salpingectomy or tubotomy for ectopic pregnancy. DESIGN: Retrospective cohort study. SETTING: Clinical University Center, Hvidovre Hospital, Copenhagen. POPULATION: Two hundred and seventy-six women undergoing salpingectomy or tubotomy for their first ectopic...... pregnancy between January 1992 and January 1999 and who actively attempted to conceive were followed for a minimum of 18 months. METHODS: Retrospective cohort study combined with questionnaire to compare reproductive outcome following salpingectomy or tubotomy for ectopic pregnancy. Cumulative probabilities...... of pregnancy for each group were calculated by the Kaplan-Meier estimator and compared by Cox regression analysis to control for potential confounders. MAIN OUTCOME MEASURES: Intrauterine pregnancy rates and recurrence rates of ectopic pregnancy after surgery for ectopic pregnancy. RESULTS: The cumulative...

  3. Improved fertility following conservative surgical treatment of ectopic pregnancy

    DEFF Research Database (Denmark)

    Bangsgaard, Nannie; Lund, Claus Otto; Ottesen, Bent

    2003-01-01

    OBJECTIVE: To evaluate fertility after salpingectomy or tubotomy for ectopic pregnancy. DESIGN: Retrospective cohort study. SETTING: Clinical University Center, Hvidovre Hospital, Copenhagen. POPULATION: Two hundred and seventy-six women undergoing salpingectomy or tubotomy for their first ectopic...... pregnancy between January 1992 and January 1999 and who actively attempted to conceive were followed for a minimum of 18 months. METHODS: Retrospective cohort study combined with questionnaire to compare reproductive outcome following salpingectomy or tubotomy for ectopic pregnancy. Cumulative probabilities...... of pregnancy for each group were calculated by the Kaplan-Meier estimator and compared by Cox regression analysis to control for potential confounders. MAIN OUTCOME MEASURES: Intrauterine pregnancy rates and recurrence rates of ectopic pregnancy after surgery for ectopic pregnancy. RESULTS: The cumulative...

  4. Role of transabdominal ultrasound in detection of ectopic pregnancy

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    Narayan Bikram Thapa

    2016-03-01

    Full Text Available Background & Objectives: Ectopic pregnancy is one of the common medical emergencies encountered in the clinical practice. Confirmation of diagnosis is usually done by urine pregnancy test and transabdominal sonography. Thus, the present study is carried out to determine the role of transabdominal ultrasonography in the diagnosis of ectopic pregnancy by comparing the ultrasonography findings with that of operative and histopathology and to evaluate clinical profile of the women with confirmed ectopic pregnancy. Materials & Methods: Transabdominal ultrasound record of patients referred for first trimester ultrasound, from January 2008 to December 2015, at radiology department of Kist medial college teaching hospital were reviewed to identify patients with ectopic pregnancy. Among these patients those who underwent surgery and histopathology confirmed ectopic pregnancies were identified and their medical records were retrieved. Ultrasound and clinical profile were recorded and statistically analyzed. Results: There were 19 patients with ultrasound diagnosis of ectopic pregnancy among 1480 first trimester ultrasound record. Among these patients, ectopic pregnancy was confirmed on 18 patients. Ultrasound diagnosis included adnexal mass with pelvic fluid in 15 (83.3% patients and pelvic fluid without adnexal mass in 4 (16.7% patients. The study result revealed that sensitivity of transabdominal ultrasonography was 100% and specificity was 99.9%. Positive predictive value and negative predictive value of transabdominal ultrasonography was 94% and 100%.Conclusion: The transabdominal ultrasound accurately diagnose ruptured ectopic pregnancy.JCMS Nepal. 2016;12(1:1-4.

  5. The ectopic pregnancy, a diagnostic and therapeutic challenge

    OpenAIRE

    2008-01-01

    The classic symptoms of ectopic pregnancy are secondary amenorrhoea, abdominal pain and vaginal haemorrhage, with a clinical picture of varying acuteness. It is among the commonest causes of maternal mortality during the first three months of pregnancy In the majority of cases (95%) the pregnancy is tubal, but other sites are possible (cervical, corneal, ovarian, peritoneal). In the treatment of sterility or medically assisted reproduction, the risk of ectopic pregnancy should be borne in min...

  6. Analysis Of Two Years Cases Of Ectopic Pregnancy.

    Science.gov (United States)

    Islam, Ansa; Fawad, Aneesa; Shah, Azmat Ali; Jadoon, Humaira; Sarwar, Iram; Abbasi, Aziz-Un-Nisa

    2017-01-01

    Ectopic pregnancy is the leading cause of pregnancy related deaths in the first trimester. The aim of this study was to evaluate the frequency of risk factors, clinical presentation, diagnostic methods and site of ectopic pregnancy. This descriptive cross sectional study was conducted in Gynaecology and Obstetrical Unit-A of Ayub Teaching Hospital Abbottabad from 1st October 2013 to 31st October 2015. All women diagnosed with ectopic pregnancy were included in the study. A predesigned proforma was used to record the details about demographic features, risk factors, clinical features at presentation, diagnostic methods and site of ectopic pregnancy. Out of total 6675 patients admitted during the study period, 45 cases of ectopic pregnancy were diagnosed with frequency of ectopic pregnancy to be 0.65%. Mean age of the patients was 28.98±5.525. Majority of patients were primigravida14 (31.3%), 9 (20.0%) gravida 2, 5 (11.1%) gravida 3, 4 (8.8%) gravida 4, 7 (15.5%) gravida 5, 6 (13.3%) found grand multi out of total 45 ectopic pregnancies, 45% of the patients had no identifiable risk factors, however history of infertility 20 (22.22%), history of Pelvic inflammatory disease (PID) 10 (22.22%), previous ectopic 2 (4.44%) and previous abdominal pelvic surgery 3 (6.67%) were identified as common risk factors of 45 ectopic pregnancies. Out of total 45 sufferers 23 (51.11%) were clinically diagnosed, 20 (44.44%) through abdominal ultrasound and 2 (4.44%) through transvaginal ultrasound. The most frequent clinical presentation was amenorrhea 30 (66.67%) followed by abdominal pain 28 (62.22%), irregular vaginal bleeding 18 (40.00%), asymptomatic patients with routine ultrasound 18 (40.0%) and 10 (22.22%) presented in shock. Twenty-eight (62.2%) of the ectopic pregnancies were found in right sided fallopian tube and 17(37.8%) were found in left sided fallopian tube. The commonest site of ectopic pregnancy was ampulla 29 (64.44%) followed by 11 (24.44%) Isthmus, 4 (8

  7. Ectopic pregnancy: a comprehensive analysis of risk factors and management

    Directory of Open Access Journals (Sweden)

    Dinesh Pal Yadav

    2016-08-01

    Conclusions: Ectopic pregnancy is a life-threatening condition occurring in women all over the world. As the incidence of ectopic pregnancy increases, ways and means have to be found to reduce the associated morbidity and mortality and to preserve future fertility. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2723-2727

  8. Spontaneous Live Twin Tubal Ectopic Pregnancy: A Case Report

    Directory of Open Access Journals (Sweden)

    R Benn

    2016-02-01

    Full Text Available We report the case of a 29-year old G3P1+1 woman with a spontaneously conceived live twin tubal ectopic pregnancy. Her history was significant for infertility for 11 years after an induced abortion. Pelvic ultrasound scan showed live twin ectopic pregnancy and a partial salpingectomy was done.

  9. Impact of ectopic pregnancy for reproductive prognosis in next generation

    DEFF Research Database (Denmark)

    Kårhus, Line Lund; Egerup, Pia; Skovlund, Charlotte Wessel

    2014-01-01

    The impact of an ectopic pregnancy in the next generation is unknown. Our aim was to compare reproductive outcomes in daughters of women with and without ectopic pregnancy. Designed as a historical prospective controlled cohort study with data collected in four Danish registries from 1977-2009, w...

  10. Serum nitric oxide and homocysteine as biomarkers of ectopic pregnancy

    OpenAIRE

    Kavitha Meiyappan; Pooja Dhiman; Soundravally Rajendiren; Krishnalatha Thayagarajan; Soundara Raghavan S

    2015-01-01

    Background: Aim of current study was to evaluate the role of serum homocysteine and nitric oxide in the diagnosis of ectopic pregnancy. Methods: The study included 32 patients with ruptured ectopic, 29 miscarriage patients and 30 normal pregnant women as controls. Fasting plasma homocysteine, serum folate, vitamin B12 levels and nitric oxide levels were estimated at the time of admission. Results: Plasma homocysteine levels were significantly lower in patients with ectopic pregnancy t...

  11. Ruptured primary ovarian ectopic pregnancy: a case series

    Directory of Open Access Journals (Sweden)

    Neha Singh

    2016-10-01

    Full Text Available Ovarian ectopic pregnancy (OEP is one of the rarest forms of nontubal ectopic pregnancies. Less than 1% of ectopic pregnancies are primary OEP. Exact etio-pathogenesis and predisposing factors for OEP are not yet well understood. Review of literature suggests its possible association with conditions like tubal sterilization, intrauterine contraceptive device (IUCD, IVF-ET in patients with bilateral salpingectomy etc. Clinical and radiological presentation often mimics like tubal ectopic pregnancy, making preoperative diagnosis difficult for clinicians. Thus, correct diagnosis can be made only intraoperatively using Speigelberg's criteria followed by histopathological confirmation. Treatment includes wedge resection of affected ovarian tissue or salpingo-oophorectomy in selected cases. We present a case series of primary ruptured ovarian ectopic pregnancy with no identifiable risk factors with inconclusive radiological diagnosis. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3641-3644

  12. Risk Factors For Ectopic Pregnancy : A Case Control Study

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    Deshmukh J.S

    1999-01-01

    Full Text Available Research question: Which are the risk factors for ectopic pregnancy . Objective: To study the strength of association between hypothesised risk factors and ectopic pregnancy. Study design: Unmatched case- control study. Setting: Government Medical College, Hospital, Nagpur. Participants: 133 cases of ectopic pregnancy and equal number of controls (non pregnant women admitted to study hospital. Study variables : Pelvic inflammatory diseases, sexually transmitted diseases, IUD use at conception , past use of IUD, prior ectopic pregnancy, OC pills use at the time of conception, past use of OC pills, induced abortion, spontaneous abortion, infertility and pelvic and abdominal surgery. Statistical analysis: Odds ratios & their 95% CI, Pearson’s chi square test, unconditional logistic regression analysis and population attributable risk proportion. Results : Use of IUD at conception, prior ectopic pregnancy , pelvic inflammatory disease, sexually transmitted diseases, infertility, OC pills use at the time of conception, past use of IUD and induced abortion were found to be significantly associated with ectopic pregnancy. Conclusion: Identification of these risk factors for etopic pregnancy shall help in early detection and appropriate management in an individual case and it may help in devising a comprehensive preventive strategy for ectopic pregnancy

  13. Modern Technologies In Ectopic Pregnancy Diagnostics On Hospital Stage

    Directory of Open Access Journals (Sweden)

    L.V. Kaushanskaya

    2009-12-01

    Full Text Available The present research provides analysis of results of preoperative examination of 680 patients with ectopic pregnancy depending on the range of surgical treatment. It has been shown that in case of progressive ectopic pregnancy the diagnostic significance of concentrations of human chorionic gonadotropin, transvaginal examination and laparos-copy depends on the duration of pregnancy. When the term of ectopic pregnancy is 3-4 weeks monitoring of p chorionic gonadotropin in blood serum (99.5%, transvaginal examination (58% and laparoscopy (78.5% are more informative. When the term of ectopic pregnancy is more than 4 weeks there is a high diagnostic value of monitoring p-subunit of chorionic gonadotropin (99.5%, transvaginal examination (68% and laparoscopy (99,5%. The research has proved that pregnancy period of 3-4 weeks is optimal for laparoscopy and other operations

  14. Uterine artery embolization for cervical ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Qiao Zhou, MD

    2015-12-01

    Full Text Available A 36-year-old woman with 3 prior C-sections is diagnosed with a caesarean scar ectopic pregnancy. Despite receiving intramuscular and transvaginal methotrexate injection 2 months before presentation, the beta human chorionic gonadotropin was recorded to be 73 mIU/mL at the time of encounter. The patient complained of vaginal bleeding with a significant drop in hematocrit from 40% to 33%. Transvaginal ultrasound confirmed retroplacental hemorrhage and because of the patient's desire to retain fertility, interventional radiology was consulted to perform an uterine artery embolization. The uterine artery embolization was successful in achieving hemostasis and resulted in a decrease of betaHCG to 46 on postprocedure day 1 to <1 mIU/mL by postoperative week 3.

  15. Technique for the Laparoscopic Management of a Cornual Ectopic Pregnancy.

    Science.gov (United States)

    Mahmoud, Mohamad S

    2016-01-01

    To describe a technique for the laparoscopic management of a cornual ectopic pregnancy. Step-by-step explanation of the procedure using video (Canadian Task Force classification III). Cornual pregnancy is a rare form of ectopic pregnancy, accounting for up to 2% to 4% of all ectopic pregnancies, with a mortality range of 2.0% to 2.5%, and this accounts for 20% of all deaths caused by ectopic pregnancies. Both medical and surgical treatments have been reported. Although laparotomy hysterectomy and cornuectomy used to be the preferred surgical approaches, more cornual ectopic pregnancies are being managed with the laparoscopic approach through cornuostomy or cornuectomy in recent years. The main concern with surgical treatment is hemorrhage and the need for cornual reconstruction, which necessitate advanced laparoscopic skills and technique. In this video, we describe our technique for the treatment of a cornual ectopic pregnancy. We present the case of a 21-year-old G3P2002 (gravida 3 para 2002) with the finding of a right live cornual ectopic pregnancy with gestational age of 6 weeks on pelvic ultrasound along with an elevated human chorionic gonadotropin level at 7,192 and right pelvic pain. After counseling regarding treatment options, the patient agreed with proceeding with surgery and underwent a laparoscopic right cornuectomy. Her surgery was uneventful, and she was discharged home a few hours after surgery. She was completely recovered at her postoperative follow-up visit. Her serial serum human chorionic gonadotropin levels were followed until complete resolution a few weeks later. Laparoscopic cornuectomy is a safe and effective procedure for the management of cornual ectopic pregnancy. The use of hemostatic agents and suturing can help prevent hemorrhage and allows a safe removal of the ectopic pregnancy and repair of the uterine defect created. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

  16. [Ectopic pregnancy in the ultrasound. Case reports. Retrospektive analysis].

    Science.gov (United States)

    Derbak, A

    2016-01-01

    To evaluate the ultrasound findings of ectopic pregnancy in the group of women examined in our department transvaginal ultrasound. Analysis of ectopic pregnancy cases covers the period from 1. 8. 2012. to 31. 9. 2015. We introduced several case studies. Retrospective analysis. Department of Gynecology and Obstetrics, Hospital Jindrichuv Hradec. The methodology is based on a retrospective evaluation of the history, laboratory and ultrasound findings in a group of 30 patients with ectopic pregnancy. At the first visit were diagnosed by transvaginal ultrasound 82% ectopic pregnancy. A patological adnexal mass was visualised in 84% cases. A negative ultrasound finding was observed in 16% cases. The results of our group of patients are more or less comparable with other studies. We recorded the same risk factors for ectopic pregnancy. Most ectopic pregnancies can be diagnosed at the first examination before starting treatment and treated at an early stage. Transvaginal ultrasound is the "gold standard" diagnostic tool of choice in the diagnosis of ectopic pregnancy in combination with the dynamics of serum levels β-hCG..

  17. [Bilateral tubal ectopic pregnancy in a spontaneous cycle--a case report].

    Science.gov (United States)

    Kubiaczyk, Filip; Suchocki, Sławomir; Puskarz, Roman; Zaborowski, Adam; Zaranek, Krzysztof

    2014-08-01

    Ectopic pregnancy occurs in 0.5-2% of all pregnancies. A double ectopic pregnancy is very rare and has the incidence of 1 in 725 ectopic pregnancies. We describe a case of a 30-year-old patient with double ectopic pregnancy located in tubas in spontaneous cycle--diagnosed and treated at the Gynecology and Obstetrics Hospital in Walbrzych. The patient had no risk factors for ectopic pregnancy. This case shows that even the diagnosis of an evident ectopic pregnancy cannot exclude the possibility of a double ectopic pregnancy.

  18. A Rare Localization of Ectopic Pregnancy: Intramyometrial Pregnancy in Twin Pregnancy following IVF

    OpenAIRE

    Lahcen Boukhanni; Yassir Ait Benkaddour; Ahlam Bassir; Abdrahim Aboulfalah; Hamid Asmouki; Abderraouf Soummani

    2014-01-01

    Intramyometrial pregnancy is a rare form of ectopic pregnancy. It makes a diagnostic and therapeutic challenge. If misdiagnosed the intramyometrial pregnancy can cause a uterine rupture and become life-threatening condition. We report a case of intramyometrial pregnancy in twin pregnancy following IVF with spontaneous abortion of the first twin At 9 weeks of gestation. The 10 weeks scan showed a normal fetus which was described to be highly localized in the uterus but the diagnosis of intramy...

  19. Improved fertility following conservative surgical treatment of ectopic pregnancy

    DEFF Research Database (Denmark)

    Bangsgaard, Nannie; Lund, Claus Otto; Ottesen, Bent

    2003-01-01

    OBJECTIVE: To evaluate fertility after salpingectomy or tubotomy for ectopic pregnancy. DESIGN: Retrospective cohort study. SETTING: Clinical University Center, Hvidovre Hospital, Copenhagen. POPULATION: Two hundred and seventy-six women undergoing salpingectomy or tubotomy for their first ectopic...... pathology, the chance of pregnancy was poor (hazard ratio 0.463) and the risk of recurrence was high (hazard ratio 2.25), assessed with Cox regression. The rate of persistent ectopic pregnancy was 8%. CONCLUSION: Conservative surgery is superior to radical surgery at preserving fertility. Conservative...

  20. Study of 50 cases of modern management of ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Rajita S. Jani

    2014-04-01

    Results: Lower abdominal pain was most common presenting symptom of ectopic pregnancy in 96% cases. The classical triad of symptoms (amenorrhea, abdominal pain and vaginal bleeding was present in only 28% cases. PID contributed 24% cases and previous abortion contributed 28% cases indicating these two as the common risk factors. Ampulla was the commonest site for ectopic pregnancy, in 52% cases. Salpingostomy performed mainly at this site. In 6% cases ectopic pregnancy in infundibulum were treated with fimbrial expression and fimbriectomy. 22% patients were managed medically (methotraxte. These were the cases having unruptured ectopic pregnancy and ectopic mass <4 cm. Laparoscopy was done in 34% cases, in 2 cases it was converted to laparotomy. While open laparotomy was done in 40% cases. Conclusions: Ectopic pregnancy is a treatable problem. Ultrasonography plays central role in the diagnosis and management. Mode of therapy is determined by a combination of clinical symptoms, sonography findings and serum b-HCG values. Surgical management is still a cornerstone of management of ectopic pregnancy. But now scope of medical and laparoscopic management is also there. In recent years laparotomy has been replaced by laparoscopic surgery which is more conservative, minimally invasive and less time consuming which leads to quick recovery. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 374-379

  1. A Rare Localization of Ectopic Pregnancy: Intramyometrial Pregnancy in Twin Pregnancy following IVF

    Directory of Open Access Journals (Sweden)

    Lahcen Boukhanni

    2014-01-01

    Full Text Available Intramyometrial pregnancy is a rare form of ectopic pregnancy. It makes a diagnostic and therapeutic challenge. If misdiagnosed the intramyometrial pregnancy can cause a uterine rupture and become life-threatening condition. We report a case of intramyometrial pregnancy in twin pregnancy following IVF with spontaneous abortion of the first twin At 9 weeks of gestation. The 10 weeks scan showed a normal fetus which was described to be highly localized in the uterus but the diagnosis of intramyometrial pregnancy was not suspected. The patient was admitted at 14 weeks of gestation with pelvic pain, hemorrhage, and shock. She was operated and the diagnosis of ruptured intramyometrial pregnancy was done and managed conservatively. This case illustrates the diagnostic difficulties of intramyometrial pregnancy. We discuss pathophysiology, diagnosis, and treatment of this exceptional form of ectopic pregnancy.

  2. THE OUTCOME OF ECTOPIC PREGNANCY-A TERTIARY CARE HOSPITAL EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Sreelakshmi

    2014-05-01

    Full Text Available AIMS: Evaluation of risk factors, variable clinical presentations, and study of outcome of ectopic pregnancy by surgical and medical management. STUDY DESIGN: PROSPECTIVE STUDY: METHODS: All the women with ectopic pregnancy managed from May 2009 to December 2012 by surgical and medical management were analyzed prospectively. RESULTS: In our study incidence of ectopic pregnancy was 12.46 per 1000 live births. Forty-three patients of ectopic pregnancy were under the study in which there was not observed maternal mortality. Abdominal pain and amenorrhoea (97.67% were the most common symptoms followed by vaginal bleeding (53.49%. Tenderness over lower abdomen was seen in 33 (76.74% patients and the classical sign of cervical motion tenderness was seen in 19(44.19% cases. Pelvic inflammatory disease (16.28%, repeat ectopic (11.63%, failed tubal sterilization procedures (11.63% were the major risk factors. Salpingectomy was done in 35(81.39 % cases, salpingo- oophorectomy in 1(2.32% case, D&C followed by laparoscopic salpingectomy was done in 1(2.32% case and 4(9.30% cases were managed by medical methods. CONCLUSION: In spite of the various recent advances in the management of ectopic pregnancy, surgical management by laparotomy is still the most widely used modality of treatment in our institution because of late referrals.

  3. Serum nitric oxide and homocysteine as biomarkers of ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Kavitha Meiyappan

    2015-02-01

    Full Text Available Background: Aim of current study was to evaluate the role of serum homocysteine and nitric oxide in the diagnosis of ectopic pregnancy. Methods: The study included 32 patients with ruptured ectopic, 29 miscarriage patients and 30 normal pregnant women as controls. Fasting plasma homocysteine, serum folate, vitamin B12 levels and nitric oxide levels were estimated at the time of admission. Results: Plasma homocysteine levels were significantly lower in patients with ectopic pregnancy than normal pregnancy. Nitric oxide levels were significantly lower in patients with abortion. Conclusions: Patients with abortion have decreased circulating nitric oxide levels in serum while those with ectopic pregnancies have decreased homocysteine levels. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 66-70

  4. Ectopic pregnancy after two times tubal ligation: a case report

    Directory of Open Access Journals (Sweden)

    Farideh Keypour

    2013-06-01

    Full Text Available Background: Tubal sterilization is the permanent and effective contraception method. This can be performed at any time, but at least half are performed in conjunction with cesarean or vaginal delivery and are termed puerperal. The most complication after tubal ligation is ectopic pregnancy. Ectopic pregnancy is the leading cause of maternal death in first trimester.Case presentation: We present a 33 years old woman gravida5, para4, all normal vaginal delivery, presented with complaints of delayed menstrual period, pelvic pain and spotting. She underwent tubal ligation for two times. For the first time she had puerperal Pomeroy tubal sterilization after third child delivery. Intra uterine pregnancy occurred three years later. One day after vaginal delivery of fourth child, she underwent post partum tubal ligation with the Parkland method. Tubal pregnancy occurred nine months later. Physical examination identified acute abdomen. Pelvic ultrasound showed no gestational sac in uterine cavity. The sac with fetal pole was in right adnexa. Beta-HCG was 2840mIU/ml. She underwent laparotomy. Surgical management included salpingectomy with cornual resection in both sides. The surgery identified Ectopic pregnancy.Conclusion: Any symptoms of pregnancy in a woman after tubal ligation must be investigated; an ectopic pregnancy should be excluded. Ectopic pregnancy must be considered, in any woman with lower abdominal pain, missed period and vaginal bleed-ing. Conception after tubal sterilization can be explained by fistula formation and re-canalization of fallopian tube.

  5. [Ectopic pregnancy: Its current interest in Primary Health Care].

    Science.gov (United States)

    López-Luque, P R; Bergal-Mateo, G J; López-Olivares, M C

    2014-01-01

    An ectopic pregnancy is the implantation and development of the ovum fertilized outside the endometrial cavity. Its incidence has increased in the last 30 years, and although its morbimortality has decreased, it is still the first cause of mortality in the first trimester of the pregnancy. Early suspicion is important, particularly in women of fertile age and with risk factors indicative of an extrauterine gestation. The symptomatology is usually amenorrhea, abdominal pain, metrorrhagia, general pregnancy symptoms, and even syncope and shock. The diagnosis of ectopic pregnancy is based on the clinical information, analytical results on mother blood and urine, ultrasound examination, transvaginal culdocentesis, laparoscopic or laparotomic inspection, and a histological study. The treatment can be surgical (salpingostomy or salpingectomy), medical (methotrexate) or expectant, depending on the factors of the ectopic pregnancy: early diagnosis, presence of acute complications, clinical condition of the patient, etc.

  6. Ectopic Pregnancy After Plan B Emergency Contraceptive Use.

    Science.gov (United States)

    Steele, Brianne Jo; Layman, Kerri

    2016-04-01

    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 (levonorgestrel) emergency contraceptive. She presented with abdominal pain and vaginal spotting, and was evaluated by serum testing and pelvic ultrasound. She was discovered to have a right adnexal pregnancy. She was treated initially with methotrexate, though she ultimately required surgery for definitive treatment. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case report aims to bring a unique clinical case to the attention of emergency providers. The goal is to review research on the topic 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 and the potential of ectopic pregnancy. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Selective Uterine Artery Embolization for Management of Interstitial Ectopic Pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Seung Boo; Lee, Sang Jin; Joe, Hwan Sung; Goo, Dong Erk; Chang, Yun Woo [Soonchunhyang University Gumi Hospital, Gumi (Korea, Republic of); Kim, Dong Hun [Chosun University Hospital, Gwangju (Korea, Republic of)

    2007-04-15

    Interstitial pregnancy is defined as any gestation that develops in the uterine portion of the fallopian tubes lateral to the round ligament. Interstitial pregnancies account for 2-4% of all ectopic pregnancies and have been reported to have an associated 2% to 2.5% maternal mortality rate. The traditional treatment for interstitial pregnancy using surgical cornual resection may cause infertility or uterine rupture in subsequent pregnancies. Recently, the early identification of intact interstitial pregnancy has been made possible in many cases with high resolution transvaginal ultrasound as well as more sensitive assays for betahuman chorionic gonadotropin ({beta}-hCG). The treatment includes: hysteroscopic transcervical currettage, local and systemic methotrexate (MTX) therapy and prostaglandin or potassium chloride injection of the ectopic mass under sonographic guidance. We describe a case of successful treatment of interstitial pregnancy using uterine artery embolization, after failure of methotrexate treatment.

  8. Clinical investigation of risk factors in ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Ling-yun HU

    2013-05-01

    Full Text Available Objective  To discuss the relative and independent risk factors in ectopic pregnancy. Methods  The clinical data of 870 patients with ectopic pregnancy, admitted from 2005 to 2012, were retrospectively analyzed, with 800 cases of normal pregnancy serving as control. Monofactorial correlation analysis was used to analyze the related risk factor, and logistic regression analysis was used to analyze the independent risk factor. Results  Pelvic adhesion, previous operation, cesarean section delivery, number of pregnancy, artificial abortion, medical abortion, in vitrofertilization and embryo replacement (IVF-ER, and placement of intrauterine device (IUD are the risk factors of ectopic pregnancy, pelvic adhesion, artificial abortion, operation, number of pregnancies and IUD are the independent risk factors, and pelvic adhesion is the major risk factor. Conclusion  Avoidance of unexpected pregnancy as possible, reduction of the number of artificial abortion, prevention and treatment of genital duct inflammation, and standardization of pelvic operation may reduce the incidence of ectopic pregnancy.

  9. Individualisation of intervention for tubal ectopic pregnancy: historical perspectives and the modern evidence based management of ectopic pregnancy.

    Science.gov (United States)

    Odejinmi, Funlayo; Huff, Keren O; Oliver, Reeba

    2017-03-01

    Historically, ectopic pregnancy was a life-threatening condition where diagnosis was possible only at post mortem or laparotomy and maternal mortality was up to 90%. The evolution in the management of ectopic pregnancy has meant that diagnosis can be made using non-invasive techniques with an aim to identify the ectopic gestation before tubal rupture. This enables health care professionals to offer management options that consider not only maternal mortality, but morbidity and fertility outcomes as well. In spite of this, diagnostic techniques and management options are not without limitations. Research is currently focused on new tests with a single diagnostic capability, diagnostic and treatment algorithms and safe methods of triaging patients. This article aims to review the current literature on the diagnosis and management of ectopic pregnancy and to formulate a pathway to help individualise care and achieve the best possible outcome. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Ectopic pregnancy following levonorgestrel emergency contraception: a case report

    Science.gov (United States)

    Kaymak, Oktay; Şimşek, Yavuz; Doğanay, Melike; Yıldız, Yasemin; Mollamahmutoğlu, Leyla

    2010-01-01

    Hormonal contraceptive pills containing 750 microgram levonorgestrel are the most commonly used postcoital contraceptive method because of their high efficacy and fewer side effects. Emergency contraceptive pills containing levonorgestrel present their effects by several mechanisms, including delayed tubal transport of the ovum. A delay of tubal transportation of an ovum is also one of the possible etiologic factors of tubal ectopic pregnancies. There are limited data on the risk of ectopic pregnancy following levonorgestrel treatment as an emergency contraception. Here, a case of tubal pregnancy associated with the use of levonorgestrel containing emergency contraceptive pills has been presented along with discussion of the relevant literature. PMID:24591928

  11. Ectopic pregnancy: a life-threatening gynecological emergency

    Directory of Open Access Journals (Sweden)

    Lawani OL

    2013-08-01

    Full Text Available Osaheni L Lawani, Okechukwu B Anozie, Paul O Ezeonu Department of Obstetrics and Gynecology, Federal Teaching Hospital, Abakaliki, Nigeria Background: Ectopic pregnancy is a life-threatening gynecological emergency, and a significant cause of maternal morbidity and mortality in Nigeria. Objective: The aim of this work was to determine and evaluate the incidence, clinical presentation, risk factors, and management outcomes of ectopic pregnancies at Ebonyi State University Teaching Hospital (EBSUTH in Abakaliki. Methods: This was a retrospective, descriptive study of ectopic pregnancies managed in EBSUTH during the study period (June 1, 2002 to May 31, 2012. The medical records of the patients managed for ectopic pregnancy as well as the total birth record and gynecological admission records during the period under review were retrieved, and data were collected with the aid of data-entry forms designed for this purpose. There were 4,610 gynecological admissions and 9,828 deliveries, with 215 cases of ectopic pregnancies. A total of 205 cases were suitable for analysis after excluding cases with incomplete records. The relevant data collected were analyzed with SPSS version 15.0 for Windows. Results: Ectopic pregnancy constituted 4.5% of all gynecological admissions, and its incidence was 2.1%. The mean age of the patients was 27 ± 2 years, 196 of 205 (95.6% had ruptured ectopic pregnancies, and the remaining nine (4.4% were unruptured. The commonest (166 of 205, 80.0% clinical presentation was abdominal pain, and the commonest (105 of 205, 51.2% identified risk factor was a previous history of induced abortion. Three deaths were recorded, giving a case-fatality rate of 1.4% (three of 205. Conclusion: Ectopic pregnancy is a recognized cause of maternal morbidity and mortality and has remained a reproductive health challenge to Nigerian women, as well as a threat to efforts in achieving the UN's Millennium Development Goal 5 in sub-Saharan Africa

  12. Total Laparoscopic Conservative Surgery for an Intramural Ectopic Pregnancy

    Directory of Open Access Journals (Sweden)

    Hiroshi Nabeshima

    2010-01-01

    Full Text Available A 38-year-old woman, gravida 3, para 1 with a history of a left salpingectomy for an ectopic pregnancy was admitted for treatment of a presumed ectopic pregnancy. Transvaginal sonography revealed an ill-defined gestational sac and fetal heart beat within the fundal myometrium adjacent to the left cornua. Laparoscopy was performed for a suspected left cornual pregnancy or intramural pregnancy. A cystic mass 3 cm in diameter was visible within the fundal myometrium. Total laparoscopic removal of the gestational sac was performed, and the uterus was preserved. Pathologic evaluation of the excised mass demonstrated chorionic villi involving the myometrium. In the literature, only one other case describing the laparoscopic removal of an intramural pregnancy has been reported. However, in the prior report, the patient still required hysterectomy after conservative surgery. Therefore, this is the first report of the successful treatment of an intramural pregnancy exclusively with laparoscopy.

  13. Nontubal Ectopic Pregnancies: Overview and Treatment via Local Injection.

    Science.gov (United States)

    Dolinko, Andrey V; Vrees, Roxanne A; Frishman, Gary N

    2017-07-20

    Ectopic pregnancies account for 1.5% to 2% of all pregnancy in the United States. Of these, approximately 10% implant in nontubal locations, including the abdominal cavity, cervix, ovary, interstitial portion of the fallopian tube, broad ligament, the uterine cornua, or within a cesarean section scar. Because these pregnancies tend to present later than typical tubal pregnancies, they have been associated with greater maternal morbidity and mortality. Advances in ultrasound technology have allowed for earlier diagnosis of nontubal ectopic pregnancies, which in turn has led to the development of novel minimally invasive techniques to manage them. One of these methods involves the local injection of 1 of several agents directly into the ectopic pregnancy. In this article we provide a guide to this technique of local injection, including an overview of the potential agents that can be used, and review the diagnostic and specific ultrasound criteria, other possible treatment options, and overall outcomes for nontubal ectopic pregnancies. Copyright © 2017 American Association of Gynecologic Laparoscopists. Published by Elsevier Inc. All rights reserved.

  14. RECURRENT CORNUAL ECTOPIC PREGNANCY – A CASE REPORT

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    Velayudam DA, Radha Bai Prabhu T, Dipenty Devi L, Meenalochani P, Isha Gutgutia

    2015-10-01

    Full Text Available Cornual ectopic gestation is one of the causes of “Maternal near miss” cases. In the modern era of IVF treatments and better imaging techniques, more number of cases of cornual ectopic pregnancies is being diagnosed and treated both by conservative and radical methods. Here, we report a case of a recurrent cornual ectopic pregnancy in the early second trimester, which was managed by hysterectomy due to uncontrolled haemorrhage. Thirty five year old Mrs. S, Gravida 4, para2, with one previous ectopic pregnancy presented to the obstetric casualty with acute abdominal pain at 15 weeks +2 days of gestation. On vaginal examination, there was right fornicial fullness and both the fornices were tender. Cervical motion tenderness was also present. On review of her previous records, dating scan done at 8 to 9 weeks showed normal intrauterine pregnancy. An emergency scan was carried out which revealed an empty uterine cavity with gestational sac measuring 3.6×4.4×4.6 cms seen outside the uterus just above the fundus with absent cardiac activity. There was evidence of haemoperitoneum, therefore she was diagnosed with recurrent ruptured ectopic pregnancy.

  15. Hydatidiform mole presentation as a tubal ectopic pregnancy.

    Science.gov (United States)

    Nakeer, Tabassum; Shahid, Muhammad; Ansari, Muhammad Asad; Nakeer, Rooham

    2014-05-01

    Presentation of hydatidiform mole as tubal ectopic pregnancy is very rare. These patients usually present with ectopic pregnancy and are later diagnosed with hydatidiform mole on the basis of histological examination following surgery. We present the case of a 32-year-old female who presented with abdominal pain and vaginal bleed since 2 days of presentation. She was vitally stable. There was mild tenderness in hypogastrium and left iliac fossa. Pelvic examination showed mild bleeding per vaginum and fullness in both fornices. The patient was suspected of having an ectopic pregnancy. Ultrasonography of pelvis revealed fluid in cul-de-sac and a sac like mass of 1.8 cm attached to the left ovary. On laparotomy, there was a left sided tubal ectopic pregnancy and subsequently left salpingectomy was done. Histopathology of the tissue sample showed features of partial hydatidiform mole. Ectopic pregnancy can present as hydatidiform mole in rare cases for which histological examination of the tissue is required to establish the diagnosis.

  16. Clinical characteristics of persistent ectopic pregnancy after salpingostomy and influence on ongoing pregnancy.

    Science.gov (United States)

    Zhang, Yongli; Chen, Jinhong; Lu, Wen; Li, Bilan; Du, Guiqiang; Wan, Xiaoping

    2017-03-01

    The aim of this study was to assay the clinical characteristics of persistent ectopic pregnancy (PEP) and its influence on ongoing pregnancy. We retrospectively reviewed 2498 patients who received salpingostomies as primary management for ectopic pregnancies from January 2004 to December 2009, using medical records and telephone inquiries. Clinical characteristics of the 52 patients (2.08%) who were diagnosed with PEP after salpingostomy were compared with those who received satisfactory treatment. The odds ratios and 95% confidential intervals were calculated for each variable by univariate and (for significantly different factors) multivariate analysis. Preoperatively, patients with PEP after salpingostomy significantly differed from the non-PEP patients in gestational age, mass size and pelvic adhesiolysis. Serum β-human chorionic gonadotropin levels in PEP patients were monitored after surgery, which had declined by 28.31% on postoperative day (POD) 4, 40.22% on POD 7, 51.46% on POD 10 and 53.43% on POD 21. Repeat ectopic pregnancy (REP) tended to occur more frequently in PEP patients (PEP: 5 cases, 10.20%; non-PEP: 4 cases, 2.80%; P = 0.034). Multivariate analysis showed that pelvic adhesions and PEP were the strongest independent predictors of REP. Gestational age, mass size and pelvic adhesions were significantly correlated with PEP. PEP was an independent prognostic factor for REP. However, a multicenter study is needed to support and extend our findings. © 2017 The Authors Journal of Obstetrics and Gynaecology Research published by John Wiley & Sons Australia, Ltd on behalf of Japan Society of Obstetrics and Gynecology.

  17. 42 CFR 50.308 - Drugs and devices and termination of ectopic pregnancies.

    Science.gov (United States)

    2010-10-01

    ... an ectopic pregnancy. ... 42 Public Health 1 2010-10-01 2010-10-01 false Drugs and devices and termination of ectopic pregnancies. 50.308 Section 50.308 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND...

  18. 42 CFR 136a.55 - Drugs and devices and termination of ectopic pregnancies.

    Science.gov (United States)

    2010-10-01

    ... and devices and termination of ectopic pregnancies. Federal funds are available for drugs or devices... termination of an ectopic pregnancy. ... 42 Public Health 1 2010-10-01 2010-10-01 false Drugs and devices and termination of...

  19. 42 CFR 136.55 - Drugs and devices and termination of ectopic pregnancies.

    Science.gov (United States)

    2010-10-01

    ... devices and termination of ectopic pregnancies. Federal funds are available for drugs or devices to... an ectopic pregnancy. ... 42 Public Health 1 2010-10-01 2010-10-01 false Drugs and devices and termination of...

  20. Acute Abdomen in Interstitial Ectopic Pregnancy, An Emergency Laparoscopic Treatment

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    E. Picardo

    2014-01-01

    Full Text Available The present case report demonstrates a laparoscopic approach to treat interstitial cornual pregnancy in emergency. Interstitial ectopic pregnancy develops in the uterine portion of the fallopian tube which accounts for 2–4% of all ectopic pregnancies and has the potential to cause life-threatening hemorrhage at rupture. The mortality rate for a woman diagnosed with such a pregnancy is 2–2.5%. Diagnosis of interstitial pregnancy is made by ultrasound. In this case a 32 year-old woman, Gravida 0 Parity 0 Living 0 Ectopic 1, presented to the emergency obstetrical room complaining acute abdominal pain. There was a history of 10 weeks of pregnancy but no pelvic ultrasound scan was performed before the access. A transvaginal ultrasound scan immediately performed demonstrated a gestational sac with viable fetus in the right interstitial region. Moreover there was an ultrasound evidence of hemoperitoneum. She was transferred to the operating room and an emergency laparoscopy surgery was performed. The postoperative course was uneventful and the patient was discharged two days after the surgery. Interstitial pregnancies present a difficult management problem with no absolute standard of care in literature. Laparoscopic technique is under study with favorable results. For our personal point of view a treatment via laparoscopy could be performed both in elective and in emergency cases.

  1. A retrospective study of 100 cases of ectopic pregnancy: clinical presentation, site of ectopic and diagnosis evaluation

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    Manthan Patel

    2016-12-01

    Conclusions: Ampullary part of the fallopian tube is the most common site of ectopic pregnancy observed during our study. Complex adnexal mass was the most common finding on ultrasound. Surgical management by laparotomy and salpingectomy continues to be the preferred mode of management of ectopic pregnancy in our institution. [Int J Reprod Contracept Obstet Gynecol 2016; 5(12.000: 4313-4316

  2. A retrospective study on ectopic pregnancy: a two year study

    Directory of Open Access Journals (Sweden)

    V. S. Sudha

    2016-12-01

    Conclusions: Early diagnosis, identifying of underlying risk factors and timely intervention in the form of conservative or surgical treatment will help in reducing the morbidity and mortality associated with ectopic pregnancy. [Int J Reprod Contracept Obstet Gynecol 2016; 5(12.000: 4365-4368

  3. Methotrexate Treatment of Ectopic Pregnancy: Experience at Nizwa Hospital withLiterature Review

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    Bhawna Rathi

    2011-03-01

    Full Text Available Objectives: Ectopic pregnancy occurs when the embryo fails to implant within the uterine cavity. Methotrexate, a folic acid antagonist has been widely used to treat ectopic pregnancy. The aim of this study is to determine the efficacy of methotrexate treatment for ectopic pregnancies in our settings which will in-turn help us reduce maternal mortality and morbidity.Methods: This was a retrospective review of 60 cases of ectopic pregnancy treated with single dose methotrexate in Nizwa hospital, Oman. Demographic data, clinical presentation, treatment progress, outcome, side effects and future fertility follow up were analysed using a computer database. Selection criteria included hemodynamically stable women with ß-hcg level of ≤5000 mIU/ml, adnexal mass ≤4 cm, absent cardiac activity and hemoperitoneum less than 100 ml. Human chorionic gonadotrophin (hcg assay and clinical presentation were used to determine cases which warranted surgical intervention.Results: The success rate of single dose methotrexate therapy in our study was 65�0(n=39 and 35�0(n=21 required surgical intervention compared to reported success rate of 67-100�0published in various studies. Careful selection of cases and confining strictly to the criteria improved the success rate from 40�0to 60�0in five and half years of the study. The mean average time of resolution of ectopic pregnancy was 32 days for a single dose and 58 days for repeat second or third doses. Eight cases of pregnancy of unknown location were treated successfully with Methotrexate. No major side effects were noted. A successful fertility outcome of 30�0in the first year followed by 13.3�0in the subsequent second year with a secondary infertility rate of 11.6�0was observed in this study.Conclusion: Methotrexate treatment of ectopic pregnancies is safe and effective with no major side effects. Intramuscular methotrexate has the advantage of tubal conservation and saves patients from

  4. Uncommon Implantation Sites of Ectopic Pregnancy: Thinking beyond the Complex Adnexal Mass.

    Science.gov (United States)

    Chukus, Anjeza; Tirada, Nikki; Restrepo, Ricardo; Reddy, Neelima I

    2015-01-01

    Ectopic pregnancy occurs when implantation of the blastocyst takes place in a site other than the endometrium of the uterine cavity. Uncommon implantation sites of ectopic pregnancy include the cervix, interstitial segment of the fallopian tube, scar from a prior cesarean delivery, uterine myometrium, ovary, and peritoneal cavity. Heterotopic and twin ectopic pregnancies are other rare manifestations. Ultrasonography (US) plays a central role in diagnosis of uncommon ectopic pregnancies. US features of an interstitial ectopic pregnancy include an echogenic interstitial line and abnormal bulging of the myometrial contour. A gestational sac that is located below the internal os of the cervix and that contains an embryo with a fetal heartbeat is indicative of a cervical ectopic pregnancy. In a cesarean scar ectopic pregnancy, the gestational sac is implanted in the anterior lower uterine segment at the site of the cesarean scar, with thinning of the myometrium seen anterior to the gestational sac. An intramural gestational sac implants in the uterine myometrium, separate from the uterine cavity and fallopian tubes. In an ovarian ectopic pregnancy, a gestational sac with a thick hyperechoic circumferential rim is located in or on the ovarian parenchyma. An intraperitoneal gestational sac is present in an abdominal ectopic pregnancy. Intra- and extrauterine gestational sacs are seen in a heterotopic pregnancy. Two adnexal heartbeats suggest a live twin ectopic pregnancy. Recognition of the specific US features will help radiologists diagnose these uncommon types of ectopic pregnancy.

  5. Doppler findings in chronic ectopic pregnancy: case report.

    Science.gov (United States)

    Abramov, Y; Nadjari, M; Shushan, A; Prus, D; Anteby, S O

    1997-05-01

    Chronic ectopic pregnancy is an uncommon form of tubal pregnancy manifested as a pelvic mass with minimal symptoms and a low or absent titer of human chorionic gonadotropin. For this reason, most of the reported cases have been diagnosed only after explorative laparotomy. The value of Doppler ultrasonography for preoperative diagnosis of this entity has not yet been established. We report on a 36-year-old patient who was admitted for intermittent right lower quadrant abdominal pain of 3 months' duration, and a right adnexal mass found on pelvic examination. On Doppler ultrasonography, a right complex adnexal mass was demonstrated, characterized by extensive external vascularization, aberrant vessels and arteriovenous shunting, but with no internal blood flow. Explorative laparotomy revealed a right tubal mass adherent to the omentum, and covered by numerous enlarged and tortuous blood vessels originating in the omentum. Pathological examination of the mass revealed a chronic ectopic pregnancy. The possible contribution of Doppler-specific characteristics for the diagnosis of chronic ectopic pregnancy is described and discussed.

  6. Ectopic Pregnancy In Previously Infertile Women Subsequent Pregnancy Outcome After Laparoscopic Management

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    Siddhartha Chatterjee

    2009-05-01

    Full Text Available Ectopic tubal pregnancy (ETP is a major event in a woman's reproductive life particularly if it happens after treatment of infertility. It complicates infertility treatment and must be recognized early to simplify the treatment strategy, which must always be directed towards optimizing subsequent fertility. All the treatment trials and the Cochrane database meta-analysis show that medical treatment with methotrexate, preferably multi-dose, is equivalent in efficacy to conservative treatment with laparoscopy in the populations studied. The prolonged follow up and repeated estimation of costly beta subunit of human chorionic gonadotropin (hCG hormone required in medical treatment become inconvenient for patients in this country. Hence people here prefer onetime surgical treatment with short stay in hospital. Occurring during infertility treatment, it marks a reproductive failure, which always results in psychological setback. Amongst 1119 patients conceived after treatment of infertilities in a five year period between ‘02 & ’07 sixty-eight ETP were detected. More than 50% of them resulted in intrauterine pregnancy (IUP spontaneously or after ovulation induction within a period of one to one & half year following the occurrence of ETP. Regardless of the treatment strategy, a successful outcome requires a subsequent ongoing IUP, the ultimate goal of fertility treatment. Nonetheless ETP resulting from fertility treatment is a specific entity, and better knowledge of it should help to improve diagnosis and prognosis, simplify treatment, and optimize subsequent pregnancy outcome.

  7. CERVICAL ECTOPIC PREGNANCY WITH MASSIVE BLEEDING: A CASE REPORT

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    Slavcho Tomov

    2015-05-01

    Full Text Available A 29-year-old patient with cervical ectopic pregnancy (CEP presented as "suspected" cervical mass, and irregular vaginal bleeding was directed to a gynecologic oncologist for consultation. During the examination a massive bleeding occurred. After an unsuccessful attempt to stop the bleeding with a balloon catheter and vaginal tamponade, a total abdominal hysterectomy was performed. The predisposing factors, the differential diagnostic possibilities and the clinical approaches in CEP are discussed. Total abdominal hysterectomy is the procedure of choice for treatment of cervical pregnancy under conditions of urgency and life-threatening bleeding.

  8. Ectopic pregnancy in a Caesarean section scar: a case study

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    Piotr Niziurski

    2013-08-01

    Full Text Available Implantation of a pregnancy in a scar after Caesarean section is one of the rarest locations of ectopic pregnancies. A diagnosis and/or treatment which is too late may lead to a uterine rupture, the necessity to remove the uterus and a significant increase in morbidity among mothers. The study presents a diagnostically difficult case of a 29-year-old woman, who was diagnosed with pregnancy in its seventh week, located in a scar after a Caesarean section, with highly increased values of human chorionic gonadotropin (β-HCG concentration in blood serum. The pregnancy was removed and the wound was stitched during laparotomy, without a need to remove the uterus.

  9. Delayed Detection of Spontaneous Bilateral Tubal Ectopic Pregnancies After Methotrexate Treatment.

    Science.gov (United States)

    Brown, Nicole E; Singer, Shereen A; Suyama, Joe

    2017-09-09

    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 previously diagnosed ectopic pregnancy and vaginal spotting. Bilateral adnexal masses were visualized on ultrasound and her serum beta-human chorionic gonadotropin level had a 5.9% decline from day 4 to day 7 after methotrexate administration 7 days prior; gynecology was consulted. The patient was successfully treated with an additional dose of intramuscular methotrexate without any complications. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The implications of this case suggest that diagnosis of bilateral tubal ectopic pregnancies requires clinicians to have a high level of suspicion in any pregnant female with a suspected or known ectopic pregnancy who presents with pelvic pain regardless of prior diagnosis or treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Serum activin B concentration as predictive biomarker for ectopic pregnancy.

    Science.gov (United States)

    Dhiman, Pooja; Senthilkumar, G P; Rajendiran, Soundravally; Sivaraman, K; Soundararaghavan, S; Kulandhasamy, Maheshwari

    2016-05-01

    We evaluated the diagnostic accuracy of activin B in discriminating tubal ectopic pregnancy (tEP) from intrauterine miscarriages (IUM), and normal viable intrauterine pregnancy (IUP). We included 28 women with tEP, 31 women with IUM, and 29 normal IUP, confirmed both by clinical examination and ultrasonography. Serum activin B concentration was measured at the time of admission using the ELISA kit. The median serum activin B concentration was found to be significantly decreased in both tEP (p=0.004) and IUM (p=0.022) compared to normal IUP. When compared between tEP and IUM, activin B concentrations did not differ significantly. ROC analysis of activin B and free β-hCG demonstrated AUC of 0.722 and 0.805, respectively to discriminate tEP from viable IUP. The model including both activin B and free β-hCG improved the discriminating potential with greater AUC (0.824), and specificity (93%) than individual one. To discriminate tEP from IUM, activin B, free β-hCG and combination of both performed poorly. We conclude that serum activin B concentration is lower in tubal ectopic pregnancy, and can discriminate it from normal pregnancy with moderate accuracy. It also shows improved diagnostic potential along with free β-hCG, but cannot distinguish tEP from IUM reliably.

  11. Long-term reproductive outcomes in women whose first pregnancy is ectopic

    DEFF Research Database (Denmark)

    Lund Kårhus, Line; Egerup, Pia; Wessel Skovlund, Charlotte;

    2013-01-01

    How does long-term reproductive prognosis among women whose first pregnancy is ectopic differ from prognosis in women with other initial pregnancy outcomes? SUMMARY ANSWER: Women with a first recorded ectopic pregnancy (EP) have a significantly lower long-term delivery rate and a manifold increased...

  12. Failure Rate of Single Dose Methotrexate in Managment of Ectopic Pregnancy

    OpenAIRE

    Feras Sendy; Eman AlShehri; Amani AlAjmi; Elham Bamanie; Surekha Appani; Taghreed Shams

    2015-01-01

    Background. One of the treatment modalities for ectopic pregnancy is methotrexate. The purpose of this study is to identify the failure rate of methotrexate in treating patients with ectopic pregnancy as well as the risk factors leading to treatment failure. Methods. A retrospective chart review of 225 patients who received methotrexate as a primary management option for ectopic pregnancy. Failure of single dose of methotrexate was defined as drop of BHCG level less than or equal to 14% in th...

  13. Risk of ectopic pregnancy following day-5 embryo transfer compared with day-3 transfer.

    Science.gov (United States)

    Smith, Laura P; Oskowitz, Selwyn P; Dodge, Laura E; Hacker, Michele R

    2013-10-01

    The incidence of ectopic pregnancy after IVF is increased approximately 2.5-5-fold compared with natural conceptions; however, the aetiology for this increased risk remains unclear. One proposed practice change to decrease the incidence of ectopic pregnancy is blastocyst embryo transfer on day 5 rather than cleavage-stage embryo transfer on day 3. A retrospective cohort study was conducted to compare the risk of ectopic pregnancy following fresh day-5 embryo transfer with day-3 embryo transfer among women who underwent IVF and achieved pregnancy from 1998 to 2011. There were 13,654 eligible pregnancies; 277 were ectopic. The incidence of ectopic pregnancy was 2.1% among day-3 pregnancies and 1.6% among day-5 pregnancies. The adjusted risk ratio for ectopic pregnancy from day-5 compared with day-3 transfer was 0.71 (95% confidence interval 0.46-1.10). Although this analysis included 13,654 cycles, with a two-sided significance level of 0.05, it had only 21.9% power to detect a difference between the low incidence of ectopic pregnancy among both day-3 and day-5 transfers. In conclusion, this study was not able to demonstrate a difference in the risk of ectopic pregnancy among day-3 compared with day-5 transfers.

  14. Association of Helicobacter Pylori Infection and Ectopic Pregnancy

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    Fariba NanBakhsh

    2016-08-01

    Full Text Available Objective: To evaluate the importance of cytokine type in embryo implantation in uterus specified and activated macrophages interfere the tube movements and embryo retention in uterine tubes by smooth muscle relaxation and disrupting ciliary function. Therefore, increased risk of infection with HP during pregnancy, we investigated relation between Helicobacter pylori (HP infection and prevalence of ectopic pregnancy (EP in this study.Materials and methods: This is cross-sectional study from March 2012 to May 2013. Totally 207 women were enrolled randomly from which 101 had EP (Case group and 106 were selected as control group with normal pregnancy. A 2-cc blood sample was taken from each patient to evaluate the specific IgG titer by ELISA method. All results of samples with positive H. pylori IgG were assayed for anti-CagA, IgG antibodies. A questionnaire was filled for each subject. The associations between CagA positive cases with odds of Ectopic pregnancy incidence were analyzed by using SPSS software, ver. 19 (Chicago, IL, USA.Results: Mean (± SD of age were 21.0 ± 5.78 and 30.78 ± 5.10 years for cases and controls group respectively. These groups didn’t show any significance difference in age and parity.H. pylori IgG antibodies were positive among 99 and 103 (98.2% vs. 97.2% in women with EP and normal pregnancy respectively. Relationship between IgG status and EP was not significant (OR = 1.31: 95% CI = 0.7-2.52, Pvalue = 0.37. In particular anti-CagA antibodies were positive among 45 and 39(45.92% vs. 36.97% in women with EP and normal pregnancy respectively. Among women with CagA positive strains had higher odds of Ep (OR = 1.46: 95% CI = 0.8-2.65, Pvalue = 0.18, but it wasn’t significant.Conclusion: According to the result of this study there was not any association between HP infection and Ectopic pregnancy. We recommend more studies with larger sample size for determining the effect of CagA positive strains on EP.

  15. Association of Helicobacter Pylori Infection and Ectopic Pregnancy.

    Science.gov (United States)

    Nanbakhsh, Fariba; Behrouzi-Lak, Tahereh; Tabean, Mahsa; Oshnouei, Sima; Mazlumi, Pooya

    2016-06-01

    To evaluate the importance of cytokine type in embryo implantation in uterus specified and activated macrophages interfere the tube movements and embryo retention in uterine tubes by smooth muscle relaxation and disrupting ciliary function. Therefore, increased risk of infection with HP during pregnancy, we investigated relation between Helicobacter pylori (HP) infection and prevalence of ectopic pregnancy (EP) in this study. This is cross-sectional study from March 2012 to May 2013. Totally 207 women were enrolled randomly from which 101 had EP (Case group) and 106 were selected as control group with normal pregnancy. A 2-cc blood sample was taken from each patient to evaluate the specific IgG titer by ELISA method. All results of samples with positive H. pylori IgG were assayed for anti-CagA, IgG antibodies. A questionnaire was filled for each subject. The associations between CagA positive cases with odds of Ectopic pregnancy incidence were analyzed by using SPSS software, ver. 19 (Chicago, IL, USA). Mean (± SD) of age were 21.0 ± 5.78 and 30.78 ± 5.10 years for cases and controls group respectively. These groups didn't show any significance difference in age and parity.H. pylori IgG antibodies were positive among 99 and 103 (98.2% vs. 97.2%) in women with EP and normal pregnancy respectively. Relationship between IgG status and EP was not significant (OR = 1.31: 95% CI = 0.7-2.52, Pvalue = 0.37). In particular anti-CagA antibodies were positive among 45 and 39(45.92% vs. 36.97%) in women with EP and normal pregnancy respectively. Among women with CagA positive strains had higher odds of Ep (OR = 1.46: 95% CI = 0.8-2.65, Pvalue = 0.18), but it wasn't significant. According to the result of this study there was not any association between HP infection and Ectopic pregnancy. We recommend more studies with larger sample size for determining the effect of CagA positive strains on EP.

  16. Embryonic miRNA profiles of normal and ectopic pregnancies.

    Directory of Open Access Journals (Sweden)

    Francisco Dominguez

    Full Text Available Our objective was to investigate the miRNA profile of embryonic tissues in ectopic pregnancies (EPs and controlled abortions (voluntary termination of pregnancy; VTOP. Twenty-three patients suffering from tubal EP and twenty-nine patients with a normal ongoing pregnancy scheduled for a VTOP were recruited. Embryonic tissue samples were analyzed by miRNA microarray and further validated by real time PCR. Microarray studies showed that four miRNAs were differentially downregulated (hsa-mir-196b, hsa-mir-30a, hsa-mir-873, and hsa-mir-337-3p and three upregulated (hsa-mir-1288, hsa-mir-451, and hsa-mir-223 in EP compared to control tissue samples. Hsa-miR-196, hsa-miR-223, and hsa-miR-451 were further validated by real time PCR in a wider population of EP and control samples. We also performed a computational analysis to identify the gene targets and pathways which might be modulated by these three differentially expressed miRNAs. The most significant pathways found were the mucin type O-glycan biosynthesis and the ECM-receptor-interaction pathways. We also checked that the dysregulation of these three miRNAs was able to alter the expression of the gene targets in the embryonic tissues included in these pathways such as GALNT13 and ITGA2 genes. In conclusion, analysis of miRNAs in ectopic and eutopic embryonic tissues shows different expression patterns that could modify pathways which are critical for correct implantation, providing new insights into the understanding of ectopic implantation in humans.

  17. Risk of Ectopic Pregnancy in Women With Inflammatory Bowel Disease

    DEFF Research Database (Denmark)

    de Silva, Punyanganie S; Hansen, Helene H; Wehberg, Sonja

    2017-01-01

    BACKGROUND & AIMS: Few data are available on adverse events of pregnancy in women with inflammatory bowel diseases (IBDs), such as ectopic pregnancy. We assessed the risk of an 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. METHODS: 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 2015. We collected data on all women with an ectopic pregnancy, hydatiform mole, miscarriages (spontaneous and other abortions, including abnormal pregnancy products, missed abortion...

  18. Incidence, diagnosis and management of tubal and nontubal ectopic pregnancies: a review.

    Science.gov (United States)

    Panelli, Danielle M; Phillips, Catherine H; Brady, Paula C

    2015-01-01

    Ectopic pregnancy is a potentially life-threatening condition occurring in 1-2 % of all pregnancies. The most common ectopic implantation site is the fallopian tube, though 10 % of ectopic pregnancies implant in the cervix, ovary, myometrium, interstitial portion of the fallopian tube, abdominal cavity or within a cesarean section scar. Diagnosis involves a combination of clinical symptoms, serology, and ultrasound. Medical management is a safe and effective option in most clinically stable patients. Patients who have failed medical management, are ineligible, or present with ruptured ectopic pregnancy or heterotopic pregnancy are most often managed with excision by laparoscopy or, less commonly, laparotomy. Management of nontubal ectopic pregnancies may involve medical or surgical treatment, or a combination, as dictated by ectopic pregnancy location and the patient's clinical stability. Following tubal ectopic pregnancy, the rate of subsequent intrauterine pregnancy is high and independent of treatment modality. This review describes the incidence, risk factors, diagnosis, and management of tubal and non-tubal ectopic and heterotopic pregnancies, and reviews the existing data regarding recurrence and future fertility.

  19. Bilateral ectopic tubal pregnancy, following in vitro fertilisation (IVF.

    Directory of Open Access Journals (Sweden)

    Wojciech Grzybowski

    2010-01-01

    Full Text Available This is a case report of a 33 year-old-woman who underwent in vitro fertilization, because of primary infertility caused by fallopian tube factor. The patient underwent three trials of frozen embryo transfers (ET-CRYO. On the 26th day after the third probe of ET-CRYO she suffered from pelvic pain and vaginal bleeding. Transvaginal ultrasonographic scan revealed bilateral tubal ectopic pregnancy without fluid in the Douglas pouch and no gestational sac in the uterus. Laparoscopic bilateral salpingectomy was performed on the next day after admission. The postoperative course was uneventful.

  20. Ectopic pregnancy with use of progestin-only injectables and contraceptive implants: a systematic review.

    Science.gov (United States)

    Callahan, Rebecca; Yacobson, Irina; Halpern, Vera; Nanda, Kavita

    2015-12-01

    Use of contraception lowers a woman's risk of experiencing an ectopic pregnancy. In the case of method failure, however, progestin-only contraceptives may be more likely to result in ectopic pregnancies than some other methods such as combined hormonal and barrier contraceptives. To describe ectopic pregnancy risk associated with use of implants and progestin-only injectable contraceptives through a systematic review of published studies. We searched electronic databases for articles in any language published through May 2015 describing studies of progestin-only injectables and implants. We also searched bibliographies and review articles for additional studies. Studies that reported any pregnancies were included in the review. Independent data extraction was performed by two authors based on predefined data fields, and where possible, we calculated the proportion of pregnancies that were ectopic and the ectopic pregnancy incidence rate per 1000 woman-years. Fifty-three studies of implants and 28 studies of injectables were identified; 79% reported pregnancy location. The proportion of ectopic pregnancy ranged from 0 to 100% with an incidence of 0-2.9 per 1000 woman-years in studies of marketed levonorgestrel implants. Studies of etonogestrel implants and the injectables, depot-medroxyprogesterone acetate and norethisterone enanthate, reported few ectopic pregnancies. Progestin-only contraceptive implants and injectables protect against ectopic pregnancy by being highly effective in preventing pregnancy overall; however, the absolute risk of ectopic pregnancy varies by type of progestin. Risk of ectopic pregnancy should not be a deterrent for use or provision of these methods. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  1. Ectopic Pregnancy after Conservative Management of Placenta Accreta: A Case Report

    Directory of Open Access Journals (Sweden)

    Chun-Kuang Yang

    2004-09-01

    Conclusion: There are few reports of successful pregnancy following conservative treatment for placenta accreta. Conservative treatment may increase the risk of secondary infertility, recurrent placenta accreta, and probably ectopic pregnancy.

  2. A RARE INTERESTING CASE OF SPONTANEOUS HETEROTOPIC PREGNANCY OPERATED FOR ECTOPIC PREGNANCY AND CONSERVATION OF INTRAUTERINE PREGNANCY TO FULL TERM WITH GOOD FETOMATERNAL OUTCOME

    Directory of Open Access Journals (Sweden)

    Pradnya

    2015-07-01

    Full Text Available A rare case of heterotopic pregnancy was diagnosed at earlier gestation in which salpingectomy was performed for ectopic pregnancy and intra uterine pregnancy was continued till term with good feto maternal outcome.

  3. Ectopic pregnancy rates with day 3 versus day 5 embryo transfer: a retrospective analysis

    OpenAIRE

    Jun Sunny H; Milki Amin A

    2003-01-01

    Abstract Background Blastocyst transfer may theoretically decrease the incidence of ectopic pregnancy following IVF-ET in view of the decreased uterine contractility reported on day 5. The purpose of our study is to specifically compare the tubal pregnancy rates between day 3 and day 5 transfers. Methods A retrospective analysis of all clinical pregnancies conceived in our IVF program since 1998 was performed. The ectopic pregnancy rates were compared for day 3 and day 5 transfers. Results Th...

  4. Surgical Management of the Cesarean Scar Ectopic Pregnancy: A Case Report

    Directory of Open Access Journals (Sweden)

    Anisodowleh Nankali

    2013-01-01

    Full Text Available Cesarean scar pregnancy is one of the rarest forms of ectopic pregnancy. Little is known about its incidence and natural history. The diagnosis and treatment of cesarean scar pregnancy (CSP is challenging. The authors reported here a case of cesarean scar pregnancy (CSP with hypovolemic shock that underwent emergency laparotomy with resection of ectopic mass. The patient was discharged from the hospital without any complications.

  5. Successful Laparoscopic Management of Ruptured Tubal Pregnancy with an Ipsilateral Ectopic Pelvic Kidney

    Directory of Open Access Journals (Sweden)

    Jimmy Belotte

    2014-01-01

    Full Text Available Objective. To report a case of successful laparoscopic management of a left ruptured tubal pregnancy in the setting of an ipsilateral ectopic pelvic kidney. Method. Case report was prepared at Wayne State University/Detroit Medical Center. The patient is a young woman gravida 2 para 0 in her twenties who presented with severe abdominal pain and vaginal bleeding. She had a plateaued beta HCG and ultrasonographic findings suggestive of ectopic left tubal pregnancy along with an ectopic ipsilateral pelvic kidney. The IRB approval is not needed, as this is a case report. The informed consent could not be obtained, as the patient was not reachable. Result. Multiple intraperitoneal adhesions, left ruptured ampullary ectopic pregnancy and left retroperitoneal pelvic mass consistent with ipsilateral ectopic pelvic kidney. Conclusion. Laparoscopic management of tubal pregnancy can be safely performed in the setting of an ipsilateral ectopic pelvic kidney.

  6. Updated Estimates of Ectopic Pregnancy among Commercially and Medicaid-Insured Women in the United States, 2002-2013.

    Science.gov (United States)

    Tao, Guoyu; Patel, Chirag; Hoover, Karen W

    2017-01-01

    To update trends in the rates of ectopic pregnancy, to compare rates of ectopic pregnancy between commercially insured and Medicaid-insured women, and to assess the differences in rates of ectopic pregnancy by different measures of ectopic pregnancy. We analyzed data from 2002 to 2013 using the Truven Health MarketScan Commercial and Medicaid Claims Database. We limited the study population to women aged 15 to 44 years with any pregnancy in each year. Pregnancy and ectopic pregnancy were identified by clinical services with diagnostic or procedural codes. Ectopic pregnancy was measured in two ways: diagnosed and treated compared with diagnosed only; pregnancy was measured in two ways: any pregnancy compared with pregnancy with delivery. We did not observe a substantial trend in the rate of ectopic pregnancy from 2002 to 2013. The rate of diagnosed and treated ectopic pregnancy substantially increased by age: 0.29% in women aged 15 to 19 years and 0.89% in women aged 40 to 44 years among the commercially insured population and 0.23% and 0.85% among the Medicaid-insured population, respectively. The rate of ectopic pregnancy also varied by the different methodologies used to estimate rates. The rate of ectopic pregnancy is relatively low and stable for women of reproductive age in the United States. Our findings highlight that it is important to clearly define the numerator and denominator in the measure of ectopic pregnancy rates.

  7. Ectopic pregnancy morbidity and mortality in low-income women, 2004-2008.

    Science.gov (United States)

    Stulberg, D B; Cain, L; Dahlquist, I H; Lauderdale, D S

    2016-03-01

    Does the risk of adverse outcomes at the time of ectopic pregnancy vary by race/ethnicity among women receiving Medicaid, the public health insurance program for low-income people in the USA? Among Medicaid beneficiaries with ectopic pregnancy, 11% experienced at least one complication, and women from all racial/ethnic minority groups were significantly more likely than whites to experience complications. In this population of Medicaid recipients, African American women are significantly more likely than whites to experience ectopic pregnancy, but the risk of adverse outcomes has not previously been assessed. We conducted a cross-sectional observational study of all women (n = 19 135 106) ages 15-44 enrolled in Medicaid for any amount of time during 2004-2008 who lived in one of the following 14 US states: Arizona; California; Colorado; Florida; Illinois; Indiana; Iowa; Louisiana; Massachusetts; Michigan; Minnesota; Mississippi; New York; and Texas. We analyzed Medicaid claims records for inpatient and outpatient encounters and identified ectopic pregnancies with a principal diagnosis code for ectopic pregnancy from 2004-2008. We calculated the ectopic pregnancy complication rate as the number of ectopic pregnancies with at least one complication (blood transfusion, hysterectomy, any sterilization, or length-of-stay (LOS) > 2 days) divided by the total number of ectopic pregnancies. We used Poisson regression to assess the risk of ectopic pregnancy complication by race/ethnicity. Secondary outcomes were each individual complication, and ectopic pregnancy-related death. We calculated the ectopic pregnancy mortality ratio as the number of deaths divided by live births. Ectopic pregnancy-associated complications occurred in 11% of cases. Controlling for age and state, the risk of any complication was significantly higher among women who were black (incidence risk ratio [IRR] 1.47, 95% CI 1.43-1.53, P ectopic pregnancy mortality ratio was 0.48 per 100 000 live births

  8. Diagnostic significance of IL-6 and IL-8 in tubal ectopic pregnancy.

    Science.gov (United States)

    Rajendiran, Soundravally; Senthil Kumar, G P; Nimesh, Archana; Dhiman, Pooja; Shivaraman, K; Soundararaghavan, S

    2016-10-01

    As there are no specific non-invasive markers for the diagnosis of tubal ectopic pregnancy, our objective in the present study was to explore the role of inflammatory cytokines IL-6 and IL-8 in the diagnosis of ruptured tubal ectopic pregnancy. Twenty-eight women with tubal ectopic pregnancy, 31 patients with intrauterine abortion and 29 gestational age matched women having normal intrauterine pregnancy were included in the study. Five millilitre of blood was collected at the time of admission, serum was separated and stored at -70 °C for subsequent analysis of β hCG, IL-6 and IL-8 levels. The level of IL-6 was a significant increase in the women with tubal ectopic pregnancy compared to intrauterine abortion and normal pregnancy. IL-8 levels decrease significantly in the tubal ectopic pregnancy and in intrauterine abortion patients when compared with the normal pregnancy group. At the cutoff of 26.48 pg/ml IL-6 level predicted the tubal ectopic pregnancy with moderate accuracy. Therefore, it can be concluded that measurement of IL-6 may have relevance in the diagnosis of ectopic pregnancy as a novel inflammatory serum biomarkers.

  9. An Appraisal of the Management of Ectopic Pregnancy in a Nigerian ...

    African Journals Online (AJOL)

    2011-12-31

    Dec 31, 2011 ... Ectopic pregnancy is a significant cause of maternal morbidity and mortality especially in ... Several factors have been shown to increase the risk of ectopic pregnancy. ... Only 94.9% (93/98) case files were retrieved and were used in the final ..... patients in Ile Ife Nigeria were also reported to have died from.

  10. 42 CFR 441.207 - Drugs and devices and termination of ectopic pregnancies.

    Science.gov (United States)

    2010-10-01

    ... APPLICABLE TO SPECIFIC SERVICES Abortions § 441.207 Drugs and devices and termination of ectopic pregnancies... and for medical procedures necessary for the termination of an ectopic pregnancy. ... 42 Public Health 4 2010-10-01 2010-10-01 false Drugs and devices and termination of...

  11. A case-control study to evaluate risk factors for ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Sangita Khedar

    2016-08-01

    Conclusions: Increase awareness and knowledge of risk factors will help obstetricians to suspect and diagnose ectopic pregnancy early and accurately and enable them to plan medical treatment. Surgical treatment will be reserved for ruptured ectopic pregnancy and haemodynamically unstable patients. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2828-2835

  12. Routine Β-HCG Monitoring for Single-Dose Methotrexate Treatment in Ectopic Pregnancy.

    Science.gov (United States)

    Dai, Yuxin; Zhang, Guorui; Zhu, Lan; Lang, Jinghe; Liu, Zhufeng

    2017-08-08

    To evaluate an alternative monitoring protocol without D4 β-HCG measurement for predicting the need for a repeated methotrexate (MTX) dose in patients undergoing single-dose MTX therapy for ectopic pregnancy. Single center, Retrospective study (Canadian Task Force classification II-3). University-affiliated hospital. 184 ectopic pregnancy patients who were treated with MTX between January 2009 and December 2016 were included in the study. Single-dose MTX treatment (50mg/m(2)) MEASUREMENTS AND MAIN RESULTS: The patients were treated with repeated doses of MTX every 7 days, if necessary, according to Stovall's protocol or with laparoscopic surgery in cases of tubal rupture. The success of a single-dose of MTX according to the alternative measure was defined as a >50% decrease in the β-HCG level between day (D) 1 and D7 in clinically stable patients. The sensitivity, specificity, false-negative rate, false-positive rate and attributable risk of this new monitoring measure were calculated and compared to the traditional regimen. The new protocol had a sensitivity and specificity of 100% and 88.7%, respectively, for predicting a required second dose in patients whose D1 β-HCG levels were HCG level ≥2000 mIU/mL, both monitoring regimens had the same efficiency. The new monitoring model without the D4 β-HCG measurement may offer both patients and clinicians multiple options to monitor single-dose MTX therapy for selected ectopic pregnancy patients, with a comparable clinical efficiency to Stovall's protocol and less expense and follow-up burden to patients. Copyright © 2017. Published by Elsevier Inc.

  13. Ectopic pregnancy rates and racial disparities in the Medicaid population, 2004-2008.

    Science.gov (United States)

    Stulberg, Debra B; Cain, Loretta R; Dahlquist, Irma; Lauderdale, Diane S

    2014-12-01

    To assess 2004-2008 ectopic pregnancy rates among Medicaid recipients in 14 states and 2000-2008 time trends in three states and to identify differences in rate by race/ethnicity. Secondary analysis of Medicaid administrative claims data. Not applicable. Women ages 15-44 enrolled in Medicaid in Arizona, California, Colorado, Florida, Illinois, Indiana, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, New York, or Texas in 2004-2008 (n = 19,135,106) and in California, Illinois, and New York in 2000-2003. None. Number of ectopic pregnancies divided by the number of total pregnancies (spontaneous abortions, induced abortions, ectopic pregnancies, and all births). The 2004-2008 Medicaid ectopic pregnancy rate for all 14 states combined was 1.40% of all reported pregnancies. Adjusted for age, the rate was 1.47%. Ectopic pregnancy incidence was 2.3 per 1,000 woman-years. In states for which longer term data were available (California, Illinois, and New York), the rate declined significantly in 2000-2008. In all 14 states, black women were more likely to experience an ectopic pregnancy compared with whites (relative risk, 1.46; 95% confidence interval, 1.45-1.47). Ectopic pregnancy remains an important health risk for women enrolled in Medicaid. Black women are at consistently higher risk than whites. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  14. The impact of expectant management, systemic methotrexate and surgery on subsequent pregnancy outcomes in tubal ectopic pregnancy.

    Science.gov (United States)

    Demirdag, E; Guler, I; Abay, S; Oguz, Y; Erdem, M; Erdem, A

    2017-05-01

    The most common treatment modalities of ectopic pregnancy may influence long-term subsequent fertility outcomes in women who previously treated for ectopic pregnancy. Our objective was to compare long-term subsequent fertility outcomes after treatment with expectant management, systemic methotrexate (MTX) and surgery in tubal ectopic pregnancy. We searched our database for all women diagnosed with tubal ectopic pregnancy between January 2007 and January 2011 who were managed expectantly, with systemic MTX and with surgery. Treatment success and spontaneous pregnancy rates were compared in patients who desire to conceive following a tubal pregnancy. One hundred twelve of 151 women desired to conceive following tubal ectopic pregnancy. Twenty-seven of 112 (24.1 %) patients were managed expectantly. Fifty-three (47.3 %) and 32 (28.5 %) patients were managed with systemic MTX or surgery, respectively. All patients in expectant and surgery groups were managed successfully. Two (3.7 %) patients had surgery after failed treatment with systemic MTX. Spontaneous intrauterine pregnancy rates were 62.9 % in expectantly managed women, 58.4 % in women with systemic MTX and 68.7 % in women with surgery (p > 0.05). Treatment of ectopic pregnancy with either expectant management or systemic MTX is equally effective as compared to surgery. Spontaneous intrauterine pregnancy rates were comparable in expectant management, systemic methotrexate and surgery.

  15. Prospective comparison of single port versus conventional laparoscopic surgery for ectopic pregnancy.

    Science.gov (United States)

    Kim, Min Kyung; Kim, Jeong Jin; Choi, Joong Sub; Eom, Jeong Min; Lee, Jung Hun

    2015-04-01

    To investigate the feasibility and safety of single port laparoscopic surgery (SP-LS) for ectopic pregnancy, irrespective of type of ectopic pregnancy and hemodynamic stability. A prospective case-control study of 106 women who underwent SP-LS or conventional LS for a suspected ectopic pregnancy was performed at a university teaching hospital from January 2009 to March 2012. Twenty-six women underwent SP-LS (SP-LS group) and 80 women underwent conventional LS (conventional LS group). There were no statistical differences between the groups in terms of demographic characteristics, operating time, hemoglobin change, return of bowel activity, hospital stay or complication rate. There were no cases of additional trocar use or conversion to laparotomy. Of five women with heterotopic pregnancy, one underwent SP-LS, and three underwent conventional LS for tubal pregnancy, which all resulted in vaginal delivery without obstetric complication; one woman received SP-LS for cornual pregnancy and had an ongoing pregnancy. SP-LS for ectopic pregnancy is feasible and safe regardless of the type of ectopic pregnancy and hemodynamic stability. However, further work is needed to confirm this conclusion and to demonstrate any advantage of SP-LS for ectopic pregnancy. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  16. Increased incidence of ectopic pregnancy after in vitro fertilization in women with decreased ovarian reserve.

    Science.gov (United States)

    Lin, Shengli; Yang, Rui; Chi, Hongbin; Lian, Ying; Wang, Jiejing; Huang, Shuo; Lu, Cuiling; Liu, Ping; Qiao, Jie

    2017-01-16

    The incidence of ectopic pregnancy after assisted reproductive technology is increased approximately 2.5-5-fold compared with natural conceptions.Strategies were used to decrease the incidence of ectopic pregnancy, but ectopic pregnancy still occurs. In the present study, women were selected with decreased ovarian reserve (defined as FSH > 10 IU/L) aged 20 to 38 years who underwent IVF-ET between 2009 and 2014. These 2,061 women were age-matched with an equal number of women with normal ovarian reserve (defined as FSH ≤ 10 IU/L). During cycles following fresh embryo transfer, 93 patients were diagnosed with ectopic pregnancy. The incidence of ectopic pregnancy in clinical pregnancies was significantly higher in the decreased ovarian reserve than in the normal ovarian reserve group (5.51% vs. 2.99%). After adjusting for confounding factors, the incidence of ectopic pregnancy was significantly associated with decreased ovarian reserve. Our results showed that decreased ovarian reserve is an independent risk factor for ectopic pregnancy after in vitro fertilization-embryo transfer.

  17. Caesarean Scar Ectopic Pregnancy: Report of Two Cases.

    Science.gov (United States)

    Mahapatro, Akshaya Kumar; Shankar, Kundavi; Varma, Thankam

    2016-05-01

    Cases of Caesarean Scar Ectopic Pregnancy (CSEP) are becoming increasingly common at tertiary care hospitals because of increase in rate of CS. This condition is often complicated by life threatening bleeding, uterine rupture, which might require hysterectomy leading to permanent infertility. Management can be medical, surgical or combined depending on the clinical presentation. It includes systemic methotrexate or local uterine artery chemoembolisation, dilatation and curettage, excision of trophoblastic tissue either by laparoscopy or laparotomy with uterine repair. We report two such cases managed medically in our hospital. Both the cases presented to us were asymptomatic except amenorrhoea and were diagnosed by transvaginal sonography. First case was managed with systemic methotrexate followed by Dilatation and Curettage (D&C). Second case was managed with systemic methotrexate alone successfully.

  18. POST STERILISATION ECTOPIC PREGNANCY IN A TERTIARY CARE CENTRE IN NORTH KERALA

    Directory of Open Access Journals (Sweden)

    Kusumam Vilangot Nhalil

    2017-03-01

    Full Text Available BACKGROUND To study the proportion of ectopic pregnancies with a history of female sterilisation and to assess the risk factors associated with post sterilisation ectopic pregnancy. MATERIALS AND METHODS This is a descriptive cross-sectional study. Cases of ectopic pregnancy that were admitted in Department of Obstetrics and Gynaecology, Kozhikode, from February 2014 to July 2015 are included in the study. Details of patient were collected and they were examined in person. Investigations were recorded and clinical findings were noted. Later outcome of cases was also recorded. Data from the study was coded and entered in MS Excel and analysed with SPSS software. RESULTS There were 372 cases of ectopic pregnancies, of which 51 had history of female sterilisation. Ectopic tubal pregnancies after tubal sterilisation accounted for 13.7% of all the ectopic pregnancies in this study. 45% cases occurred in patients less than 30 years. More than 75% cases of ectopic pregnancy in the study presented at less than 7 weeks. Abdominal pain was the main symptom with which they presented. Out of the 51 cases, more than 80% patients had undergone sterilisation by modified Pomeroy’s technique while 17.6% cases had undergone laparoscopic sterilisation. 98% of the patients had their sterilisation done before 30 years of age. 64.7% cases had undergone sterilisation from a secondary care centre while 35.5% had it from a tertiary care centre. In the present study, more than half of the cases presented (as ectopic pregnancy within 5 years after sterilisation. 15% cases had history of pelvic inflammatory disease. Bilateral near total salpingectomy was done in all cases. CONCLUSION In the present study, it is observed that ectopic pregnancies following female sterilisation are not rare. It constituted 13.7% cases of ectopic pregnancies. There may be a delay in diagnosis as there is a history of sterilisation. Absence of amenorrhoea does not rule out ectopic. Most of

  19. Demonstration of the route of embryo migration in retroperitoneal ectopic pregnancy using contrast-enhanced computed tomography.

    Science.gov (United States)

    Liang, Changhu; Li, Xueli; Zhao, Bin; Du, Yinglin; Xu, Shifeng

    2014-03-01

    Retroperitoneal abdominal pregnancy is exceptionally rare. An unusual retroperitoneal pregnancy has a high risk of severe bleeding. Abdominal ultrasonography and whole abdominal computerized tomography scanning should be performed for the early diagnosis of ectopic pregnancy. A case of retroperitoneal ectopic pregnancy located very close to large retroperitoneal blood vessels and treated with resection is presented. Many unusual features of retroperitoneal ectopic pregnancy were highlighted as providing further evidence in support of the main proposed embryo migration mechanism via lymphatic vessels.

  20. Improving reproductive long-term prognosis for women with a first ectopic pregnancy

    DEFF Research Database (Denmark)

    Egerup, Pia; Kårhus, Line Lund; Skovlund, Charlotte Wessel;

    2014-01-01

    OBJECTIVE: To describe developments in reproductive long-term prognosis in women with a first ectopic pregnancy as compared with two control cohorts. DESIGN: Controlled cohort study. SETTING: Data were collected from four national Danish registries. POPULATION: All Danish women of reproductive age...... (15-49 years) through the period 1977-2009 and all reproductive outcomes in these women. METHODS: Data were collected from four national Danish registries. Three cohorts of women with a first recorded ectopic pregnancy during the periods 1980-84, 1985-89, and 1990-94, were compared with age......-matched controls with a first miscarriage and a first induced abortion and followed for 15 years for all further pregnancy outcomes. MAIN OUTCOME MEASURES: Pregnancy outcomes included deliveries, miscarriages, induced abortions and ectopic pregnancies. RESULTS: The birth rate for women with a first ectopic...

  1. EMERGENCY LAPAROTOMY AND DEATH IN ECTOPIC PREGNANCY: A RARITY NOWADAYS? A DESCRIPTIVE STUDY OF ECTOPIC PREGNANCY CASES IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Suja Mary

    2015-02-01

    Full Text Available Pregnancy implanted outside the endometrial cavity constitutes ectopic gestation. The reproductive performance can be poor following an ectopic pregnancy. The purpose of the study is to emphasize the importance of public awareness about the need for early reporting to hospital in doubtful cases, to analyze the risk factors for ectopic, to study the role of βHCG estimation and transvaginal sonography in early detection in order to preserve the fallopian tube by medical therapy and/or to do early elective surgery preventing emergency laparotomy and death from ectopic pregnancy. METHODOLOGY: All cases of ectopic gestations managed in a tertiary care hospital for a period of one year is reviewed, roughly around 70 cases. The objectives were to analyze demographic characteristics, risk factors, methods of diagnosis and to evaluate the protocol for ectopic management in the hospital. RESULTS: The study showed that the maximum number of ectopic was seen in the 26 - 30 age group and more commonly among multies. Maximum number of ectopic cases is seen between 5.1 to 6 weeks and 80% of the cases are seen in ≤8 weeks. 42/70 patients showed one or more risk factors like previous history of ectopic, LSCS, infertility treatment, sterilization and use of IUCD.82.9% patients presented either with pain alone or pain along with spotting/bleeding p/v. Earlier, majority of the cases were reported after tubal rupture resulting in shock, which sometimes even lead to death. In the present scenario, however, only 2 patients developed hypotension, 11 out of 70 alone required blood transfusion and none required laparotomy. Majority of cases of unruptured ectopic (83% showed <66% rise in βHCG in 48 hours. Pelvic ultrasound and serum βHCG estimation has revolutionized the diagnostic proce ss of ectopic pregnancy enabling detection in the unruptured stage itself in 50% of the cases and the rest in early stages of rupture. In most cases, medical line of management with

  2. Spontaneous Bilateral Tubal Ectopic Pregnancy: Incidental Finding During Laparoscopy - Brief Report and Review of Literature.

    Science.gov (United States)

    Hoffmann, S; Abele, H; Bachmann, C

    2016-04-01

    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 suspicious for ectopic pregnancy. Bilateral salpingotomy was performed laparoscopically. Pathological examination confirmed the diagnosis. Conclusions for Practice: Although ectopic tubal pregnancy is seen more often after assisted reproductive techniques, bilateral spontaneous ectopic pregnancies must also be considered in other cases. Laparoscopic surgery is effective to confirm the diagnosis and treat heterotopic pregnancies. Further studies will be needed to confirm whether unilateral or bilateral conservative fertility-preserving surgery is more appropriate.

  3. Spontaneous Bilateral Tubal Ectopic Pregnancy: Incidental Finding During Laparoscopy – Brief Report and Review of Literature

    Science.gov (United States)

    Hoffmann, S.; Abele, H.; Bachmann, C.

    2016-01-01

    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 suspicious for ectopic pregnancy. Bilateral salpingotomy was performed laparoscopically. Pathological examination confirmed the diagnosis. Conclusions for Practice: Although ectopic tubal pregnancy is seen more often after assisted reproductive techniques, bilateral spontaneous ectopic pregnancies must also be considered in other cases. Laparoscopic surgery is effective to confirm the diagnosis and treat heterotopic pregnancies. Further studies will be needed to confirm whether unilateral or bilateral conservative fertility-preserving surgery is more appropriate. PMID:27134298

  4. Clinical course of ectopic pregnancy: A single-center experience

    Directory of Open Access Journals (Sweden)

    Aqueela Ayaz

    2013-01-01

    Full Text Available Objectives: The objective was to highlight the frequency, clinical profile, and predisposing factors of ectopic pregnancy (EP in a general hospital. Materials and Methods: This descriptive study was conducted at the Obstetrics and Gynaecology department of Hera General hospital, Makkah, Saudi Arabia, from July 1, 2009 to December 29, 2010. Data were collected on chief medical complaints, sociodemographic characteristics, past obstetrics and gynecological history, management done, and outcome of management. Data were analyzed using Microsoft Office Excel (version 2007. Results: Out of total 7564 pregnancies, 44 (0.58% patients were diagnosed as EP. Out of 44, 22 (50% patients presented within 24 h of onset of symptoms. Mean age was 28 ± 7 years. Multigravida were predominant in 25 (57%, and 21 (48% had gestational age of 6-8 weeks at the time of presentation; the common presenting features were amenorrhea (41, 93.2%, abdominal pain (39, 88.6%, and tenderness (38, 86%. Previous pelvic surgery (13, 29.5%, infertility treatment (11, 25%, and pelvic inflammatory disease (10, 22.7% were the common predisposing factors. Twenty-five (57% presented with ruptured EP and were operated within 24 h, and the remaining were kept under observation till further diagnosis. After confirming the diagnosis, 12/19 underwent laparoscopy, whereas 7/19 received medical treatment. Surgery confirmed fallopian tube pregnancies in 35 (94.5%. No mortality was observed. Conclusion: Previous pelvic surgeries were the major etiological factor for EP. Other factors were infertility treatment and pelvic inflammatory disease. The most common site of EP was fallopian tubes.

  5. Recurrent pregnancy-related upper airway obstruction caused by intratracheal ectopic thyroid tissue

    DEFF Research Database (Denmark)

    Døssing, H; Jørgensen, K E; Oster-Jørgensen, E

    1999-01-01

    An unusual case of recurrent pregnancy-related thyroid growth stimulation is reported. A 27-year-old euthyroid woman had pulmonary symptoms, thought to be asthma during her first pregnancy, that improved postpartum. Bronchodilatators had no effect and symptoms recurred from gestational week 22 du...... intratracheal ectopic thyroid tissue diagnosed during pregnancy....

  6. Reproductive Outcomes Following Ectopic Pregnancy: Register-Based Retrospective Cohort Study

    Science.gov (United States)

    Bhattacharya, Sohinee; McLernon, David J; Lee, Amanda J; Bhattacharya, Siladitya

    2012-01-01

    Background We aimed to compare reproductive outcomes following ectopic pregnancy (EP) versus livebirth, miscarriage, or termination in a first pregnancy. Methods And Findings A retrospective cohort study design was used. Scottish national data on all women whose first pregnancy occurred between 1981 and 2000 were linked to records of a subsequent pregnancy. The exposed cohort comprised women with an EP in their first pregnancy. There were three unexposed cohorts: women with livebirth, miscarriage, and termination of their first pregnancies. Any differences in rates of second pregnancy, livebirth, EP, miscarriage, or terminations and complications of a second ongoing pregnancy and delivery were assessed among the different exposure groups. A total of 2,969 women had an initial EP; 667,299 had a livebirth, 39,705 women miscarried, and 78,697 terminated their first pregnancies. Women with an initial EP had an increased chance of another pregnancy within 2 years (adjusted hazard ratio (AHR) 2.76 [95% CI 2.58–2.95]) or after 6 years (AHR 1.57 [95% CI 1.29–1.91]) compared to women with a livebirth. In comparison with women with an initial miscarriage, women who had an EP had a lower chance of a second pregnancy (AHR 0.53 [95% CI 0.50–0.56]). Compared to women with an initial termination, women with an EP had an increased chance of a second pregnancy (AHR 2.38 [95% CI 2.23–2.55]) within 2 years. Women with an initial EP suffered an increased risk of another EP compared to women with a livebirth (AHR 13.0 [95% CI 11.63–16.86]), miscarriage (AHR 6.07 [95% CI 4.83–7.62]), or termination (AHR 12.84 [95% CI 10.07–16.37]). Perinatal complications in a pregnancy following EP were not significantly higher than those in primigravidae or in women with a previous miscarriage or termination. Conclusion Women with an initial EP have a lower chance of conception than those who miscarry but an increased risk of a repeat EP in comparison with all three comparison groups. A

  7. Risk of ectopic pregnancy lowest with transfer of single frozen blastocyst.

    Science.gov (United States)

    Li, Z; Sullivan, E A; Chapman, M; Farquhar, C; Wang, Y A

    2015-09-01

    What type of transferred embryo is associated with a lower rate of ectopic pregnancy? The lowest risk of ectopic pregnancy was associated with the transfer of blastocyst, frozen and single embryo compared with cleavage stage, fresh and multiple embryos. Ectopic pregnancy is a recognized complication following assisted reproductive technology (ART) treatment. It has been estimated that the rate of ectopic pregnancy is doubled in pregnancies following ART treatment compared with spontaneous pregnancies. However, it was not clear whether the excess rate of ectopic pregnancy following ART treatment is related to the underlying demographic factors of women undergoing ART treatment, the number of embryos transferred or the developmental stage of the embryo. A population-based cohort study of pregnancies following autologous treatment cycles between January 2009 and December 2011 were obtained from the Australian and New Zealand Assisted Reproduction Technology Database (ANZARD). The ANZARD collects ART treatment information and clinical outcomes annually from all fertility centres in Australia and New Zealand. Between 2009 and 2011, a total of 44 102 pregnancies were included in the analysis. The rate of ectopic pregnancy was compared by demographic and ART treatment factors. Generalized linear regression of Poisson distribution was used to estimate the likelihood of ectopic pregnancy. Odds ratios, adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated. The overall rate of ectopic pregnancy was 1.4% for women following ART treatment in Australia and New Zealand. Pregnancies following single embryo transfers had 1.2% ectopic pregnancies, significantly lower than double embryo transfers (1.8%) (P ectopic pregnancy rate was 1.9% for pregnancies from transfers of fresh cleavage embryo, followed by transfers of frozen cleavage embryo (1.7%), transfers of fresh blastocyst (1.3%), and transfers of frozen blastocyst (0.8%). Compared with fresh blastocyst

  8. Developing a knowledge base to support the annotation of ultrasound images of ectopic pregnancy.

    Science.gov (United States)

    Dhombres, Ferdinand; Maurice, Paul; Friszer, Stéphanie; Guilbaud, Lucie; Lelong, Nathalie; Khoshnood, Babak; Charlet, Jean; Perrot, Nicolas; Jauniaux, Eric; Jurkovic, Davor; Jouannic, Jean-Marie

    2017-01-31

    Ectopic pregnancy is a frequent early complication of pregnancy associated with significant rates of morbidly and mortality. The positive diagnosis of this condition is established through transvaginal ultrasound scanning. The timing of diagnosis depends on the operator expertise in identifying the signs of ectopic pregnancy, which varies dramatically among medical staff with heterogeneous training. Developing decision support systems in this context is expected to improve the identification of these signs and subsequently improve the quality of care. In this article, we present a new knowledge base for ectopic pregnancy, and we demonstrate its use on the annotation of clinical images. The knowledge base is supported by an application ontology, which provides the taxonomy, the vocabulary and definitions for 24 types and 81 signs of ectopic pregnancy, 484 anatomical structures and 32 technical elements for image acquisition. The knowledge base provides a sign-centric model of the domain, with the relations of signs to ectopic pregnancy types, anatomical structures and the technical elements. The evaluation of the ontology and knowledge base demonstrated a positive feedback from a panel of 17 medical users. Leveraging these semantic resources, we developed an application for the annotation of ultrasound images. Using this application, 6 operators achieved a precision of 0.83 for the identification of signs in 208 ultrasound images corresponding to 35 clinical cases of ectopic pregnancy. We developed a new ectopic pregnancy knowledge base for the annotation of ultrasound images. The use of this knowledge base for the annotation of ultrasound images of ectopic pregnancy showed promising results from the perspective of clinical decision support system development. Other gynecological disorders and fetal anomalies may benefit from our approach.

  9. Ectopic pregnancy following in vitro fertilization with embryo transfer: A single-center experience during 15 years.

    Science.gov (United States)

    Cheng, Ling-Yun; Lin, Pin-Yao; Huang, Fu-Jen; Kung, Fu-Tsai; Chiang, Hsin-Ju; Lin, Yu-Ju; Lan, Kuo-Chung

    2015-10-01

    Ectopic pregnancy is an obstetrical disease that is potentially associated with maternal death in the first trimester. It is one of the well-known complications following in vitro fertilization (IVF) with embryo transfer (ET). The incidence of ectopic pregnancy is estimated to be 2.1-8.6% of clinical pregnancy after IVF-ET, which is higher than natural conceptions (incidence rate 2%). This study aimed to re-evaluate the ectopic pregnancy rate in patients undergoing IVF-ET and to investigate the effects of embryo stage and frozen-thawed blastocyst transfer and ET during full bladder distention on ectopic pregnancy rate. This retrospective study reviewed women who achieved a clinical pregnancy after IVF-ET at the Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital between 1999 and 2013. We compared ectopic pregnancy rate following Day 3 ET with Day 5 ET, and after fresh ET with thawed ET. Besides, multivariate analysis was used to clarify the factors affecting ectopic pregnancy after IVF-ET. Of the total 1213 clinical pregnancies after fresh ET, 18 (1.5%) were verified as ectopic, which is similar to the rate following natural conception. The ectopic pregnancy rates were similar for Day 3 (1.2%) and Day 5 (1.7%) ETs. The incidence of ectopic pregnancy in thawed ET cycles (0.6%) was not significantly reduced than fresh ET cycles (1.5%). Tubal ET (TET) and ET under full bladder distention had a significant effect on ectopic pregnancy. Thawed ET was not associated with a lower incidence of ectopic pregnancy than fresh ET, and embryo stage did not affect the rate of ectopic pregnancy. In addition, TET and ET under conditions of full bladder distention may increase the ectopic pregnancy rate. Copyright © 2015. Published by Elsevier B.V.

  10. A Third Surgically Managed Ectopic Pregnancy after Two Salpingectomies Involving the Opposite Tube

    Science.gov (United States)

    Deguchi, Yoko; Horiuchi, Yuko; Ino, Kazuhiko; Furukawa, Kenichi

    2017-01-01

    Recurrent ectopic pregnancy in a remnant fallopian tube after ipsilateral salpingectomy is clinically rare. We report the extremely rare case of a third recurrent ectopic pregnancy after two previous salpingectomy procedures involving the opposite tube. A 26-year-old woman, gravida 3 para 0, experienced three ectopic pregnancies brought about by natural conception, all of which were treated surgically (right partial salpingectomy, right remnant tube resection, and left total salpingectomy). During the two salpingectomy procedures involving the right tube, the patency of the intact left tube was intraoperatively confirmed with indigo carmine. The most appropriate surgical intervention should be discussed when managing recurrent ectopic pregnancies. It might be necessary to perform total salpingectomy to reduce the risk of future recurrence on the remaining tube.

  11. Ruptured ectopic pregnancy: the long and tortuous journey to the theatre.

    Science.gov (United States)

    Ugboma, Henry Aa; Oputa, Victory Oa; Ugboma, E W

    2014-07-01

    Ectopic pregnancy is a common gynaecological emergency in Nigeria, West Africa. Here we present a case that brings to light some of the problems facing the health sector in reducing the high maternal mortality rate.

  12. Risk of Ectopic Pregnancy Associated With Assisted Reproductive Technology in the United States, 2001–2011

    Science.gov (United States)

    Perkins, Kiran M.; Boulet, Sheree L.; Kissin, Dmitry M.; Jamieson, Denise J.

    2015-01-01

    OBJECTIVE To assess national trends in ectopic pregnancy incidence among assisted reproductive technology users and identify risk factors associated with ectopic pregnancy. METHODS We identified 553,577 pregnancies reported to the National ART Surveillance System between 2001 and 2011. Of those, 9,480 were ectopic, of which 485 were heterotopic. As a result of small numbers, ectopic and heterotopic pregnancies were combined for analysis. We assessed temporal trends in annual ectopic pregnancy rates using Poisson regression. We used log-binomial regression models with generalized estimating equations for correlated outcomes within clinics to calculate unadjusted and adjusted risk ratios for the association between ectopic pregnancy and selected patient characteristics and treatment factors. RESULTS The rate of ectopic pregnancy declined from 2.0% (n5735, 95% confidence interval [CI] 1.9–2.2) in 2001 to 1.6% (n=968, 95% CI 1.5–1.7) in 2011 (P for trend ,.001). The ectopic pregnancy rate ranged from 2.0% (n=7,469, 95% CI 1.9–2.0) for fresh, nondonor cycles to 1.0% (n=641, 95% CI 0.9–1.1) for fresh, donor cycles. Among fresh, nondonor cycles, the rate of ectopic pregnancy was 1.6% (95% CI 1.4–1.7) when one embryo was transferred compared with 1.7% (95% CI 1.7–1.8), 2.2% (95% CI 2.1–2.3), and 2.5% (95% CI 2.4–2.6) when two, three, or four or more embryos were transferred, respectively (adjusted risk ratios 1.11, 95% CI 0.94–0.30; 1.33, 95% CI 1.12–1.56; and 1.49, 95% CI 1.25–1.78). CONCLUSION Ectopic pregnancy incidence after assisted reproductive technology has decreased over time, but factors such as multiple embryo transfer increase the risk of ectopic pregnancy. PMID:25560107

  13. Ruptured Ectopic Pregnancy with Contralateral Ovarian Serous Cyst Adenoma Torsion: Laparoscopic Management of Double Trouble

    Science.gov (United States)

    Rajkumar, Anirudh; Rajkumar, J. S.; Guru, Venkatesan

    2016-01-01

    Adnexal torsion is responsible for 2.7% of all gynecological emergencies. Ectopic pregnancy is relatively common, occurring in 2% of all pregnancies. We report the second case of ruptured right tubal ectopic gestation with torsion of serous cystadenoma of left ovary. This was diagnosed after emergency laparoscopy done for acute abdomen. Right salpingectomy and left ovarian detorsion followed by cystectomy were done laparoscopically. PMID:27840755

  14. Ectopic pregnancy as contraceptive failure in patient with epilepsy.

    Science.gov (United States)

    Radaković, Branko; Goldstajn, Marina Sprem

    2012-12-01

    Epilepsy is a common neurologic condition which includes many women's health issues. Menstrual disorders, reproductive endocrinological disturbances, ovulatory dysfunction and infertility appear to be relatively frequent in women with epilepsy. Clinical decision making which contraceptive regimen is optimal for an individual woman with epilepsy is one of the most challenging tasks when taking care of women with epilepsy. A higher incidence of breakthrough bleeding and contraceptive failure was determined among women using antiepileptic drugs. There is the increased risk for contraceptive failure with the use of P450 3A4 enzyme-inducing antiepileptic drugs (AEDs) such as phenobarbital, carbamazepine, phenytoin, felbamate, topiramate and oxcarbazepine. Therefore, it is recommended to use noninducing AEDs, or for those who use inducing AEDs, the use of oral hormonal contraceptive pills which contained equal or more than 50 microg of estrogen, or intrauterine devices. The aim of the article is to present woman with epilepsy who was used combined low dose oral contraceptive pills containing 20 microg of ethinyl estradiol which in interaction with carbamazepine resulted with ectopic tubar pregnancy.

  15. Main Risk Factors for Ectopic Pregnancy: A Case-Control Study in A Sample of Iranian Women

    Directory of Open Access Journals (Sweden)

    Shayesteh Parashi

    2014-07-01

    Full Text Available Background: Although the risk factors of ectopic pregnancy have been determined in previous studies, the main risk factors of ectopic pregnancy are different in various countries due to different cultural and social characteristics. Determination of main risk factors of ectopic pregnancy leads to a rapid diagnosis and an improvement in strategies for its prevention. The purpose of this study was to determine the main risk factors of ectopic pregnancy in a sample of Iranian women. Materials and Methods: We designed a case-control study to include 150 cases and 300 controls and to compare them by the following factors: socio-demographic characteristics, contraceptive methods, prior tubal surgery, tubal pathology, prior ectopic pregnancy, prior caesarean section, prior abortion, prior infertility, and prior abdominal/pelvic surgery. Results: The case and control groups were significantly similar in term of education and parity. There was an association between ectopic pregnancy and age which was disappeared after controlling for the main risk factors (adjusted OR=2.45, 95% CI: 0.86-6.97. There was no statistically significant relation between ectopic pregnancy and prior tubal surgery, tubal pathology, prior abortion, prior infertility, assisted reproductive technology, and oral contraceptive method (p>0.05. However, there was a significant association between prior ectopic pregnancy, prior tubal ligation, use of intrauterine device, and prior abdominal/pelvic surgery with ectopic pregnancy (p<0.05. The risk of ectopic pregnancy increased with the use of intrauterine device and tubal ligation, whereas decreased with use of oral contraception. Conclusion: This study identified prior ectopic pregnancy, prior tubal ligation, use of intrauterine device, and prior pelvic/abdominal surgery as the main risk factors for ectopic pregnancy in a sample of Iranian women. Our findings can be useful for early diagnosis of ectopic pregnancy and for improvement in

  16. Immunohistological demonstration of intermediate trophoblast in the diagnosis of uterine versus ectopic pregnancy

    DEFF Research Database (Denmark)

    Sørensen, Flemming Brandt; Marcussen, N; Daugaard, H O;

    1991-01-01

    . The histological presence and distribution of hPL was investigated in endometrial curettings from 90 patients studied retrospectively (47 had ectopic pregnancies, 14 miscarriages, and 29 legal abortions), and a consecutive, prospective series of 50 patients (40 had miscarriages and 10 had ectopic pregnancies......PL for intrauterine pregnancy was 1.00, and the sensitivity of hPL, as an indicator of uterine gestation, was 0.62. In absence of specific hPL-staining, the risk of ectopic pregnancy was about 50%. The immunohistochemical demonstration of hPL is a useful tool for identifying patients who are suspected of having had......Immunohistological demonstration of human placental lactogen (hPL) in non-villous, mononuclear intermediate trophoblastic cells may be of routine diagnostic value, when chorionic villi are absent in endometrial curettings from patients suspected of miscarriage of an intrauterine pregnancy...

  17. Prioritization of Susceptibility Genes for Ectopic Pregnancy by Gene Network Analysis.

    Science.gov (United States)

    Liu, Ji-Long; Zhao, Miao

    2016-02-01

    Ectopic pregnancy is a very dangerous complication of pregnancy, affecting 1%-2% of all reported pregnancies. Due to ethical constraints on human biopsies and the lack of suitable animal models, there has been little success in identifying functionally important genes in the pathogenesis of ectopic pregnancy. In the present study, we developed a random walk-based computational method named TM-rank to prioritize ectopic pregnancy-related genes based on text mining data and gene network information. Using a defined threshold value, we identified five top-ranked genes: VEGFA (vascular endothelial growth factor A), IL8 (interleukin 8), IL6 (interleukin 6), ESR1 (estrogen receptor 1) and EGFR (epidermal growth factor receptor). These genes are promising candidate genes that can serve as useful diagnostic biomarkers and therapeutic targets. Our approach represents a novel strategy for prioritizing disease susceptibility genes.

  18. Magnetic resonance imaging in tubal and non-tubal ectopic pregnancy.

    Science.gov (United States)

    Srisajjakul, Sitthipong; Prapaisilp, Patcharin; Bangchokdee, Sirikan

    2017-08-01

    Ectopic pregnancy is the leading cause of pregnancy-related death in the first trimester. Ectopic pregnancy is usually diagnosed by clinical, laboratory, and sonographic findings, with implantation most commonly located in the ampullary part of the fallopian tube. However, pregnancies that develop at unusual implantation sites, such as angular, interstitial, cornual, cervical, ovarian, cesarean scar, and abdominal cavity pregnancies, may rarely occur. Although ultrasound is considered the primary pregnancy-related imaging modality, it may not be able to illustrate the implantation site in certain types of pregnancy. Magnetic resonance imaging (MRI) has gained popularity as an imaging tool for evaluating pregnant patients, and it is used as a problem-solving tool in special circumstances, including ectopic pregnancy. MRI can confirm abnormal implantation site, and distinguish rupture from nonrupture cases before management. Other benefits include absence of ionizing radiation, superb soft tissue contrast, and sensitivity sufficient for identifying hemorrhage and its stages. This article summarizes imaging findings in tubal and non-tubal ectopic pregnancy with an emphasis on the roles and protocols of MRI, key MRI features, and differential diagnosis. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Ectopic pregnancy morbidity and mortality in low-income women, 2004–2008

    Science.gov (United States)

    Stulberg, D.B.; Cain, L.; Dahlquist, I.H.; Lauderdale, D.S.

    2016-01-01

    STUDY QUESTION Does the risk of adverse outcomes at the time of ectopic pregnancy vary by race/ethnicity among women receiving Medicaid, the public health insurance program for low-income people in the USA? SUMMARY ANSWER Among Medicaid beneficiaries with ectopic pregnancy, 11% experienced at least one complication, and women from all racial/ethnic minority groups were significantly more likely than whites to experience complications. WHAT IS KNOWN ALREADY In this population of Medicaid recipients, African American women are significantly more likely than whites to experience ectopic pregnancy, but the risk of adverse outcomes has not previously been assessed. STUDY DESIGN, SIZE, AND DURATION We conducted a cross-sectional observational study of all women (n = 19 135 106) ages 15–44 enrolled in Medicaid for any amount of time during 2004–2008 who lived in one of the following 14 US states: Arizona; California; Colorado; Florida; Illinois; Indiana; Iowa; Louisiana; Massachusetts; Michigan; Minnesota; Mississippi; New York; and Texas. PARTICIPANTS/MATERIALS, SETTINGS, METHODS We analyzed Medicaid claims records for inpatient and outpatient encounters and identified ectopic pregnancies with a principal diagnosis code for ectopic pregnancy from 2004–2008. We calculated the ectopic pregnancy complication rate as the number of ectopic pregnancies with at least one complication (blood transfusion, hysterectomy, any sterilization, or length-of-stay (LOS) > 2 days) divided by the total number of ectopic pregnancies. We used Poisson regression to assess the risk of ectopic pregnancy complication by race/ethnicity. Secondary outcomes were each individual complication, and ectopic pregnancy-related death. We calculated the ectopic pregnancy mortality ratio as the number of deaths divided by live births. MAIN RESULTS AND THE ROLE OF CHANCE Ectopic pregnancy-associated complications occurred in 11% of cases. Controlling for age and state, the risk of any complication was

  20. Main Risk Factors for Ectopic Pregnancy: A Case-Control Study in A Sample of Iranian Women

    Science.gov (United States)

    Parashi, Shayesteh; Moukhah, Somayeh; Ashrafi, Mahnaz

    2014-01-01

    Background Although the risk factors of ectopic pregnancy have been determined in previous studies, the main risk factors of ectopic pregnancy are different in various countries due to different cultural and social characteristics. Determination of main risk factors of ectopic pregnancy leads to a rapid diagnosis and an improvement in strategies for its prevention. The purpose of this study was to determine the main risk factors of ectopic pregnancy in a sample of Iranian women. Materials and Methods We designed a case-control study to include 150 cases and 300 controls and to compare them by the following factors: socio-demographic characteristics, contraceptive methods, prior tubal surgery, tubal pathology, prior ectopic pregnancy, prior caesarean section, prior abortion, prior infertility, and prior abdominal/pelvic surgery. Results The case and control groups were significantly similar in term of education and parity. There was an association between ectopic pregnancy and age which was disappeared after controlling for the main risk factors (adjusted OR=2.45, 95% CI: 0.86-6.97). There was no statistically significant relation between ectopic pregnancy and prior tubal surgery, tubal pathology, prior abortion, prior infertility, assisted reproductive technology, and oral contraceptive method (p>0.05). However, there was a significant association between prior ectopic pregnancy, prior tubal ligation, use of intrauterine device, and prior abdominal/pelvic surgery with ectopic pregnancy (pectopic pregnancy increased with the use of intrauterine device and tubal ligation, whereas decreased with use of oral contraception. Conclusion This study identified prior ectopic pregnancy, prior tubal ligation, use of intrauterine device, and prior pelvic/abdominal surgery as the main risk factors for ectopic pregnancy in a sample of Iranian women. Our findings can be useful for early diagnosis of ectopic pregnancy and for improvement in strategies of its prevention through

  1. Episodes of repeated sudden deafness following pregnancies.

    Science.gov (United States)

    Pawlak-Osinska, Katarzyna; Burduk, Pawel K; Kopczynski, Andrzej

    2009-04-01

    Sex hormones influence and provoke changes in hearing levels. Sudden deafness is rarely observed in pregnant women. The effective treatment of sudden deafness in pregnant women is a challenging problem. We present a case of repeatable, completely regressed sudden deafness in a woman during her first and second pregnancies.

  2. A molar masquerading as an ectopic pregnancy in the early first trimester: a salutary lesson.

    Science.gov (United States)

    Govind, Abha; Lakhi, Nisha

    2012-01-01

    The authors report a case in which a molar pregnancy was mistaken for an ectopic pregnancy in the early first trimester. This confusion delayed diagnosis and caused distress; follow-up led to the final diagnosis of complete hydatidiform mole. Correct preoperative diagnosis of molar pregnancy by ultrasound in early pregnancy may be tricky. It is important to obtain histological evidence to make the final diagnosis of gestational trophoblastic disease. While relatively rare, consideration of molar pregnancy in the differential diagnosis of early pregnancy loss may avoid unnecessary distress.

  3. Factors influencing fertility outcome after ectopic pregnancy: a descriptive observational study

    Directory of Open Access Journals (Sweden)

    Veena KS

    2015-06-01

    Conclusions: Subfertility, tubal pathology and age will influence on future fertility outcome following ectopic pregnancy. Radical or conservative surgery does not have influence on future pregnancy outcome. [Int J Reprod Contracept Obstet Gynecol 2015; 4(3.000: 820-823

  4. Persistent ectopic pregnancy after linear salpingotomy: a non-predictable complication to conservative surgery for tubal gestation

    DEFF Research Database (Denmark)

    Lund, Claus Otto; Nilas, Lisbeth; Bangsgaard, Nannie;

    2002-01-01

    BACKGROUND: The drawback of conservative surgery for ectopic pregnancy (EP) is the risk of persistent trophoblast. The purpose was to characterize patients who develop persistent ectopic pregnancy (PEP) after salpingotomy for EP and to assess prognostic factors. METHODS: The medical records of 417...... surgery, ruptured EP, pelvic adhesions, absence of products of conception at microscopy and hemoperitoneum. CONCLUSIONS: Persistent ectopic pregnancy can neither be predicted from clinical variables nor from single measurements of hCG with an accuracy sufficient for clinical use....

  5. Persistent ectopic pregnancy after linear salpingotomy: a non-predictable complication to conservative surgery for tubal gestation

    DEFF Research Database (Denmark)

    Lund, Claus Otto; Nilas, Lisbeth; Bangsgaard, Nannie

    2002-01-01

    BACKGROUND: The drawback of conservative surgery for ectopic pregnancy (EP) is the risk of persistent trophoblast. The purpose was to characterize patients who develop persistent ectopic pregnancy (PEP) after salpingotomy for EP and to assess prognostic factors. METHODS: The medical records of 417...... surgery, ruptured EP, pelvic adhesions, absence of products of conception at microscopy and hemoperitoneum. CONCLUSIONS: Persistent ectopic pregnancy can neither be predicted from clinical variables nor from single measurements of hCG with an accuracy sufficient for clinical use....

  6. Abdominal ectopic pregnancy after in vitro fertilization and single embryo transfer: a case report and systematic review.

    Science.gov (United States)

    Yoder, Nicole; Tal, Reshef; Martin, J Ryan

    2016-10-19

    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. A total of 28 cases were identified. Patients' ages ranged from 23 to 38 (Mean 33.2, S.D. = 3.2). Infertility causes included tubal factor (46 %), endometriosis (14 %), male factor (14 %), pelvic adhesive disease (7 %), structural/DES exposure (7 %), and unexplained infertility (14 %). A history of ectopic pregnancy was identified in 39 % of cases. A history of tubal surgery was identified in 50 % of cases, 32 % cases having had bilateral salpingectomy. Transfer of two embryos or more (79 %) and fresh embryo transfer (71 %) were reported in the majority of cases. Heterotopic abdominal pregnancy occurred in 46 % of cases while 54 % were abdominal ectopic pregnancies. Our systematic review has revealed several trends in reported cases of abdominal ectopic pregnancy after IVF including tubal factor infertility, history of tubal ectopic and tubal surgery, higher number of embryos transferred, and fresh embryo transfers. These are consistent with known risk factors for ectopic pregnancy following IVF. Further research focusing on more homogenous population may help in better characterizing

  7. Ruptured Heterotopic Tubal Pregnancy for a Patient with a History of Segmental Salpingectomy from Ectopic Pregnancy: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Kyung Bum; Namkung, Sook; Hong, Myung Sun; Kim, Heung Cheol; Cho, Young; Choi, Young Hee [Chuncheon Sacred Heart Hospital, Chyncheon (Korea, Republic of)

    2012-06-15

    Heterotopic pregnancy refers to the simultaneous development of an intrauterine pregnancy and an extrauterine pregnancy. We experienced a case of a ruptured heterotopic pregnancy for a patient with a history of a right segmental salpingectomy from an ectopic pregnancy. The 30-year-old patient with amenorrhea for six weeks complained of lower abdominal pain with hypovolemic shock. Transabdominal ultrasonography showed diffuse hemoperitoneum with a structure similar to an ectatic tube or a deformed cyst with no echogenic double ring or peripheral hypervascularity in the right adnexa and an intrauterine gestational sac. We considered a ruptured corpus luteum cyst as an ultrasonographic finding and found a ruptured tubal mass in the right salpinx and hemoperitoneum through an emergency laparotomy. We performed a right salpingectomy, and the histopathologic report confirmed ectopic pregnancy.

  8. The Lin28/Let-7 system in early human embryonic tissue and ectopic pregnancy.

    Directory of Open Access Journals (Sweden)

    Teresa Lozoya

    Full Text Available Our objective was to determine the expression of the elements of the Lin28/Let-7 system, and related microRNAs (miRNAs, in early stages of human placentation and ectopic pregnancy, as a means to assess the potential role of this molecular hub in the pathogenesis of ectopic gestation. Seventeen patients suffering from tubal ectopic pregnancy (cases and forty-three women with normal on-going gestation that desired voluntary termination of pregnancy (VTOP; controls were recruited for the study. Embryonic tissues were subjected to RNA extraction and quantitative PCR analyses for LIN28B, Let-7a, miR-132, miR-145 and mir-323-3p were performed. Our results demonstrate that the expression of LIN28B mRNA was barely detectable in embryonic tissue from early stages of gestation and sharply increased thereafter to plateau between gestational weeks 7-9. In contrast, expression levels of Let-7, mir-132 and mir-145 were high in embryonic tissue from early gestations (≤ 6-weeks and abruptly declined thereafter, especially for Let-7. Opposite trends were detected for mir-323-3p. Embryonic expression of LIN28B mRNA was higher in early stages (≤ 6-weeks of ectopic pregnancy than in normal gestation. In contrast, Let-7a expression was significantly lower in early ectopic pregnancies, while miR-132 and miR-145 levels were not altered. Expression of mir-323-3p was also suppressed in ectopic embryonic tissue. We are the first to document reciprocal changes in the expression profiles of the gene encoding the RNA-binding protein, LIN28B, and the related miRNAs, Let-7a, mir-132 and mir-145, in early stages of human placentation. This finding suggests the potential involvement of LIN28B/Let-7 (deregulated pathways in the pathophysiology of ectopic pregnancy in humans.

  9. The Lin28/Let-7 system in early human embryonic tissue and ectopic pregnancy.

    Science.gov (United States)

    Lozoya, Teresa; Domínguez, Francisco; Romero-Ruiz, Antonio; Steffani, Liliana; Martínez, Sebastián; Monterde, Mercedes; Ferri, Blanca; Núñez, Maria Jose; AinhoaRomero-Espinós; Zamora, Omar; Gurrea, Marta; Sangiao-Alvarellos, Susana; Vega, Olivia; Simón, Carlos; Pellicer, Antonio; Tena-Sempere, Manuel

    2014-01-01

    Our objective was to determine the expression of the elements of the Lin28/Let-7 system, and related microRNAs (miRNAs), in early stages of human placentation and ectopic pregnancy, as a means to assess the potential role of this molecular hub in the pathogenesis of ectopic gestation. Seventeen patients suffering from tubal ectopic pregnancy (cases) and forty-three women with normal on-going gestation that desired voluntary termination of pregnancy (VTOP; controls) were recruited for the study. Embryonic tissues were subjected to RNA extraction and quantitative PCR analyses for LIN28B, Let-7a, miR-132, miR-145 and mir-323-3p were performed. Our results demonstrate that the expression of LIN28B mRNA was barely detectable in embryonic tissue from early stages of gestation and sharply increased thereafter to plateau between gestational weeks 7-9. In contrast, expression levels of Let-7, mir-132 and mir-145 were high in embryonic tissue from early gestations (≤ 6-weeks) and abruptly declined thereafter, especially for Let-7. Opposite trends were detected for mir-323-3p. Embryonic expression of LIN28B mRNA was higher in early stages (≤ 6-weeks) of ectopic pregnancy than in normal gestation. In contrast, Let-7a expression was significantly lower in early ectopic pregnancies, while miR-132 and miR-145 levels were not altered. Expression of mir-323-3p was also suppressed in ectopic embryonic tissue. We are the first to document reciprocal changes in the expression profiles of the gene encoding the RNA-binding protein, LIN28B, and the related miRNAs, Let-7a, mir-132 and mir-145, in early stages of human placentation. This finding suggests the potential involvement of LIN28B/Let-7 (de)regulated pathways in the pathophysiology of ectopic pregnancy in humans.

  10. Chlamydia public health programs and the epidemiology of pelvic inflammatory disease and ectopic pregnancy.

    Science.gov (United States)

    Rekart, Michael L; Gilbert, Mark; Meza, Rafael; Kim, Paul H; Chang, Michael; Money, Deborah M; Brunham, Robert C

    2013-01-01

    Many countries have witnessed a disturbing increase in cases of Chlamydia trachomatis infection despite enhanced control programs. Since the goal of Chlamydia control is to prevent reproductive complications such as pelvic inflammatory disease and ectopic pregnancy, an understanding of recent trends in these conditions is needed to fully evaluate the effect of control efforts. We analyzed 2 provincial, comprehensive health services administrative databases (encompassing hospitalizations and all physician-delivered services) for pelvic inflammatory disease and ectopic pregnancy trends from 1992 through 2009 in women of reproductive age in British Columbia, Canada. Trends were compared to provincial Chlamydia surveillance data by time-series analysis, using the cross-correlation function method and Granger causality testing. Chlamydia cases substantially increased from 1992 through 2009. Inpatient, outpatient, and total diagnoses of pelvic inflammatory disease and ectopic pregnancy declined from 1992 through 2003. After 2003, pelvic inflammatory disease rates continued to fall, while ectopic pregnancy rates significantly increased. The male Chlamydia urethritis rate increased from 39.4 to 173.6 cases/100,000 from 1996 to 2009. In the context of increasing Chlamydia infection rates, the reproductive complications of Chlamydia infection in women are declining overall. A recent increase in rates of ectopic pregnancies is cause for concern.

  11. Predictive factors for the methotrexate treatment outcome in ectopic pregnancy: A comparative study of 400 cases.

    Science.gov (United States)

    Bonin, Lucie; Pedreiro, Cécile; Moret, Stéphanie; Chene, Gautier; Gaucherand, Pascal; Lamblin, Géry

    2017-01-01

    We sought to evaluate the global success rate of intramuscular methotrexate for the treatment of ectopic pregnancy, identify factors predictive of treatment success or failure, and study methotrexate tolerability in a large patient cohort. For this single-center retrospective observational study, we retrieved the records of all women who had a clinically or echographically confirmed ectopic pregnancy with a Fernandez score ectopic pregnancy. The medical treatment protocol was effective for 314 patients, i.e., an overall success rate of 78.5%. A single methotrexate dose was sufficient for 63.5% of the women and a second dose was successful for 73.2% of the remaining women. The medical treatment success rate fell as initial hCG levels climbed. The main factors associated with methotrexate failure included day (D) 0, D4 and D7 hCG levels, pretherapeutic blood progesterone, hematosalpinx at D0 and pain at D7. Early favorable kinetics of hCG levels was predictive of success. Methotrexate treatment was successful in 90% of women who had D0 hCG ectopic pregnancy was 80.7%. In this study, we showed that an initial hCG value ectopic pregnancy by methotrexate, and hematosalpinx and pretherapeutic blood progesterone >5ng/ml at diagnosis were predictive of its failure. We also confirmed good tolerability for single-dose methotrexate protocols. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. Disparities in receipt of a laparoscopic operation for ectopic pregnancy among TRICARE beneficiaries.

    Science.gov (United States)

    Ranjit, Anju; Chaudhary, Muhammad Ali; Jiang, Wei; Zhan, Tiannan; Schneider, Eric B; Cohen, Sarah L; Little, Sarah E; Haider, Adil H; Robinson, Julian N; Witkop, Catherine T

    2017-05-01

    Racial disparities in receipt of a laparoscopic operation for ectopic pregnancy are attributed to inequalities in access to care. This study sought to determine if racial disparities in laparoscopic operation for ectopic pregnancy exist among a universally insured population. Using 2006-2010 TRICARE (insurance for members of the United States Armed Services and their dependents) data, patients who received a laparoscopic operation or laparotomy for ectopic pregnancy were stratified into direct/military or purchased/civilian system of care. Odds of receipt of a laparoscopic operation in each racial group were compared adjusting for patient demographics, system of care, and severity of ectopic pregnancy. Among 3,041 patients in the study sample, 1,878 (61.7%) received laparotomy and 1,163 (38.2%) received a laparoscopic operation within 30 days of diagnosis. Overall, 42.4% of white women received a laparoscopic operation compared with 33.1% of Asian women and 34.9% of black women (P ectopic pregnancy despite universal insurance coverage within civilian/purchased care. Further work is warranted to better understand the factors other than insurance access that may contribute to racial disparities in selection of operative approach. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Negative histology with surgically treated tubal ectopic pregnancies - A retrospective cohort study.

    Science.gov (United States)

    Farahani, Linda; Sinha, Anjita; Lloyd, Jilly; Islam, Melissa; Ross, Jackie A

    2017-06-01

    To determine the outcome of histological examinations of surgical specimens obtained from treatment of tubal ectopic pregnancy and to correlate with clinical findings, pre-operative ultrasound scans and the type of surgery. A retrospective cohort study of 941 women diagnosed with a tubal ectopic pregnancy in the Early Pregnancy Unit and having surgical treatment at King's College Hospital, London. Clinical and ultrasound data had been entered contemporaneously on our electronic early pregnancy database and hospital clinical records over an 11year period from 2004 to 2014. Demographic data, clinical history, ultrasound scan parameters, type of surgical management and histological diagnosis were recorded. The primary outcome measure was the presence or absence of chorionic villi in the surgical specimen. Data were analysed using Mann Whitney U test for non-parametric data, relative risk for categorical data and binomial logistic regression. A surgical specimen was obtained in 925 cases. Of these, 881/925 (95.2%) were positive for the presence of chorionic villi on histological examination. Patients with negative histology had a lower median gestational age, smaller ectopic pregnancies and lower serum human chorionic gonadotrophin levels. The relative risk of negative histology was significantly higher with a solid ectopic pregnancy on ultrasound (RR1.91, 95% CI 1.07-3.4) and with conservative surgery (RR 3.68, 95% CI 1.25-10.77). The relative risk was significantly lower with the presence of embryonic cardiac activity (RR 0.12, 95% CI 0.02-0.85). Only the serum hCG level was a significant predictor of negative histology on logistic regression analysis (p=0.048). In 39/44 women with negative histology, the human chorionic gonadotrophin level declined after surgery with no further intervention. Five of the 44 required a second surgical procedure as the ectopic pregnancy had been missed at the initial surgery and did not resolve. There is lack of histological

  14. Can we widen the scope of medical management in ectopic pregnancy?

    Directory of Open Access Journals (Sweden)

    Usha Kiran TS

    2016-04-01

    Full Text Available The objective of the study was to Safe Medical management of ectopic pregnancy in those where surgical management was indicated. Patients with one or more criteria not suitable for medical treatment but refusing surgical management were included. Exclusion criteria were those who were not haemodynamically stable. They were managed with close monitoring as inpatient to assess resolution of ectopic with Methotrexate. All five cases have been managed successfully by medical method. There is a possible role for medical management in patients who might not satisfy the criteria fully, however further research is needed. Ectopic pregnancy is life threatening disorder. With advances in diagnostic approaches such as ultrasound coupled with hormone markers diagnosis of ectopic has become easier in cases having first trimester bleeding per vaginum. Ectopic can be managed expectantly, medically and surgically. Medical management includes Inj. Methotrexate (MTX. In this case series we have studied five cases which are managed successfully with hundred percent successful results by medical management despite not satisfying criteria. It is a retrospective study. So from this study we can conclude that we can manage ectopic pregnancies medically based upon clinical judgment. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 1257-1259

  15. Frequency and related factors of tubal patency after methotrexate treatment in women with ectopic pregnancy.

    Science.gov (United States)

    Seyedoshohadaei, Fariba; Mohammadbeigi, Robabeh; Tahmuri, Atefe; Ghaderi, Ebrahim

    2016-03-01

    Ectopic pregnancy is a medical emergency. The classic treatment for this condition is surgery but early diagnosis allows for non-surgical treatment. In recent years, intramuscular methotrexate has been considered, due to easy administration, its less invasive nature and low complications, but there are arguments about its effects. The aim of this study was to evaluate tubal patency after treatment of ectopic pregnancy with methotrexate and related factors. This cross-sectional study was conducted on 80 women with ectopic pregnancy who were admitted to Sanandaj Be'sat Hospital in 2014. Patients who had successful treatment for ectopic pregnancy with single or multiple doses of methotrexate 50 mL/m(2) were enrolled. Three to 6 months after treatment, the patients were evaluated for tubal patency by hysterosalpingography. Data were analyzed using spss, t-tests, χ(2) -test and logistic regression. The tubal patency rate after treatment of ectopic pregnancy with methotrexate was 75% in hysterosalpingography. The average size of the ectopic pregnancy mass of women with open fallopian tubes was 22.5 ± 7.0 mm and for women with closed fallopian tubes it was 34.7 ± 10.0 mm (P = 0.0001). β-human chorionic gonadotropin levels were 642.1 ± 850.5 in women with open fallopian tubes and 3816.3 ± 4487.3 for women with closed fallopian tubes (P = 0.0001). There was no significant correlation statistically between tubal patency with a history of stillbirth and number of pregnancies (P > 0.5). There was a statistically significant relation between tubal patency and the number of births and also methotrexate dose (P ectopic pregnancy with methotrexate is effective for saving tubal patency. Levels of human chorionic gonadotrophin-β ectopic pregnancy mass size smaller than 33.5 mm are significant predictors of tubal patency. © 2015 Japan Society of Obstetrics and Gynecology.

  16. Ectopic pregnancy: pictorial essay focusing on computed tomography and magnetic resonance imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Febronio, Eduardo Miguel; Rosas, George de Queiroz; D' Ippolito, Giuseppe [Escola Paulista de Medicina - Universidade Federal de Sao Paulo (EPM-Unifesp), Sao Paulo, SP (Brazil). Dept. of Imaging Diagnosis; Cardia, Patricia Prando, E-mail: giuseppe_dr@uol.com.br [Centro Radiologico Campinas, Campinas, SP (Brazil)

    2012-09-15

    The objective of the present study is to describe key computed tomography and magnetic resonance imaging findings in patients with acute abdominal pain caused by ectopic pregnancy. For this purpose, two radiologists consensually selected and analyzed computed tomography and magnetic resonance imaging studies performed in female patients with acute abdominal pain caused by proven ectopic pregnancy in the period between January 2010 and December 2011. The imaging diagnosis of ectopic pregnancy is usually obtained by ultrasonography, however, with the increasing use of computed tomography and magnetic resonance imaging in the assessment of patients with acute abdomen of gynecological origin it is necessary that the radiologist becomes familiar with the main findings observed at these diagnostic methods. (author)

  17. High Titers of Chlamydia trachomatis Antibodies in Brazilian Women with Tubal Occlusion or Previous Ectopic Pregnancy

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    A. C. S. Machado

    2007-01-01

    Full Text Available Objective. To evaluate serum chlamydia antibody titers (CATs in tubal occlusion or previous ectopic pregnancy and the associated risk factors. Methods. The study population consisted of 55 women wih tubal damage and 55 parous women. CAT was measured using the whole-cell inclusion immunofluorescence test and cervical chlamydial DNA detected by PCR. Odds ratios were calculated to assess variables associated with C. trachomatis infection. Results. The prevalence of chlamydial antibodies and antibody titers in women with tubal occlusion or previous ectopic pregnancy was significantly higher (P<.01 than in parous women. Stepwise logistic regression analysis showed that chlamydia IgG antibodies were associated with tubal damage and with a larger number of lifetime sexual partners. Conclusions. Chlamydia antibody titers were associated with tubal occlusion, prior ectopic pregnancy, and with sexual behavior, suggesting that a chlamydia infection was the major contributor to the tubal damage in these women.

  18. Determination of Human Chorionic Gonadotropin in Postmortem Samples in Ectopic Pregnancies.

    Science.gov (United States)

    Palmiere, Cristian; Lesta, Maria del Mar; Fanton, Laurent; Ventura, Francesco; Bonsignore, Alessandro; Reggiani Bonetti, Luca

    2016-01-01

    Increased human chorionic gonadotropin levels (HCG) can be detected in femoral blood, bile, and vitreous humor collected during autopsy of pregnant women using a standard kit designed for living patients. In the study herein, the concentrations of HCG were measured in postmortem serum, vitreous, bile, cerebrospinal, and pericardial fluids in 4 cases of fatal ectopic pregnancy and 40 controls using a quantitative electrochemiluminescence immunoassay designed for living patients. No false-negative cases were identified in any of the analyzed samples in any of the ectopic pregnancy cases. No correlations were found between total HCG levels in postmortem serum and the other tested specimens. The results of this study would suggest that higher HCG in bile, vitreous, pericardial, and cerebrospinal fluids may confirm the existence of ectopic pregnancy and therefore identify other situations in which this hormone is increased, although gestational age cannot be reliably estimated using these values. © 2015 American Academy of Forensic Sciences.

  19. Interventional radiology and endovascular surgery in the treatment of ectopic pregnancies

    Energy Technology Data Exchange (ETDEWEB)

    Fornazari, Vinicius Adami Vayego; Szejnfeld, Denis; Elito, Julio Júnior; Goldman, Suzan Menasce [Universidade Federal de São Paulo, São Paulo, SP (Brazil)

    2015-07-01

    The advent of interventional radiology enabled remarkable advances in diagnosis and treatment of several situations in obstetrics and gynecology. In the field of obstetrics, these advances include temporary occlusion of the iliac arteries to the management of placenta accreta and/or prior, arteriovenous fistulas after embolization of uterine curettage and management of ectopic uterine and extra-uterine pregnancies. The non-tubal ectopic pregnancy, either cervical, abdominal, ovarian or in a cesarean scar, often represents major therapeutic challenge, especially when exists a desire to maintain fertility. Despite the systemic methotrexate therapy and surgical resection of the ectopic gestational sac be the most used therapeutic options, the interventionist approach of non-tubal ectopic pregnancies, direct injection of methotrexate in the gestational sac and intra-arterial chemoembolization of uterine arteries constitute in the currently literature viable, safe, effective modalities with low morbidity, shorter hospital stay, and rapid clinical recovery. Because of little variety of materials used, and the increase in training of specialists in the area, the radiological intervention as a treatment option in ectopic pregnancies is financially viable and present considerable accessibility in the world and at most of Brazilian medical centers.

  20. Failure Rate of Single Dose Methotrexate in Managment of Ectopic Pregnancy

    Directory of Open Access Journals (Sweden)

    Feras Sendy

    2015-01-01

    Full Text Available Background. One of the treatment modalities for ectopic pregnancy is methotrexate. The purpose of this study is to identify the failure rate of methotrexate in treating patients with ectopic pregnancy as well as the risk factors leading to treatment failure. Methods. A retrospective chart review of 225 patients who received methotrexate as a primary management option for ectopic pregnancy. Failure of single dose of methotrexate was defined as drop of BHCG level less than or equal to 14% in the seventh day after administration of methotrexate. Results. 225 patients had methotrexate. Most of the patients (151 (67% received methotrexate based on the following formula: f 50 mg X body surface area. Single dose of methotrexate was successful in 72% (162/225 of the patients. 28% (63/225 were labeled as failure of single dose of methotrexate because of suboptimal drop in BhCG. 63% (40/63 of failure received a second dose of methotrexate, and 37% (23/63 underwent surgical treatment. Among patient who received initial dose of methotrexate, 71% had moderate or severe pain, and 58% had ectopic mass size of more than 4 cm on ultrasound. Conclusion. Liberal use of medical treatment of ectopic pregnancy results in 71% success rate.

  1. Failure rate of single dose methotrexate in managment of ectopic pregnancy.

    Science.gov (United States)

    Sendy, Feras; AlShehri, Eman; AlAjmi, Amani; Bamanie, Elham; Appani, Surekha; Shams, Taghreed

    2015-01-01

    Background. One of the treatment modalities for ectopic pregnancy is methotrexate. The purpose of this study is to identify the failure rate of methotrexate in treating patients with ectopic pregnancy as well as the risk factors leading to treatment failure. Methods. A retrospective chart review of 225 patients who received methotrexate as a primary management option for ectopic pregnancy. Failure of single dose of methotrexate was defined as drop of BHCG level less than or equal to 14% in the seventh day after administration of methotrexate. Results. 225 patients had methotrexate. Most of the patients (151 (67%)) received methotrexate based on the following formula: f 50 mg X body surface area. Single dose of methotrexate was successful in 72% (162/225) of the patients. 28% (63/225) were labeled as failure of single dose of methotrexate because of suboptimal drop in BhCG. 63% (40/63) of failure received a second dose of methotrexate, and 37% (23/63) underwent surgical treatment. Among patient who received initial dose of methotrexate, 71% had moderate or severe pain, and 58% had ectopic mass size of more than 4 cm on ultrasound. Conclusion. Liberal use of medical treatment of ectopic pregnancy results in 71% success rate.

  2. Cesarean scar ectopic pregnancy. Laparoscopic resection and total scar dehiscence repair. A case report.

    Science.gov (United States)

    Mahgoub, Sara; Gabriele, Victor; Faller, Emilie; Langer, Bruno; Wattiez, Arnaud; Lecointre, Lise; Akladios, Cherif

    2017-02-04

    Illustrate laparoscopic technique for resection of cesarean scar ectopic pregnancy, associated with isthmocele repair. Case report SETTING: Tertiary referral centre in Strasbourg, France. The study was approved by the local IRB. Cesarean scar pregnancy is a rare form of ectopic pregnancy. The major risk of this type of pregnancy is the early uterine rupture with massive bleeding and maternal life-threatening. It is therefore crucial to manage actively these pregnancies as soon as they are diagnosed. Therapeutic options can be medical, surgical, or a combination of both. Many case reports or case series are found in the literature, but only few clinical studies, too difficult to carry out because of cases rarity and inconclusiveness. "Systematic review: What is the best first-line approach for cesarean section ectopic pregnancy?" is a meta-analysis that was published in 2016, and includes 194 studies between 1978 and 2014 (126 case reports, 45 cases series and 23 clinical studies). According to this systematic review, hysteroscopy or laparoscopic hysterotomy seems to be the best first-line approach to treat cesarean scar ectopic pregnancy. Uterine artery embolization seems to be reserved for significant bleeding and/or a high suspicion index for arteriovenous malformation. There is however no consensus on treatment of reference. The case concerns a 38-year-old primiparous women with cesarean section in 2010, who was diagnosed by US scan at 7 WG as cesarean scar ectopic pregnancy, confirmed by pelvic MRI. The patient has initially received medical treatment with two intramuscular injections of Methotrexate and one local intra-gestational injection of KCl. Initial rate of HCG was 82000 IU/L. Through a rigorous weekly biological and US scan monitoring, it has been observed an involution of the ectopic pregnancy at ultrasonography associated to HCG decreasing. No bleeding or infectious complications occurred during this period. After 10 weeks of monitoring, because of a

  3. EVALUATION OF THE IMPORTANCE OF BIOCHEMICAL PARAMETERS IN RELATION TO ULTRASONOGRAPHIC FINDING IN ECTOPIC PREGNANCY DIAGNOSIS

    Directory of Open Access Journals (Sweden)

    Dragan Lončar

    2011-09-01

    Full Text Available The implantation of the fertilized egg outside the uterine cavity leads to the development of ectopic pregnancy. The incidence of ectopic pregnancy is 1/100 births. The most common place of ectopic implantation of the fertilized ovum is the oviduct (98% with predilection for the ampullar part of the Fallopian tube. The aim of this study was to determine the predictive importance of beta-hCG and progesterone concentration compared to ultrasonographic finding in the ectopic pregnancy diagnosis.We examined 24 patients with ectopic pregnancies which we divided according to the days of amenorrhea into two groups: the first group with the total of 28 patients from 16–42 days and another group of 8 patients with amenorrhea longer than 42 days. The control group was comprised of 20 patients with vital intrauterine pregnancy, gestational age of 42-52 days. Blood samples for quantitative determination of hormones were collected on three occasions after 48 hours in the forenoon time in the examined and control group of pregnant women. Ultrasonographic examinations of all pregnant women were carried out immediately after blood sampling, with the trans-vaginal approach using "make loop" option, and measurements with an accuracy of 0.1 mm.Mean values for beta-hCG range from 698-1774 mlU/ml in the first group of pregnant women, and in the second group of 1896 mlU/ml to 4410 mlU/ml with a statistically significant difference compared to the values in the control group (p <0.001. The concentration of progesterone in the first group of women ranging from 41-70 nmol/l, and in the second group of 76-94 nmol/l which is also the statistically significant difference compared to the control group (p<0.002. We have shown that ultrasonographic finding with its parameters reliably predicts the values of biochemical parameters both in normal intrauterine pregnancy and in the case of ectopic pregnancy.Embryo viability and implantation place condition the values of

  4. Somatic Dysfunction in the Diagnosis of Uncommon Ectopic Pregnancies: Surgical Correlation and Comparison With Related Pathologic Findings.

    Science.gov (United States)

    Martingano, Daniel; Canepa, Hannah; Fararooy, Setareh; Rybitskiy, Dmitriy; Shahem, Sam; Martingano, Francis X; Aglialoro, George

    2017-02-01

    Ectopic pregnancies occur when the implantation of a fertilized ovum occurs outside the endometrial cavity. Such pregnancies occur in approximately 1.5% to 2.0% of all pregnancies and cause 6% of maternal deaths. To evaluate osteopathic structural examination (OSE) findings in patients with ectopic pregnancies of uncommon locations and to establish the utility of these findings in the diagnosis of these ectopic pregnancies. In this prospective case series, a focused OSE was performed on each patient with an ectopic pregnancy at her initial presentation after the patient history but before other diagnostic or laboratory tests were performed and surgical treatment was initiated. Chapman reflex points (CRPs) were evaluated pre- and postoperatively. For comparison, patients who had otherwise normal first pregnancies, underwent elective postpartum bilateral tubal ligation, or had simple ovarian cysts were also included and received OSEs. Seven cases with ectopic pregnancies outside the fallopian tube were included. Two primary ovarian pregnancies and 1 heterotopic pregnancy (uterine and ovarian) had somatic dysfunction at the T10-T11 spinal levels and CRPs posterior for the ovary, 1 primary omental pregnancy with somatic dysfunction at the T9-T12 spinal levels and CRPs anterior and posterior for the ileum and jejunum, and 1 tubal pregnancy with somatic dysfunction at the T10-L1 spinal levels and CRPs anterior and posterior for the fallopian tube. Two cornual ectopic pregnancies were not associated with unique findings. These somatic dysfunctions and CRP findings appear to be distinct from those of comparison cases, including first pregnancies at any trimester, simple ovarian cysts, and elective bilateral tubal ligation. The OSE findings demonstrated in these cases aided in the final diagnosis and thus can potentially prove helpful in cases of ovarian, tubal, and omental pregnancies to provide clues to abnormal ectopic pregnancy locations where diagnostic imaging results

  5. Hemoperitoneum: a diagnostic dilemma. A solid ovarian tumour mimicking ruptured ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Wills G. Sheelaa

    2013-04-01

    Full Text Available 39 year old sterilized women presented like ruptured ectopic pregnancy with 40 days amenorrhea, pain, and shock Urine Pregnancy Test negative. Culdocentesis was positive. Ultra sonogram confirmed hemoperitoneum and TO mass. Laparotomy revealed left solid ovarian tumour with tumour mass protruding from perforated site and hemoperitoneum. Histological diagnosis was granulosa cell (GC tumour Stage 1c. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 254-256

  6. Caesarean section and subsequent ectopic pregnancy: a systematic review and meta-analysis

    NARCIS (Netherlands)

    O'Neill, S.M.; Khashan, A.S.; Kenny, L.C.; Greene, R.A.; Henriksen, T.B.; Lutomski, J.E.; Kearney, P.M.

    2013-01-01

    BACKGROUND: Caesarean section rates are increasing worldwide, and the long-term effects are unknown. OBJECTIVE: To evaluate the risk of subsequent ectopic pregnancy in women with a previous caesarean section, compared with vaginal delivery. SEARCH STRATEGY: Systematic review of the literature using

  7. 异位妊娠的超声诊断%Ultrasonic Diagnosis of Ectopic Pregnancy

    Institute of Scientific and Technical Information of China (English)

    董铄

    2001-01-01

    目的为评价二维超声诊断异位妊娠中的应用价值。方法 514例进行二维超声检查,均经手术、病理等 证实。结果声像图表现未破型15例,流产型51例,破裂型448例,超声诊断符合率95%。结论二维超声可帮助 诊断及鉴别诊断异位妊娠,而且对临床确定治疗方案有实用价值。%Purpose To evaluate the value of two dimensional ultrasound in diagnosis of ectopic pregnancy. Methods 514 cases with ectopic pregnancy were examined by two dimensional ultrasound and confirmed by operation and pa thology. Results Three types of sonographic findings in ectopic pregnancy, Abortion type 51 cases, rupture type 448 cases, and unrepture type 15 cases. The rate of correct diagnosis is 95%. Conclusion Two dimensional ultrasound should be useful for diagnosis and differential diagnosis ectopic pregnancy and valuable to decide the treating program.

  8. Methotrexate treatment in progressive tubal ectopic pregnancies and hCG-related clinicosurgical implications

    Directory of Open Access Journals (Sweden)

    Askin Dogan

    2016-06-01

    Full Text Available Our aim was to evaluate the relationship between the success of methotrexate treatment and β-hCG levels in progressive tubal ectopic pregnancies. We defined a retrospective cohort of 394 progressive tubal ectopic pregnancy patients treated with methotrexate. A single-dose methotrexate protocol using 50 mg/m2 was administered to patients with progressive tubal ectopic pregnancy. Surgery was performed in patients who exhibited signs of acute abdomen due to tubal rupture. Of 394 patients that received methotrexate treatment, 335 (84.6% responded to medical treatment, while the remaining 59 (15.36% underwent surgery due to treatment failure. β-hCG levels in the failure group were significantly higher as compared with the success group at Day 1, Day 4, and Day 7 (2116±3157 vs. 4178±3422, 2062±3551 vs. 4935±4103, and 1532±3007 vs. 3900±4783, respectively. The receiver operating characteristics curve for β-hCG levels at Day 1 was 0.738, with a cutoff value of 1418 mIU/mL, while sensitivity and specificity values reached the optimum for treatment success (83.1% and 59.4%, respectively. Medical treatment with methotrexate achieved an 85.02% success rate for the treatment of progressive tubal ectopic pregnancy, while success rates for medical treatment decreased significantly when initial β-hCG levels were >1418 mIU/mL.

  9. Ectopic pregnancy an obstetric emergency: retrospective study from medical college Ambala, Haryana, India

    Directory of Open Access Journals (Sweden)

    Shweta Tomar Yadav

    2016-07-01

    Conclusions: The ectopic pregnancy remains a public health issue. Timely diagnosis and transfer to higher center in hemodynamically stable state along with the use of conservative surgery or medical management can reduce morbidity and mortality. [Int J Reprod Contracept Obstet Gynecol 2016; 5(7.000: 2210-2214

  10. Ectopic pregnancy risk factors for ART patients undergoing the GnRH antagonist protocol: a retrospective study.

    Science.gov (United States)

    Weiss, A; Beck-Fruchter, R; Golan, J; Lavee, M; Geslevich, Y; Shalev, E

    2016-03-23

    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 number of oocytes aspirated, insemination technique, and prior Cesarean section. Excessive ovarian response, IVF (as opposed to ICSI), prior Cesarean section and GnRH agonist trigger were found to be independent risk factors for ectopic pregnancy. Caution should be exercised before incorporating the GnRH agonist trigger for indications other than preventing OHSS. When excessive ovarian response leads to utilization of GnRH agonist trigger, strategies for preventing ectopic pregnancy, such as a freeze all policy or blastocyst transfer, should be considered. Further studies should elucidate whether adjusting the luteal support can reduce the ectopic pregnancy risk.

  11. Case-control study of ectopic pregnancies in Myanmar: infectious etiological factors.

    Science.gov (United States)

    Khin-Nwe-Oo; Wah-Wah-Aung; Moe-Thida; Khin-Thet-Wai; Hta-Hta-Yi; Win-Win-Mya

    2011-03-01

    We studied the role of infections in ectopic pregnancy and the different methods of detecting Chlamydia trachomatis infection using serology, cervical and tubal PCR assays, by using a hospital-based, case-control study conducted between November 2007 and September 2009. The sample size was 339 with 113 cases and 226 controls. The cases were women admitted for the management of ectopic pregnancy while the controls were women admitted for spontaneous miscarriage. Both cases and controls were tested for syphilis and chlamydial infection by serology. In addition, cervical samples from controls and both cervical and tubal samples from cases were examined for the presence of chlamydia and gonococcal DNA. Sociodemographic data and past histories were collected using set Proforma. Independent variables for multivariate analysis included previous history of spontaneous abortion, ectopic pregnancy, symptoms of sexully transmitted infections (STI), and use of contraception. Women with a previous history of ectopic pregnancy (adjusted OR 28.3; 95% CI 5.8-138.8; p = 0.01) and a past history of having had symptoms of STI (adjusted OR 11.06; 95% CI 5.45-22.44; p = 0.0005) were significantly more likely to have an ectopic pregnancy than those without such a history. Syphilis serology was positive in 13.3% of ectopic pregnancy cases compared to only 3.5% of controls (crude OR 0.24; 95% CI -0.10-0.58; p = 0.001). From cervical swabs, chlamydia DNA was detected significantly more frequently in cases than controls (8.0% vs 2.2%; crude OR 0.261; 95% CI -0.09-0.80, p = 0.012) but gonorrhea DNA detection rates were not significantly different (3.5% vs 0.9%, crude OR 0.24; 95% CI -0.04-1.35; p = 0.1). Chlamydia was positive in cases only as diagnosed tubal samples for PCR in 17 (15.0%), cervical samples for PCR in 9 (8.0%) and IgM ELISA in 6 (5.3%). Among the three STI tested for in this study, C. trachomatis was the most frequently associated with ectopic pregnancy and was more

  12. Risk of Ectopic Pregnancy in Women With Inflammatory Bowel Disease: A 22-Year Nationwide Cohort Study.

    Science.gov (United States)

    de Silva, Punyanganie S; Hansen, Helene H; Wehberg, Sonja; Friedman, Sonia; Nørgård, Bente M

    2017-07-08

    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 abortions, and births in women with and without IBD. Our study population included 7548 pregnancies in women with UC, 6731 pregnancies in women with CD, and 1,832,732 pregnancies in women without IBD. We controlled for multiple covariates, including pelvic and abdominal surgery. Women with CD had a greater risk of ectopic pregnancy, per pregnancy, than women without IBD (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.01-1.49), whereas women with UC did not (OR, 0.98; 95% CI, 0.80-1.20). In pregnancies of women with CD and UC who underwent IBD-related surgery before pregnancy, there was a nonsignificant increase in risk of ectopic pregnancy compared with pregnancies in women with IBD who did not have surgery (OR, 1.49; 95% CI, 0.91-2.44 for CD, and OR, 1.17; 95% CI, 0.54-2.52 for UC). We found a statistically significant increased risk of ectopic pregnancy in pregnancies of women with CD compared with pregnancies of women without IBD. Surgery for IBD before pregnancy increased the risk of ectopic pregnancy, although this increase was not statistically significant

  13. Insertion sequence inversions mediated by ectopic recombination between terminal inverted repeats.

    Science.gov (United States)

    Ling, Alison; Cordaux, Richard

    2010-12-20

    Transposable elements are widely distributed and diverse in both eukaryotes and prokaryotes, as exemplified by DNA transposons. As a result, they represent a considerable source of genomic variation, for example through ectopic (i.e. non-allelic homologous) recombination events between transposable element copies, resulting in genomic rearrangements. Ectopic recombination may also take place between homologous sequences located within transposable element sequences. DNA transposons are typically bounded by terminal inverted repeats (TIRs). Ectopic recombination between TIRs is expected to result in DNA transposon inversions. However, such inversions have barely been documented. In this study, we report natural inversions of the most common prokaryotic DNA transposons: insertion sequences (IS). We identified natural TIR-TIR recombination-mediated inversions in 9% of IS insertion loci investigated in Wolbachia bacteria, which suggests that recombination between IS TIRs may be a quite common, albeit largely overlooked, source of genomic diversity in bacteria. We suggest that inversions may impede IS survival and proliferation in the host genome by altering transpositional activity. They may also alter genomic instability by modulating the outcome of ectopic recombination events between IS copies in various orientations. This study represents the first report of TIR-TIR recombination within bacterial IS elements and it thereby uncovers a novel mechanism of structural variation for this class of prokaryotic transposable elements.

  14. Analysis of ultrasound images for 32 cases with ectopic pregnancy%异位妊娠32例超声影像分析

    Institute of Scientific and Technical Information of China (English)

    康秀梅

    2014-01-01

    Objective:To analyze the imaging characteristics of ectopic pregnancy. Methods:The related data of 32 cases of ectopic pregnancy from 2010 January to 2013 January in our hospital were retrospectively analyzed. Results:In the ultrasound images of the 32 cases of ectopic pregnancy, there were 2 cases with broad ligament pregnancy, 8 cases with interstitial tubal pregnancy, 7 cases with tubal isthmus pregnancy, 8 cases with tubal ampullary pregnancy, and 7 cases with tubal umbrella ministry pregnancy. Conclu-sions:Ultrasonography can be repeated and is painless in the clinic, and it is of great significance for the diagnosis of ectopic pregnan-cy.%目的:对各类异位妊娠的影像特征开展分析。方法:对32例异位妊娠的患者的相关资料进行回顾性分析。结果:本组32例异位妊娠经过超声影像的分析,其中阔韧带妊娠2例,输卵管间质部妊娠8例,输卵管峡部妊娠7例,输卵管壶腹部妊娠8例,输卵管伞部妊娠7例。结论:超声影像在临床上的应用具有可重复、无痛苦等一些比较明显的优势,对于异位妊娠的诊断有着十分积极的意义。

  15. RISK FACTOR EPIDEMIOLOGY OF ECTOPIC PREGNANCY AND SUCCESS OF NONSURGICAL MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Vijayan C.P

    2016-10-01

    Full Text Available BACKGROUND Ectopic pregnancies are increasing in number and proportions. Real increase and better detection methods are contributing for this rise. All the cases diagnosed now are not surgical emergencies. Medical management and expectant line of management are possible. Revised clinical guidelines are there for the selection of cases for nonsurgical management. Knowledge about the risk factors is good for prophylaxis and to have a high suspicion about ectopic pregnancy in high-risk individuals. Knowing the success rate is absolutely essential for counselling before starting the therapy. Aim of the study- 1. To study the risk factor profile of ectopic pregnancies and to compare them with the old data of the study setting. 2. To follow up the cases receiving nonsurgical treatment and to assess the success rate. MATERIALS AND METHODS Study Setting- Department of Obstetrics and Gynaecology, Government Medical College, Kottayam. It is a tertiary care centre with 1500 beds and catering for the population of five districts of Kerala. Study Design- Observational Study Study Period- This study was completed by eighteen months from April 2014 to September 2015. RESULTS 219 cases of ectopic pregnancies were diagnosed during the study period. The ratio of this number with the total number of deliveries during that period is 3.48% and this is three times higher than that of the ratio twenty years ago (1.23%. Risk factor profile is also showing changes over this period. 15.1% had medical treatment and 11% had expectant line of therapy. Success rates are 87.87% and 95.65%, respectively. CONCLUSIONS Incidence and detection of ectopic pregnancies are increasing and the risk factor profile is changing. In properly selected cases, the success of nonsurgical management is excellent.

  16. Laparoscopic treatment of ectopic pregnancy%宫外孕的腹腔镜治疗

    Institute of Scientific and Technical Information of China (English)

    陈玉

    2016-01-01

    ectopic pregnancy, also known as ectopic pregnancy. Is refers to the pregnant egg is not in the womb and in other places the abnormal condition of plant development. The site of pregnancy can be planted in the fallopian tube, ovary or abdominal cavity, so, some people in different parts of pregnancy, called tubal pregnancy, ovarian pregnancy or abdominal pregnancy. However, the general ectopic pregnancy, occurred in the fallopian tube for the most common, accounting for about 98% of patients with ectopic pregnancy. Ectopic pregnancy, more than the young women of childbearing age. This disease is ferocious, because a large number of acute hemorrhagic shock caused by abdominal cavity. If not handled in a timely manner, there may be a risk of life. Laparoscopic diagnosis and treatment can reduce the risk of early diagnosis and treatment.%宫外孕又称异位妊娠。就是指孕卵不在子宫内而在其他地方种植发育的异常情况。孕卵种植的部位可以在输卵管、卵巢或腹腔等处,所以,有的人按照妊娠的不同部位,称之输卵管妊娠、卵巢妊娠或腹腔妊娠。然而;一般异位妊娠,发生在输卵管内为最常见,约占宫外孕患者98%左右。宫外孕,多发生于生育年龄的青壮年妇女。本病来势凶猛,因腹腔内大量急性出血而致休克。若不及时处理,有可能发生生命危险。利用腹腔镜及早的诊断及治疗,方可减少风险的发生。

  17. Cervical ectopic pregnancy: Mersilene tape in surgical management

    African Journals Online (AJOL)

    pregnancy made in the consulting room with a transvaginal ultrasound examination. Evacuation with ... showed decreasing levels until <5 mIU/ml 3 weeks after procedure. The patient ... abortion, a history of smoking, a history of dilatation and.

  18. A case of splenic torsion and rupture presenting as ruptured ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Somdatta Lahiri

    2010-12-01

    Full Text Available Splenic torsion with rupture of spleen is an extremely rare phenomenon. The clinical picture mimics several common conditions which are causes of acute abdomen and so it is seldom detected pre-operatively. An 18 year old female patient was admitted with an acute abdomen and shock. The provisional diagnosis was of a ruptured ectopic pregnancy. Peri-operatively we found a spontaneous rupture of the spleen following torsion along with early intrauterine pregnancy. Splenectomy was carried out and patient recovered well. Our report confirms that this rare entity can present as an acute abdomen which is very difficult to diagnose preoperatively and can masquerade as ruptured ectopic pregnancy in women of childbearing age group.

  19. Does adenosine deaminase activity play a role in the early diagnosis of ectopic pregnancy?

    Science.gov (United States)

    Turkmen, G G; Karçaaltıncaba, D; Isık, H; Fidancı, V; Kaayalp, D; Tımur, H; Batıoglu, S

    2016-01-01

    Early diagnosis of ectopic pregnancy (EP) is important due to life-threatening consequences in the first trimester of pregnancy. In this study we aimed to investigate the role of adenosine deaminase (ADA) activity in the prediction of EP. Forty-one patients with unruptured ectopic pregnancy comprised the case group and forty-two first trimester pregnant women with shown foetal heart beating in ultrasound comprised the control group. The mean ADA level in EP (10.9 ± 3.0 IU/L) was higher than that in control group (9.2 ± 3.6 IU/L) (p = 0.018). Receiver operating characteristics or ROC curve identified ADA value of 10.95 IU/L as optimal threshold for the prediction of EP with 56% sensitivity and 67% specificity. High ADA levels are valuable in the early diagnosis of EP. However more comprehensive studies are required.

  20. Bilateral septic knee arthritis after treatment of an ectopic pregnancy with methotrexate

    Directory of Open Access Journals (Sweden)

    Karaaslan F

    2015-01-01

    Full Text Available Fatih Karaaslan,1 Musa Uğur Mermerkaya,1 Emre Yurdakul,2 Özlem Tanin3 1Department of Orthopaedics and Traumatology, Faculty of Medicine, Bozok University, Yozgat, Turkey; 2Department of Orthopaedics and Traumatology, Osmaniye State Hospital, Osmaniye, Turkey; 3Department of Gynecology and Obstetrics, Faculty of Medicine, Bozok University, Yozgat, Turkey Abstract: We describe a case of bilateral septic knee arthritis that followed the administration of methotrexate for nonsurgical termination of an ectopic pregnancy. We believe that methotrexate is a relatively effective alternative to surgery in patients with early unruptured tubal pregnancies, but suggest that it be used with caution in view of possible septic events. Keywords: bilateral septic arthritis, methotrexate, ectopic pregnancy, immunsupression

  1. Unilateral twin tubal ectopic pregnancy in a patient following tubal surgery

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    Nahid Ghanbarzadeh

    2015-01-01

    Full Text Available We report a spontaneous unilateral live tubal twin pregnancy in a patient with a history of previous ectopic pregnancy (EP and tubal surgery. Transvaginal ultrasound showed one pregnancy sac containing two fetal poles with cardiac activity, which appeared to be sited within the right adnexum. The right tubal EP was removed by salpingectomy. Ultrasound findings of suspected adnexal mass and free liquid in the Douglas pouch along with an increased a beta-human chorionic gonadotrophin levels, especially in association of risk factors, can help the early diagnosis of EP and reduce the related mortality and morbidity.

  2. Comparison of ectopic pregnancy risk among transfers of embryos vitrified on day 3, day 5, and day 6.

    Science.gov (United States)

    Du, Tong; Chen, Hong; Fu, Rong; Chen, Qiuju; Wang, Yun; Mol, Ben W; Kuang, Yanping; Lyu, Qifeng

    2017-07-01

    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). Ectopic pregnancy rates after day-3, day-5, and day-6 vitrified embryo transfers were 3.1% (287/9,224), 2.0% (11/562), and 0.6% (6/950), respectively. After adjusting for confounders, the risks of ectopic pregnancy in day-3 and day-5 vitrified embryo transfers were both significantly higher than in day-6 vitrified embryo transfers. The associations were similar when we did calculations per cycle. In women undergoing FET, day-6 vitrified embryo transfer is associated with a significantly lower risk of ectopic pregnancy than both day-3 and day-5 vitrified embryo transfers. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  3. A Case of Live Birth after Uterine Reconstruction for Recurrent Cornual Ectopic Pregnancy following IVF Treatment

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    Deivanayagam Maruthini

    2013-01-01

    Full Text Available We present a case of recurrent ruptured right cornual ectopic pregnancies conceived after IVF. Following the second episode, a sonohysterography was undertaken to identify possible areas of scar weakness that may rupture with uterine distension in a future pregnancy. The scan revealed asymmetrical muscle thickness in the cornual regions, the right (6 mm being thinner than the left (1.6 cm. Subsequently, an elective laparotomy was undertaken, and the cornua were reconstructed and thickened in several layers by bringing the laterally retracted myometrial fibres onto the reconstruction site. A sono-hysterography after surgery showed satisfactory (3-4 cm myometrial thickness all around. A further cycle of IVF resulted in a singleton pregnancy. Pelvic scans confirmed normal intrauterine pregnancy without any myometrial thinning. She was delivered by an uneventful elective caesarean section at term. We propose that, in those who intend to have further pregnancies after a cornual ectopic pregnancy, a sono-hysterography is possibly the best investigative tool to assess myometrial integrity. This case demonstrates that in women with areas of muscle weakness it is possible to successfully perform an interval elective reconstructive surgery on the uterus that can result in an uneventful pregnancy and birth.

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

    Science.gov (United States)

    Stulberg, Debra B; Cain, Loretta; Hasham Dahlquist, Irma; Lauderdale, Diane S

    2017-01-01

    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 documentation of preventive care within 1 year prior to the ectopic pregnancy and prenatal care within 4 months prior. Controlling for race, age, and state of residence, women's risks of any ectopic pregnancy complication were independently higher among those who did not receive any Medicaid-covered preventive care within 1 year before the ectopic pregnancy compared to those who did (RR 1.12, 95% confidence interval (CI) 1.09, 1.16), and among those who did not receive any Medicaid-covered prenatal care within 4 months prior, compared to those who did (RR 1.89, 95% CI 1.83, 1.96). Pre-pregnancy and prenatal care are independently associated with decreased risk of ectopic pregnancy complications among Medicaid beneficiaries. © 2016 John Wiley & Sons Ltd.

  5. Observation and nursing of ectopic pregnancy%异位妊娠的观察及护理

    Institute of Scientific and Technical Information of China (English)

    冉如冰; 罗付英

    2015-01-01

    目的 研究异位妊娠的护理方法 .方法 对异位妊娠患者的临床观察及护理方法 进行总结.结果 经过精心的护理,发生异位妊娠的患者均康复出院.结论 对于异位妊娠,只要护理人员仔细观察,及时做好抢救和术前准备,完全可以使病人转危为安.%Objective: To study the nursing method of ectopic pregnancy.Methods Clinical observation and nursing of patients with ectopic pregnancy method is summarized.Results The occurrence of ectopic pregnancy patients were recovered from.Conclusion For ectopic pregnancy, as long as the careful nursing observation, timely rescue and preoperative preparation, can make the patient turned the corner.

  6. IMELDA transvaginal approach to ectopic pregnancy: diagnosis by transvaginal hydrolaparoscopy and treatment by transvaginal natural orifice transluminal endoscopic surgery.

    Science.gov (United States)

    Baekelandt, Jan; Vercammen, Jona

    2017-01-01

    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 pregnancy is treated transvaginally by vNOTES. If the TVHL investigation of the pelvis is negative (fallopian tubes and ovaries are normal), the procedure is stopped and the patient is followed up further. If the TVHL is inconclusive, the NaCl is drained and CO2 is insufflated (requiring general anesthesia) through the 4-mm TVHL port to improve visualization. Again, an ectopic pregnancy is then treated by vNOTES, and in case of a negative investigation the procedure is stopped and the patient is followed up further. Successful diagnosis and treatment of ectopic pregnancies. All patients were successfully operated without complications or conversions to standard laparoscopy. Twelve patients were treated by vNOTES for ectopic pregnancy. Three TVHL explorations for PUL were negative, and these patients were followed up; two patients developed a normal intrauterine pregnancy, and the third patient was treated with methotrexate for persistent asymptomatic raised hCG levels. Transvaginal hydrolaparoscopy and vNOTES are complementary techniques enabling gynecologic surgeons to explore PUL and treat ectopic pregnancies via minimally invasive

  7. Predictive value of maternal serum β-hCG concentration in the ruptured tubal ectopic pregnancy.

    Science.gov (United States)

    Faraji Darkhaneh, Roya; Asgharnia, Maryam; Farahmand Porkar, Nastaran; Alipoor, Ali Akbar

    2015-02-01

    Measurement of serum β-hCG concentration commonly used to diagnose tubal ectopic pregnancy (EP) and follow up patients treated conservatively. The aim of this study was to determine the predictive value of maternal serum β-hCG concentration in ruptured tubal ectopic pregnancy to help physicians identify those women who are at greatest risk. This is a cross-sectional study conducted on all women with a diagnosis of tubal ectopic pregnancy who were treated in Alzahra Hospital, in Rasht, from March 2002 to February 2011. The data was collected for each woman from medical records and included age, parity, gravidia, gestational age, primary level of serum β-hCG, rupture status, past history of pelvic inflammation disease, EP, abortion, and intrauterine contraceptive device use. Women with tubal rupture were compared to those without rupture. Statistical analysis was conducted by SPSS 19 for Windows. A total of 247 cases of tubal ectopic pregnancy were recorded during the study period. One hundred and ninety seven (79.8%) were cases with unruptured EP and 50 patients (20.2 %) were cases with ruptured EP. The mean level of β-hCG was significantly higher in patients with ruptured EP compared to patients with unruptured EP (p=0.03). Logistic regression analysis revealed that >1750 IU/ml of β-hCG levels (OR: 1.41; 95% CI: 1.18-1.68) was the significant risk factors for tubal rupture. Higher β-hCG levels seem to be significant risk factors for rupture of a tubal EP.

  8. A randomized controlled comparison of minialpartomy and lapartomy in ectopic pregnancy cases.

    Directory of Open Access Journals (Sweden)

    Sharma J

    2003-11-01

    Full Text Available BACKGROUND: As ectopic pregnancy is associated with significant maternal mortality and morbidity it may be worthwhile to find alternative surgical method to traditional laparotomy. AIMS: To compare the efficacy, safety and cost effectiveness of minilaparotomy surgery for ectopic pregnancy cases with standard laparotomy method. SETTING AND DESIGN: A total of 60 patients of ectopic pregnancy were randomized for minilaparotomy and laparotomy (30 cases each for three years from January. 1998 to March 2001 in a medical college hospital. MATERIAL AND METHODS: Patients history, clinical examination, intraoperative, preoperative and postoperative data were recorded and compared in minilaparotomy and laparotomy groups. STATISTICAL ANALYSIS USED: Chi-square and Fischer chi-square test is used using P value of less than 0.05 as level of significance. RESULTS: Mean operative time was significantly less in minilaparotomy (38 minutes than in laparotomy group (54 minutes. Postoperative complications were fever in 4(13.33% and 6(20% cases, paralytic ileus in 3(10% and 8(26.66% cases, urinary tract infection in 2(6.66% and 3(10% cases and wound infection in 1(3.33% and 5(16.66% cases respectively in the two groups and were significantly less in the minilaparotomy cases. Mean day of mobility, starting normal diet and discharge from the hospital were 10 hours and 24 hours, 1.5 days and 3.1 days and 3.4 days and 6.9 days respectively in the two groups and were significantly less in the minilaparotomy group than the laparotomy group. CONCLUSIONS: Surgery by minilaparotomy technique in ectopic pregnancy cases appears to be a safe and feasible method and is superior to conventional laparotomy as there are minimum perioperative and postoperative complications and patients can be discharged early from the hospital without the need of expensive equipment.

  9. Clinical predictors of failing one dose of methotrexate for ectopic pregnancy after in vitro fertilization.

    Science.gov (United States)

    Brady, Paula C; Missmer, Stacey A; Farland, Leslie V; Ginsburg, Elizabeth S

    2017-03-01

    The aim of this study is to investigate the clinical predictors of failure of a single dose of methotrexate (MTX) for management of ectopic pregnancy after in vitro fertilization (IVF). A retrospective cohort study was performed of women who conceived ectopic pregnancies following fresh or frozen IVF cycles at an academic infertility clinic between 2007 and 2014, and received intramuscular MTX (50 mg/m(2)). Successful single-dose MTX treatment was defined as a serum beta-human chorionic gonadotropin (hCG) decline ≥15% between days 4 and 7 post-treatment. Logistic regression models adjusted for oocyte age, number of embryos transferred, and prior ectopic pregnancy were used to estimate the adjusted odds ratio (OR) (95% confidence interval [CI]) of failing one dose of MTX. Sixty-four patients with ectopic pregnancies after IVF were included. Forty required only one dose of MTX (62.5%), while 15 required additional MTX alone (up to four total doses, 23.4%), and 9 required surgery (14.1%). By multivariable logistic regression, the highest tertiles of serum hCG at peak (≥499 IU/L, OR = 9.73, CI 1.88-50.25) and at first MTX administration (≥342 IU/L, OR = 4.74, CI 1.11-20.26), fewer embryos transferred (OR = 0.37 per each additional embryo transferred, CI 0.19-0.74), and adnexal mass by ultrasound (OR = 3.65, CI 1.10-12.11) were each correlated with greater odds of requiring additional MTX and/or surgery. This is the first study to report that in women with ectopic pregnancies after IVF, higher hCG-though well below treatment failure thresholds previously described in spontaneous pregnancies-fewer embryos transferred, and adnexal masses are associated with greater odds of failing one dose of MTX. These findings can be used to counsel IVF patients regarding the likelihood of success with single-dose MTX.

  10. Rupture of ectopic pregnancy in rudimentary horn of uterus at 20 weeks of gestation

    Directory of Open Access Journals (Sweden)

    Yasmeen Akhtar Haseeb

    2015-08-01

    Full Text Available Ectopic pregnancy is a well-known complication in early pregnancy .the commonest site is ampullary region of fallopian tube but sometime presentations at rare sites like rudimentary uterine horn can also happen. These rare presentations are difficult to diagnose and needs high index of suspicion on behalf of obstetrician. A 28 years old Saudi female patient with previous cesarean delivery in her second pregnancy at 20 weeks presented to the emergency department of medicine with severe abdominal pain, nausea, vomiting, dizziness and breathlessness. She was investigated on lines of pulmonary embolism but it was all inconclusive. Obstetrics and gynaecology department was consulted regarding the status of her pregnancy. On examination she was hypotensive and distended abdomen. Clinical and sonographic examination was going with internal bleeding in pelvis. Uterus was seen as separated from the fetus which was floating in free fluid in pouch of Douglas and measurements were going with 20 weeks of gestation. Initial suspicion was scarred ruptured ectopic pregnancy. The patient was immediately shifted to theatre and laparotomy performed with removal of blood and blood clots in abdomen and pelvis, an accessory horn on right side of uterus with a rent on posterior aspect noted and horn was excised. Patient recovered well and received 8 units of packed RBCs, FFP. [Int J Reprod Contracept Obstet Gynecol 2015; 4(4.000: 1209-1210

  11. Use of FloSeal Sealant in the Surgical Management of Tubal Ectopic Pregnancy

    Directory of Open Access Journals (Sweden)

    Mara Clapp

    2013-01-01

    Full Text Available Background. Surgery is sometimes required for the management of tubal ectopic pregnancies. Historically, surgeons used electrosurgery to obtain hemostasis. Topical hemostatic sealants, such as FloSeal, may decrease the reliance on electrosurgery and reduce thermal injury to the tissue. Case. A 33-year-old G1 P0 received methotrexate for a right tubal pregnancy. The patient became symptomatic six days later and underwent a laparoscopic right salpingotomy. After multiple unsuccessful attempts to obtain hemostasis with electrocoagulation, FloSeal was used and hemostasis was obtained. Six weeks later, a hysterosalpingogram (HSG confirmed tubal patency. The patient subsequently had an intrauterine pregnancy. Conclusion. FloSeal helped to achieve hemostasis during a laparoscopic salpingotomy and preserve tubal patency. FloSeal is an effective alternative and adjunct to electrosurgery in the surgical management of tubal pregnancy.

  12. Predictors of single-dose methotrexate treatment failure in ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Azam Azargoon

    2014-07-01

    Methods: In this quasi-experimental research, we studied 70 women with ectopic preg-nancies who were treated with MTX, according to a single dose protocol from 2010 to 2013. EP was diagnosed whenever an intrauterine gestational sac was not identified by transvaginal ultrasonography (TVUS, accompanied by an abnormal rise or plateau in human chorionic gonadotropin (beta-hCG concentration. Briefly, women with ectopic pregnancies were considered candidates for MTX treatment if they were hemodynami-cally stable; did not desire surgical therapy, agreed to weekly follow-up; and did not have hepatic, hematologic, or renal disease. A Patient was considered a treatment suc-cess (group 1 if her beta-hCG levels decreased ≤10 m IU/ml after the first dose of MTX. Treatment failure (group 2 was defined as the need for a second or a third dose of MTX or surgery. The following risk factors were compared between the two groups: serum beta-hCG on the days 1 and 4, a ≥ 15% decrease in serum beta-hCG between the days 1-4 of the treatment, age, parity, gravidity, the size of the ectopic mass and the endometrial thickness. Results: The success rate of MTX treatment was 77.1%. There were no significant dif-ferences between the two groups in regard to the age, parity, gravidity, the size of ec-topic mass and the endometrial thickness in vaginal sonography, but the mean serum beta-hCG concentration on days 1 and 4 was lower in the success group than the failure group. We also observed a ≥ 15% decrease in serum beta-hCG in 80.9% of the women from the success group and in 38.5% of the cases whose treatment had failed. The presence of fetal heart activity was seen in only one patient and this patient’s treatment failed. Two patients had previous history of ectopic pregnancy and the treatment of both ended in failure. Conclusion: Among women with ectopic pregnancies who were candidates for MTX treatment, a high serum beta-hCG concentration on the days 1-4 and also a ≤ 15% fall in

  13. Laparoscopic Excision of Coexisting Left Tubal and Right Pseudotubal Pregnancy after Conservative Management of Previous Ectopic Pregnancy with Methotrexate: An Unusual Clinical Entity

    Directory of Open Access Journals (Sweden)

    Panayotis Xiromeritis

    2015-01-01

    Full Text Available Tubal pregnancy concerns 97% of all ectopic pregnancies. Treatment can be either surgical (salpingostomy or salpingectomy or medical (methotrexate administration. We present a case of a pseudotubal pregnancy after methotrexate treatment of a previous ectopic pregnancy. A37-year-old woman was diagnosed with ectopic pregnancy in the left Fallopian tube. A year ago, she had an ectopic pregnancy in the right tube, which was successfully treated with intramuscular methotrexate. During laparoscopy, two tubal masses were revealed, one in each Fallopian tube, and bilateral salpingectomy was performed. Histological analysis confirmed tubal pregnancy in the left Fallopian tube and presence of endosalpingitis in the right tube with no signs of chorionic villi. The optimal management of such cases has not yet been clarified. However, evaluation of tubal patency after a medically treated ectopic pregnancy would permit proper counsel of the patient on her fertility options, in order to choose the appropriate method of conception to achieve and accomplish a future pregnancy.

  14. Ectopic pregnancy: A 5 year review of cases at Nnamdi Azikiwe University Teaching Hospital (NAUTH Nnewi

    Directory of Open Access Journals (Sweden)

    G O Udigwe

    2010-01-01

    Full Text Available Background: Ruptured ectopic pregnancy continues to be a common life threatening emergency in our environment as well as a public health problem. Objective:This is to study the incidence, clinical presentation, risk factors and the management of cases that presented in our centre over a five year period. Methods:This is a retrospective study of cases of ectopic gestations managed in the gynaecological unit of NAUTH Nnewi from January 1 st , 2002 to December 31 st , 2006. Information was obtained from the case notes, theatre and labour ward registers. Results: During the period, a total of 2,746 deliveries were recorded while 556 gynaecological patients were admitted. Thirty six patients had ectopic gestations accounting for 1.3% of all deliveries and 6.5% of all gynaecological admissions. The peak age group was 26-30 years (44.4%; 28(77.7% were married and 20 (55.6% attained secondary school as their highest level of education. All 36(100% of the patients were symptomatic at presentation. Abdominal pain, amenorrhoea and syncopal attack were the most common symptoms at presentation. Also, multiple sexual partners 27(75%, previous abortions 25(69.4% and previous sexually transmitted infections 10(27.8% were the most common risk factors present in the patients. Abdominal paracentesis 32(88.9%, ultrasound 8(22.2% and urine pregnancy tests 7(19.4% were most commonly utilized for diagnosis. None of the cases was diagnosed before rupture. Open abdominal surgery was the treatment employed in all the patients. Conclusion:Ectopic pregnancy is still a major challenge in gynaecological practice in our centre. Most cases present late making tubal conservation treatment inapplicable. This has far reaching implications in a society where there is high premium on child bearing.

  15. Role of Chlamydia trachomatis and emerging Chlamydia-related bacteria in ectopic pregnancy in Vietnam.

    Science.gov (United States)

    Hornung, S; Thuong, B C; Gyger, J; Kebbi-Beghdadi, C; Vasilevsky, S; Greub, G; Baud, D

    2015-09-01

    In this case-control study, we investigated the seroprevalence and molecular evidence of Chlamydia trachomatis and Waddlia chondrophila in ectopic pregnancies (EP) and uneventful control pregnancies in 343 women from Vietnam. Whereas presence of C. trachomatis IgG was strongly associated with EP [adjusted odds ratio (aOR) 5·41, 95% confidence interval (CI) 2·58-11·32], its DNA remained undetected in all tubal lesions. We confirmed an independent association between antibodies against Waddlia and previous miscarriage (aOR 1·87, 95% CI 1·02-3·42). Further investigations are needed to understand the clinical significance of Waddlia's high seroprevalence (25·9% in control pregnancies) in this urban population.

  16. Persistent Human Chorionic Gonadotropin After Methotrexate Treatment and an Emergency Surgical Procedure for Ectopic Pregnancy.

    Science.gov (United States)

    Kurt-Mangold, Michelle; Van Voorhis, Bradley J; Krasowski, Matthew D

    2015-01-01

    The case study is a 33-year-old white female with persistently elevated serum human chorionic gonadotropin (hCG) levels following methotrexate treatment and emergency surgery for ectopic pregnancy. At the time of the first methotrexate dose, the serum hCG concentration was 27,995 IU/L. The laboratory was consulted 3.5 months after the surgery, because serum hCG levels had stopped declining and had leveled off to around 80 to 90 IU/L but with negative urine pregnancy tests. Laboratory studies ruled out heterophile antibody interference and hook effect by multiple methods including analysis by different serum hCG assays, treatment with heterophile antibody blocking agents, and dilution studies. Three additional doses of methotrexate over six months were required for serum hCG concentrations to decline to undetectable levels. This case illustrates challenges that may arise with serum hCG measurements in management of ectopic pregnancies. Close collaboration between the laboratory and clinical service is key for optimal patient care.

  17. LAPAROSCOPIC SURGERY IN PATIENTS WITH HYPOVOLEMIC SHOCK DUE TO ECTOPIC PREGNANCY

    Institute of Scientific and Technical Information of China (English)

    Zhi-gang Li; Jin-hua Leng; Jing-he Lang; Zhu-feng Liu; Da-wei Sun; Zhu Lan

    2005-01-01

    Objective To evaluate the feasibility and safety of operative laparoscopy for ectopic pregnancy with hypovolemic shock.Methods Two hundred and fifteen women with ectopic pregnancy underwent operative laparoscopy. These patients were divided into two groups. The study group included 21 patients with shock and intraperitoneal hemorrhage more than 1000 mL,and control group included 194 patients, hemodyramically stable, with blood loss less than 1000 mL. Clinical data of perioperative periods in two groups were retrospectively analyzed.Results All patients were tubal pregnancies. The occurrence rate of tubal rupture was higher in study group than in control group (80.95% vs. 15.98%, P < 0.001). Intraabdominal blood loss was significantly higher in study group than in control group (1900 mL vs. 300 mL, P < 0.001), and autologous blood transfusions were given to 95.24% and 9.3% of patients in study and control group, respectively (P < 0.001). Laparoscopic salpingectomy was performed on 85.7 % and 50.5%of patients in study and control group (P < 0.001). The operative time was somewhat longer in study group than that in control group (60 minutes vs. 45 minutes), but with no significant difference. All patients had no perioperative complications.Conclusion Operative laparoscopy in patients with hopovolemic shock can be safely and effectively performed by experienced laparoscopists with the aid of optimal anesthesia, advanced cardiovascular monitoring, and autologous blood transfusion.

  18. Serum β-hCG levels post-treatment of ectopic pregnancy with a single dose of intramuscular methotrexate.

    Science.gov (United States)

    Hadinata, Ignatius E; Doyle, Lex W; Thompson, Derrick; Reti, Leslie

    2015-04-01

    The cytotoxic management of ectopic pregnancy using a single dose of intramuscular methotrexate injection has been well established as effective for a select number of women with unruptured tubal ectopic pregnancy where there are minimal symptoms. The purpose of this study was to create centile curves of serum β-hCG levels following successful treatment with a single dose of 50 mg/m(2) of intramuscular methotrexate to treat ectopic pregnancy. Data were retrieved from women treated at the Royal Women's Hospital for ectopic pregnancy between 2006 and 2012. Only women with minimal symptoms, initial serum β-hCG ≤5000 IU/L and ectopic mass size of ≤35 mm on ultrasound were included. Two hundred and fifty-three cases of ectopic pregnancy were analysed. Initial β-hCG of women in the study ranged from 18 to 3995 IU/L with a median of 497 (25th to 75th centiles; 222-1160) IU/L. The median levels of β-hCG levels at day 4, 7 and 14 postmethotrexate injection were 73.8, 47.2 and 10.4% of the initial β-hCG level, respectively. The 90th centiles of β-hCG levels at day 4, 7 and 14 were 124.7, 93.8 and 40.0% of initial β-hCG level, respectively. Whilst no comparison with those unsuccessfully treated was made, pending further validation studies, the use of these curves may reduce the reliance on specialist units and streamline care for many women with ectopic pregnancy, such as those whose β-hCG regress in line with centile values without crossing a certain threshold. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  19. Clinical analysis of 184 cases of ectopic pregnancy%184例异位妊娠临床分析

    Institute of Scientific and Technical Information of China (English)

    王新霞

    2015-01-01

    Objective To explore the diagnosis and treatment of 184 cases of ectopic pregnancy.Methods Retrospective analysis of 2011 January-2014 year in June in our hospital 184 cases of ectopic pregnancy clinical data.Results 184 cases of ectopic pregnancy,9 cases were misdiagnosed,the misdiagnosis rate of 4.9%.All patients underwent abdominal operation and laparotomy were diagnosed by pathology. Conclusion The clinical features of ectopic pregnancy,reduce misdiagnosis,early diagnosis,timely treatment is the key to the diagnosis and treatment of ectopic pregnancy.%目的:探讨184例异位妊娠诊断与治疗方法。方法回顾分析2011年1月—2014年6月我科收治的184例异位妊娠的临床资料。结果184例异位妊娠,误诊9例,误诊率4.9%。所有患者均行腹腔手术或开腹手术经病理确诊。结论掌握异位妊娠的临床特点,减少误诊,早期诊断,及时处理是诊治异位妊娠的关键。

  20. Conventional laparotomy for management of caesarean scar ectopic pregnancy: a case report

    Directory of Open Access Journals (Sweden)

    Nilesh C. Mhaske

    2015-10-01

    Full Text Available Increase in the rates of caesarean deliveries has led to a concurrent rise in the number of caesarean scar ectopic pregnancies (CSEP. With recent advances, diagnosis can be made at an early gestational age, hence facilitating a prompt intervention. With the varied treatment options available, choosing the right one may possess a clinical dilemma. However, in a low resource setting, conventional laparotomy may be the only option feasible. A case of CSEP managed with laparotomy is presented. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1581-1584

  1. Ectopic Pregnancy

    Science.gov (United States)

    ... in women who have had the following conditions: Pelvic inflammatory disease (an infection of the uterus, fallopian tubes, and ... prior written permission from the publisher. Related FAQs Pelvic Inflammatory Disease (PID) (FAQ077) Sterilization for Women and Men (FAQ011) ...

  2. Ectopic Pregnancy

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    ... stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any ... Council on Patient Safety For Patients Patient FAQs Spanish Pamphlets Teen Health About ACOG About Us Leadership & ...

  3. Ectopic pregnancy

    Science.gov (United States)

    ... JC, Hobel CJ, eds. Hacker & Moore's Essentials of Obstetrics and Gynecology . 6th ed. Philadelphia, PA: Elsevier; 2016:chap 24. Read More Cervix Endometriosis Infertility Pelvic inflammatory disease (PID) Tubal ligation Review Date ...

  4. The Value of Hysterosalpingography following Medical Treatment with Methotrexate for Ectopic Pregnancy

    Directory of Open Access Journals (Sweden)

    Emma Garcia Grau

    2011-01-01

    Full Text Available After an ectopic pregnancy (EP fertility decreases, mostly due to tubal factor. Hysterosalpingography (HSG is the most cost-effective tool for tubal patency assessment. Objective. To evaluate the usefulness of a HSG after a medical treatment for an EP, in order to counsel women on the most appropriate way to conceive future pregnancies. Methods. Between 1998 and 2008, 144 patients were submitted to medical treatment for an EP and performed HSG 3 months after the event. Results. 72.2% of normal HSG, 18.8% with unilateral obstruction, 6.3% tubal patency with defect, and 2.8% bilateral obstruction. Conclusion. Routine HSG following medical treatment for an EP does not seem necessary, as it does not change the initial management in 97.2% of the cases, but might be considered in selected risk cases, permitting timely referral of patients to in vitro fertilization.

  5. 异位妊娠药物治疗研究进展%Progress on Pharmacotherapy of Ectopic Pregnancy

    Institute of Scientific and Technical Information of China (English)

    张佳丽

    2011-01-01

    近年异位妊娠(ectopic pregnancy,EP)的发病日趋年轻化,剖宫产率增加致剖宫产切口疤痕妊娠(cesarean scar pregnancy,CSP)显著增加,使异位妊娠的药物治疗,成为目前研究的热点.本文聚焦异位妊娠的药物治疗研究进展,旨在探索更为安全、简便、有效、低毒且能保留生育功能的异位妊娠治疗方法.%Currently, the patients suffered from ectopic pregnancy (EP) become younger day by day,the incidence of cesarean scar pregnancy (CSP) increased obviously as a result of the increase of cesarean section rate. Pharmacotherapy of ectopic pregnancy became a hot research. This article aims to make a summarize for the progress on pharmacotherapy of ectopic pregnancy and to search which method is more safety, convenient, effective, harmless and can keep future fertility.

  6. Diagnostic accuracy of serum activin A in detection of ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Roghaei

    2012-01-01

    Full Text Available Background: Ectopic pregnancy (EP still remains a main cause of maternal mortalities. This study is designed to evaluate the accuracy of serum Activin A in detection of ectopic pregnancy. Methods : This prospective observational study was conducted from 2009 to 2010 at two main referral university hospitals, Isfahan University of Medical Sciences, Isfahan, Iran. Two hundred subjects who were under 10 week′s pregnancy with clinical presentations of abdominal pain and vaginal bleeding were enrolled. After sampling serum Activin A, patients underwent ultrasonography, titer of B-HCG and surgery (if indicated and were divided into two groups: EP (n = 100 and intrauterine pregnancy (IUP (n = 100. The mean of Activin A was compared between groups and by ROC curve, the optimal cut off with sensitivity, specificity, positive predictive value (PPV and negative predictive value (NPV were determined. Results : The mean age of women with IUP was 25.4 ± 4.3 years (15-40 years compared with 25.9 ± 4.1 years in women in EP group (P = 0.448. Statistical difference was not found between EP versus IUP groups in gestational age (6.32 ± 1.03 vs. 6.85 ± 1.82 weeks, P = 0.124. The mean of serum Activin A in EP group was 0.264 ± 0.0703 ng/ml versus 0.949 ± 0.5283 ng/ml in IUP group (P < 0.05. According to ROC curve (area under the curve = 0.981, P < 0.05, confidence interval: 0.961-1.000, the optimal cut off was estimated as 0.504 ng/ml with sensitivity of 97% and specificity of 93.5%. Conclusion : This study indicated that the mean of serum Activin A is lower in EP compared with IUP. The serum Activin A has a fair accuracy in detecting EP.

  7. 联合用药保守治疗异位妊娠72例临床观察%Clinical observation of drug combination expectant treatment in 72 cases of ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    赵慧敏; 司红敏

    2016-01-01

    Objective:To explore the curative effect of methotrexate(MTX) combined with mifepristone and ectopic pregnancy decoction No.2 in the treatment of ectopic pregnancy.Methods:72 patients with ectopic pregnancy were selected.They were divided into the control group and the experimental group.The control group was given methotrexate treatment.The experimental group was given methotrexate combined with mifepristone and ectopic pregnancy decoction No.2 treatment.The curative effects of two groups were compared.Results:The treatment success rate of the control group was 73%,and the experimental group was 94%. The treatment failure patients were given 1 time of repeated conservative treatment or surgical treatment.Conclusion:Methotrexate combined with mifepristone and ectopic pregnancy decoction No.2 in the treatment of ectopic pregnancy have a good curative effect.%目的:探讨甲氨蝶呤(MTX)联合米非司酮和宫外孕汤2号方治疗异位妊娠的疗效。方法:收治异位妊娠患者72例,分为对照组和试验组。对照组给予甲氨蝶呤治疗,试验组给予甲氨蝶呤联合米非司酮和宫外孕2号方治疗。对比两组患者的疗效。结果:对照组治疗成功率73%,试验组94%。治疗失败者给予重复保守治疗1次或手术治疗。结论:甲氨蝶呤联合米非司酮和宫外孕汤2号方治疗异位妊娠具有较好的疗效。

  8. The ESEP study: Salpingostomy versus salpingectomy for tubal ectopic pregnancy; The impact on future fertility: A randomised controlled trial

    Directory of Open Access Journals (Sweden)

    van Mello Norah M

    2008-06-01

    Full Text Available Abstract Background For most tubal ectopic pregnancies (EP surgery is the treatment of first choice. Whether surgical treatment should be performed conservatively (salpingostomy or radically (salpingectomy in women wishing to preserve their reproductive capacity, is subject to debate. Salpingostomy preserves the tube, but bears the risks of both persistent trophoblast and repeat ipsilateral tubal EP. Salpingectomy, avoids these risks, but leaves only one tube for reproductive capacity. This study aims to reveal the trade-off between both surgical options: whether the potential advantage of salpingostomy, i.e. a better fertility prognosis as compared to salpingectomy, outweighs the potential disadvantages, i.e. persistent trophoblast and an increased risk for a repeat EP. Methods/Design International multi centre randomised controlled trial comparing salpingostomy versus salpingectomy in women with a tubal EP without contra lateral tubal pathology. Hemodynamically stable women with a presumptive diagnosis of tubal EP, scheduled for surgery, are eligible for inclusion. Patients pregnant after in vitro fertilisation (IVF and/or known documented tubal pathology are excluded. At surgery, a tubal EP must be confirmed. Only women with a tubal EP amenable to both interventions and a healthy contra lateral tube are included. Salpingostomy and salpingectomy are performed according to standard procedures of participating hospitals. Up to 36 months after surgery, women will be contacted to assess their fertility status at six months intervals starting form the day of the operation. The primary outcome measure is the occurrence of spontaneous viable intra uterine pregnancy. Secondary outcome measures are persistent trophoblast, repeat EP, all pregnancies including those resulting from IVF and financial costs. The analysis will be performed according to the intention to treat principle. A cost-effectiveness analysis will be performed within a decision

  9. A comparison of women with induced abortion, spontaneous abortion and ectopic pregnancy in Ghana.

    Science.gov (United States)

    Schwandt, Hilary M; Creanga, Andreea A; Danso, Kwabena A; Adanu, Richard M K; Agbenyega, Tsiri; Hindin, Michelle J

    2011-07-01

    Despite having one of the most liberal abortion laws in sub-Saharan Africa, complications from induced abortion are the second leading cause of maternal mortality in Ghana. The sample is composed of patients with pregnancy termination complications in Ghana between June and July 2008. The majority of patients report having had a spontaneous abortion (75%; n=439), while 17% (n=100) and 8% (n=46) report having had an induced abortion or an ectopic pregnancy, respectively. Factors associated with women in each of the three groups were explored using multinomial logistic regression. When compared to women with spontaneous abortions, women with induced abortions were younger, poorer, more likely to report no religious affiliation, less likely to be married, more likely to report making the household decisions and more likely to fail to disclose this pregnancy to their partners. Within the induced abortion subsample, failure to disclose the most recent pregnancy was associated with already having children and autonomous household decision making. Identifying the individual and relationship characteristics of induced abortion patients is the first step toward targeted policies and programs aimed at reducing unsafe abortion in Ghana. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. [Ectopic pregnancy at the Ignace Deen University Hospital in Conakry: epidemiologic, social, demographic, therapeutic, and prognostic aspects].

    Science.gov (United States)

    Baldé, I S; Diallo, F B; Conté, I; Diallo, M H; Sylla, I; Diallo, B S; Diallo, T S; Sy, T

    2014-01-01

    The objectives of this study were to calculate the frequency of ectopic pregnancy in the department, define its epidemiological, diagnostic, therapeutic, and prognostic aspects, and determine a clear therapeutic approach appropriate to our setting. In this prospective study, we compiled all cases of ectopic pregnancy seen in 2011 and 2012 in the obstetrics-gynecology department at Ignace Deen University Hospital in Conakry. Ectopic pregnancies represented 1.3% of all deliveries over this period. In the 111 cases in this population, women aged 30-34 years accounted for 31.5%, those pregnant for the first time 40.5%, nulliparous women 35.1%, married women 72.1%, those without schooling 43.2%), and those with a history of sexually transmitted infection 57.6% (these categories are not exclusive, and the same women may be included in several). Secondary amenorrhea with abdominopelvic pain and metrorrhagia was the reason for admission in 56.5% of cases. Ultrasound in early pregnancy is infrequent in Conakry. Almost all of our patients underwent emergency surgery (80.2%) More than half of the ectopic pregnancies were located in the ampulla of the uterine tubes (73.0%). There were three abdominal pregnancies and 2 ovarian. In all cases the treatment was surgical, most often salpingectomy. Postoperative complications occurred in 35.1% of cases, most often anemia (27.9% of all cases) requiring blood transfusion in 11.7% of all cases before, during, or after surgery. The maternal death rate was 1.8%. Ectopic pregnancy remains a major concern at Ignace Deen CHU. Reduction of its frequency requires increased population awareness of sexually transmitted infections and illegal abortions. Management should be prompt and appropriate.

  11. Evaluation of ADAM-12 as a diagnostic biomarker of ectopic pregnancy in women with a pregnancy of unknown location.

    Directory of Open Access Journals (Sweden)

    Andrew W Horne

    Full Text Available BACKGROUND: Ectopic pregnancy (EP remains the most life-threatening acute condition in modern gynaecology. It remains difficult to diagnose early and accurately. Women often present at emergency departments in early pregnancy with a 'pregnancy of unknown location' (PUL and diagnosis/exclusion of EP is challenging due to a lack of reliable biomarkers. Recent studies suggest that serum levels of a disintegrin and metalloprotease protein-12 (ADAM-12 can be used differentiate EP from viable intrauterine pregnancy (VIUP. Here we describe a prospective study evaluating the performance of ADAM-12 in differentiating EP from the full spectrum of alternative PUL outcomes in an independent patient cohort. METHODOLOGY/PRINCIPAL FINDINGS: Sera were collected from 120 patients at their first clinical presentation with a PUL and assayed for ADAM-12 by ELISA. Patients were categorized according to final pregnancy outcomes. Serum ADAM-12 concentrations were increased in women with histologically-confirmed EP (median 442 pg/mL; 25%-75% percentile 232-783 pg/mL compared to women with VIUP (256 pg/mL; 168-442 pg/mL or miscarriage (192 pg/mL; 133-476 pg/mL. Serum ADAM-12 did not differentiate histologically-confirmed EP from spontaneously resolving PUL (srPUL (416 pg/mL; 154-608 pg/mL. The diagnostic potential of ADAM-12 was only significant when 'ambiguous' PUL outcomes were excluded from the analysis (AROC = 0.6633; P = 0.03901. CONCLUSIONS/SIGNIFICANCE: When measured in isolation, ADAM-12 levels had limited value as a diagnostic biomarker for EP in our patient cohort. The development of a reliable serum biomarker-based test for EP remains an ongoing challenge.

  12.  The Values of CA-125, Progesterone, ß-HCG and Estradiol in the Early Prediction of Ectopic Pregnancy

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    Hala Abdul Qadir Al-Moayed

    2012-03-01

    Full Text Available  Objective: To explore the diagnostic value and measurement of serum CA-125, the single measurement of progesterone (P,ß-HCG, and estradiol (E2 in the early diagnosis of ectopic pregnancy.Methods: Serum levels of CA-125, progesterone, ß-HCG and estradiol were measured by Enzyme Linked Immuno Sorbent Assay (ELISA techniques in 40 symptomatic women with ectopic pregnancy and 24 women with normal intrauterine pregnancy during gestational age of 4-10 weeks at Al-Kadhmiya Teaching Hospital, Baghdad, Iraq, between November 2010 and June 2011.Results: The mean ±SEM serum levels of CA-125, progesterone, ß-HCG, and estradiol in patients with ectopic pregnancies (16.51±2.39U/ml; 2.54±0.47ng/ml; 72.75±12.27mIU/ml; 13.4±2.14pg/ml; respectively were significantly lower than the levels in normal intrauterine pregnancies (74.25±18.5U/ml; 28.36±3.7ng/ml; 249.54±18.0mIU/ml; 112.7±23.6pg/ml; respectively. When using a CA-125 concentration of 20.5 U/ml as a cut-off value for the diagnosis of ectopic pregnancy, sensitivity was 75.7�20specificity 100�20the positive predictive value was100�0and the negative predictive value 71.4�onclusion: The measurement of CA-125 and progesterone levels is useful in discriminating ectopic from normal gestations.

  13. Fetal outcome in repeat cervical encirclage in same pregnancy

    Directory of Open Access Journals (Sweden)

    Nirmala Sharma

    2013-08-01

    Full Text Available A 30 year old sixth gravida patient having five spontaneous abortions between fifth and sixth months of amenorrhea. Patient had an incompetent cervix, cervical cerclage was done at 14 weeks of gestation by Mc Donald’s method. Pregnancy was uneventful for more than one month and patient reported back with complaints of bleeding per vaginum, and pain abdomen, cerclage was removed by duty doctor in emergency, but pains subsided. Ultrasound was done revealing low lying placenta reaching upto the os with 22 weeks live intrauterine pregnancy. Repeat transvaginal cervical cerclage was decided and done in similar manner. Patient was kept indoor on bed rest, tocolytics, antibiotics and progesterone support till the time of delivery. At 30 weeks pregnancy ultrasound revealed low amniotic fluid index (1.2 for which amino acid infusion was administered. Later on patient developed bleeding & leaking per vaginum with cervical dilatation, so immediate cesarean section decided and corticosteroid administered for fetal lung maturity, emergency cesarean section was done. In follow up mother and baby were absolutely healthy. The pregnancy outcome is significantly improved even after repeat cervical cerclage in same pregnancy and if there is a need for repeat cervical cerclage during same pregnancy it should be done to improve fetal salvage. [Int J Reprod Contracept Obstet Gynecol 2013; 2(4.000: 728-729

  14. Face and Construct Validity of the SimSurgery SEP VR Simulator for Salpingectomy in Case of Ectopic Pregnancy

    NARCIS (Netherlands)

    Hessel, M.; Buzink, S.N.; Schoot, B.C.; Jakimowicz, J.J.

    2012-01-01

    Objective: To secure patient safety, skills needed for laparoscopy are preferably obtained in a non-patient setting. Therefore, we assessed face and construct validity of performance of a salpingectomy in case of ectopic pregnancy on the SimSurgery SEP VR simulator. Materials and Methods: Fifteen e

  15. The efficacy of the systemic methotrexate treatment in caesarean scar ectopic pregnancy: A quantitative review of English literature.

    Science.gov (United States)

    Bodur, S; Özdamar, Ö; Kılıç, S; Gün, I

    2015-04-01

    To determine the efficacy and safety of primary medical treatment with systemic methotrexate (MTX) in caesarean scar ectopic pregnancy, we conducted a Medline/PubMed search on the relevant English literature from January 1978 to January 2012. The search yielded 27 publications of 40 cases of caesarean scar ectopic pregnancy. The literature search showed a very liberal use of systemic MTX treatment with unfavourable outcomes, although the major determinant of the clinical efficacy was found in here to be β-hCG level together with embryonic cardiac activity (ECA) status. A caesarean scar ectopic pregnancy presented with a serum β-hCG concentration of ≤ 12,000 mIU/ml (odds ratio, OR 5.68, 95% confidence interval, CI, 1.37-23.48) and absence of ECA (OR 4.80, 95% CI, 1.14-20.08) was found to be associated with higher efficacy rate of primary systemic MTX treatment. Administration of primary systemic MTX treatment was found to be ideal for a caesarean scar ectopic pregnancy presented before 8 weeks' gestation, with a β-hCG concentration of ≤ 12,000 mIU/ml together with an absent ECA (OR 14.52, 95% CI, 2.36-89.09).

  16. 异位妊娠的临床护理体会%Clinical nursing experience of ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    明淑芹

    2015-01-01

    目的:探讨异位妊娠的相关因素,制定相应的预防和护理对策。方法:收治异位妊娠患者90例,回顾性分析其临床资料。结果:在基础护理的基础上,结合患者特点给予相应护理干预措施,有助于异位妊娠患者的治疗与康复。结论:通过术前、术中和术后系统护理,对异位妊娠患者的治疗和康复有着十分重要的意义。%Objective:To explore the related factors of ectopic pregnancy,and to make corresponding prevention and nursing countermeasures.Methods:90 patients with ectopic pregnancy were selected,and the clinical data were retrospectively analyzed. Results:On the basis of basic nursing,combined with the features of the patients,giving the corresponding nursing intervention measures was helpful in healing and recovery of patients with ectopic pregnancy.Conclusion:Preoperative,intraoperative and postoperative systemic nursing care played a very important role in the treatment and rehabilitation of patients with ectopic pregnancy.

  17. The Regulation of Nitric Oxide Synthase Isoform Expression in Mouse and Human Fallopian Tubes: Potential Insights for Ectopic Pregnancy

    Directory of Open Access Journals (Sweden)

    Junting Hu

    2014-12-01

    Full Text Available Nitric oxide (NO is highly unstable and has a half-life of seconds in buffer solutions. It is synthesized by NO-synthase (NOS, which has been found to exist in the following three isoforms: neuro nitric oxide synthase (nNOS, inducible nitric oxide synthase (iNOS, and endothelial nitric oxide synthase (eNOS. NOS activity is localized in the reproductive tracts of many species, although direct evidence for NOS isoforms in the Fallopian tubes of mice is still lacking. In the present study, we investigated the expression and regulation of NOS isoforms in the mouse and human Fallopian tubes during the estrous and menstrual cycles, respectively. We also measured isoform expression in humans with ectopic pregnancy and in mice treated with lipopolysaccharide (LPS. Our results confirmed the presence of different NOS isoforms in the mouse and human Fallopian tubes during different stages of the estrous and menstrual cycles and showed that iNOS expression increased in the Fallopian tubes of women with ectopic pregnancy and in LPS-treated mice. Elevated iNOS activity might influence ovulation, cilia beats, contractility, and embryo transportation in such a manner as to increase the risk of ectopic pregnancy. This study has provided morphological and molecular evidence that NOS isoforms are present and active in the human and mouse Fallopian tubes and suggests that iNOS might play an important role in both the reproductive cycle and infection-induced ectopic pregnancies.

  18. Heterochronic bilateral ectopic pregnancy after ovulation induction%促排卵后的不同步双侧异位妊娠

    Institute of Scientific and Technical Information of China (English)

    Bo ZHU; Gu-feng XU; Yi-feng LIU; Fan QU; Wei-miao YAO; Yi-min ZHU; Hui-juan GAO; Dan ZHANG

    2014-01-01

    研究目的:报道一例不同步双侧异位妊娠,并回顾相关文献,总结规律。创新要点:第一次报道了不同步的双侧异位妊娠。研究方法:对促排卵后行宫腔内人工授精病人发生非同步双侧输卵管妊娠的病例进行报告,辅以人绒毛膜促性腺激素(hCG)值波动曲线、超声图像以及病理切片加以阐述;同时回顾2008年以来关于双侧异位妊娠的文献,并分析病例特征。重要结论:促排卵后可能会提高双侧异位妊娠风险,一侧异位妊娠发生后,需要注意对侧是否也存在异位妊娠。%Ectopic pregnancy is identified with the widely-applied assisted reproductive technology (ART). Bilateral ectopic pregnancy is a rare form of ectopic pregnancy which is difficult to be diagnosed at the pre-operation stage. In this paper, we presented an unusual case of heterochronic bilateral ectopic pregnancy after stimulated intrauterine insemination (IUI), where there has been a delay of 22 d between the diagnoses of the two ectopic pregnancies. Literature was reviewed on the occurrence of bilateral ectopic pregnancy during the past four years in the MEDLINE database. We found 16 cases of bilateral ectopic pregnancy reported since 2008, and analyzed the characteristics of those cases of bilateral ectopic pregnancy. We emphasize that ovulation induction and other ARTs may increase the risk of bilateral ectopic pregnancy. Because of the difficulty in identification of bilateral ectopic pregnancy by ultraso-nography, the clinician should be aware that the treatment of one ectopic pregnancy does not preclude the occurrence of a second ectopic pregnancy in the same patient and should pay attention to the intra-operation inspection of both side fallopian tubes in any ectopic pregnancy case.

  19. Ectopic pregnancy-derived human trophoblastic stem cells regenerate dopaminergic nigrostriatal pathway to treat parkinsonian rats.

    Science.gov (United States)

    Lee, Tony Tung-Yin; Tsai, Cheng-Fang; Hsieh, Tsung-Hsun; Chen, Jia-Jin Jason; Wang, Yu-Chih; Kao, Mi-Chun; Wu, Ruey-Meei; Singh, Sher; Tsai, Eing-Mei; Lee, Jau-Nan

    2012-01-01

    Stem cell therapy is a potential strategy to treat patients with Parkinson's disease (PD); however, several practical limitations remain. As such, finding the appropriate stem cell remains the primary issue in regenerative medicine today. We isolated a pre-placental pluripotent stem cell from the chorionic villi of women with early tubal ectopic pregnancies. Our objectives in this study were (i) to identify the characteristics of hTS cells as a potential cell source for therapy; and (ii) to test if hTS cells can be used as a potential therapeutic strategy for PD. hTS cells expressed gene markers of both the trophectoderm (TE) and the inner cell mass (ICM). hTS cells exhibited genetic and biological characteristics similar to that of hES cells, yet genetically distinct from placenta-derived mesenchymal stem cells. All-trans retinoic acid (RA) efficiently induced hTS cells into trophoblast neural stem cells (tNSCs) in 1-day. Overexpression of transcription factor Nanog was possibly achieved through a RA-induced non-genomic c-Src/Stat3/Nanog signaling pathway mediated by the subcellular c-Src mRNA localization for the maintenance of pluripotency in tNSCs. tNSC transplantation into the lesioned striatum of acute and chronic PD rats not only improved behavioral deficits but also regenerated dopaminergic neurons in the nigrostriatal pathway, evidenced by immunofluorescent and immunohistological analyses at 18-weeks. Furthermore, tNSCs showed immunological advantages for the application in regenerative medicine. We successfully isolated and characterized the unique ectopic pregnancy-derived hTS cells. hTS cells are pluripotent stem cells that can be efficiently induced to tNSCs with positive results in PD rat models. Our data suggest that the hTS cell is a dynamic stem cell platform that is potentially suitable for use in disease models, drug discovery, and cell therapy such as PD.

  20. Local injection of diluted vasopressin followed by suction curettage for cervical ectopic pregnancy.

    Science.gov (United States)

    Ishikawa, Hiroshi; Unno, Youichi; Omoto, Akiko; Shozu, Makio

    2016-12-01

    To report the results of local injection of diluted vasopressin followed by suction curettage as a conservative treatment for women with cervical ectopic pregnancy, who wish to preserve their future fertility. This was a retrospective chart review in a university hospital and a municipal hospital. We injected diluted vasopressin (Pitressin R, total amount of 4-10 units) transvaginally into the cervix surrounding the gestational sac, but not directly into the gestational sac, and/or the lower segment of the uterine body under transvaginal ultrasonographic guidance. After cessation of fetal heartbeats, we aspirated the conceptus by performing suction curettage. We injected additional vasopressin into the gestational sac in cases with a viable fetus after the initial injection. Forced contraction of the cervical smooth muscle facilitated removal of the conceptus with minimal blood loss during curettage. We measured operative time, total blood loss, complications, and the need for additional treatment. We included 11 women. Mean patient age, gestational age, and serum human chorionic gonadotrophin (hCG) at the intervention were 31.2±6.4years, 6.0±0.6 weeks, and 18,370±21,570 IU/L, respectively. Mean size of the gestational sac was 19.6±9.5mm. The uterus was successfully preserved without any complications in all patients. All procedures were completed within 15min except for the first case (range: 5-33min). In 4 cases, the conceptus containing a gestational sac was spontaneously extruded en bloc from the external os after the injection. Additional systematic methotrexate administration was required in one case because of remaining villi at the implantation site with persistence of serum hCG levels after the procedure. Local injection of diluted vasopressin and subsequent suction curettage is a feasible conservative treatment for cervical ectopic pregnancy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. ECTOPIC PREGNANCY RATES WITH CLEAVAGE STAGE EMBRYO TRANSFER AT DAY 3 VERSUS BLASTOCYST STAGE TRANSFER AT DAY 5: A PROSPECTIVE ANALYSIS

    Directory of Open Access Journals (Sweden)

    Prabhleen

    2014-10-01

    Full Text Available OBJECTIVE: The purpose of our study was to compare the tubal pregnancy rates between day 3 and day 5 transfers. As theoretically blastocyst transfer is said to decrease the incidence of ectopic pregnancy following IVF-ET due to the decreased uterine contractility reported on day 5. METHODS: A prospective analysis of all clinical pregnancies conceived in our IVF program between May 2010 to April 2011 was performed. The ectopic pregnancy rates were compared for day 3 and day 5 transfers. RESULTS: There were 44 pregnancies resulting from day 3 transfers of which one was ectopic (2.27%. In day 5 transfers, there was also one ectopic pregnancies out of 66 clinical pregnancies (1.52%, difference between these rates was not statistically significant (P>0.05 CONCLUSION: This suggests that the ectopic pregnancy rate is not reduced following blastocyst transfer on day 5 compared to cleavage stage embryo on day 3. While there may be several benefits to extended culture in IVF, the decision to offer blastocyst transfer should be made independently from the issue of ectopic pregnancy risk.

  2. Ectopic Pregnancy risk factors among the patients referred to Shariati hospital in Bandarabbas

    Directory of Open Access Journals (Sweden)

    Minoo Rajaee

    2011-08-01

    Full Text Available Background: Ectopic pregnancy (EP is the most common cause of death related to pregnancy during the first trimester and its' incidence is increasing. Knowledge about the risk factors of EP can be helpful in diagnosis and also in prevention of EP, because some of these risk factors are preventable. The aim of this study is to assess the EP patients and the prevalence of EP risk factors among them in Bandarabbas.Methods: Eighty two patients with EP referred to Shariati hospital in Bandarabbas in 2009 were included in our descriptive study. Study was conducted using a questionnaire about demographic characteristics, EP risk factors, and information about treatment and duration of hospital stay. Data was collected using interview with patients by educated personnel and patients' records during hospitalization. After data collection we analysed the data using SPSS 17.0 software using descriptive statistics (Mean, Standard Deviation, and frequency.Results: Mean age of the participants was 27.46±5.98. Sixty four (78% patients were households and 18(22% were employees. Sixteen (19.5% had low socioeconomic status, 62(75.6% had intermediate socioeconomic status and 4 (4.9% had high socioeconomic status.Twenty one (25.6% of patients were using withdrawal method for contraception at the time of conception. Condom, Oral Contraceptive Pills (OCP, DMPA, and IUD was reported in 7 (8.5%, 13 (15.9%, 8 (9.8%, and 2 (2.4% respectively. Other 31 (37.8% patients weren’t using any method for contraception. Six (7.3% patients had previous history of EP. Also 4 (4.9% had history of previous EP in their near family members. One (1.2% patient was undergone surgery for Tubal Ligation (TL.Four (4.9% patient were using tobacco. EP location was in fallopian tube in 62 (75.6% and in other places in 20 (24.4% of patients. Thirty four (41.5% received drug therapy, 35 (42.7% undergone surgery and 13 (15.9% received both drug and surgery treatment. Mean duration of hospital

  3. Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case-control, population-based study in France.

    OpenAIRE

    BOUYER, Jean; Coste, Joël; Shojaei, Taraneh; Pouly, Jean-Luc; Fernandez, Hervé; Gerbaud, Laurent; Job-Spira, Nadine

    2003-01-01

    This case-control study was associated with a regional register of ectopic pregnancy between 1993 and 2000 in France. It included 803 cases of ectopic pregnancy and 1,683 deliveries and was powerful enough to investigate all ectopic pregnancy risk factors. The main risk factors were infectious history (adjusted attributable risk = 0.33; adjusted odds ratio for previous pelvic infectious disease = 3.4, 95% percent confidence interval (CI): 2.4, 5.0) and smoking (adjusted attributable risk = 0....

  4. MicroRNA-873 is a Potential Serum Biomarker for the Detection of Ectopic Pregnancy

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    Qi Lu

    2017-05-01

    Full Text Available Background: Ectopic pregnancy (EP refers to the implantation of the zygote outside the uterine cavity. In clinical practice, the diagnosis of EP relies on a combination of ultrasound findings and serum human chorionic gonadotrophin (hCG measurements. However, the need for serial hCG measurements increases the risk of tubal rupture and death, underscoring the need to identify biomarkers for the early detection of EP. Methods: The serum concentrations of 21 microRNAs (miRNAs associated with pregnancy or with known placental expression, as well as serum hCG and progesterone levels were analyzed 36 patients with viable intrauterine pregnancy (VIP, 30 patients with spontaneous abortion (SA, and 34 patients with EP using specific assay kits and reverse transcription PCR. The diagnostic performance of the different serum markers for detecting EP was analyzed by ROC curve analysis. Results: Five miRNAs were differentially expressed between the three groups, of which miR-873 and miR-223 were significantly lower in EP than in VIP and SA patients and did not change significantly according to gestational age, and miR-323 was significantly higher in EP than in VIP and SA. As a single marker, miR-873 had the highest sensitivity for detecting EP at 61.76% (at a fixed specificity of 90%. In comparison, the combination of hCG, progesterone and miR-873 had the highest sensitivity for detecting EP at 79.41% (at a fixed specificity of 90%. Conclusion: Although further validation in large-scale prospective studies is necessary, our results suggest that miR-873 could be a valuable noninvasive and stable biomarker for the early detection of EP.

  5. 宫外孕汤剂治疗子宫外孕64例临床观察%Ectopic pregnancy decoction treatment of 64 patients with ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    王亚荀

    2013-01-01

    Objective To probe into clinical application value of ectopic pregnancy decoction for patients with ectopic pregnancy. Methods Selected from November 2011 to November 2012, 128 ectopic pregnancy patients in our hospital. The patients were divided into study group and control group randomly. There were 64 patients in each group. The patients in two groups with ectopic pregnancy were confirmed by inspection and definitive diagnosis. The patients in study group were given ectopic pregnancy Chinese medicine decoction for clinical treatment. The patients in control group were given western medicine for clinical treatment. The clinical effect and toxicity of ectopic pregnancy patients in two groups were compared and analysis. Results Compared with control group, patients in study group the efficiency and total efficiency were improved significantly, up to 51.56% and 95.31%,there were statistically significant(P<0.05). Compared with control group, patients in study group the toxicity incidence of gastrointestinal irritation and liver dysfunction rates were decreased, but there were no statistically significant(P>0.05). Conclusion Ectopic pregnancy Chinese medicine decoction has a positive clinical value for improving clinical outcomes and reduced toxicity in patients with ectopic pregnancy.%目的 探讨宫外孕汤剂在子宫外孕患者中的临床应用价值.方法 选取我院2011年11月~2012年11月期间收治的子宫外孕患者128例,随机将其分为研究组和对照组,每组患者各64例.两组子宫外孕患者经相关检查和明确诊断后,研究组患者给予宫外孕中药汤剂临床治疗,对照组患者则给予西药临床治疗,分别比较和分析两组子宫外孕患者的临床疗效和毒副反应.结果 研究组患者的显效率和总有效率分别为51.56%、95.31%,均明显高于对照组患者,两组比较差异有统计学意义(P<0.05);研究组患者胃肠道刺激和肝功能损害的毒副反应发生率较对照

  6. Ectopic pregnancy-derived human trophoblastic stem cells regenerate dopaminergic nigrostriatal pathway to treat parkinsonian rats.

    Directory of Open Access Journals (Sweden)

    Tony Tung-Yin Lee

    Full Text Available BACKGROUND: Stem cell therapy is a potential strategy to treat patients with Parkinson's disease (PD; however, several practical limitations remain. As such, finding the appropriate stem cell remains the primary issue in regenerative medicine today. We isolated a pre-placental pluripotent stem cell from the chorionic villi of women with early tubal ectopic pregnancies. Our objectives in this study were (i to identify the characteristics of hTS cells as a potential cell source for therapy; and (ii to test if hTS cells can be used as a potential therapeutic strategy for PD. METHODS AND FINDINGS: hTS cells expressed gene markers of both the trophectoderm (TE and the inner cell mass (ICM. hTS cells exhibited genetic and biological characteristics similar to that of hES cells, yet genetically distinct from placenta-derived mesenchymal stem cells. All-trans retinoic acid (RA efficiently induced hTS cells into trophoblast neural stem cells (tNSCs in 1-day. Overexpression of transcription factor Nanog was possibly achieved through a RA-induced non-genomic c-Src/Stat3/Nanog signaling pathway mediated by the subcellular c-Src mRNA localization for the maintenance of pluripotency in tNSCs. tNSC transplantation into the lesioned striatum of acute and chronic PD rats not only improved behavioral deficits but also regenerated dopaminergic neurons in the nigrostriatal pathway, evidenced by immunofluorescent and immunohistological analyses at 18-weeks. Furthermore, tNSCs showed immunological advantages for the application in regenerative medicine. CONCLUSIONS: We successfully isolated and characterized the unique ectopic pregnancy-derived hTS cells. hTS cells are pluripotent stem cells that can be efficiently induced to tNSCs with positive results in PD rat models. Our data suggest that the hTS cell is a dynamic stem cell platform that is potentially suitable for use in disease models, drug discovery, and cell therapy such as PD.

  7. The impact of salpingectomy and single-dose systemic methotrexate treatments on ovarian reserve in ectopic pregnancy.

    Science.gov (United States)

    Sahin, Cagdas; Taylan, Enes; Akdemir, Ali; Ozgurel, Banu; Taskıran, Dilek; Ergenoglu, Ahmet M

    2016-10-01

    To investigate the effects of salpingectomy and methotrexate treatments on ovarian reserve in ectopic pregnancy. In this prospective study, a total of 131 patients with ectopic pregnancy were divided into 3 groups of methotrexate (MTX) only (Group-1, n: 55), salpingectomy only (Group-2, n: 61), and salpingectomy following MTX (Group-3, n: 15). Pretreatment and post-treatment anti-Müllerian hormone (AMH) levels were evaluated. Significant differences in AMH levels were detected between group 1 and group 2 (2.52±1.28 vs. 1.96±1.66, p=0.043), and group 1 and group 3 (2.52±1.28 vs. 1.77±0.76, p=0.035) at one month postoperative. However, these differences disappeared at the 3rd postoperative month. When AMH levels were compared within the same group, postoperative one month AMH levels were significantly lower than the preoperative AMH levels only in group 3 (p=0.03). However, this difference also disappeared at the 3rd postoperative month. Systemic single-dose methotrexate treatment, unilateral salpingectomy, and salpingectomy following methotrexate administration in ectopic pregnancy were reassuring based on pretreatment and post-treatment AMH levels. Current medical and surgical treatment approaches do not have an obvious negative effect on ovarian reserve. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Management of non-tubal ectopic pregnancies at a large tertiary hospital.

    Science.gov (United States)

    Hunt, Sarah P; Talmor, Alon; Vollenhoven, Beverley

    2016-07-01

    There are limited data on the management of non-tubal ectopic pregnancies (NTEP). We reviewed the management of these cases at a tertiary centre with a dedicated institutional protocol. All cases of confirmed NTEP were retrospectively identified from 2006 to 2014. Records were reviewed for presenting features, mode and success of initial management, preservation of fertility and length of hospital stay. The main outcome measure was the success rate of medical management with methotrexate. The 60 cases identified included 34 cornual, 14 Caesarean section scar, nine cervical and three cervical involving previous Caesarean scar. Primary surgical management was performed in 22 patients. Thirty-eight patients received medical therapy with single or multidose methotrexate. Successful medical management was observed in 33 (87%); however, length of stay was significantly longer compared with surgical patients (mean 14 ± 12 days versus 5 ± 2 days, P < 0.01). Hysterectomy was performed in three patients (one surgical group, two medical group). There was one case of methotrexate toxicity with no long-term adverse outcome. Medical management of NTEP is a safe first-line therapy for clinically stable patients desiring preservation of fertility despite a longer period of inpatient monitoring and follow-up. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  9. 宫外妊娠的超声诊断价值%Ultrasound Diagnosis in Ectopic Pregnancy

    Institute of Scientific and Technical Information of China (English)

    尹红艳

    2015-01-01

    目的:探讨超声对宫外妊娠的诊断价值。方法对31例经手术证实为宫外妊娠的超声声像图进行回顾性分析。结果31例超声检查出28例,误诊3例,诊断符合率为90%。结论宫外妊娠声像图具有特征性表现,超声检查尤其是阴式超声检查可以提高宫外妊娠的诊断率。%Objective To Discuss the diagnosis value of ultrasound in ectopic pregnancy. Methods 31 examples after the surgery confirmed the pregnancy supersonic acoustic image chart carries on the review analysis for ectopic pregnancy. Results Supersonic inspect 28 examples in 31 examples,misdiagnoses 3 examples, the diagnosis coincidence rate was 90%. Conclusion The conclusion palace the pregnancy acoustic image chart has the characteristic value performance, the supersonic inspection cloudy-like supersonic inspection may enhance outside in particular the palace the pregnancy diagnosis rate.

  10. Trends in ectopic pregnancy, hydatidiform mole and miscarriage in the largest obstetrics and gynaecology hospital in China from 2003 to 2013.

    Science.gov (United States)

    Li, Xue-Lian; Du, Dan-Feng; Chen, Shang-Jie; Zheng, Sai-Hua; Lee, Arier C; Chen, Qi

    2016-05-20

    Ectopic pregnancies, miscarriages and hydatidiform moles are the major types of pathological pregnancies in the early gestations of pregnancy and constitute an important public health problem. The trends and incidences of these pathological pregnancies may vary by ethnicity and geographical regions. This has not been fully investigated in the Chinese population. In this study we retrospectively report the trends of pathological pregnancies in Chinese population. Data on 22,511 women with ectopic pregnancy, hydatidiform mole and miscarriage were collected from the largest obstetrics and gynaecology hospital in China from 2003 to 2013. Data included age at diagnosis and the annual number of women with diagnosed ectopic pregnancy, hydatidiform mole and miscarriage. The total number of ectopic pregnancy, hydatidiform mole and miscarriage was increased 3.5folds in 2013 compared to 2003. Ectopic pregnancy is the leading pathological pregnancy and miscarriage is increasing at a greater rate among the pathological pregnancies. The median age of women with hydatidiform mole at diagnosis significantly increased from 25.5 years to 29 years (p = 0.002), however the median age for other pathological pregnancies was not different between 2003 and 2013. The number of women with hydatidiform mole at diagnosis who were over 40 years old has increased. The mean maternal age is increased from 28.1 years old in 2003 to 29.4 years old in 2013 in this hospital. We speculate that the increased maternal age may contribute to the increase in these pathological pregnancies between 2003 and 2013 in China.

  11. Endometrial cysteine-rich secretory protein 3 is inhibited by human chorionic gonadotrophin, and is increased in the decidua of tubal ectopic pregnancy

    DEFF Research Database (Denmark)

    Horne, A W; Duncan, W C; King, A E;

    2009-01-01

    Ectopic pregnancy (EP) remains a considerable cause of morbidity and occasional mortality. Currently, there is no reliable test to differentiate ectopic from intrauterine gestation. We have previously used array technology to demonstrate that differences in gene expression in decidualized...... chorionic gonadotrophin (hCG) levels. Immortalized endometrial epithelial cells were cultured with physiological concentrations of hCG. CRISP-3 mRNA and protein expression were greater in endometrium from ectopic when compared with intrauterine pregnancies (P ... to epithelium and granulocytes of endometrium. CRISP-3 serum concentrations were not different in women with ectopic compared with intrauterine pregnancies. CRISP-3 expression in endometrium was not related to the degree of decidualization or to serum progesterone levels. Endometrial CRISP-3 expression...

  12. Cytogenetic studies in couples experiencing repeated pregnancy losses.

    Science.gov (United States)

    De Braekeleer, M; Dao, T N

    1990-07-01

    A computerized database generated from the literature on cytogenetic studies in couples experiencing repeated pregnancy losses has been set up at the University of Quebec at Chicoutimi. At the present time, it contains data on 22,199 couples (44,398 individuals). The statistical analyses showed a relationship between the distribution of the chromosome abnormalities and the number of abortions. An uneven distribution of the chromosomal structural rearrangements according to the sex of the carrier was found (P less than 0.05). Overall, 4.7% of the couples ascertained for two or more spontaneous abortions included one carrier. It also appeared that only translocations (both reciprocal and Robertsonian) and inversions were associated with a higher risk of pregnancy wastage. Therefore, genetic counselling should be offered to these couples and investigations performed on their extended families.

  13. 异位妊娠发病的原因临床分析%The pathogenesis of ectopic pregnancy clinical analysis of the reasons

    Institute of Scientific and Technical Information of China (English)

    汪涟

    2013-01-01

    objective: to study and analysis of the relevant causes of ectopic pregnancy and positive way of prevention and treatment. Methods: In our hospital in December 1, 2011 -2013 year in April 1st 118 cases of ectopic pregnancy patients in clinical study.Results: The main reasons lead to ectopic pregnancy patients is inflammation of Department of gynaecology, multiple pregnancy. Conclusion: To lead to early intervention related factors of ectopic pregnancy, conducive to the prevention and treatment of ectopic pregnancy, it has important clinical value.%目的:研究并分析异位妊娠的相关发病原因以及积极的预防和治疗方式。方法:选取我院2011年12月1日-2013年4月1日收治异位妊娠患者118例进行临床研究。结果:导致患者出现异位妊娠的主要原因是妇科炎症、多次孕产等。结论:对导致异位妊娠相关因素进行早期干预,有利于防治异位妊娠,具有重要的临床价值。

  14. Clinical analysis of recurrent ectopic pregnancy in 50 cases%50例重复性异位妊娠临床分析

    Institute of Scientific and Technical Information of China (English)

    侯淑萍; 刘溪; 邱娅

    2013-01-01

    Objective To summarize the clinical characteristics of recurrent ectopic pregnancy and to discuss the prevetion of recurrent ectopic pregnancy.Methods 50 cases of recurrent ectopic pregnancy collected between January 2011 and July 2012 were retrospectively evaluated for demographic features,risk factors and treatment modalities.Results The risk of recurrent ectopic pregnancy was increased with history of surgery,previous ectopic pregnancy and pevic infection.Conclusion The important measures for prevention and reduction of recurrent ectopic pregnancy include management of pelvic inflammatory disease actively,improvement of local medical and sanitary conditions,and selection of preferred treatment options for ectopic pregnancy.%目的 总结重复异位妊娠的临床特点,探讨重复异位妊娠的预防方法.方法 回顾性分析2011年1月-2012年7月的50例重复异位妊娠患者的社会人口学特征、危险因素和诊疗结果并进行随访.结果 盆腔炎症、前一次腹部手术史及其手术方式是重复异位妊娠的危险因素.结论 积极治疗盆腔炎症,改善当地的医疗卫生条件,选择最佳的异位妊娠治疗方式是预防并降低本地重复性异位妊娠发生的重要措施.

  15. Analysis of Ectopic Pregnancy Ultrasound%异位妊娠的超声检查分析

    Institute of Scientific and Technical Information of China (English)

    江雪霞; 韩群英

    2011-01-01

    目的:探讨对异位妊娠患者进行超声检查的合理方法.方法:选取我院2005-2009年间诊治的100例异位妊娠患者,将其随机分为两组.以50例经腹部超声检查(TAS)异位妊娠的患者作为对照组,以50例经阴道彩超检查(TVS)异位妊娠患者作为实验组,将两者的检查结果、确诊时间以及诊断准确情况进行对比分析.结果:经阴道超声检查所探到的附件包块最小直径为10mm,小于经腹部超声检查所探到直径23mm的最小附件包块,且经阴道彩超诊断的确诊天数少于经腹部诊断的确诊天数.经阴道超声检查的诊断准确率为94.0%,高于经腹部超声检查62%的诊断准确率.对两组进行SPSS17.0软件的计数卡方检验,结果为X2=14.92,P<0.01,两者对比差异显著,具有统计学意义.结论:经阴道进行异位妊娠的诊断有着高度的精密性、较快的确诊速度以及高度的诊断准确率,对诊断异位妊娠有着重要价值.%Objective: To study the ectopic pregnancy on ultrasound in patients with a reasonable way.Method: 100 cases of ectopic pregnancy diagnosed and treated in our hospital between 2005-2009, They were randomly divided into two groups. 50 patients with abdominal ultrasound ( TAS ) in patients with ectopic pregnancy as the control group, 50 cases of transvaginal ultrasonography ( TVS ) in patients with ectopic pregnancy as the experimental group. The two test results, diagnosis time and accurate information on diagnosis were analyzed. Resulit: The results of the transvaginal ultrasound probe to the minimum diameter of adnexal masses 10mm, less than the abdominal ultrasound probe to the minimum diameter of 23mm adnexal mass and diagnosed by transvaginal color Doppler ultrasound diagnosis is less than the number of days of abdominal diagnosis confirmed by the number of days . Transvaginal ultrasound examination of the diagnostic accuracy rate was 94.0%, higher than 62% by abdominal ultrasound diagnostic

  16. Analysis of Early Ectopic Pregnancy by Transvaginal Ultrasonography%经阴道超声诊断早期宫外孕的分析

    Institute of Scientific and Technical Information of China (English)

    马红梅; 李玉兰; 季守莲

    2016-01-01

    目的:探讨经阴道超声对宫外孕的早期诊断价值。方法:对收治的154例患者经阴道超声诊断及经手术、病理结果证实为宫外孕。结果:154例患者中,异位妊娠148例,未破裂型72例,破裂型76例,黄体破裂6例。结论:经阴道超声诊断宫外孕,准确性高,结合临床病史及血HCG,能对宫外孕作出早期诊断,为临床治疗提供可靠及时的诊断依据。%Objective:To analyze the value of diagnosing ectopic pregnancy by Transvaginal ultrasonography. Methods:154 patients in Affiliated Hospital of Dali University were diagnosed with ectopic pregnancy by transvaginal ultrasonography diagnosing, operations and pathological results. Results:In 154 cases, 148 cases were ectopic pregnancy, 72 cases were non rupture, 86 cases were ruptured, and 6 cases were ruptured corpus. Conclusion: Transvaginal ultrasonography diagnosis of ectopic pregnancy, which has a high accuracy, combined with clinical history and blood HCG, can make early diagnosis of ectopic pregnancy, and provide reliable and timely diagnosis basis for clinical treatment.

  17. 保守疗法治疗宫外孕的护理体会%Nursing experience of conservative treatment for ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    季恒俊

    2014-01-01

    Objective:To investigate the clinical nursing method of conservative therapy in the treatment of ectopic pregnancy. Methods:50 patients with ectopic pregnancy treated with conservative treatment were selected,the clinical data of them were retrospectively analyzed to explore the effective nursing measures of conservative treatment for ectopic pregnancy.Results:After the nursing measures of scientific and systematic intervention,conservative treatment for ectopic pregnancy was successful in 46 cases,the cure rate was 92% .Conclusion:Effect of conservative therapy for ectopic pregnancy combined with scientific and effective nursing measures is significant,and the cure rate is high.%目的:探讨保守疗法治疗宫外孕的临床护理方法。方法:收治保守治疗宫外孕患者50例,对其临床资料进行回顾性分析,探讨保守疗法治疗宫外孕的有效护理措施。结果:经过科学系统的护理措施干预后,保守疗法治疗宫外孕成功46例,治愈率92%。结论:保守疗法治疗宫外孕配合科学有效的护理措施疗效显著,治愈率高。

  18. Frozen-thawed day 5 blastocyst transfer is associated with a lower risk of ectopic pregnancy than day 3 transfer and fresh transfer.

    Science.gov (United States)

    Fang, Cong; Huang, Rui; Wei, Li-Na; Jia, Lei

    2015-03-01

    To determine the ectopic pregnancy rate with fresh versus frozen-thawed embryo transfers, and factors associated with ectopic pregnancy in patients undergoing IVF-ET. Retrospective analysis. Institutional IVF center. A total of 3,183 patients who received 3,340 blastocysts transfers: 1,994 fresh transfers and 1,346 frozen-thawed transfers. Patients received fresh day 3 embryos (F-D3 group), fresh day 5 blastocysts (F-D5 group), frozen-thawed day 3 embryos (T-D3 group), or frozen-thawed day 5 or 6 blastocysts (T-D5 and T-D6 groups). Ectopic pregnancy rate. The ectopic pregnant rates were 2.4% in the F-D3 group, 1.7% in F-D5, 1.9% in T-D3, 0.3% in T-D5, and 0.5% in T-D6. The ectopic pregnant rate of the T-D3 group was significantly greater than that of the T-D5 and T-D6 groups (1.9% vs. 0.3% and 0.5%). The ectopic pregnancy rate of the F-D5 group was significantly greater than that of the T-D5 group (1.7% vs. 0.3%). Frozen-thawed day 5 blastocyst transfer is associated with a lower ectopic pregnancy rate than frozen-thawed day 3 transfer and fresh transfer in patients undergoing IVF-ET. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  19. 宫外孕误诊原因分析及体会%Analysis of the causes of misdiagnosis of ectopic pregnancy and experience

    Institute of Scientific and Technical Information of China (English)

    徐晓群

    2015-01-01

    异位妊娠(宫外孕)是妇科急腹症之一,当宫外妊娠流产及破裂时可引起严重的腹腔内出血,如不及时抢救,可危急生命。一般诊断并不困难,但误诊也不少。现将所遇20例误诊病例分析如下。%ectopic pregnancy (ectopic pregnancy)is one of the gynecological acute abdomen,ectopic pregnancy and rupture of abortion can cause severe abdominal bleeding,if not timely rescue can be life -threatening.General diagnosis is not dif icult,but also a lot of misdiagnosis.We encountered 20 cases were misdiagnosed as fol ows.

  20. Subnuclear relocalization and silencing of a chromosomal region by an ectopic ribosomal DNA repeat

    DEFF Research Database (Denmark)

    Jakociunas, Tadas; Domange Jordö, Marie Elise; Mebarek, Mazhoura Aït;

    2013-01-01

    dimerization, providing a mechanism for the observed relocalization. Replacing the full rDNA repeat with Reb1-binding sites, and using mutants lacking the histone H3K9 methyltransferase Clr4, indicated that the relocalized region was silenced redundantly by heterochromatin and another mechanism, plausibly...

  1. Clincial analysis about the relative factors of ectopic pregnancy occurrence%异位妊娠发病相关因素的临床分析

    Institute of Scientific and Technical Information of China (English)

    叶凤霞

    2009-01-01

    Objective To analyze the relative factors of ectopic pregnancy occurrence to provide scientitfic evidence for the procreation health care work. Methods 240 cases of ectopic pregnancy were diagnosed in our hospital from December 2005 to December 2008. The mean age was 26 years with a range of 18~42 years. The position, occurrence rate, relative factors, and treatment of ectopic pregnancy were analyzed. Results The rate of ectopic pregnancy in the ampullae of oviduct was marked higher than that in the other part of oviduct (P0.05). Condusion The increased ectopic pregnancy occurrence was obviously related with pelvic inflammatory disease, abortion, IUD, and pathological change'in oviduct. Pelvic inflammatory disease, abortion his-tory and ectopic pregnancy history were the important factors.%目的 通过对异位妊娠发病的相关因素进行分析探讨,为生育健康保健工作提供科学依据.方法 2005年12月~2008年12月来我院就诊,经过相关检查确诊为畀位妊娠患者240例.对其发病部位、发生率、发病的相关因素、治疗方法等进行临床分析.结果 壶腹部妊娠较其他部位输卵管妊娠比例明显增高,P0.05.结论 异位妊娠发病率的增加与盆腔炎、流产、IUD、输卵管病理改变有明显的相关性,盆腔炎、流产史及异位妊娠史是重要因素.

  2. CAN INITIAL βHCG VALUES PREDICT THE NEED FOR SECOND DOSE OF METHOTREXATE IN MEDICAL MANAGEMENT OF ECTOPIC PREGNANCY?

    Directory of Open Access Journals (Sweden)

    Priya Narayanan

    2016-09-01

    Full Text Available INTRODUCTION Prediction of requirement of second dose of methotrexate in patients treated with single dose would help in guiding treatment and counseling. The aim of this study is to determine whether pretreatment beta HCG values can predict the need for second dose of methotrexate in medically managed ectopic pregnancy. MATERIALS AND METHODS 46 women with ectopic pregnancies who were managed medically were included. The median of beta HCG titres on day 1, day 4 and day 7 was assessed in patients who responded to single dose methotrexate and those who required a second dose. RESULTS Out of the 46 patients studied, 41 responded to medical treatment (success 91%. 14 out of 41 required second dose of methotrexate (34%. Two patients required third dose of methotrexate. Five patients required surgery. DISCUSSION The median of day 1 and day 4 beta HCG values were not statistically different between those who responded to single dose methotrexate and those who required a second dose. Only day 7 values were found to be different. CONCLUSION The beta-hCG titre on day 1 and day 4 is not a predictor of requirement of second dose of methotrexate.

  3. Cesarean Section and Rate of Subsequent Stillbirth, Miscarriage, and Ectopic Pregnancy: A Danish Register-Based Cohort Study

    Science.gov (United States)

    O'Neill, Sinéad M.; Agerbo, Esben; Kenny, Louise C.; Henriksen, Tine B.; Kearney, Patricia M.; Greene, Richard A.; Mortensen, Preben Bo; Khashan, Ali S.

    2014-01-01

    Background With cesarean section rates increasing worldwide, clarity regarding negative effects is essential. This study aimed to investigate the rate of subsequent stillbirth, miscarriage, and ectopic pregnancy following primary cesarean section, controlling for confounding by indication. Methods and Findings We performed a population-based cohort study using Danish national registry data linking various registers. The cohort included primiparous women with a live birth between January 1, 1982, and December 31, 2010 (n = 832,996), with follow-up until the next event (stillbirth, miscarriage, or ectopic pregnancy) or censoring by live birth, death, emigration, or study end. Cox regression models for all types of cesarean sections, sub-group analyses by type of cesarean, and competing risks analyses for the causes of stillbirth were performed. An increased rate of stillbirth (hazard ratio [HR] 1.14, 95% CI 1.01, 1.28) was found in women with primary cesarean section compared to spontaneous vaginal delivery, giving a theoretical absolute risk increase (ARI) of 0.03% for stillbirth, and a number needed to harm (NNH) of 3,333 women. Analyses by type of cesarean section showed similarly increased rates for emergency (HR 1.15, 95% CI 1.01, 1.31) and elective cesarean (HR 1.11, 95% CI 0.91, 1.35), although not statistically significant in the latter case. An increased rate of ectopic pregnancy was found among women with primary cesarean overall (HR 1.09, 95% CI 1.04, 1.15) and by type (emergency cesarean, HR 1.09, 95% CI 1.03, 1.15, and elective cesarean, HR 1.12, 95% CI 1.03, 1.21), yielding an ARI of 0.1% and a NNH of 1,000 women for ectopic pregnancy. No increased rate of miscarriage was found among women with primary cesarean, with maternally requested cesarean section associated with a decreased rate of miscarriage (HR 0.72, 95% CI 0.60, 0.85). Limitations include incomplete data on maternal body mass index, maternal smoking, fertility treatment, causes of

  4. Cesarean section and rate of subsequent stillbirth, miscarriage, and ectopic pregnancy: a Danish register-based cohort study.

    Directory of Open Access Journals (Sweden)

    Sinéad M O'Neill

    2014-07-01

    Full Text Available BACKGROUND: With cesarean section rates increasing worldwide, clarity regarding negative effects is essential. This study aimed to investigate the rate of subsequent stillbirth, miscarriage, and ectopic pregnancy following primary cesarean section, controlling for confounding by indication. METHODS AND FINDINGS: We performed a population-based cohort study using Danish national registry data linking various registers. The cohort included primiparous women with a live birth between January 1, 1982, and December 31, 2010 (n = 832,996, with follow-up until the next event (stillbirth, miscarriage, or ectopic pregnancy or censoring by live birth, death, emigration, or study end. Cox regression models for all types of cesarean sections, sub-group analyses by type of cesarean, and competing risks analyses for the causes of stillbirth were performed. An increased rate of stillbirth (hazard ratio [HR] 1.14, 95% CI 1.01, 1.28 was found in women with primary cesarean section compared to spontaneous vaginal delivery, giving a theoretical absolute risk increase (ARI of 0.03% for stillbirth, and a number needed to harm (NNH of 3,333 women. Analyses by type of cesarean section showed similarly increased rates for emergency (HR 1.15, 95% CI 1.01, 1.31 and elective cesarean (HR 1.11, 95% CI 0.91, 1.35, although not statistically significant in the latter case. An increased rate of ectopic pregnancy was found among women with primary cesarean overall (HR 1.09, 95% CI 1.04, 1.15 and by type (emergency cesarean, HR 1.09, 95% CI 1.03, 1.15, and elective cesarean, HR 1.12, 95% CI 1.03, 1.21, yielding an ARI of 0.1% and a NNH of 1,000 women for ectopic pregnancy. No increased rate of miscarriage was found among women with primary cesarean, with maternally requested cesarean section associated with a decreased rate of miscarriage (HR 0.72, 95% CI 0.60, 0.85. Limitations include incomplete data on maternal body mass index, maternal smoking, fertility treatment

  5. Serum Human Chorionic Gonadotropin (β- hCG) Clearance Curves in Women with Successfully Expectantly Managed Tubal Ectopic Pregnancies: A Retrospective Cohort Study.

    Science.gov (United States)

    Helmy, Samir; Mavrelos, Dimitrios; Sawyer, Elinor; Ben-Nagi, Jara; Koch, Marianne; Day, Andrea; Jurkovic, Davor

    2015-01-01

    To establish clearance curves for serum β -hCG in women with successfully expectantly managed tubal ectopic pregnancies. Retrospective cohort study. Non- viable tubal ectopic pregnancy was diagnosed on transvaginal ultrasound. If initial serum β hCG was less than 5000 IU/L and patients were asymptomatic, expectant management was offered. Patients underwent serial β hCG measurements until serum β hCG was less than 20 IU/l, or the urine pregnancy test was negative. Early Pregnancy and Gynaecology Assessment Unit, Kings College Hospital, London (December 1998 to July 2006). We included 161 women with diagnosed non-viable tubal ectopic pregnancy who underwent successful expectant management. Serum β hCG level. Mean initial serum β- hCG was 488 IU/L (41 - 4883) and median serum β hCG clearance time was 19 days (5 - 82). The average half-life of β hCG clearance was 82.5 hours (±SD 50.2) in patients with steadily declining serum β- hCG levels compared to 106.7 hours (±SD 72.0) in patients with primarily plateauing β-hCG levels in the declining phase. However, these differences were not significant (p>0.05). We identified a median follow-up of 19 days until serum β hCG clearance in women with tubal ectopic pregnancy and successful expectant management. Although non- significant, women with initially plateauing serum β hCG showed a longer follow-up time until clearance compared to women with steadily declining β hCG levels. This information may serve as a guideline enabling clinicians to predict the length of follow-up for women with tubal ectopic pregnancy and expectant management.

  6. 270名重复性异位妊娠病人的生育史分析%The pathogeny analysis of 270 example recurrent ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    钟素静; 余泽雄

    2013-01-01

    目的:分析异位妊娠病人的生育史,宣传妇女保健。方法对某院2006年1月至2013年9月收治的异位妊娠病例的生育史进行分析。结果270例纳入患者中妊娠次数6次的有16例。结论重复性移位妊娠与输卵管炎症、妊娠的次数密切相关,应加强对妇女进行避孕、流产后保健教育。%Objective To explore the pathogenetic cause and precaution of the recurrent ectopic pregnancy. Methods Clinical data of 270 cages with recurrent ectopic pregnancy were analysed retrospectively from January 2006 to September 2013.Results Among the 270 eases, the recurrent ectopic pregnancy number of 37 cases is not more than 3.Conclusion Recurrent ectopic pregnancy is relevant to the number of pregnancies.

  7. Quantitative analysis of hormones and inflammatory cytokines in Chlamydia trachomatis-infected women with tubal ectopic pregnancy and early intrauterine pregnancy

    Directory of Open Access Journals (Sweden)

    Ruijin Shao

    2016-03-01

    Full Text Available 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-10, tumor necrosis factor α (TNFα, and interferon-γ (IFN-γ, epidermal growth factor, the Chlamydia (C. trachomatis IgG and HSP60 were analyzed. Receiver operating characteristic analysis was used to assess the diagnostic discrimination of tubal EP and gestational age-matched IUP. Our data show that C. trachomatis infection is associated with IL-8 levels, which had excellent discriminative validity in positively identifying tubal EP (concomitant with C. trachomatis infection from IUP and non-pregnant conditions regardless of C. trachomatis infection.

  8. Quantitative Analysis of Serumβ-HCG in Patients with Ectopic Pregnancy%宫外孕患者血清β-HCG定量分析

    Institute of Scientific and Technical Information of China (English)

    陶春妃; 朱晓莉

    2016-01-01

    Objective By patients serumβ-HCG quantitative analysis is simple and effective method of early diagnosis of ectopic pregnancy.Methods using chemiluminescence method to detect the contents ofβ-HCG serum of 623 cases of ectopic pregnancy patients and 250 cases of normal pregnancy group ofβ-HCG levels and compare.Results 250 cases of normal pregnancy serumβ-HCG average concentration is 71.78 mIU/mL,623 cases of ectopic pregancy group serumβ-HCG average concentration of 37.49 mIU/mL.Ectopic pregnancy patients serumβ-HCG average concentration is lower than normal pregnancy;Ectopic pregnancy patients serum concentration ofβ-HCG on between 15mIU/mL to 45 mIU/mL.Conclusion Ectopic pregnancy patients serum beta HCG levels significantly lower than the control group ( ﹤0.05),β-HCG serum quantitative analysis has an important value for early diagnosis of ectopic pregnancy diagnosis,worth clinical promotion.%目的:通过患者血清β-HCG定量分析探讨早期诊断宫外孕的简便有效的方法。方法采用化学发光方法检测623例宫外孕患者血清β-HCG含量与250例正常妊娠组β-HCG含量并进行比较。结果250例正常妊娠组的血清β-HCG平均浓度为71.78 mIU/mL,623例宫外孕组的血清β-HCG平均浓度为37.49 mIU/mL。宫外孕患者的血清β-HCG平均浓度低于正常妊娠组;宫外孕患者血清β-HCG的浓度集中在15~45 mIU/mL。结论异位妊娠组患者血清β-HCG水平明显低于对照组(<0.05),对早期诊断宫外孕诊断具有重要的价值。

  9. Ectopic Kidney

    Science.gov (United States)

    ... Ectopic Kidney Medullary Sponge Kidney Kidney Dysplasia Ectopic Kidney What is an ectopic kidney? An ectopic kidney is a birth defect in ... has an ectopic kidney. 1 What are the kidneys and what do they do? The kidneys are ...

  10. Reduced Ectopic Pregnancy Rate on Day 5 Embryo Transfer Compared with Day 3: A Meta-Analysis

    Science.gov (United States)

    Tang, Rong; Ding, Lingling; Yan, Lei; Chen, Zi-Jiang

    2017-01-01

    Objective To compare the risk of ectopic pregnancy (EP) after embryo transfer on day 3(D3-ET) and day 5(D5-ET). Design Meta-analysis Patients Women with pregnancy resulting from in vitro undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) Result(s) 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%] and frozen-thawed embryo-transfer (Fro-ET) cycles [RR, 0.43; 95%CI, 0.36–0.51; 51 772 pregnancies in 10 studies; I2 = 33%]. After separating out the randomized controlled trials (RCTs), a significant difference was found in the retrospective studies in both subgroups [both Fre-ET (RR,0.78;95% CI 0.69–0.88);91182 pregnancies in 14 studies; I2 = 45%] and Fro-ET(RR,0.43;95% CI 0.36–0.51; 51751pregnancies in 9 studies;I2 = 33%)], while the RCTs showed no statistical significance for Fre-ET cycles[RR,0.86;95% CI 0.32–2.26); 689 pregnancies in 7 studies; I2 = 0%]. Conclusion(s) The present study indicates that D5-ET reduces the risk for EP in cycles that use IVF or ICSI, compared with D3-ET. It suggests that D5-ET may be a better choice for decreasing the EP rate in assisted reproductive technology. Further high-quality randomized controlled trials are anticipated. PMID:28121989

  11. 异位妊娠发生的相关因素及预防%Study on relative factors and prevention of ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    谢秀媚

    2012-01-01

    目的 探讨分析引发异位妊娠的相关因素及预防措施.方法 随机抽取2009年1月~2011年1月某院妇产科诊治的100例异位妊娠患者的临床资料,同时随机抽取同期100例正常妊娠者的临床资料,对引发异位妊娠的相关因素资料进行单因素分析与Logistic回归分析.结果 Logistic回归模型分析显示引发异位妊娠的主要因素有口服紧急避孕药史、IUD、妇科炎症史、腹部手术史和孕产次.结论 异位妊娠是由一种或多种因素综合作用的结果,与多种因素有关,应采取措施,防患于未然.%OBJECTIVE To study the related factors and prevention measures of ectopic pregnancy. METHODS A randomized selection for clinical materials of 100 cases of ectopic pregnancy patients in obstetrics and gynecology department from January 2010 to January 2011. At the same time, randomly selected the clinical materials of 100 cases of normal pregnancy. The related factors of causing ectopic pregnancy were analyzed by single factor analysis and Logistic regression analysis. RESULTS Logistic regression model analysis showed that causes of ectopic pregnancy were the oral history of emergency contraception, IUD, gynecological inflammation history, abdominal surgeries and production time with child. CONCLUSION Ectopic pregnancy is caused by one or more related factors, it should take measures to prevent it.

  12. Methotrexate Combined with Clinical Study Treatment of Ectopic Pregnancy Ectopic PregnancyⅡ%甲氨蝶呤联合宫外孕Ⅱ号治疗异位妊娠的临床研究

    Institute of Scientific and Technical Information of China (English)

    王力清; 高惠敏; 吴琦

    2013-01-01

      目的:探讨甲氨蝶呤(MTX)联合宫外孕Ⅱ号治疗异位妊娠的临床疗效.方法:将180例异位妊娠患者随意分为两组,对照组90例采用静脉推注甲氨蝶呤治疗.治疗组90例在对照组基础上加服宫外孕Ⅱ号治疗.结果:治疗组治愈87例,治愈率为96.6%,对照组治愈74例,治愈率为83.3%,两组比较差异有统计学意义(P<0.05).结论:甲氨蝶呤联合宫外孕Ⅱ号治疗异位妊娠的临床疗效较单用西药治疗疗效好用药时间短,安全性高,值得推广.%Objective:Study on methotrexate(MTX)a joint clinical effect of treating ectopic pregnancy,ectopic pregnancyⅡ.Method:180 cases of ectopic pregnancy patients randomly divided into 2 groups,the control group of 90 cases with intravenous injection of methotrexate treatment. Treatment of 90 cases of treatment,control group Ⅱby taking on the basis of ectopic pregnancy.Result:The treatment cured 87 cases,cure rates for 96.6%,control group heal 74 cases,cure rates for 83.3%,comparison of two groups,the difference has significant meaning(P<0.05).Conclusion:Methotrexate a joint clinical effect of treating ectopic pregnancy,ectopic pregnancy Ⅱcompared with Western medicines alone good therapeutic medication time is short,high safety,merit promotion.

  13. The cost-effectiveness analysis of laparoscopic treatment of ectopic pregnancy: a single-center review of a five-year experience.

    Science.gov (United States)

    Tao, M F; Rong, R; Shao, H F; Xia, J

    2014-01-01

    The aim of this study was to investigate the cost-effectiveness of laparoscopic treatment for ectopic pregnancy by comparing the medical expenses and time of hospitalization of laparoscopic and open surgery for ectopic pregnancy in partial area of Shanghai, China. Clinical data of 762 cases with ectopic pregnancy undergoing surgical treatment (307 cases for laparoscopic surgery and 455 cases for open surgery) were analyzed retrospectively. The clinical information including the medical expenses and time of hospitalization was compared. The patients were divided into three groups according to the treatments of different lesions (lesions resection, conservative laparotomy, and exploration group) and were analyzed. The total hospitalization expenses and the top three single costs including surgery, exams, and medicine expenses were higher in laparoscopic group than in open surgery group. There was no significant difference between the two groups on the total time of hospitalization. The hospital days of preoperation were higher but the postoperative hospital days were lower in laparoscopic group than in open surgery group. Compared with the open surgery treatment, the hospitalization expenses of laparoscopic treatment for ectopic pregnancy increased. There was no significant difference on the total hospitalization days. The preoperative waiting period of inpatients increased and the post-operative hospital days reduced in laparoscopic group.

  14. Nursing of laparoscopic surgical in treatment of patients with ectopic pregnancy%腹腔镜手术治疗宫外孕患者的护理

    Institute of Scientific and Technical Information of China (English)

    钱海燕

    2013-01-01

    Objective:To investigate nursing interventions of patients with ectopic pregnancy in treatment with laparoscopic surgery.Methods:252 cases of laparoscopic surgical treatment of patients with ectopic pregnancy give comprehensive nursing measures,includ emergency care,psychological care,surgical care and discharge instructions.Results:Patients with ectopic pregnancy in this group were all discharged with no serious complication.Conclusion:Positive and complete clinical nursing measures are important to enhance the success rate of laparoscopic surgery,as well as to improve postoperative rehabilitation for patients with ectopic pregnancy.%目的:探讨腹腔镜手术治疗宫外孕患者的护理措施.方法:对行腹腔镜手术治疗的252例宫外孕患者给予完善的护理措施,包括急救护理、心理护理、手术护理及出院指导.结果:本组宫外孕患者均痊愈出院,未发生严重并发症.结论:积极、完善的临床护理措施对提高腹腔镜手术成功率、促进宫外孕患者术后康复具有重要意义.

  15. Prognosis for couples who have experienced repeated pregnancy loss.

    Science.gov (United States)

    Abuelo, D N; Barsel-Bowers, G

    1983-12-01

    To determine whether amniocentesis should be recommended to couples who have had multiple spontaneous abortions, we obtained information on the subsequent pregnancy outcome for 70 couples who had had two or more pregnancy losses. Fifty-two (74%) had one or more successful pregnancies, resulting in 64 newborns, all but 1 of whom were normal; the abnormal infant had a normal chromosome analysis.

  16. Colpotomia no tratamento da gestação ectópica Treating ectopic pregnancy with colpotomy

    Directory of Open Access Journals (Sweden)

    Heleodoro Corrêa Pinto

    2012-03-01

    Full Text Available OBJETIVO: Relatar o uso da colpotomia para o tratamento de gestações ectópicas. MÉTODOS: Estudo transversal retrospectivo. Foram incluídos todos os casos internados com suspeita clínico-laboratorial de gestação ectópica que não preenchiam critérios para tratamento medicamentoso com Methotrexato no período de fevereiro de 2007 a agosto de 2008. Foram analisadas variáveis demográficas, história ginecológica e características associadas ao tratamento foram obtidas através de revisão de prontuário. RESULTADOS: Dezoito mulheres foram incluídas no estudo. A média de idade foi de 27±5,2 anos. Todos os casos apresentavam gestação ectópica rota e todas as pacientes foram submetidas à salpingectomia parcial. O tempo cirúrgico variou de 30 a 120 minutos (média de 64,5 minutos, sendo contabilizado desde o momento de entrada da paciente na sala cirúrgica até o horário da saída. Nenhuma paciente apresentou infecção pós-operatória. O tempo médio de internação foi de 40± 14,3 horas. As medicações utilizadas no período pós-operatório foram semelhantes em todos os casos, sendo baseadas em anti-inflamatório não esteroide, dipirona, paracetamol e meperidina, conforme a necessidade. A dieta foi reintroduzida 8 horas após o término da cirurgia. CONCLUSÕES: A utilização da colpotomia no tratamento da gestação ectópica apresentou bons resultados, com ausência de complicações importantes e tempo de internação curto. O instrumental cirúrgico básico para a realização desse procedimento é relativamente comum a todos os hospitais, e a técnica cirúrgica é reprodutível.PURPOSE: To report the use of colpotomy for the treatment of ectopic pregnancies. METHODS: This was a retrospective cross-sectional study conducted on all women hospitalized with a clinical-laboratory suspicion of ectopic pregnancy who did not fulfill the criteria for drug treatment with methothrexate, during the period from February 2007 to

  17. Diagnostic value of vaginal B ultrasound in ectopic pregnancy%阴道B超对宫外孕的诊断价值

    Institute of Scientific and Technical Information of China (English)

    张昭萍

    2014-01-01

    目的:探讨B超对宫外孕的诊断价值。方法对2010年3月~2014年1月收治的77例宫外孕患者的阴道B超结果进行回顾性分析。结果77例患者行阴道B超检查,有75例与诊断相符合,诊断符合率97.4%,有1例卵巢肿瘤被误诊为宫外孕,l例漏诊。结论阴道B超诊断能够显著提高宫外孕诊断的准确率,且无创伤性,方便经济,减轻了患者痛苦,对早期诊断宫外孕有重要价值。%Objective To investigate the value of B ultrasound in the diagnosis of ectopic pregnancy. Methods 77 cases with ectopic pregnancy vaginal B ultrasound were retrospectively analyzed, March, 2010 to January, 2014. Results 77 cases of ultrasound correctly diagnosed 75cases with diagnostic accuracy rate of 97.4%.1 case of ovarian tumour was misdiagnosis with ectopic pregnancy, 1 case missed diagnosis. Conclusion B ultrasound can improve the diagnostic accuracy of ectopic pregnancy with non-invasive, onvenient to use and economy and relieve the pain. It can assist in the early diagnosis of ectopic pregnancy.

  18. Recurrent pregnancy-related upper airway obstruction caused by intratracheal ectopic thyroid tissue

    DEFF Research Database (Denmark)

    Døssing, H; Jørgensen, K E; Oster-Jørgensen, E

    1999-01-01

    An unusual case of recurrent pregnancy-related thyroid growth stimulation is reported. A 27-year-old euthyroid woman had pulmonary symptoms, thought to be asthma during her first pregnancy, that improved postpartum. Bronchodilatators had no effect and symptoms recurred from gestational week 22...... developed normally. We believe that this case illustrates the recurrent effect of pregnancy-related thyroid tissue stimulation by a combination of increasing human chorionic gonadotropin (hCG) stimulation and iodine deficiency in a borderline iodine-deficient region. This is the first report on symptomatic...

  19. Impact of the 'Providing Access to Continued Education' Programme on Repeat Teenage Pregnancy in the Bahamas.

    Science.gov (United States)

    Sakharkar, V P; Frankson, M A; Sakharkar, P R

    2015-05-15

    To determine the relationship of determinants such as age, ethnicity, education and sexual behaviour with repeat teenage pregnancy and to determine the impact of 'Providing Access to Continued Education' (PACE) programme in reducing repeat teenage pregnancy amongst its participants in The Bahamas. This retrospective cohort study included 397 attendees of the Adolescent Health Centre (AHC). Eighty-eight out of 139 registered participants completed the PACE programme. Data on age, ethnicity, education, sexual behaviour and repeat pregnancy in two years were analysed for descriptive statistics, and association of demographic characteristics and participation in the PACE programme with repeat pregnancy using the Chi-squared test. Mean age of participants was 16.4 ± 1.1 years; median school grade and mean grade point average (GPA) was 11 and 1.97 ± 0.7, respectively. The mean age at the first sexual activity was 14.9 ± 1.2 years. The mean age and number of sexual partners were 21 ± 4.3 years and 2 ± 1, respectively. Overall, repeat pregnancy rate was 39%: 37.4% amongst PACE registered and 31.8% amongst PACE completed mothers. No significant difference was observed in repeat pregnancy between registered and non-registered as well as those who completed the programme and those who did not. The odds ratio of 0.525 suggested that completion of the PACE programme had a moderate protective effect on reducing repeat pregnancy. Age, ethnicity, education and sexual behaviour showed no association with repeat pregnancy. The PACE programme did not reduce repeat pregnancy rate significantly. However, completion of the programme offered a moderate protection.

  20. Logistic Regression Analysis of the Risk Factors of Ectopic Pregnancy%异位妊娠危险因素Logistic回归分析

    Institute of Scientific and Technical Information of China (English)

    陈小华

    2014-01-01

    目的:研究异位妊娠发生的危险因素,为提高其防治水平提供科学有力证据。方法采用Logisitic回归分析法,选取2011年3月-2013年10月在该院妇产科住院治疗140例异位妊娠患者作为研究对象,进行异位妊娠相关因素的多元回归分析。结果流产史、异位妊娠史、盆腔感染史和宫内节育器是异位妊娠发生的显著危险因素,其优势比(odds ratio,OR)及95.0%可信区间(confidence interval,CI)分别为OR=3.79,95.0% CI:2.23~6.42、OR=6.98,95.0% CI:2.64~15.53、OR=4.21,95.0%CI:2.43~7.15和OR=2.19,95.0%CI:1.21~3.98。结论加强生殖健康教育、减少非意愿妊娠和预防盆腔感染,可降低异位妊娠的风险。%Objective To study the risk factors related to ectopic pregnancy in order to provide a scientific evidence for improving the level of prevention and treatment. Methods 140 cases of patients with ectopic pregnancy hospitalized in the Department of Obstetrics and Gynecology of our hospital from March, 2011 to October, 2013 were selected as the subjects. And logistic regression analysis method was used to analyze the factors related to ectopic pregnancy. Results The main risk factors related to ectopic pregnancy were history of abortion with the odds ratio (OR) =3.79, 95% confidence interval (CI):2.23-6.42; and history of ectopic pregnancy with OR=6.98; 95% CI: 2.64-15.53; history of pelvic infection with OR=4.21, 95% CI:2.43-7.15;the intrauterine de-vice with OR=2.19, 95%CI:1.21-3.98. Conclusion Strengthening the reproductive health education, reducing the unwanted preg-nancy and preventing pelvic infection, can reduce the risk of ectopic pregnancy.

  1. Clinical Application of Transvaginal Ultrasound in Diagnosis of Ectopic Pregnancy%经阴道超声诊断宫外孕的临床应用体会

    Institute of Scientific and Technical Information of China (English)

    温美艳

    2011-01-01

    目的:探讨经阴道超声诊断宫外孕的临床价值。方法:采用PHILIPS实时超声诊断仪,对我院经腹部壁声(TAS)和阴道超声(TVS)检查的108例术前宫外孕患者进行回顾性分析。结果:TVS诊断异位妊娠76例,其中完整胎囊型18例,混合包块型51例,实性包块7例;32例异位妊娠经TAS诊断仅12例为异位妊娠。108例术后病理证实,输卵管妊娠103例(占95%),卵巢妊娠1例(占0.92%),宫角妊娠2例(占1.85%),TVS误诊2例(占2.6%)。TVS诊断符合率为96.3%,TAS诊断符合率为25%。结论:TVS诊断异位妊娠操作方便,诊断符合率高,对早期未破裂的输卵管妊娠具有重要诊断意义。%Objective: To explore the clinical effective of Transvaginal ultrasound in diagnosis of ectopic pregnancy.Methods: One hundred and eight cases of ectopic pregnancy received ultrasound examination before surgery in our hospital were conducted a retrospectively analysis.Results: There were 76 cases of ectopic pregnancy diagnosed according to transvaginal ultrasound(TVS) diagnosis,in which 18 cases were complete gestational sac type,51 cases were mixed type mass,7 cases were solid mass.Whereas,there were 12 cases in 32 cases diagnosed as ectopic pregnancy with abdominal ultrasound(TAS).Pathological diagnosis confirmed that there were 103 cases(95%) of tubal pregnancy,1 case of(0.92%) ovarian pregnancy,2 cases(1.85%) of cornual pregnancy.The diagnose accordance rate of TVS was 96.3% and 25% of TAS.Conclusion: With the easy operation and the high rate of diagnosis,TVS is valuable in diagnosis of ectopic pregnancy,especially the early unruptured tubal pregnancy.

  2. The Clinical Analysis of Examination by Abdominal Ultrasound in Diagnosis of Ectopic Pregnancy%腹部超声诊断宫外孕的临床分析

    Institute of Scientific and Technical Information of China (English)

    刘治荣

    2015-01-01

    Objective Clinical value of examination by abdominal ultrasound in diagnosis of ectopic pregnancy is to be investigated. Methods Chose 43 patients with ectopic pregnancy received and treated in our hospital from May 2013 to May 2014 and examined by abdominal ultrasound,then compare patients’examination results to their pathology result in order to analyze the application value of abdominal ultrasound examination in diagnosis of ectopic pregnancy. Results there were 43 cases diagnosed as ectopic pregnancy by pathology examination and 38 cases were diagnosed by abdominal ultrasound examination; the diagnosis accuracy rate was up to 88.37%; there was no statistic differential between pathology examination and abdominal ultrasound examination(P>0.05). Conclusion Adominal ultrasound examination is the primary approach to diagnose ectopic pregnancy; it is of guidance significance and practical in clinical treatment of ectopic pregnancy.%目的:分析宫外孕应用腹部超声诊断的临床价值。方法选取2013年5月~2014年5月间我院收治的宫外孕患者43例,均给予腹部超声诊断,并与病理结果作为对照,分析腹部超声诊断在宫外孕中的应用价值。结果病理证实宫外孕43例,腹部超声检出38例,准确率为88.37%,腹部超声诊断结果与病理结果比较差异无统计学意义(P>0.05)。结论腹部超声是宫外孕的首选诊断方法,对临床治疗具有指导意义,切实可行。

  3. Analysis of Related Risk Factors of Ectopic Pregnancy%异位妊娠相关危险因素分析

    Institute of Scientific and Technical Information of China (English)

    李雪; 游虹; 苑小倩

    2015-01-01

    目的:通过病例-对照研究回顾性分析造成异位妊娠的潜在危险因素。方法:将2009年7月-2013年7月在笔者所在中心明确诊断为异位妊娠的80例患者作为病例组,收集同期正常生产的300例产妇作为对照组。记录相关因素,采用Logistic回归分析筛选出造成异位妊娠的危险因素。结果:有慢性盆腔炎病史、不孕史、流产史、既往异位妊娠病史等是异位妊娠的危险因素。结论:异位妊娠高危因素的确定有助于早期对可改变的因素进行干预,降低异位妊娠的发生率。%Objective:To analyze the potential risk factors for ectopic pregnancy through the retrospective analysis of case-control study. Method:80 women who diagnosed as ectopic pregnancy in our center from July 2009 to July 2013 were selected as the case group.300 cases for normal production were collected in the same period as the control group.The related factors were recorded,the risk factors of ectopic pregnancy were screened by Logistic regression analysis.Result:The findings revealed that the following factors were associated with increased risk of ectopic pregnancy,including:the history of chronic pelvic inflammatory disease,infertility history,abortion history,past history of ectopic pregnancy.Conclusion:By identifying risk factors is helpful to the early intervention of the modifiable factors,can reduce the incidence of ectopic pregnancy.

  4. 异位妊娠的临床超声诊断分析%Analysis of clinical ultrasound diagnosis of ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    陈梦宇

    2014-01-01

    Objective To analyze the application value of ultrasound examination in the diagnosis of ectopic pregnancy. Methods 84 patients suspected with ectopic pregnancy were selected and given ultrasonic examination.The ultrasonic examination results were compared with the surgical and pathological examination results. Results All the 84 patients suspected with ectopic pregnancy were diagnosed with ectopic pregnancy by surgical and pathological examination. Seventy-seven cases were detected by ultrasound,of which 27 cases were ruptured type,20 cases were non-ruptured type,7 cases were old type and 23 cases were abortive type,and all were confirmed by surgical and pathological exami-nation.The ultrasound detection rate of ectopic pregnancy was 91.7%. Conclusion Ultrasound examination can increase the diagnosis rate of ectopic pregnancy largely,it is worthy of popularization and application in clinic.%目的:分析超声检查在宫外孕诊断中的应用价值。方法选取疑似异位妊娠患者84例,均行超声检查,并将超声检查结果与手术及病理检查结果进行对比。结果84例疑似异位妊娠的患者手术及病理检查均确诊为异位妊娠,超声检出77例,其中破裂型27例,未破裂型20例,陈旧型7例,流产型23例,均经手术及病理检查证实,异位妊娠超声检出率为91.7%。结论超声检查可大幅提高异位妊娠的诊断率,值得临床推广应用。

  5. Rate, correlates and outcomes of repeat pregnancy in HIV-infected women.

    Science.gov (United States)

    Floridia, M; Tamburrini, E; Masuelli, G; Martinelli, P; Spinillo, A; Liuzzi, G; Vimercati, A; Alberico, S; Maccabruni, A; Pinnetti, C; Frisina, V; Dalzero, S; Ravizza, M

    2017-07-01

    The aim of the study was to assess the rate, determinants, and outcomes of repeat pregnancies in women with HIV infection. Data from a national study of pregnant women with HIV infection were used. Main outcomes were preterm delivery, low birth weight, CD4 cell count and HIV plasma viral load. The rate of repeat pregnancy among 3007 women was 16.2%. Women with a repeat pregnancy were on average younger than those with a single pregnancy (median age 30 vs. 33 years, respectively), more recently diagnosed with HIV infection (median time since diagnosis 25 vs. 51 months, respectively), and more frequently of foreign origin [odds ratio (OR) 1.36; 95% confidence interval (CI) 1.10-1.68], diagnosed with HIV infection in the current pregnancy (OR: 1.69; 95% CI: 1.35-2.11), and at their first pregnancy (OR: 1.33; 95% CI: 1.06-1.66). In women with sequential pregnancies, compared with the first pregnancy, several outcomes showed a significant improvement in the second pregnancy, with a higher rate of antiretroviral treatment at conception (39.0 vs. 65.4%, respectively), better median maternal weight at the start of pregnancy (60 vs. 61 kg, respectively), a higher rate of end-of-pregnancy undetectable HIV RNA (60.7 vs. 71.6%, respectively), a higher median birth weight (2815 vs. 2885 g, respectively), lower rates of preterm delivery (23.0 vs. 17.7%, respectively) and of low birth weight (23.4 vs. 15.4%, respectively), and a higher median CD4 cell count (+47 cells/μL), with almost no clinical progression to Centers for Disease Control and Prevention stage C (CDC-C) HIV disease (0.3%). The second pregnancy was significantly more likely to end in voluntary termination than the first pregnancy (11.4 vs. 6.1%, respectively). Younger and foreign women were more likely to have a repeat pregnancy; in women with sequential pregnancies, the second pregnancy was characterized by a significant improvement in several outcomes, suggesting that women with HIV infection who desire multiple

  6. Ectopic pregnancy within a rudimentary horn in a case of unicornuate uterus

    Energy Technology Data Exchange (ETDEWEB)

    Smolders, D.; Pouillon, M. [Department of Radiology, St. Augustinus Hospital, Wilrijk-Antwerpen (Belgium); Deckers, F. [Department of Radiology, St. Augustinus Hospital, Wilrijk-Antwerpen (Belgium); Department of Radiology, University Hospital of Antwerp, Edegem (Belgium); Vanderheyden, T.; Vanderheyden, J. [Department of Gynecology and Obstetrics, St. Augustinus Hospital, Wilrijk-Antwerpen (Belgium); De Schepper, A. [Department of Radiology, University Hospital of Antwerp, Edegem (Belgium)

    2002-01-01

    We report the MRI features of two cases of unicornuate uterus and occluded rudimentary horn. In one patient pregnancy had occurred in the occluded horn, prompting to urgent resection. The second patient illustrates more conventional findings in occluded rudimentary horn. In both cases MRI was able to correctly characterise the nature of the developmental anomaly. Furthermore, on the basis of signal intensities, differentiation between distended lumen due to blood accumulation and amniotic sac in the case of pregnancy could be made. Because of its high accuracy in determining the type of anomaly present, the lack of ionizing radiation, and the ability to evaluate, with the exception of the fallopian tubes, the entire genitourinary tract, MR imaging is essential and plays a key role in the evaluation of women who are consulting for infertility. (orig.)

  7. 彩色多普勒超声诊断异位妊娠的临床意义%Clinical assessment of ectopic pregnancy by color Doppler sonography

    Institute of Scientific and Technical Information of China (English)

    张敏

    2011-01-01

    Objective: To evaluate clinical sigiificance of color Doppler ultrasound in diagnosis of ectopic pregnancy.Methods: 176 patients with suspected ectopic pregnancy were checked by transvaginal two-dimensional ultrasound, color Doppler flow imaging (CDFI), the results of the ultrasound and clinical pathology and follow-up datas were compared.Results: 148 cases of ultrasound diagnosis of ectopic preWancy and surgical and conservative treatment of clinically diagnosed 143 cases, false positive rate was 0.2% and false negative rate 0.14%, diagnostic accuracy was 96.6%.Conclusion:Color Doppler ultrasound diagnosis of ectopic pregnancy with high accuracy, diagnosis of ectopic pregnancy is intuitive,safe, convenient and reproducible is good, it can proviod reliable clinical basis for the diagnoaia.It has important clinical value and is preferred examination method in the ditWiosis of ectopic pregnancy.%目的:探讨彩色多普勒超声诊断异位妊娠的临床意义.方法:对176例临床可疑异位妊娠的患者,采用经阴道二维超声、彩色多普勒(CDFI)进行检查,将超声结果与临床病理以及随访资料进行对比.结果:超声诊断异位妊娠148例,经临床手术及保守治疗后确诊143例,假阳性率0.2%,假阴性率0.14%,诊断准确率为96.6%.结论:彩色多普勒超声检查对异位妊娠诊断准确性高,对异位妊娠诊断直观、安全、方便、重复性好,能为临床提供可靠诊断依据,具有重要的临床应用价值,是诊断异位妊娠的首选检查方法.

  8. 异位妊娠发生影响因素的病例对照研究%Case control study on influence factors of ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    李菊枝

    2013-01-01

    Objective To study the risk factors of ectopic pregnancy in order to provide the theoretical foundation for ectopic pregnancy prevention and control. Methods The information of patients with ectopic pregnancy in our hospital during January 2011 to March 2013 was retrospectively collected and the information of normal pregnant women were collected during the same period and compared. The influence factors of ectopic pregnancy were studied by using case control method. Results The univariate analysis on marital status, first-time pregnant age, educational level, pregnancy-labor history, abortion history, ectopic pregnancy history, abdominal surgery history and gynecological diseases history showed that the factors such as first-time pregnant age(x2=13.36,P<0.05), pregnancy-labor history(x2=176.61, P < 0.05), abortion history(x2=28.18, P < 0.05), ectopic pregnancy history(x2=10.41, P < 0.05), abdominal surgery history(x2=7.32, P < 0.05) and gynecological diseases history(x2=33.10, P < 0.05) were the risk factors of ectopic pregnancy. The analysis of multivariate Logistic regression models showed that first-time pregnant age(OR=2.21,95%CI: 1.58-3.57), pregnancy-labor history(OR=4.18,95%CI: 2.16-6.54), abortion history(OR=3.97,95%CI: 1.87-5.29), ectopic pregnancy history(OR=1.56,95%CI:1.15-2.66), gynecological diseases history(OR=2.57,95%CI: 1.94-4.87)were independent risk factors for ectopic pregnancy. Conclusion Ectopic pregnancy is the comprehensive result of multiple factors, enhancing health education, reducing unintended pregnancy and preventing gynecological diseases are important measures to reduce the incidence of ectopic pregnancy.%目的研究异位妊娠发生的危险因素,为预防和控制异位妊娠的发生提供理论依据。方法回顾性收集我院2011年1月~2013年3月期间异位妊娠的患者资料,同期收集正常孕妇的资料进行对比,采用病例对照的方法,研究影响异位妊娠的影响因素。结果对婚姻

  9. Ectopic pregnancy as a model to identify endometrial genes and signaling pathways important in decidualization and regulated by local trophoblast.

    Directory of Open Access Journals (Sweden)

    W Colin Duncan

    Full Text Available The endometrium in early pregnancy undergoes decidualization and functional changes induced by local trophoblast, which are not fully understood. We hypothesized that endometrium from tubal ectopic pregnancy (EP could be interrogated to identify novel genes and pathways involved in these processes. Gestation-matched endometrium was collected from women with EP (n = 11 and intrauterine pregnancies (IUP (n = 13. RNA was extracted from the tissue. In addition, tissues were prepared for histological analysis for degree of decidualization. We compared a the samples from EP that were decidualized (n = 6 with non-decidualized samples (n = 5, and b the decidualized EP (n = 6 with decidualization-matched IUP (n = 6 samples using an Affymetrix gene array platform, with Ingenuity Pathway Analysis, combined with quantitative RT-PCR. Expression of PRL and IGFBP1 was used to confirm the degree of decidualization in each group. There were no differences in PRL or IGFBP1 expression in the decidualization-matched samples but a marked reduction (P<0.001 in the non-decidualized samples. Decidualization was associated with increased expression of 428 genes including SCARA5 (181-fold, DKK1 (71-fold and PROK1 (32-fold, and decreased expression of 230 genes including MMP-7 (35-fold and SFRP4 (21-fold. The top canonical pathways associated with these differentially expressed genes were Natural Killer Cell and Wnt/b-Catenin signaling. Local trophoblast was associated with much less alteration of endometrial gene expression with an increase in 56 genes, including CSH1 (8-fold, and a reduction in 29 genes including CRISP3 (8-fold. The top associated canonical pathway was Antigen Presentation. The study of endometrium from tubal EP may promote novel insights into genes involved in decidualization and those influenced by factors from neighboring trophoblast. This has afforded unique information not highlighted by previous studies and adds to our

  10. 腹腔镜治疗未破裂型异位妊娠的疗效分析%Efficacy Analysis of Laparoscopic Treatment of Unruptured Ectopic Pregnancy

    Institute of Scientific and Technical Information of China (English)

    孙岩

    2013-01-01

      目的:探讨腹腔镜治疗未破裂型异位妊娠的疗效分析,寻找更佳的治疗方案。方法:回顾性分析2008年3月~2010年10月在我院收治的60例未破裂型异位妊娠患者,随机分为两组:试验组和对照组各30例,密切观察两组患者的临床疗效。结果:治疗组未破裂型异位妊娠患者的β-HCG转阴(10.1d)、包块消失(12.5d)以及异位妊娠率(6.5%)低于对照组的β-HCG转阴(18.2d)、包块消失(31.2d)以及异位妊娠率(25.8%),治疗组未破裂型异位妊娠患者的输卵管碘油造影再通率(94.0%)以及宫内妊娠成功率(69.8%)高于输卵管碘油造影再通率(73.5%)以及宫内妊娠成功率(30.5%),两组间有显著性差异(P0.05)。结论:腹腔镜下输卵管切开取胚术在临床上可以作为保留患者生育功能的首选治疗方法,腹腔镜下输卵管切开取胚术是治疗未破裂型异位妊娠患者的一种安全、有效的治疗方法。%Objective:To study Efficacy analysis of laparoscopic treatment of unruptured ectopic pregnancy. To find better treatments. Methods:During the period March 2008 to October 2010, 60 cases of the unruptured ectopic pregnancy patients for appendectomy were performed. and all patients were divided into 2 groups randomly:test group and control group.Close observation of the clinical efficacy of the two groups of patients. Results:Treatment group of unruptured ectopic pregnancy the patients withβ-HCG was negative(10.1d), and the mass disappeared (12.5d), and ectopic pregnancy rate (6.5%) lower than the control group,β-HCG was negative (18.2d), the mass disappeared (31.2d), and ectopic pregnancy (25.8%), high treatment group unruptured ectopic pregnancy in patients with tubal lipiodol recanalization rate (94.0%) and intrauterine pregnancy success rate (69.8%)lipiodol in tubal recanalization rate (73.5%), as well as the success rate of intrauterine pregnancy (30.5%), there are significant differences (P 0

  11. The Role of Serum Beta hCG in Early Diagnosis and Management Strategy of Ectopic Pregnancy.

    Science.gov (United States)

    Surampudi, Kameswari; Gundabattula, Sirisha Rao

    2016-07-01

    The presentation of Ectopic Pregnancy (EP) can be highly variable and serum Beta hCG estimation plays an important role in early diagnosis. Aim of the study was to determine the trends of hCG levels in EP and to explore the role of hCG in decisions related to management and follow-up of EPs. A retrospective study of women who had EPs from January 2006 to December 2012 at an advanced tertiary care centre in southern India was carried out. These women had undergone treatment based on the hospital protocol. The study identified 337 women with EP. Thirty one surgically confirmed cases were diagnosed below the discriminatory zone of 1500 mIU/ml. Among women who had Beta hCG estimations 48 hours apart, plateauing was observed in 22.5% while decrease >15% was noted in 26.8%. Almost half (47.9%) of the cases had an increase >15% and a few (2.8%) demonstrated an initial fall followed by a rise in titres. In 23.9% of these women, there was a rise >53% similar to intrauterine pregnancy. The average pre-treatment Beta hCG was 429.8, 3866.2 and 12961.5 mIU/ml for those who received expectant, medical and direct surgical treatment respectively. 43 women with relative contraindications received medical management and 39 were lost to follow-up after medical and expectant management. Excluding them, the success rate of these two modalities was 76.6% and 85.0% respectively. No single level of Beta hCG is diagnostic of EP and serial levels can demonstrate atypical trends in some cases. Hence, interpretation of these results should be done in conjunction with clinical and sonographic findings to arrive at a correct diagnosis.

  12. 氨甲喋呤治疗异位妊娠的临床分析%Clinical Analysis of Ectopic Pregnancy With Methotrexate Therapy

    Institute of Scientific and Technical Information of China (English)

    丁涛; 刘树妍

    2015-01-01

    目的:分析研究异位妊娠采取氨甲喋呤治疗的临床应用价值。方法选取2013年3月~2014年3月我院接收的异位妊娠患者76例,采取氨甲喋呤治疗,对治疗效果分析研究。结果76例患者中,治愈70例,占92.11%。结论异位妊娠采取氨甲喋呤治疗,可以使治愈率明显提高,且不良反应较小。%ObjectiveAnalysis the clinical value of ectopic pregnancy using methotrexate therapy. Methods76 cases of ectopic pregnancy in March 2013~March 2014 in our hospital were taking methotrexate therapy,analysis of its therapeutic effect.Results70 in 76 cases were cured, accounting for 92.11%.ConclusionEctopic pregnancy using methotrexate therapy can make the cure rate signiifcantly improved.

  13. 宫外孕的彩超诊断价值及临床意义%Diagnostic value and clinical significance of color Doppler ultrasound for ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    高鸣

    2014-01-01

    目的:探讨彩超对宫外孕的诊断价值以及临床意义。方法回顾性分析88例宫外孕患者的临床及影像学资料。结果超声检查的88例宫外孕患者,诊断符合82例,误诊6例,确诊率为93.18%。结论彩超对宫外孕的诊断分辨力高、简便、快捷、诊断符合率较高,能为临床提供及时和切实可靠的诊断依据。%Objective To explore the diagnostic value and clinical significance of color Doppler ultrasound for ectopic pregnancy. Methods A retrospective analysis was made on the clinical and imaging data of 88 ectopic pregnancy patients. Results Among the 88 cases, who underwent color Doppler ultrasound examination, there were 82 cases with qualified diagnosis and 6 misdiagnosed cases. The accurate diagnosis rate was 93.18%. Conclusion Color Doppler ultrasound for ectopic pregnancy has the advantages of high diagnostic definition, convenience, high speed, and high diagnose accordance rate, thus it can provide timely and reliable information for clinicosis.

  14. Analysis of Clinical Nursing Care of 26 Cases of Ectopic Pregnancy%26例宫外孕的临床护理分析

    Institute of Scientific and Technical Information of China (English)

    李慧

    2015-01-01

    目的:分析宫外孕患者的抢救治疗及护理。方法选取26例宫外孕的临床抢救及护理资料进行分析。结果26例宫外孕患者经积极抢救和精心的护理所有患者均治愈出院,住院时间7~30天,平均13天。结论出血得到控制,生命体征恢复正常,缓解疼痛,患者情绪平稳,能积极配合治疗和护理。%Objective To salvage therapy in patients with ectopic pregnancy and nursing.Methods26 cases of clinical data rescue and care of ectopic pregnancy were analyzed.Results 26 cases of ectopic pregnancy patients with active rescue and careful care of all patients were cured, hospitalization time of 7 to 30 days, an average of 13 days.Conclusion Bleeding under control, vital signs returned to normal, pain relief, the patient emotional stability, to actively cooperate with the treatment and care.

  15. 35例特殊部位异位妊娠临床分析%Clinical analysis of 35 cases specific ectopic pregnancies

    Institute of Scientific and Technical Information of China (English)

    冯惠娟

    2001-01-01

    Objective: Investigate the clinical characteristics and misdiagnosis cause of specific ectopic pregnancies to decrease misdiagnosis rate. Methods: 35 cases of the specific ectopic pregnancies were analysed retrospectively. Results: This group accounted for 9.04% of all ectopic pregnancies occurring during this period.the rate of misdiagnosis is 80%. Tubal interstital pregnancies often had fatal intraperitoneal hemorrhage . Cornual pregancy presented unsyminetrical uterus enlargement.Abdominal pregnancy had the lower abdominal pain momently. It is difficult to diagnose ovarian pregnancy prior to surgical exploration . Painless vaginaI recurrent bleeding is main clinical manifestatio in cervical pregnancy. Conclusion:To advantageous recognition specific ectopic pregnancy . detail history, attention to clinical manipestation, Analyse comprehensively β-HCG、B-ultrasound and laparoscope ect and avoide the misdiagnosis.%目的:探讨特殊部位异位妊娠的临床特征及误诊原因,降低误诊率。方法:对35例特殊部位异位妊娠进行回顾性分析。结果:其发生率占同期异位妊娠的9.04%,误诊率80%。输卵管间质部妊娠易引起致命性腹腔出血、宫角妊娠子宫不对称性增大,腹腔妊娠孕早期一过性下腹痛,卵巢妊娠术前不易确诊,宫颈妊娠以无痛性阴道反复流血为主要临床表现。结论:提高对特殊部位异位妊娠的认识、详询病史,重视临床表现,结合β-HCG、B超及腹腔镜等综合分析、避免误诊。

  16. Awareness about a Life-Threatening Condition: Ectopic Pregnancy in a Network for Surveillance of Severe Maternal Morbidity in Brazil

    Directory of Open Access Journals (Sweden)

    Edilberto Alves Rocha Filho

    2014-01-01

    Full Text Available Objective. To assess occurrence of severe maternal complications associated with ectopic pregnancy (EP. Method. A multicenter cross-sectional study was conducted, with prospective surveillance of potentially life-threatening conditions (PLTC, maternal near miss (MNM, and maternal death (MD. EP complications, patient sociodemographic/obstetric characteristics, and conditions of severity management were assessed, estimating prevalence ratios with respective 95% CI. Factors independently associated with greater severity were identified using multiple regression analysis. Results. Of the 9.555 severe maternal morbidity patients, 312 women (3.3% had complications after EP: 286 (91.7% PLTC, 25 (8.0% MNM, and 1 (0.3% MD. Severe maternal outcome ratio (SMOR was 0.3/1000 LB among EP cases and 10.8/1000 LB among other causes. Complicated EP patients faced a higher risk of blood transfusion, laparotomy, and lower risk of ICU admission and prolonged hospitalization than women developing complications resulting from other causes. Substandard care was the most common in more severe maternal morbidity and EP cases (22.7% MNM and MD versus 15% PLTC, although not significant. Conclusion. Increased maternal morbidity due to EP raised awareness about the condition and its impact on female reproductive life. No important risk factors for greater severity were identified. Care providers should develop specific guidelines and interventions to prevent severe maternal morbidity.

  17. 异位妊娠切除一侧输卵管术后的心理护理%Psychological Nursing for Ectopic Pregnancy Resection Side of the Fallopian Tube after Operation

    Institute of Scientific and Technical Information of China (English)

    刘佳洁

    2014-01-01

    异位妊娠是指孕卵在子宫以外着床称为异位妊娠,俗称宫外孕。输卵管切除术是治疗异位妊娠的重要手段之一。手术治疗后患者容易出现焦虑和抑郁的心理问题,异位妊娠切除一侧输卵管术后的心理护理非常重要。本文就异位妊娠切除一侧输卵管术后的心理护理提出了一点看法。%Ectopic pregnancy refers to the fertilized egg outside uterine implantation cal ed ectopic pregnancy, commonly known as ectopic pregnancy. Salpingectomy is one of the important means for the treatment of ectopic pregnancy. After surgery patients prone to anxiety and depression, psychological problems, ectopic pregnancy to remove salpingectomy after psychological nursing is very important. In this paper, the side oviduct ectopic pregnancy excision postoperative psychological nursing is put forward.

  18. 异位妊娠的发病危险因素及临床诊断研究进展%Research Progress of Risk Factors and Clinical Diagnosis of Ectopic Pregnancy

    Institute of Scientific and Technical Information of China (English)

    马娟

    2015-01-01

    异位妊娠是妇产科急腹症中的一种常见病,为孕产妇死亡的主要病因,发病率持续上升。异位妊娠发生的原因复杂,本文旨在总结异位妊娠的发病危险因素,做好防范措施,降低异位妊娠的发生率,并总结异位妊娠的诊断方法,为异位妊娠的预防、治疗提供重要的参考。%Ectopic pregnancy is a common disease in the acute disease of Obstetrics and Gynecology,is the main cause of maternal mortality,and incidence rate continues to rise.Reasons for the occur ence of ectopic pregnancy are complicated,and this paper aims to summarize the incidence of ectopic pregnancy risk factors,take preventive measures,and reduce the incidence of ectopic pregnancy.And this paper also summarizes the diagnostic methods of ectopic pregnancy,and provide important reference data for the prevention,treatment of ectopic pregnancy.

  19. 浅谈异位妊娠的病因及护理对策%Discussion on Causes and Nursing Measures of Ectopic Pregnancy

    Institute of Scientific and Technical Information of China (English)

    张平花

    2011-01-01

    异位妊娠中的输卵管妊娠是妇产科最常见的急腹症之一,当输卵管妊娠流产或破裂时,可引起腹腔内严重出血,如不能及时就诊、处理,可危及生命.文章着重就异位妊娠中的输卵管妊娠发生的病因及护理措施,进行了分析和探讨.%Tubal pregnancy of ectopic pregnancy is one of the most common acute abdominal disease in gynecology and obstetrics.When tubal pregnancy is abortion or rupture, it can cause intra-abdominal severe bleeding.If they do not see a doctor, they will have life risk.The causes and nursing measures of tubal pregnancy of ectopic pregnancy were mainly analyzed and discussed in this paper.

  20. Ultrasound diagnosis of ectopic pregnancy in 56 cases and its clinical application value%超声诊断异位妊娠56例及其临床应用价值

    Institute of Scientific and Technical Information of China (English)

    朱渊

    2016-01-01

    Objective:To explore the accuracy of transabdominal ultrasound in the diagnosis of ectopic pregnancy.Methods:Compared with the results of operation and pathological examination,the results of ultrasonic examination in 56 cases of ectopic pregnancy were analyzed.Results:In 56 cases of ectopic pregnancy,there were 31 cases of tubal pregnancy,2 cases of cervical pregnancy,1 case of abdominal pregnancy,1 case of ovarian pregnancy,1 case of right uterine horn pregnancy and 10 cases of old ectopic pregnancy.Conclusion:Ultrasound diagnosis of ectopic pregnancy has a high accuracy.It has a extremely important clinical application value,and it has a very important reference value on the choice of treatment schedule for patients with ectopic pregnancy.%目的:探讨经腹超声(TAS)诊断异位妊娠的准确性。方法:与手术和病理检查结果对照,分析56例异位妊娠超声检查结果。结果:56例异位妊娠中有输卵管妊娠31例,宫颈妊娠2例,腹腔妊娠1例,卵巢妊娠1例,右侧宫角妊娠1例,陈旧性宫外孕10例。结论:超声诊断异位妊娠具有很高的准确率,有极其重要的临床应用价值,并对异位妊娠患者选择治疗方案有很重要的参考价值。

  1. Double Balloon Cervical Ripening Catheter for Control of Massive Hemorrhage in a Cervical Ectopic Pregnancy

    Science.gov (United States)

    Zambrano, Nabila; Reilly, James; Moretti, Michael

    2017-01-01

    Cervical pregnancy can be complicated by perfuse vaginal bleeding. Mechanical compression directed at tamponing the cervical vessels can control hemostasis. There are several types of balloon catheters that have been described for cervical compression. However use of a double balloon catheter is a novel approach for cervical tamponade, as one balloon is positioned below the external cervical os and the second balloon is situated above in the internal cervical os. This compresses the cervix from internal os to external os between the two balloons, forming a “cervical sandwich.” We describe this method of cervical tamponade using a silicone double balloon cervical ripening catheter that rapidly controlled hemorrhage in a patient that failed conservative management with methotrexate. PMID:28261511

  2. 宫外孕急诊特点及抢救治疗的护理配合%Nursing Coordination of Ectopic Pregnancy Emergency and Rescue Therapy

    Institute of Scientific and Technical Information of China (English)

    洪玉珍

    2013-01-01

    Objective:To investigate the features of ectopic pregnancy in emergency rescue,evaluation of ectopic pregnancy the importance of nursing in the treatment.Methods:Retrospective analysis was performed on 17 cases of ectopic pregnancy,summarizing the characteristic of emergency department visits, ruptured ectopic pregnancy hemorrhagic shock patients should be in correct shock at the same time do quickly after careful nursing and preparation before operation. Results:Through fast,antishock,immediately preparation before operation,nursing in operation and meticulous hemostasis after the operation,17 cases were cured and discharged.Conclusion:The ectopic pregnancy early identification,diagnosis in the emergency department as soon as possible,the timely processing of hemorrhagic shock patients.Nursing of rich can make the patient emotional stability,cooperate actively,safely and successfully passed the dangerous period.%  目的:探讨宫外孕在急诊时的表现特点,评价宫外孕抢救治疗中护理配合的重要性。方法:对17例宫外孕患者的临床资料进行回顾性分析,总结急诊就诊特点,对宫外孕破裂失血性休克患者应在纠正休克的同时迅速做好手术前准备及术后精心护理。结果:通过快速、积极抗休克治疗,立即做好术前准备,及时手术止血及细致术后护理,17例患者均痊愈出院。结论:对宫外孕在急诊应早期识别,尽快诊断,及时处理失血性休克患者。丰富的专科护理,可使患者情绪稳定、积极配合、安全顺利度过危险期。

  3. Clinical value of transvaginal color Doppler ultrasound in diagnosis of ectopic pregnancy%阴道彩超诊断异位妊娠的临床价值

    Institute of Scientific and Technical Information of China (English)

    刘华; 张卉

    2012-01-01

    目的 探讨经阴道彩超检查对早期异位妊娠的诊断价值.方法 对226例经阴道超声检查诊断为早期异位妊娠的超声声像图和临床资料进行回顾性分析.结果 226例经阴道超声检查诊断为异位妊娠的病例,218例与临床及病理诊断符合,诊断符合率为96.4%,漏诊率为1.77% (4/226),误诊率为1.77%(4/226).结论 经阴道彩超诊断异位妊娠技术操作简单,图像显示清晰,对异位妊娠的检出率非常高.同时对异位妊娠发生的部位定位较准确,对病变的进展程度也可作出相应的评价.%[Objective]To explore the diagnostic value of transvaginal color Doppler ultrasound examination for early ectopic pregnancy. [Methods] The ultrasound images and clinical data of 226 early ectopic pregnancy cases diagnosed by transvaginal color Doppler ultrasound were analyzed retrospectively. [ Results ] Among 226 early ectopic pregnancy cases diagnosed by transvaginal color Doppler ultrasound, 218 cases accorded with the clinical and pathological diagnosis, the diagnostic accordance rate was 96.4% , the rate of missed diagnosis was 1.77% (4/226), and the rate of misdiagnosis was 1.77% (4/226). [Conclusion] The transvaginal color Doppler ultrasound in diagnosis of ectopic pregnancy has the advantages of simple operation, clear image display and high detection rate. Meanwhile, it can accurately determine the position of ectopic pregnancy, and make an appropriate evaluation on degree of disease.

  4. Salpingotomy versus salpingectomy in women with tubal pregnancy (ESEP study) : an open-label, multicentre, randomised controlled trial

    NARCIS (Netherlands)

    Mol, Femke; van Mello, Norah M.; Strandell, Annika; Strandell, Karin; Jurkovic, Davor; Ross, Jackie; Barnhart, Kurt T.; Yalcinkaya, Tamer M.; Verhoeve, Harold R.; Graziosi, Giuseppe C. M.; Koks, Carolien A. M.; Klinte, Ingmar; Hogstrom, Lars; Janssen, Ineke C. A. H.; Kragt, Harry; Hoek, Annemieke; Trimbos-Kemper, Trudy C. M.; Broekmans, Frank J. M.; Willemsen, Wim N. P.; Ankum, Willem M.; Mol, Ben W.; van Wely, Madelon; van der Veen, Fulco; Hajenius, Petra J.

    2014-01-01

    Background Tubal ectopic pregnancy can be surgically treated by salpingectomy, in which the affected Fallopian tube is removed, or salpingotomy, in which the tube is preserved. Despite potentially increased risks of persistent trophoblast and repeat ectopic pregnancy, salpingotomy is often preferred

  5. Diagnosis -Treatment and th e An alysis ofP sych ological Status of Ectopic Pregnancy Again for 13 Cases%穴位埋线治疗慢性前列腺炎68例临床观察

    Institute of Scientific and Technical Information of China (English)

    贾天鹏

    2011-01-01

    目的:观察穴位埋线治疗慢性前列腺炎的临床疗效.方法:下腹部穴位埋线治疗慢性前列腺炎患者68例,15天治疗1次为1个疗程,疗程间休息2~3天.结果:治愈56例,占82.3%,总有效率为96.0%.结论:穴位埋线治疗慢性前列腺炎,治愈率高.%Objective:To analyze the diagnosis、treatment and outcome of the patients with ectopic pregnancy a gain. Methods:Retrospective analyzed the diagnosis、 treatment method and the relationship between this ectopic pregnancy of 13 patients with ectopic pregnancy again from Janury 2000 to December 2007. Results:Among the patients with ec topic pregnancy again,the patients with pelvic adhesions were 8 cases(61.54%),with endometriosis were 4 cases (30.77%),with the side salpingectomy were 5 cases,with retained tubal were cases,conservative treatment with TCM were 3 cases;patients fear of sex living to some extent,and significantly worse than the previous ectopic pregnancy. Conclusion:The incidence of ectopic pregnancy again was related to disease in the organs of pelvic inflammatory,the treatment of previous ectopic pregnancy is suggested with TCM,requiring long-term care and psychological counseling,to eliminate the serious psychological and physical injury of women with ectopic pregnancy again.

  6. Postoperative repeated respiratory insufficiency and thyrotoxicosis in molar pregnancy.

    Science.gov (United States)

    Cekic, B; Geze, S; Ulusoy, H; Coskun, I; Erturk, E

    2012-06-01

    Following the removal of a hydatiform mole in a 34-year-old, 14-week pregnant patient, thyrotoxicosis and respiratory insufficiency attacks were twice unexpectedly repeated. The symptoms were resolved with the administration of plasmapheresis, antithyroid and β-blocker drugs and non-invasive mechanical ventilation; however, she was again operated due to prolonged elevated β-hCG.

  7. The response of Islamic jurisprudence to ectopic pregnancies, frozen embryo implantation and euthanasia.

    Science.gov (United States)

    Ghanem, I

    1987-07-01

    The opinions of the Jurisconsult of Egypt on Islamic law regarding test tube fertilization, embryo transfer and abortion are explained. Test tube babies, if not derived from the husband's sperm, are by definition, "zina" or the result of illicit sexual intercourse. This type of quasi-adultery is punishable by mere disgracing, rather than lapidation, or stoning to death. Such children cannot inherit even from the mother. Possibly, a female child may marry the husband, to be legitimized in terms of inheritance. Under Islamic law, embryo transfer is illegal insofar as it involves artificial insemination of the donor by the husband; temporary maternity by the donor is a jural concept that has no place in Islamic family law. The egg of the donor, not the surrogate mother, places the issue in the thorny area of multiple suckling. There have been no pronouncements by Islamic legal experts on euthanasia or pregnancy by in vitro fertilization of orphaned embryos. Abortion law "ijhad" in Kuwait was amended in 1982 to permit abortion where either grievous bodily harm to the mother is imminent or it is proved that the baby will suffer incurable brain damage or severe mental retardation. The decision must be approved unanimously by 3 Muslim consultant physicians presided over by an obstetrician or gynecologist, parental consent is required, and the hospital must have an obstetric-gynecological wing. There is precedent in Islamic law for saving the life of the mother where there is a clear choice of allowing either the fetus or the mother to survive. Similarly in case of miscarriage or attempted miscarriage, damages for a fetus or stillborn are less than those paid for a live birth. Penalties for therapeutic abortion, for example after exposure to German measles, have been viewed as less serious before 120 days of gestation, when the Prophet indicated that the embryo is given a soul. These ethical interpretations are worth considering for Western jurists as a source of ideas.

  8. Embarazo ectópico tubárico roto posterior a esterilización quirúrgica (Ruptured tubal ectopic pregnancy after surgical sterilization

    Directory of Open Access Journals (Sweden)

    Ismael Suárez Torres

    2014-07-01

    Full Text Available Resumen (español La esterilización tubárica quirúrgica es un método comúnmente utilizado de anticoncepción. Aunque el embarazo después de la esterilización es poco común, este puede ocurrir y cuando esto ocurre existe un riesgo substancial de convertirse en un embarazo ectópico. Se presenta el caso un embarazo ectópico posterior a la esterilización quirúrgica tubárica en una paciente de 38 años, V gesta, III paras, I cesárea, con antecedentes de uso de dispositivos intrauterinos por varios años antes de la salpingectomía realizada 12 meses antes durante la cesárea, quien consultó por presentar marcada palidez cutáneo-mucosa, retraso menstrual y dolor abdominal de fuerte intensidad. Durante la laparotomía ambas trompas estaban separadas en dos porciones. La porción terminal de la trompa derecha se observó la presencia de una tumoración compatible con un embarazo ectópico tubárico roto. Abstract (english Surgical tubal sterilization is a commonly used method of contraception. Although pregnancy after sterilization is uncommon, when it occurs, there is a substantial risk that it will be an ectopic pregnancy. We report a case of ruptured tubal ectopic pregnancy following surgical tubal sterilization in a 38 years-old patient, gravida V, para III, cesarean I, with history of intrauterine device use for many years before salpingectomy performed 12 months before during cesarean section, who consulted for presenting menstrual delay and severe abdominal pain. During laparotomy both tubes were separated in two portions. There was observed in terminal portion of right tube the presence of a tumor compatible with ruptured tubal ectopic pregnancy.

  9. Has increased clinical experience with methotrexate reduced the direct costs of medical management of ectopic pregnancy compared to surgery?

    Directory of Open Access Journals (Sweden)

    Westaby Daniel T

    2012-09-01

    Full Text Available Abstract Background There is a debate about the cost-efficiency of methotrexate for the management of ectopic pregnancy (EP, especially for patients presenting with serum human chorionic gonadotrophin levels of >1500 IU/L. We hypothesised that further experience with methotrexate, and increased use of guideline-based protocols, has reduced the direct costs of management with methotrexate. Methods We conducted a retrospective cost analysis on women treated for EP in a large UK teaching hospital to (1 investigate whether the cost of medical management is less expensive than surgical management for those patients eligible for both treatments and (2 to compare the cost of medical management for women with hCG concentrations 1500–3000 IU/L against those with similar hCG concentrations that elected for surgery. Three distinct treatment groups were identified: (1 those who had initial medical management with methotrexate, (2 those who were eligible for initial medical management but chose surgery (‘elected’ surgery and (3 those who initially ‘required’ surgery and did not meet the eligibility criteria for methotrexate. We calculated the costs from the point of view of the National Health Service (NHS in the UK. We summarised the cost per study group using the mean, standard deviation, median and range and, to account for the skewed nature of the data, we calculated 95% confidence intervals for differential costs using the nonparametric bootstrap method. Results Methotrexate was £1179 (CI 819–1550 per patient cheaper than surgery but there were no significant savings with methotrexate in women with hCG >1500 IU/L due to treatment failures. Conclusions Our data support an ongoing unmet economic need for better medical treatments for EP with hCG >1500 IU/L.

  10. Role of day 4 HCG as an early predictor of success after methotrexate therapy for ectopic pregnancies.

    Science.gov (United States)

    Girija, S; Manjunath, A P; Salahudin, A; Jeyaseelan, L; Gowri, V; Abu-Heija, A; Al Kharusi, L

    2017-08-01

    To validate whether change in serum HCG levels between days 0 and 4 confer any prognostic value during methotrexate therapy and to quantify its change. This is a retrospective study of 48 tubal ectopic pregnancies treated with single dose methotrexate protocol at University Hospital, Muscat, Oman from January 2012 to December 2013. The clinical outcome was analyzed based on the complete resolution of HCG levels or need for additional doses of methotrexate or recourse to surgery. The percentage change in HCG levels between days 0 and 4 (HCG index) of methotrexate were calculated and receiver operator characteristics curve was plotted to identify the best cutoff levels. In order to get a robust 95% confidence interval, bootstrap method using R software was done using 1000 re-sampling. ROC curve and the predictive values were estimated using MEDCALC software. The mean HCG level on day 4 is significantly higher in treatment failure group (4254±4095 IU/L vs. 2109±3646 IU/L, P=0.008). The HCG levels between day 0 and 4 decreased in 42.7% (21/48) of cases and 80.9% of these cases had treatment success. The HCG levels increased in 57.4% (27/48) of cases and 33.3% of these cases had treatment success. (P=0.001). A 10 percent decline in day 4 HCG levels predict the treatment success with sensitivity of 77% and Specificity 81%. The area under the ROC curve was 0.82 (95% CI: 0.67-0.92), (PHCG values on day 4, decrease in HCG level from day 0 to 4 and 10% or more fall in day 4 HCG levels. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Do women give the same information on binge drinking during pregnancy when asked repeatedly?

    DEFF Research Database (Denmark)

    Strandberg-Larsen, K; Andersen, Anne-Marie Nybo; Olsen, Jørn;

    2006-01-01

    OBJECTIVE: To study if pregnant women give the same answers to questions on frequency and timing of binge drinking when asked more than once during and after pregnancy. DESIGN: Cohort study.Setting:The Danish National Birth Cohort. SUBJECTS: The study is based on 76 307 pregnant women with repeated...... information on binge drinking during the early part of pregnancy and 8933 pregnant women with information on binge drinking during pregnancy weeks 30-36, obtained while pregnant and 6 months after delivery. RESULTS: More women reported binge drinking, if the interview took place close to the period...... in question. As the report of binge drinking was highest in the first of two interviews referring to the same period, as well as women who participated in the first interview in pregnancy week 12 or earlier reported more binge drinking compared to women who participated in the interview later in pregnancy...

  12. Value of serum β-HCG, P, CA125, and color Doppler ultrasound in early diagnosis of ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    Yan-Li Liu

    2016-01-01

    Objective:To explore the clinical value of serum β-HCG, P, CA125, and color Doppler ultrasound in the early diagnosis of ectopic pregnancy (EP). Methods:A total of 50 patients with EP who were admitted in our hospital from September, 2014 to September, 2015 were included in the study and served as the observation group, while 50 normal pregnant women were served as the control group. A volume of 5 mL of fasting elbow venous blood the day on admission in the two groups was extracted, and then was centrifuged for serum. The chemiluminescence immunoassay was used to detect the levels of serum β-HCG, P, and CA125. After 48h,β-HCG level was detected again. The vaginal color Doppler diasonograph was used to detect the changes of RI and PSV. The blood supply of LH was observed. Results:The levels of serumβ-HCG, P, and CA125 in the observation group were significantly lower than those in the control group (P<0.05). When β-HCG<2 000 IU/L, after 48 h, β-HCG level was doubled in 3 cases (6.0%) in the observation group, while in 49 cases (98.0%) in the control group, and the differences between the two groups were not statistically significant (P<0.05). RI in the observation group was significantly higher than that in the control group, while PSV was significantly lower than that in the control group (P<0.05). Blood supply in the observation group was in a half ring shape, accounting for 58.0%;in the control group was in a ring shape, accounting for 70.0%, and the difference was statistically significant (P<0.05). Conclusions:Determination of the levels of serumβ-HCG, P, and CA125 in the pregnant women, in combined with the vaginal color Doppler ultrasound detection of RI and PSV, can contribute to distinguish the normal intrauterine pregnancy with EP and prevent the misdiagnosis, which can provide an accurate reference value for the early diagnosis and timely treatment of EP, and can be used as an ideal method for the diagnosis of EP.

  13. 经腹超声对早期异位妊娠的诊断价值研究%Value of Abdominal Ultrasound in Diagnosis of Early Ectopic Pregnancy

    Institute of Scientific and Technical Information of China (English)

    宁海燕; 王岩

    2015-01-01

    ObjectiveTo investigate the diagnostic value of abdominal ultrasound in early ectopic pregnancy.MethodsA retrospective analysis of 38 patients with ectopic pregnancy in our hospital from August 2013 to, 12 patients with ectopic pregnancy were retrospectively analyzed.Results 38 patients by color Doppler ultrasound in diagnosis of early ectopic pregnancy and results of ultrasonography and surgical results are consistent. Therefore, the clinical feasibility and accuracy of ultrasound in the diagnosis of early ectopic pregnancy patients.Conclusion Application of ultrasound in the diagnosis of ectopic pregnancy has found earlier unruptured smal package block characteristics, can be scientific and accurate diagnosis of early ectopic pregnancy patients, in order to provide the clinical basis for early treatment, has precious value.%目的:探讨经腹部超声对早期异位妊娠的诊断价值。方法回顾性分析2013年8月~2014年12月经我院诊断为异位妊娠的38例患者,分析其腹部超声影像资料。结果38例患者经彩色多普勒超声诊断为早期异位妊娠,超声检查的结果与手术结果一致,由此可证超声在诊断早期异位妊娠患者的临床可行性和准确性。结论应用超声诊断异位妊娠具有较早发现未破裂的小型包块的特点,能够科学准确的诊断早期异位妊娠患者,为早期治疗提供重要的临床依据,具有宝贵的价值。

  14. 腔内超声引导异位妊娠囊穿刺注射氨甲喋呤治疗宫外孕的效果%The Effect of Intracavity Ultrasound Guided Puncture Ectopic Pregnancy Sac Injection of Methotrexate in Treatment of Ectopic Pregnancy

    Institute of Scientific and Technical Information of China (English)

    王娜

    2016-01-01

    Objective To investigate the clinical effect of endoluminal ultrasound guided injection of methotrexate treatment of ectopic pregnancy ectopic pregnancy.Methods From January 2015 to December 2015, 60 cases of ectopic pregnancy in our hospital were investigated, which were randomly divided into the observation group and the control group, each group had 30 cases. MTX-CF regimen in treatment of patients in the control group received; patients in the observation group with intracavity ultrasound guided ectopic pregnancy sac puncture injection of methotrexate for treatment, analysis and compare the therapeutic effect of two groups.Results The treatment success was compared, the observation group was 100%, and the control group was 73.3%, there was statistical significance (P<0.05).Conclusion Endosonography guided ectopic pregnancy sac puncture ammonia injection MTX MTX treatment of ectopic pregnancy has better curative effect, is superior to the traditional scheme of MTX-CF treatment.%目的:探讨腔内超声引导异位妊娠穿刺注射氨甲喋呤治疗宫外孕的临床效果。方法选取2015年1月~12月我院收治的60例宫外孕患者。将患者随机分为观察组及对照组,各30例。对照组接受MTX-CF方案治疗;观察组以腔内超声引导异位妊娠囊穿刺注射氨甲喋呤进行治疗,分析比较治疗效果。结果观察组治疗有效率100%,对照组73.3%,差异有统计学意义(P<0.05)。结论腔内超声引导异位妊娠囊穿刺注射氨甲喋呤治疗宫外孕具有较好的疗效,优于传统的MTX-CF方案治疗。

  15. 异位妊娠发病相关因素及其与盆腔手术的相关性分析%Analysis the Related Factors of Ectopic Pregnancy and the Correlation with Pelvic Surgery

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

      目的:分析异位妊娠发病相关因素及其与盆腔手术的相关性。方法:随机选取80例异位妊娠与80例正常妊娠孕妇,分别为观察组与对照组,对两组进行问卷调查,对盆腔手术史、附件炎、盆腔炎、流产史、异位妊娠史、不孕史、子宫病变史以及宫内节育器放置等相关情况予以统计,比较与异位妊娠发生的相关性。结果:以上几项指标均与异位妊娠的发生具有相关性,盆腔手术是发生异位妊娠的高危因素。结论:明确发生异位妊娠的相关因素,并积极采取有效的预防措施,严格执行盆腔手术,利于降低异位妊娠发生率。%Objective:To analyse the correlation between ectopic pregnancy and pelvic surgery and the relevant factors causing ectopic pregnancy.Method:80 cases ectopic pregnancy pregnant women and 80 cases normal pregnancy pregnant women were seclected randomly,they were divide into the observation group and the control group,then made questionnaire survey of two groups and collected the relevant situation about pelvic surgery history,appendagitis,pelvic inflammatory disease,abortion history,ectopic pregnancy history,history of infertility,uterine lesions history and intrauterine device,then compared the correlation between several indexes above and the happeness of ectopic pregnancies.Result:Several indexes above all had correlation with ectopic pregnancy,pelvic surgery was risk factor of the happeness of ectopic pregnancy. Conclusion:Clear the relevant factors above about the happeness of ectopic pregnancy,and take effective measures actively,make pelvic surgery strictly can reduce the incidence rate of ectopic pregnancy.

  16. Factors influencing repeated teenage pregnancy: a review and meta-analysis.

    Science.gov (United States)

    Maravilla, Joemer C; Betts, Kim S; Couto E Cruz, Camila; Alati, Rosa

    2017-04-19

    Existing evidence of predictors of repeated teenage pregnancy has not been assessed rigorously. This systematic review provides a comprehensive evaluation of protective and risk factors that are associated with repeated teenage pregnancy through a metaanalytical consensus. We used PubMed, EMBASE, CINAHL, ProQuest, PsychINFO, ScienceDirect, Scopus, and Web of Science databases from 1997-2015 and the reference list of other relevant research papers and related reviews. Eligibility criteria included (1) epidemiologic studies that analyzed factors associated with repeated pregnancy or birth among adolescents pregnancy, and (2) experimental studies with an observational component that was adjusted for the intervention. We performed narrative synthesis of study characteristics, participant characteristics, study results, and quality assessment. We also conducted random-effects and quality-effects metaanalyses with meta-regression to obtain pooled odds ratios of identified factors and to determine sources of between-study heterogeneity. Twenty-six eligible epidemiologic studies, most from the United States (n=24), showed >47 factors with no evidence of publication bias for each metaanalysis. Use of contraception (pooled odds ratio, 0.60; 95% confidence interval, 0.35-1.02), particularly long-acting reversible contraceptives (pooled odds ratio, 0.19; 95% confidence interval, 0.08-0.45), considerably reduced repeated teenage pregnancy risk. Among studies about contraception, the number of follow-up visits (adjusted coefficient, 0.72; P=.102) and country of study (unadjusted coefficient, 2.57; permuted P=.071) explained between-study heterogeneity. Education-related factors, which included higher level of education (pooled odds ratio, 0.74; 95% confidence interval, 0.60-0.91) and school continuation (pooled odds ratio, 0.53; 95% confidence interval, 0.33-0.84), were found to be protective. Conversely, depression (pooled odds ratio, 1.46; 95% confidence interval, 1

  17. Laparoscopic treatment of 68 cases of ectopic pregnancy clinical experience%腹腔镜治疗宫外孕68例临床体会

    Institute of Scientific and Technical Information of China (English)

    邱洁

    2012-01-01

      目的:研究68例腹腔镜手术治疗宫外孕的临床特点。方法:整合性研究2011年1月到2012年3月在我院接受腹腔镜治疗的68例宫外孕患者的临床疗效。结果:68例患者在腹腔镜下确诊为患有宫外孕疾病,并即刻实行手术治疗。手术中检查发现为输卵管妊娠的有37例,卵巢妊娠有7例,而这其中输卵管妊娠的流产型为9例,破裂型为17例。手术进行最短的用时为30分钟,最长时间为70分钟,平均的时间为40分钟。手术中腹腔内出现出血过多的为1200毫升,出血较少的为20毫升,平均出血量为260毫升。小于500毫升的有49例,500毫升至1000毫升之间的有11例,大于1000毫升的有8例。术后无并发症现象,5—10天内血HCG已恢复如常。结论:腹腔镜手术治疗宫外孕疾病,具有伤口小、创伤轻微、住院时间短等优点。对于治疗宫外孕疾病是最有效的方法。%  objective:to study the treatment of 68 cases of laparoscopic surgery clinical characteristics of the ectopic pregnancy. Methods:integration research between January 2011 and March 2012 in our hospital laparoscopic treatment of 68 cases of ectopic pregnancy patients clinical curative effect. Results:in 68 patients with laparoscopic diagnosed as ectopic pregnancy disease, and immediate surgery treatment. In the operation findings for tubal pregnancy with 37 cases, ovarian pregnancy have 7 cases, of which the abortion type tubal pregnancy for 9 cases, fracture type for 17 cases. The operation when the shortest for 30 minutes, the longest time for 70 minutes, the average time for 40 minutes. Surgery intraperitoneal appear haemorrhage too much for 1200 ml, less bleeding for 20 ml, average amount of bleeding for 260 ml. Less than 500 ml of 49 cases, 500 ml to 1000 ml of between 11 cases, more than 1000 ml of 8 cases. No postoperative complications phenomenon, 5--10 days HCG blood has returned to normal. Conclusion:laparoscopic surgery

  18. 异位妊娠的21例治疗分析%The Treatment Analysis of 21 Cases of Patients with Ectopic Pregnancy

    Institute of Scientific and Technical Information of China (English)

    张艳波

    2014-01-01

    目的:对异位妊娠进行临床治疗分析。方法随机选取异位妊娠患者21例,根据患者病情实施相关的治疗方法,评价临床治疗效果。结果经过积极治疗,治愈20例(90.91%)1例(9.01%)转院,有效率90.91。结论异位妊娠是妇产科常见的一种并发症,要及时做出正确的诊断,及时救治,以免延误病情,危险患者的生命及健康。%Objective The clinical treatment analysis of patients with ectopic pregnancy to be investigated. Methods Making a selection of 21 cases of patients with ectopic pregnancy and offering them with proper treatment based on their il ness state and then making an assessment on the clinical treatment effect. Results Because of the active treatment and attendance, 20 cases of patients are cured(90.91%)and one case of patient is transferred to another hospital(9.01%),the effectiveness probability reaches to 90.91 percent. Conclusion Ectopic pregnancy is a common complication in Obstetrics and Gynecology Department;in case of il ness of incur loss through delay;it is required to diagnose and cure it correctly and rapidly in order to prevent patients from risking their lives.

  19. To Investigate the Clinical Value of Early Diagnosis of Ectopic Pregnancy B Ultrasound%探讨B超对异位妊娠早期诊断的价值

    Institute of Scientific and Technical Information of China (English)

    玛依拉·达吾列提

    2015-01-01

    目的探讨B超对异位妊娠的诊断价值。方法对在我服务站检查的15例异位妊娠患者资料进行回顾性分析。结果输卵管妊娠9例,卵巢妊娠4例,右宫角妊娠1例,1例黄体破裂误诊为异位妊娠,准确率高达93.3%。结论腹部超声检查是一种无创性检查方法,能及时、准确诊断异位妊娠,对临床治疗具有指导意义。%Objective To investigate the B ultrasound diagnostic value of ectopic pregnancy.Methods A retrospective analysis of clinical data of 15 patients with ectopic pregnancy.Results 9 cases of tubal pregnancy,4 cases of ovarian pregnancy,1 cases of right cornual pregnancy,1 cases of rupture of corpus luteum misdiagnosed as ectopic pregnancy,The accuracy rat is as high as 93.3%. Conclusion Abdominal ultrasonography is a noninvasive method,can diagnose ectopic pregnancy in time and accurately,and has significance in guiding clinical treatment.

  20. Prediction of outcome of tubal ectopic pregnancy on the basis of site of implantation of embryo in the fallopian tube

    Directory of Open Access Journals (Sweden)

    Rajshree D. Katke

    2015-10-01

    Conclusions: Early detection of tubal ectopic and its site of implantation can help in deciding further management especially to go for conservative or surgical management. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1431-1435

  1. Clincial analysis of the relative onset factors of 120 cases of ectopic pregnancy%120例异位妊娠发病相关因素的临床分析

    Institute of Scientific and Technical Information of China (English)

    任英俊

    2011-01-01

    目的 探讨异位妊娠的发病相关因素及治疗方法,为生育健康和保健工作提供科学依据.方法 回顾性分析2006年7月至2010年5月本院收治的120例异位妊娠患者的临床资料.结果 壶腹部妊娠较其他部位输卵管妊娠比例明显增高(P0.05).结论 异位妊娠的致病因素复杂,盆腔炎性病变、流产史、宫内节育器史、异位妊娠史是异位妊娠发生的危险因素.%Objective To investigate the incidence of ectopic pregnancy-related factors and treatment,and provide scientific basis for reproductive health and health care. Methods Retrospective analysis from July 2006 to May 2010,120 cases of ectopic pregnancy treated patients with clinical information.Results The rate of ectopic pregnancy in the ampullae of oviduct was markedly higher than that in other part of oviduct(P0.05).Conclusions The ectopic pregnancy risk factors is complex,including pelvic inflammatory disease, abortion, IUD and ectopic pregnancy history.

  2. 异位妊娠误诊为急性胃肠炎15例分析%Analysis of Ectopic Pregnancy Misdiagnosed as Acute Gastroenteritis (15 Cases)

    Institute of Scientific and Technical Information of China (English)

    饶贵云; 谭艳丽

    2011-01-01

    Objective To investigate the cause of ectopic pregnancy misdiagnosed as acute gastroenteritis, and to propose preventive measures. Methods The clinical data of 15 cases of ectopic pregnancy misdiagnosed in our hospital was retrospectively analyzed. Results All patients had the initial symptom of abdominal pain. 9 cases was observed as acute gastroenteritis at primary period, during which hemorrhagic shock appeared after treatment, so ectopic pregnancy was suspected and surgery was performed and then it was later confirmed as ruptured ectopic pregnancy with a blood loss of 2000 ~30 000 ml; 1 case was treated as acute gastroenteritis for 3 times in the local hospital, but died from excessive bleeding in our hospital. Urinary HCG of the patient was positive, intraperitoneal blood was drawn and confirmed as ruptured entopic pregnancy and hemorrhage shock; 5 cases was treated as acute gastroenteritis 2 or 3 times without remission, diagnosed as tubal pregnancy through gynecological consultation after abdominal B-ultrasound showed adnexal mass and abdominal effusion. The blood loss was 1000 ~ 1500 ml in the surgery. 1 patient died, and 14 patients were cured and discharged. Conclusion Ectopic pregnancy may be easily misdiagnosed because of its complicated clinical manifestations, and more attention should be paid to history and differential diagnosis to avoid misdiagnosis.%目的 探讨异位妊娠误诊为急性胃肠炎的原因,并提出防范对策.方法 对我院收治并误诊的异位妊娠15例的临床资料进行回顾性分析.结果 本组均以上腹痛为首发症状,其中9例病初按急性胃肠炎观察治疗,期间病情加重,出现失血性休克,拟诊异位妊娠行手术治疗而明确诊断为输卵管妊娠破裂出血,出血量2000~30000 ml;1例发病后在当地曾3次就诊,均按急性胃肠炎处理,后因失血过多到我院,经抢救无效死亡,后导尿查绒毛膜促性腺激素(HCG)阳性,腹穿抽出不凝血而明确诊

  3. The Feasibility Study of Color Doppler Ultrasound to Diagnose Early Ectopic Pregnancy%彩超诊断早期异位妊娠的可行性研究

    Institute of Scientific and Technical Information of China (English)

    张微

    2016-01-01

    Objective To explore the color doppler ultrasound applied value in the diagnosis of early ectopic pregnancy.Methods Selected 50 patients with early ectopic pregnancy, the 50 cases of early ectopic pregnancy patients were examined by vaginal colour to exceed and abdominal colour to exceed, compared two methods for check the value in the diagnosis of early ectopic pregnancy.ResultsVagina colour to exceed the accuracy in diagnosing early ectopic pregnancy (98.00%), was better than abdominal colour to exceed diagnose accuracy (74.00%),P<0.05.Conclusion Vaginal colour to exceed in early ectopic pregnancy has high diagnostic value.%目的:探究彩超在早期异位妊娠诊断中的应用价值。方法选取50例早期异位妊娠患者,这50例早期异位妊娠患者均接受阴道彩超检查以及腹部彩超检查,对比2种检查方式在早期异位妊娠诊断中的应用价值。结果阴道彩超诊断早期异位妊娠的准确率(98.00%),优于腹部彩超诊断的准确率(74.00%),P<0.05。结论阴道彩超在早期异位妊娠中具有较高的诊断价值。

  4. The Correlation between Family Planning Surgery and Ectopic Pregnancy-related Factors%计划生育手术与异位妊娠相关因素的分析

    Institute of Scientific and Technical Information of China (English)

    段灵燕

    2014-01-01

    Objective: To explore the correlation between the family planning surgery and ectopic pregnancy. Methods: Medical records of patients with ectopic pregnancy in our hospital in the past were retrospectively analyzed. The medical records of 78 patients with ectopic pregnancy treated in our hospital were selected as the study object. Th correlation between the family planning surgery and ectopic pregnancy was analyzed. Result: The majority of patients with ectopic pregnancy had had family planning surgery before. Conclusion:Improper operation and surgical infection of family planning surfery often lead to the occurrence of ectopic pregnancy.%目的:探讨进行计划生育手术患者与异位妊娠发生的相关性。方法:对以往我院的异位妊娠患者的病历资料进行回顾性分析,研究对象选择我院收治的78例异位妊娠患者的病历,同时分析行计划生育手术患者与异位妊娠发生的相关性。结果:异位妊娠患者中,多数患者进行过计划生育手术。结论:由于计划生育手术的操作不当或手术感染容易导致患者发生异位妊娠。

  5. 辅助生殖技术助孕后不同步异位妊娠原因探究及文献回顾%Investigation and literature review about heterochronic ectopic pregnancy after ART

    Institute of Scientific and Technical Information of China (English)

    吴洋; 杨霞; 李丽斐; 张瑞; 张学红

    2016-01-01

    Objective:To discuss the prevention and treatment measures that can reduce the risk of ectopic pregnancy of assisted reproductive technology (ART).Methods:Two unusual cases of heterochronic ectopic pregnancy have been reported.A retrospective clinical study was performed to analyze the five relevant cases in recent years.Results:The cause of heterochronic ectopic pregnancy was complicated.This kind of ectopic pregnancy could be spontaneously or related to ART.It could be happened about one month after the first ectopic pregnancy at the latest,and the patient was often required the second surgical treatment.Conclusion:The patient with tubal factor can be treated with laparoscopic "core-pulling" salpingectomy before IVF.Vitrified-thawed singleblastocyst was another great solution to reduce the potential heterochronic ectopic pregnancy rates.The patient should be monitored continuously after the operation of ectopic pregnancy a month or so,heterochronic ectopic pregnancy should be discovered and treated timely.%目的:探讨辅助生殖技术(ART)能够降低异位妊娠风险的预防、治疗措施.方法:报道2例国内外少见的不同步异位妊娠病例,并结合近年来相关的5个案例进行回顾性分析.结果:不同步异位妊娠成因复杂,自然受孕及ART助孕都可发生,最迟可发生在初次异位妊娠后1个月左右,且往往需要2次手术治疗.结论:对有相应适应证的患者,输卵管抽芯切除作为预处理或冻融单囊胚移植可降低不同步异位妊娠的发生率;异位妊娠手术处理后1个月左右均需密切监测患者情况,尽早发现不同步异位妊娠病灶并给予及时处理.

  6. The value of ratio of hCG, progesterone in local blood of pregnancy location versus venous blood in the diagnosis of ectopic pregnancy.

    Science.gov (United States)

    Lu, Qi; Li, Yuhong; Shi, Hong; Lang, Xiao; Wang, Yudong

    2015-01-01

    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. For patients receiving culdocentesis and laparoscopic exploration, abdominal fluid and venous blood samples were obtained synchronously during surgery. The sensitivity and specificity of Rp/v-hCG>1.0 and Rp/v-P>1.0 for diagnosis of EP was 88.2% and 80.71%, 93.8% and 87.53%, respectively. The sensitivity of parallel test (Rp/v-hCG>1.0 or Rp/v-P>1.0) was 92.23%. The specificity of serial test (Rp/v-hCG>1.0 and Rp/v-P>1.0) was 100%. For the area under the ROC curve of Rp/v-hCG and Rp/v-P, the parallel test and serial test were 0.91 and 0.82,0.90 and 0.87, respectively. At the determining threshold point of 1.0, the sensitivity of Rv/c-hCG and Rv/c-P for the diagnosis of EP was 56.73% and 60.01%. The specificity was 100% and 100%, respectively. The sensitivity of parallel test (Rv/c-hCG>1.0 or Rv/c-P>1.0) was 73.33%. For the area under the ROC curve of Rv/c-hCG, Rv/c-P and the parallel test was 0.78,0.80 and 0.87, respectively. It is proposed that EP can more rapidly and accurately be diagnosed by multiple biomarkers' test of Rp/v-hCG>1.0 and/or Rp/v-P>1.0, as well as Rv/c-hCG>1.0 and/or Rv/c-P>1.0 via culdocentesis or curettage.

  7. Bleeding during Pregnancy

    Science.gov (United States)

    ... FAQ090 “Early Pregnancy Loss”). What is an ectopic pregnancy? An ectopic pregnancy occurs when the fertilized egg does not implant ... vaginal bleeding is the only sign of an ectopic pregnancy. Other symptoms may include abdominal, pelvic, or shoulder ...

  8. The Research Development Summary of Predicting Ectopic Pregnancy with Serum Markers%血清标志物预测异位妊娠的研究进展综述

    Institute of Scientific and Technical Information of China (English)

    冯静

    2016-01-01

    临床上异位妊娠就是指在妊娠的过程中,受精卵在子宫腔外着床,为妊娠早期孕妇死亡的主要危险因素。对异位妊娠实施早期准确诊断可有效降低死亡率。现阶段对血清标志物进行检测在异位妊娠早期预测和诊断中研究不断深入。本文从人绒毛膜促性腺激素、CA125抗原2个血清指标对异位妊娠的早期预测价值方面进行了阐述。%Clinically,ectopic pregnancy refers to that,in the process of pregnancy,the fertilized egg im-plants outside the uterine cavity,which is a main risk factor for the death of pregnant women in early preg-nancy.Early diagnosis of ectopic pregnancy can effectively reduce the mortality rate.At the present stage,the detection of serum markers in the early diagnosis and early diagnosis of ectopic pregnancy has been studied.In this paper,the early predictive value of human chorionic gonadotropin and CA125 antigen to the early predic-tion of ectopic pregnancy were described in this paper.

  9. The relationship between repeated unintended pregnancies and current contraceptive use: National Survey of Family Growth (NSFG) 2006-2008 data.

    Science.gov (United States)

    Matsuda, Yui; Masho, Saba; McGrath, Jacqueline M

    2012-01-01

    The purpose of this study is to examine the relationship between the number of unintended pregnancies and current contraceptive use. This is a secondary analysis of a cross-sectional survey, the 2006-2008 National Survey of Family Growth, which included 4,052 women between the ages of 15 and 44 years. A statistically significant association was found between the nonuse of contraceptives and repeated unintended pregnancies, as well as among those who used an effective contraceptive method and repeated unintended pregnancies. Nurses are encouraged to ask questions about intendedness of pregnancies during women's visits and help women choose appropriate contraceptive methods.

  10. 宫内早孕与异位妊娠子宫内膜的声像图特征分析%Endometrial sonographic features of intrauterine pregnancy and ectopic pregnancy by ultrasonography

    Institute of Scientific and Technical Information of China (English)

    吴宗美

    2015-01-01

    Objective To investigate the early intrauterine pregnancy and ectopic pregnancy endometrial sonographic characteristics. Methods Totally 107 patients were selected with pregnancy but without a clear location of clinical were divided into early intrauterine pregnancy group(51 cases) and ectopic pregnancy group(56 cases). Each case was follow-up observed by abdominal color Doppler ultrasound on the endometrial echo features,the endometrial thickness and the nature of endometrial blood flow spectrum[(the artery minimum diastolic velocity(Vmin) and resistance index(RI)] were measured until the gestational sac appeared in uterine cavity or outside parts of it. The endometrial growth rate was calculated. The results were comparatively analyzed. Results Endometrial growth rates and endometrial thickness of early intrauterine pregnancy group and ectopic pregnancy group were (0.52±0.14) mm/d,(0.15±0.15)mm/d and (16.29±2.21) mm,(9.14±2.48)mm with statistical significance between the two groups(U=12.76,15.89,P<0.01). Endometrial thickening rate less than 0.4 mm/d was chosen as the cutoff point for the diagnosis of ectopic pregnancy, with a sensitivity of 85.7%and a specificity of 82.4%. Endometrial showed linear strong echo in 48 cases in ectopic pregnancy group and ground-glass change was found in 8 cases. Endometrial showed ground-glass change in all 51 cases in early intrauterine pregnancy. Statistical significance was found between the two groups (χ2=62.34,P<0.01).Endometrial nutrient artery was detected in 2 cases in early intrauterine pregnancy goup but not in ectopic pregnancy group. No statistical significance was found between the two group (χ2=2.21). Conclusion Detection of endometrial growth rate, thickness and echo features by ultrasonography can help to identify the early intrauterine pregnancy with the ectopic pregnancy.%目的:探讨宫内早孕与异位妊娠子宫内膜变化的声像图特征。方法107例患者分为宫内早孕组51

  11. 异位妊娠的发生危险因素调查%The investigation of the risk factors for ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    石波

    2016-01-01

    ABSTRACT:Objectives To investigate the risk factors for ectopic pregnancy . In order to formulate the corresponding nursing intervention measure to lay the foundation. Methods 783 women with ectopic pregnancy from Jiaonan City People’s Hospital between February 9, 2005 to March 22, 2009 who were diagnosed were used as the case group. And 800 women who had normal pregnant with the maternity hospital out-patient cards in the same period were served as the control group. Carries on the investigation to two group of patient’s common materials and the extrauterine pregnancy dangerous factor. The age, the menopause number of days with the T-test, the occupation, the school record and the marital situation comparison with the chi-square test, other return with Logistic carries on the multi-factor analysis. Results In 18 kind of factors the pelvic infection or=10.772, appendicitis or=9.964, annex inlfammation or=14.024, ovarian tumors or=9.151, history of induced abortion or=2.940, in medicine contraception or=2.852, the palace birth control or=2.623, pelvic cavity surgery or=2.768 factors and so on has remarkable correlation with ectopic pregnancy. Conclusion The ectopic pregnancy ,occurrence and the annex inlfammation, the pelvic infection, the appendicitis, the ovarian tumors, the history of induced abortion, the medicine contraception, the palace the birth control, the pelvic cavity surgery and so on many kinds of dangerous factors are related.%目的:探讨异位妊娠发生的危险因素,为制定相应的护理干预措施奠定基础。方法以2005年2月9日至2009年3月22日在胶南市人民医院确诊的异位妊娠患者783例为异位妊娠组,选取同期院内产科门诊建卡的正常孕妇800例为对照组,对两组病人的一般资料及异位妊娠危险因素进行调查,年龄、停经天数用t检验,职业、学历和婚姻情况的比较用x2检验,其余用Logistic回归进行多因素分析。结果18

  12. Comparison of the diagnostic values of circulating steroid hormones, VEGF-A, PIGF, and ADAM12 in women with ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Zou Shien

    2013-02-01

    Full Text Available Abstract Background Several peripheral proteins that might be useful for detecting the presence of ectopic pregnancy (EP have been evaluated, but none have been proven entirely useful in the clinic. We investigated the presence and the possible changes in circulating molecules that distinguish between normal intrauterine pregnancy (IUP and tubal ectopic pregnancy. Methods Non-pregnant women during the menstrual cycle, women with IUP, and women with tubal EP after informed consent. Serum levels of 17β-estradiol (E2, progesterone (P4, testosterone (T, beta-human chorionic gonadotropin (β-hCG, vascular endothelial growth factor-A (VEGF-A, placental growth factor (PIGF, and a distintegrin and metalloprotease protein 12 (ADAM12 were analyzed. Receiver operating characteristic analysis was used to assess the diagnostic discrimination of EP and gestational age-matched IUP. Results E2, P4, PIGF, and ADAM12 levels increased and β-hCG decreased throughout IUP. E2 and VEGF-A levels were significantly different between women with tubal EP and IUP. However, using a serum β-hCG cut-off of less than 1000 mIU/mL, P4 was significantly lower in women with tubal EP compared to IUP. Although E2 was inversely correlated with VEGF-A in women in the early stages of IUP, E2 was not correlated with VEGF-A in women with EP prior to tubal surgery. There were no significant differences in either PIGF or ADAM12 alone between women with tubal EP or IUP. Although no significant correlations were seen between E2 and PIGF or P4 and ADAM12 in women in the early stages of IUP, E2 was positively correlated with PIGF and P4 was positively correlated with ADAM12 in women with EP prior to tubal surgery. Our studies defined associations but not causality. Conclusions Individual measurements of serum E2 or VEGF-A levels are strongly related to early pregnancy outcomes for women with IUP and EP, and pregnancy-associated E2 and VEGF-A levels provide diagnostic accuracy for the

  13. 体外受精-胚胎移植技术中74例异位妊娠的临床分析%Analysis of 74 cases ectopic pregnancy in in vitro fertilization and embryo transfer

    Institute of Scientific and Technical Information of China (English)

    何巧花; 梁琳琳; 李杭生; 王路; 张翠莲

    2011-01-01

    Objective: To investigate the influential factors, diagnosis and treatment of ectopic pregnancy received in vitro fertilization and embryo transfer(IVF-ET) and to discuss the methods on how to prevent ectopic pregnancy. Methods: A retrospective study of ectopic pregnancy during IVF-ET was performed.Result: A total of 74 cases of ectopic pregnancy happened among 1 585 cases of clinical pregnancy patients,the occurrence rate was 4.67%; 71 cases ectopic pregnancy were tubal pregnancy, which constituted 95.95% of all ectopie pregnancy. There was significant difference on occurrence rate of ectopic pregnancy between the fresh embryo transfer (5.14%) and thawing embryo transfer (2.35%)(P<0.05). According to the distance to fundal endometrium, the patients were divided into 2 groups, the occurrence rate of ectopic pregnancy in group B (>1.2 cm) was significant lower than that in group A (0.8-1.2 cm). Conclution: The occurrence rate of ectopic pregnancy in IVF is higher than that of spontaneous pregnancy. Tubal pathological changes, controlled ovarian hyperstimulation and the depth of embryo transfer are the main causes of ectopic pregnancy.%目的:分析体外受精-胚胎移植(in vitro fertilization and embryo trallfer,IVF-ET)助孕技术中发生异位妊娠的影响因素、诊断、治疗方法及预防措施.方法:回顾性分析IVF-ET助孕技术中发生异位妊娠74例患者的临床资料.结果:所有接受IVF-ET的1 585患者中,共发生异位妊娠74例,异位妊娠发生率为4.67%;异位妊娠类型中输卵管妊娠71例,占总异位妊娠的95.95%.新鲜胚胎移植周期组异位妊娠发生率(5.41%)显著性高于冷冻胚胎复苏移植(frozing embryo transfer,FET)周期组(2.35%)(P1.2 cm时异位妊娠发生率显著性低于移植深度0.8~1.2 cm组.结论:IVF-ET助孕技术中异位妊娠发生率较自然妊娠过程中高;输卵管因素、促排卵药物的应用以及胚胎移植的深度是异位妊娠发生的主要影响因素.

  14. 异位妊娠保守治疗38例临床分析%Clinical analysis of the effect of conservative treatment of 38 patients with ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    支翠芳

    2009-01-01

    Objective To explore the feasibility of conservative treatment in patients with ectopic pregnancy.Methods The clinical data of 38 cases of ectopic pregnancy treated with conservative treatment were retrospectively analyzed.Results All the 38 patients with ectopic pregnancies were treated with MTX single dosage.There were 7 patients who failed in the conservative treatment and the rest of which were successfully cured.Conclusion For those early diagnosis and strictly selected ectopic pregnancy patients .conservative drug treatment is safe and effective.%目的 探讨异位妊娠保守治疗的可行性.方法 回顾性分析38例异位妊娠行药物保守治疗的临床资料.结果 8例均采用甲氨蝶呤单剂量保守治疗,7例失败后改为手术治疗,其余均治愈,治愈率81.6%,未发生严重并发症.结论 对诊断早、严格选择的异位妊娠患者行药物保守治疗是安全、有效的.

  15. The clinical value of transvaginal ultrasound and transabdominal ultrasound in diagnosis of ectopic pregnancy%阴道超声与腹部超声联合诊断宫外孕的临床应用价值

    Institute of Scientific and Technical Information of China (English)

    崔晓梅

    2014-01-01

    目的:探讨在宫外孕的临床诊断中阴道超声以及腹部超声联合检测所具有的临床价值。方法:收治疑似宫外孕患者60例,对所有患者行腹部二维超声以及阴道二维超声检查,比较患者的临床诊断结果与临床病理。结果:超声联合诊断显示有40例患者为宫外孕。经临床手术以及保守治疗之后,确诊38例患者为宫外孕,诊断准确率95.0%,2例患者误诊。结论:利用阴道超声与腹部超声联合对疑似宫外孕患者进行诊断,诊断准确率较高,能够为宫外孕临床检查提供有效信息,有助于宫外孕的临床诊断。%Objective:To investigate the clinical value of joint transvaginal ultrasound and transabdominal ultrasound ultrasonic testing in diagnosis of ectopic pregnancy.Methods:60 cases with suspected ectopic pregnancy were selected.All patients were given abdominal ultrasound and transvaginal ultrasound examination.Compare the diagnosis results and the clinical pathology after examination.Results:The ultrasound combined diagnosis showed that 40 patients were diagnosed as ectopic pregnancy.After clinical operation and conservative treatment,38 cases were confirmed diagnoses of ectopic pregnancy,and 2 cases in misdiagnosis.The diagnosis accurate rate was 95% .Conclusion:The diagnosis of suspected ectopic pregnancy patients by joint transvaginal ultrasound and abdominal ultrasonography,can ensure the high diagnostic accurate rate,It can provide useful information for clinical diagnosis of ectopic pregnancy,and contribute to diagnose ectopic pregnancy.

  16. 异位妊娠246例临床资料回顾与分析%Review and analysis of clinical data of 246 cases of ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    周正; 王鑫; 沈旭娜

    2012-01-01

    目的 探讨异位妊娠的主要病因及各种治疗方法对异位妊娠治疗的临床价值,提高对异位妊娠的认识.方法 回顾分析2010年1-12月1年间所收治的246例异位妊娠病例的临床资料,其中药物保守治疗136例,转手术治疗33例.手术治疗共141例,55例腹腔镜下病灶切除或输卵管造口.结果 本研究246例异位妊娠患者,有人流或药流病史的190例,占77.24%,腹腔镜下病灶切除或输卵管造口术55例,占手术比例的41.78%.结论 人流或药流若并发感染可造成慢性输卵管炎、盆腔炎等增加异位妊娠的发病率.腹腔镜技术损伤小,恢复快,住院时间短,用药少,外观好,在治疗异位妊娠中已发挥越来越重要的作用.%Objective To find the main causes of ectopic pregnancy and the various methods of treatment of ectopic pregnancy treatment to better understand ectopic pregnancy. Methods Retrospective analysis of hospital treated 246 cases of ectopic pregnancy cases from January to December of 2010, including 136 cases of the conservative treatment ,33 cases turn to operation treatment. 141 cases of operation treatment, 55 cases of laparoscopic resection of lesions or tubal ostomy. Results In the 246 cases of patients with ectopic pregnancy 190 cases had abortion or medical abortion history, accounting for 77. 24% , laparoscopic resection of lesions or salpingostomy in 55 cases, accounting for the proportion of operation 41. 78%. Conclusions Abortion or medical abortion with concurrent infection can cause chronic tubal inflammation of pelvic inflammatory disease and increase the incidence of ectopic pregnancies. As laparoscopic technique has little injury, quick recovery, shorter hospitalization time, appearance in treatment of ectopic pregnancy has played an increasingly important role.

  17. Posible embarazo ectópico intraprepucial en un perro. Reporte de un caso - (Possible ectopic pregnancy inside the foreskin of a dog. Report of a case

    Directory of Open Access Journals (Sweden)

    Denis Escobar-Barroso

    2009-01-01

    Full Text Available ResumenEste es el reporte de un posible embarazo ectópico casi a términodesarrollado dentro del prepucio de un perro. El fenómeno se presentóen la Finca “La Juanita”, municipio Cifuentes, provincia Villa Clara,Cuba. Se examinaron el perro y el feto, se realizó una investigaciónbibliográfica del tema y se ofrecen criterios al respecto.SummaryThis is the report of a case of a possible pregnancy of ectopic type,almost at the end of the normal term inside the foreskin of a dog.This case occurred in a place called ´¨La Juanita ¨´ .Cifuentes. Villa Clara. Cuba. It was examined the dog and the fetus, a bibliographical investigation was made about the topic, and we give our opinions about this phenomenon.

  18. Vaginal bleeding in pregnancy

    Science.gov (United States)

    ... may be a sign of a miscarriage or ectopic pregnancy. Contact the health care provider right away. During ... Cervical polyp or growth Early labor (bloody show) Ectopic pregnancy Infection of the cervix Trauma to the cervix ...

  19. Pretreatment serum human chorionic gonadotropin cutoff value for medical treatment success with single-dose and multi-dose regimen of methotrexate in tubal ectopic pregnancy

    Science.gov (United States)

    Kim, Junhwan; Jung, Young Mi; Lee, Da Yong

    2017-01-01

    Objective To investigate individual pretreatment serum human chorionic gonadotropin (hCG) cutoff value for medical treatment success with single-dose and multi-dose regimen of methotrexate in tubal ectopic pregnancy. Methods Eighty-five women who received methotrexate for the treatment of tubal ectopic pregnancy during 2003 to 2015 were selected. Fifty-three women received a single-dose regimen and 32 women received a multi-dose regimen. Medical treatment failure was defined as necessity of surgical treatment. The medical treatment success rate was estimated in both regimens and the pretreatment serum hCG titer to predict the success was assessed by receiver operating characteristics curve analysis. Results Pretreatment clinical and laboratory parameters were similar between group of single-dose regimen and multi-dose regimen. Treatment success rate was 64.2% in the single-dose regimen group and 71.9% in the multi-dose regimen group (P>0.05). Pretreatment serum hCG titer was an independent prognostic factor for treatment success in each regimen. Serum hCG cutoff value to predict the treatment success was 3,026 IU/L in single-dose regimen group and 3,711 IU/L in multi-dose regimen group. Conclusion We recommend use of single-dose regimen when pretreatment serum hCG <3,026 IU/L but multi-dose regimen may be favored when initial serum hCG level between 3,026 and 3,711 IU/L. PMID:28217676

  20. Repeat HIV testing during pregnancy and delivery: missed opportunities in a rural district hospital in Zambia.

    Science.gov (United States)

    Heemelaar, Steffie; Habets, Nicole; Makukula, Ziche; van Roosmalen, Jos; van den Akker, Thomas

    2015-03-01

    To assess coverage of repeat HIV testing among women who delivered in a Zambian hospital. HIV testing of pregnant women and repeat testing every 3 months during pregnancy and breastfeeding is the recommended policy in areas of high HIV prevalence. A prospective implementation study in a second-level hospital in rural Zambia. Included were all pregnant women who delivered in hospital during May and June 2012. Data regarding antenatal visits and HIV testing were collected by two investigators using a standardised form. Of 401 women who delivered in hospital, sufficient antenatal data could be retrieved for 322 (80.3%) women. Of these 322 women, 301 (93.5%) had attended antenatal care (ANC) at least once. At the time of discharge after delivery in hospital, 171 (53.1%) had an unclear HIV status because their negative test result was more than 3 months ago or of an unknown date, or because they had not been tested at all during pregnancy or delivery. An updated HIV status was present for 151 (46.9%) women: 25 (7.8%) were HIV positive and 126 (39.1%) had tested negative within the last 3 months. In this last group, 79 (24.5%) had been tested twice or more during pregnancy. During the study period, none of the women was tested during admission for delivery. Despite high ANC coverage, opportunities for repeat HIV testing were missed in almost half of all women who delivered in this hospital in a high-prevalence HIV setting. © 2014 John Wiley & Sons Ltd.

  1. Preventing rapid repeat pregnancy and promoting positive parenting among young mothers in foster care.

    Science.gov (United States)

    Finigan-Carr, Nadine M; Murray, Kantahyanee W; O'Connor, Julia M; Rushovich, Berenice R; Dixon, Desyree A; Barth, Richard P

    2015-01-01

    Young mothers in foster care face considerable challenges above and beyond that of their non-foster care peers. Child welfare workers have few resources to guide them in the selection of evidence-informed programs, models, and strategies that address the unique risk factors and needs of youth in foster care who are at risk for rapid repeat pregnancy and inadequate parenting practices. Workers need knowledge of the evidence about which programs are most likely to improve key health and well-being outcomes. The article assesses the evidence-based programs identified and yields a list that reflects the best evidence for efficacy and effectiveness.

  2. Systematic review of sexual risk among pregnant and mothering teens in the USA: pregnancy as an opportunity for integrated prevention of STD and repeat pregnancy.

    Science.gov (United States)

    Meade, Christina S; Ickovics, Jeannette R

    2005-02-01

    Behaviors that lead to teen pregnancy also place young women at risk for STDs and repeat pregnancy. Compared to the broad literature on adolescent sexual risk behavior, our understanding of sexual risk in pregnant/mothering teens lags far behind. Primary objectives of this systematic review (1981-2003) of pregnant/mothering teens were to: (1) document rates of STD, repeat pregnancy, condom use, and contraception; (2) identify correlates of these biological and behavioral outcomes; (3) review sexual risk reduction interventions; and (4) discuss directions for future research and implications for clinical care. Fifty-one studies met inclusion criteria. Rates of STD and repeat pregnancy were high, with the majority of teens engaging in unprotected sex during and after pregnancy. An Ecological Model of Sexual Risk, based on Bronfenbrenner's (1989) Ecological Systems Theory, was proposed to organize findings on correlates of sexual risk. Improvements in research, including integration of outcomes and risk factors, stronger methodologies, and standardized assessments, are essential. Results suggest that teen pregnancy is a marker for future sexual risk behavior and adverse outcomes, and that pregnant/mothering teens need hybrid interventions promoting dual use of condoms and hormonal contraception. Pregnancy may provide a critical "window of opportunity" for sexual risk reduction.

  3. [A case-control study of factors associated with repeat teen pregnancy based on a sample from a university maternity hospital].

    Science.gov (United States)

    Silva, Andréa de Albuquerque Arruda; Coutinho, Isabela C; Katz, Leila; Souza, Alex Sandro Rolland

    2013-03-01

    Repeat teen pregnancy is a frequent issue and is considered an aggravating factor for increased maternal and fetal morbidity and social problems. The aim of the study was to identify factors associated with repeat teen pregnancy. A case-control study was conducted in 90 postpartum adolescents with more than one pregnancy (cases) and 90 adult women with a history of only one pregnancy during adolescence (controls). Statistical analysis used hierarchical logistic regression with 5% significance. Early sexual initiation (< 15 years), early age at first pregnancy (< 16 years), not raising the children themselves, and low family income (< one minimum wage) were associated with repeat teenage pregnancy, while partner change was inversely associated. Repeat teen pregnancy was mainly associated with reproductive and socioeconomic factors. Partner change appeared as a protective factor. Measures should be adopted during the postpartum period of teenage mothers in order to avoid repeat pregnancy.

  4. 辅助生殖技术后特殊部位异位妊娠8例临床分析%Clinical analysis of assisted reproductive technology in 8 cases with ectopic pregnancy of specific position

    Institute of Scientific and Technical Information of China (English)

    胡芬; 王仙萍; 王咏莲; 武学清

    2015-01-01

    Objective To investigate the diagnosis and treatment plan of assisted reproductive technology (ART) in specific ectopic pregnancy.Methods 8 cases with specific ectopic pregnancy in our center from January 2014 to June 2014 were analyzed retrospectively. After the diagnosis of ectopic pregnancy were promptly underwent laparoscopic surgery.Results Eight cases were pathologically confirmed ectopic pregnancy, intrauterine pregnancy with tubal pregnancy were four cases, and interstitial tubal pregnancy were two cases, one case with bilateral tubal pregnancies, one case with abdominal pregnancy. 4 cases with ectopic pregnancy after intrauterine pregnancy did not occur abortion, one case had been childbirth, the neonatal currently had no obvious abnormalities, and the other three cases were continuing pregnancy. The remaining four cases were in the postoperative serum hCG to normal within 30 days.Conclusion In patients with clinical work for ART should be carefully followed up after, and should be given individualized treatment combined with patient needs based on the patient's condition. Incidence of ectopic pregnancy after ART treatment by a variety of factors, clinical work should be strengthened to specific ectopic pregnancy awareness and attention in order to avoid misdiagnosis.%目的:探讨在辅助生殖技术(ART)后特殊部位异位妊娠的诊治方案。方法对我中心2014年1~6月ART后特殊部位异位妊娠8例进行回顾性分析,其诊断为异位妊娠后均及时进行了腹腔镜手术。结果8例术后病理均证实为异位妊娠,其中宫内妊娠合并输卵管妊娠4例,输卵管间质部妊娠2例,双侧输卵管同时妊娠1例,腹腔妊娠1例。术后宫内妊娠合并异位妊娠患者4例术后均未发生流产,其中1例已分娩,新生儿目前无明显异常,另3例目前仍在继续妊娠中。其余4例患者血HCG均在术后30d之内降至正常。结论在临床工作中对于进行ART后的患者应

  5. Implementation of repeat HIV testing during pregnancy in Kenya: a qualitative study.

    Science.gov (United States)

    Rogers, Anna Joy; Weke, Elly; Kwena, Zachary; Bukusi, Elizabeth A; Oyaro, Patrick; Cohen, Craig R; Turan, Janet M

    2016-07-11

    Repeat HIV testing in late pregnancy has the potential to decrease rates of mother-to-child transmission of HIV by identifying mothers who seroconvert after having tested negative for HIV in early pregnancy. Despite being national policy in Kenya, the available data suggest that implementation rates are low. We conducted 20 in-depth semi-structured interviews with healthcare providers and managers to explore barriers and enablers to implementation of repeat HIV testing guidelines for pregnant women. Participants were from the Nyanza region of Kenya and were purposively selected to provide variation in socio-demographics and job characteristics. Interview transcripts were coded and analyzed in Dedoose software using a thematic analysis approach. Four themes were identified a priori using Ferlie and Shortell's Framework for Change and additional themes were allowed to emerge from the data. Participants identified barriers and enablers at the client, provider, facility, and health system levels. Key barriers at the client level from the perspective of providers included late initial presentation to antenatal care and low proportions of women completing the recommended four antenatal visits. Barriers to offering repeat HIV testing for providers included heavy workloads, time limitations, and failing to remember to check for retest eligibility. At the facility level, inconsistent volume of clients and lack of space required for confidential HIV retesting were cited as barriers. Finally, at the health system level, there were challenges relating to the HIV test kit supply chain and the design of nationally standardized antenatal patient registers. Enablers to improving the implementation of repeat HIV testing included client dissemination of the benefits of antenatal care through word-of-mouth, provider cooperation and task shifting, and it was suggested that use of an electronic health record system could provide automatic reminders for retest eligibility. This study

  6. 深圳市南山区异位妊娠发病现状的调查分析%Survey and Analysis on Incidence of Ectopic Pregnancy in Nan Shan District of Shenzhen

    Institute of Scientific and Technical Information of China (English)

    张慧; 刘建; 张淑芝

    2011-01-01

    Objective To investigate the risk factors of ectopic pregnancy and current clinical management, and to provide a basis for the disease control strategies. Methods The clinical data of ectopic pregnancy (case group, n= 272) and early abortion women(control group,n =544) form June 2009 to June 2010 were analyzed retrospectively. The following factors were analyzed by retrospective clinical research method: Age, gravidity, history of uterine fibroids, contraception, pelvic surgery, history of ectopic pregnancy, chronic pelvic infection history, etc. The multiple logistic regression analysis was used to estimate the association between risk factors and occurrence of ectopic pregnancy. Chi-squared test was used for nominal(categorical) data. Results There was a tendency toward a increase of ectopic pregnancy in Nanshan District. The risk factors of ectopic pregnancy and its odds ratio (OR) form the multvariate non-conditional Logistic regression analysis were as follows: chronic pelvic infection history( OR =2.589,P = 0.012 ), history of ectopic pregnancy ( OR = 10.560, P = 0.049 ) ,intrauterine device ( OR = 1. 356, P = 0. 006 ), lower abdominal surgery( OR = 5. 910 ,P = 0. 028 ). Chi-squared test showed that the infection was significantly higher in case group (P<0.05). Conclusion Chronic pelvic inflammatory disease,placing IUD,oral emergency contraceptive,pelvic surgery,history of ectopic pregnancy is the risk factors for ectopic pregnancy;in which the reproductive tract infections is the root cause.%目的 探讨异位妊娠发生相关现状及危险因素,为该病的防治策略提供依据.方法 以2009年6月-2010年6月在南山医疗单位住院确诊的272例异位妊娠患者的临床病历资料及同期在三家医院门诊行流产的早孕妇女544例,按1:2比例为研究对象.采用回顾性临床研究法对其年龄、孕次、子宫肌瘤史、避孕方式、盆腔手术史、异位妊娠史、慢性盆腔感染史等、采用多因素非条

  7. Implementation Study of Patient-Ready Syringes Containing 25 mg/mL Methotrexate Solution for Use in Treating Ectopic Pregnancy

    Science.gov (United States)

    Respaud, R.; Gaudy, A. S.; Arlicot, C.; Tournamille, J. F.; Viaud-Massuard, M. C.; Elfakir, C.; Antier, D.

    2014-01-01

    Background. Ectopic pregnancy (EP) is a significant cause of morbidity and mortality during the first trimester of pregnancy. Small unruptured tubal pregnancies can be treated medically with a single dose of methotrexate (MTX). Objective. The aim of this study was to evaluate the stability of a 25 mg/mL solution of MTX to devise a secure delivery circuit for the preparation and use of this medication in the management of EP. Method. MTX solutions were packaged in polypropylene syringes, stored over an 84-day period, and protected from light either at +2 to +8°C or at 23°C. We assessed the physical and chemical stability of the solutions at various time points over the storage period. A pharmaceutical delivery circuit was implemented that involved the batch preparation of MTX syringes. Results. We show that 25 mg/mL MTX solutions remain stable over an 84-day period under the storage conditions tested. Standard doses were prepared, ranging from 50 mg to 100 mg. The results of this study suggest that MTX syringes can be prepared in advance by the pharmacy, ready to be dispensed at any time that a diagnosis of EP is made. Conclusion. The high stability of a 25 mg/mL MTX solution in polypropylene syringes makes it possible to implement a flexible and cost-effective delivery circuit for ready-to-use preparations of this drug, providing 24-hour access and preventing treatment delays. PMID:24900977

  8. Implementation Study of Patient-Ready Syringes Containing 25 mg/mL Methotrexate Solution for Use in Treating Ectopic Pregnancy

    Directory of Open Access Journals (Sweden)

    R. Respaud

    2014-01-01

    Full Text Available Background. Ectopic pregnancy (EP is a significant cause of morbidity and mortality during the first trimester of pregnancy. Small unruptured tubal pregnancies can be treated medically with a single dose of methotrexate (MTX. Objective. The aim of this study was to evaluate the stability of a 25 mg/mL solution of MTX to devise a secure delivery circuit for the preparation and use of this medication in the management of EP. Method. MTX solutions were packaged in polypropylene syringes, stored over an 84-day period, and protected from light either at +2 to +8°C or at 23°C. We assessed the physical and chemical stability of the solutions at various time points over the storage period. A pharmaceutical delivery circuit was implemented that involved the batch preparation of MTX syringes. Results. We show that 25 mg/mL MTX solutions remain stable over an 84-day period under the storage conditions tested. Standard doses were prepared, ranging from 50 mg to 100 mg. The results of this study suggest that MTX syringes can be prepared in advance by the pharmacy, ready to be dispensed at any time that a diagnosis of EP is made. Conclusion. The high stability of a 25 mg/mL MTX solution in polypropylene syringes makes it possible to implement a flexible and cost-effective delivery circuit for ready-to-use preparations of this drug, providing 24-hour access and preventing treatment delays.

  9. Analysis of the Related Factors of Ectopic Pregnancy after IVF-ET%不同移植方法IVF-ET后异位妊娠相关因素分析

    Institute of Scientific and Technical Information of China (English)

    黄志辉; 余敏; 伍琼芳; 辛才林; 赵琰

    2013-01-01

    [Objective]To explore the related factors of ectopic pregnancy after in vitro fertilization and embryo transfer (IVF-ET) .[Methods]Clinical data of patients receiving routine IVF-ET(group A) from Sept .2006 to Dec .2008 and pa-tients receiving the modified IVF-ET(group B) from Jan .2009 to June 2012 were collected .Ectopic pregnancy rate of differ-ent embryo transfer methods was compared .The related factors of ectopic pregnancy were analyzed .[Results]Compared with group A ,ectopic pregnancy rate in group B was markedly decreased (7 .84% vs .2 .69% )( P<0 .01) .The modified embryo transfer method (OR=0 .428 ,P<0 .01) and HCG endometrial thickness (OR=0 .521 ,P<0 .01) were the independent pro-tective factors to decrease ectopic pregnancy rate after IVF-ET .[Conclusion]To a certain extent ,improving embryo transfer method and increasing endometrial thickness on HCG day can obviously decrease ectopic pregnancy rate after IVF-ET .%[目的]探讨不同移植方法体外受精-胚胎移植(IVF-ET )后异位妊娠相关因素。[方法]收集2006年9月至2008年12月(常规移植推注方法,A组)与2009年1月至2012年6月(改良移植推注方法,B组)接受IVF-ET获得临床妊娠患者的临床资料,比较不同移植推注方法的异位妊娠率,分析异位妊娠的影响因素。[结果]B组异位妊娠率(2.69%)较A组(7.84%)显著性降低( P<0.01);改良移植推注方法(OR=0.428,P<0.01)、HCG时子宫内膜厚度≥8 mm(OR=0.521,P<0.01)是降低IVF-ET后异位妊娠的独立保护因素。[结论]在一定程度上改进移植推注方法和增加HCG日子宫内膜厚度可明显降低IVF-ET后异位妊娠率。

  10. 腹腔镜在未破裂型异位妊娠治疗中的应用%Application of laparoscopy in the treatment of unruptured ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    石秀金

    2015-01-01

    Objective:To investigate the clinical effect of laparoscopy in the treatment of unruptured ectopic pregnancy.Methods:64 patients with unruptured ectopic pregnancy were selected from January 2010 to December 2013.They were divided into the laparoscopy group(34 cases)and the conventional group(30 cases)according to the treatment plan.The treatment-related indicators of the two groups were compared.1 years of follow-up,the incidence of patients with ectopic pregnancy again was counted.Results:The intraoperative bleeding volume,vaginal bleeding days,the total amount of bleeding,hospitalization days,recovery time ofβ-HCG and other indicators of the laparoscopy group were better than the conventional group.3 years of follow-up,the incidence of ectopic re-pregnancy was 8.33%,significantly lower than the conventional group 38.46%.Conclusion:The effect of laparoscopic operation for the treatment of unruptured ectopic pregnancy is good.It can reduce the harm to the patient and reduce the incidence of ectopic re-pregnancy.%目的:探讨腹腔镜治疗未破裂型异位妊娠的临床效果。方法:2010年1月-2013年12月收治未破裂型异位妊娠患者64例,按照治疗方案分为腹腔镜组(34例)和常规组(30例),比较两组治疗相关指标,随访1年,统计患者再次异位妊娠发生率。结果:腹腔镜组患者术中出血量、阴道流血天数、总出血量、住院天数、β-HCG复常时间等指标均优于常规组,随访3年,再次异位妊娠发生率8.33%,明显低于常规组38.46%。结论:腹腔镜手术治疗未破裂型异位妊娠效果较好,可减少对患者的损伤,降低再次异位妊娠发生率。

  11. The Exploration of Risk Factors and Clinical Diagnosis and Treatment of Ectopic Pregnancy%异位妊娠危险因素及临床诊治探讨

    Institute of Scientific and Technical Information of China (English)

    隋丽红

    2014-01-01

    目的:探讨异位妊娠危险因素和临床诊治的方法。方法以该院2011年2月—2012年12月期间收治的50例异位妊娠患者为研究对象,并将其作为实验组,另外选取50例正常妊娠的孕妇为对照组。然后比较两组孕妇各相关指标的差异,以分析引起异位妊娠发生的危险因素。结果流产、妇科炎症、剖宫产史引起异位妊娠的OR值分别为5.732、3.452、3.124。结论流产、妇科炎症、剖宫产都是引起因为妊娠的危险因素。要提高异位妊娠的治愈率就应当降低流产率和剖宫产率,则必须做好妇科炎症的预防措施。%Objective To explore the risk factors of ectopic pregnancy and the method of clinical diagnosis and treatment for the disease. Methods 50 cases with ectopic pregnancy admitted in our hospital from February 2011 to December 2012 were selected as the subjects in the experimental group, and other 50 normal pregnant women were selected as the control group. Then the differ-ences in relevant indexes between the two groups were compared for analyzing the risk factors that could cause ectopic pregnancy. Results The OR value of the history of abortion, gynecological inflammation, history of cesarean section that caused ectopic preg-nancy was 5.732, 3.452, 3.124, respectively. Conclusion Abortion, gynecological inflammation and cesarean section are the risk factors that cause ectopic pregnancy. In order to improve the cure rate of ectopic pregnancy, the rate of abortion and cesarean sec-tion should be reduced, and the preventive measures of gynecological inflammation should be done well.

  12. 腹腔镜下输卵管妊娠术后持续性异位妊娠病因分析%Persistent Ectopic Pregnancy after Surgery for Tubal Pregnancy by Laparoscopic

    Institute of Scientific and Technical Information of China (English)

    陈伟明; 梁丽珍; 李亮宽

    2014-01-01

    目的:分析腹腔镜下手术治疗输卵管妊娠后持续性异位妊娠的病因,指导预防和治疗。方法将114例行腹腔镜手术治疗的输卵管妊娠患者分为2组:术后发生持续性异位妊娠的12例患者为A组,未发生持续性异位妊娠的102例患者为B组。分析比较两组患者的术前血人绒毛膜促性腺激素水平及其术后下降幅度、停经时间、妊娠部位、手术方式、保守性手术是否术中使用甲氨蝶呤局部注射、盆腔包块大小等。结果持续性异位妊娠的易发因素:术前血人绒毛膜促性腺激素水平高、术后下降幅度小,停经<40d或>60d,峡部妊娠,伞端挤压术,保守性手术中未使用甲氨蝶呤局部注射;盆腔包块大小与持续性异位妊娠的发生无相关性。结论对异位妊娠拟行腹腔镜手术治疗者,应仔细分析其术前资料,选择合适的手术方式,术中仔细操作,以避免手术后续性异位妊娠。%Objective To investigate the factors of persistent ectopic pregnancy(PEP) after surgery for tubal pregnancy by laparoscopic, and provide guideline for the clinical prevention and therapy.Methods 114 cases of tubal pregnancy by laparoscopic surgery were divided into 2 groups: 12 cases of PEP as the group A, 102 cases without PEP as the group B. The factors including β-HCG levels of pre and after surgery, time of menopause, the sites of ectopic pregnancy, patterns of surgery, conservative surgery with injection of MTX or not, and the size of the pelvic mass between the two groups were compared. Results The factors of higher rate of PEP were patients with higher β-HCG pre-surgery and limited decrease after operation, days of menopause less than 40 or more than 60, pregnancy in the isthmus, the compression surgery of pregnancy from the fimbriae tube, conservative surgery without injection of MTX. The PEP had no correlation with the size of pelvic mass. ConclusionThe preoperative data

  13. Ectopic heartbeat

    Science.gov (United States)

    ... forceful beats Note: There may be no symptoms. Exams and Tests A physical exam may show an ... help reduce ectopic heartbeats for some people: Limiting caffeine, alcohol, and tobacco Regular exercise for people who ...

  14. Determinants and Experiences of Repeat Pregnancy among HIV-Positive Kenyan Women--A Mixed-Methods Analysis.

    Directory of Open Access Journals (Sweden)

    Victor Akelo

    Full Text Available To identify factors associated with repeat pregnancy subsequent to an index pregnancy among women living with HIV (WLWH in western Kenya who were enrolled in a 24-month phase-II clinical trial of triple-ART prophylaxis for prevention of mother-to-child transmission, and to contextualize social and cultural influences on WLWH's reproductive decision making.A mixed-methods approach was used to examine repeat pregnancy within a 24 month period after birth. Counselor-administered questionnaires were collected from 500 WLWH. Forty women (22 with a repeat pregnancy; 18 with no repeat pregnancy were purposively selected for a qualitative interview (QI. Simple and multiple logistic regression analyses were performed for quantitative data. Thematic coding and saliency analysis were undertaken for qualitative data.Eighty-eight (17.6% women had a repeat pregnancy. Median maternal age was 23 years (range 15-43 years and median gestational age at enrollment was 34 weeks. In multiple logistic regression analyses, living in the same compound with a husband (adjusted odds ratio (AOR: 2.33; 95% confidence interval (CI: 1.14, 4.75 was associated with increased odds of repeat pregnancy (p ≤ 0.05. Being in the 30-43 age group (AOR: 0.25; 95% CI: 0.07, 0.87, having talked to a partner about family planning (FP use (AOR: 0.53; 95% CI: 0.29, 0.98, and prior usage of FP (AOR: 0.45; 95% CI: 0.25, 0.82 were associated with a decrease in odds of repeat pregnancy. QI findings centered on concerns about modern contraception methods (side effects and views that they 'ruined the womb' and a desire to have the right number of children. Religious leaders, family, and the broader community were viewed as reinforcing cultural expectations for married women to have children. Repeat pregnancy was commonly attributed to contraception failure or to lack of knowledge about post-delivery fertility.In addition to cultural context, reproductive health programs for WLWH may need to

  15. Who has a repeat abortion? Identifying women at risk of repeated terminations of pregnancy: analysis of routinely collected health care data.

    Science.gov (United States)

    McCall, Stephen J; Flett, Gillian; Okpo, Emmanuel; Bhattacharya, Sohinee

    2016-04-01

    Repeat termination of pregnancy highlights the issues of unplanned pregnancies and effective post-termination contraceptive practices. To examine the risk factors at the time of a first termination that are associated with subsequent repeat termination. Registry-based study. Grampian region of Scotland, UK. A retrospective study using data from the Termination of Pregnancy Database, NHS Grampian for the period 1997-2013. Associations between repeat termination and women's sociodemographic characteristics and contraceptive use were assessed using multivariable logistic regression models. This study showed that 23.4% of women who had an initial termination (n=13 621) underwent a repeat termination. Women who had repeat terminations were more likely to be aged under 20 years at their initial termination with an adjusted odds ratio (AOR) of 5.59 [95% confidence interval (CI) 4.17-7.49], to belong to the most deprived social quintile [AOR 1.23 (95% CI 1.05-1.43)], and to be more likely to have had two or more previous livebirths [AOR 1.51 (95% CI 1.12-2.02)] or miscarriages [AOR 1.40 (95% CI 1.02-1.92)]. The likelihood of having a repeat termination was increased in women who had a contraceptive implant as post-termination contraception [AOR 1.78 (95% CI 1.50-2.11)] compared to women who left with none or unknown methods following the first termination. In those who had repeat terminations, women who had an implant or Depo-Provera(®) were at increased odds of repeat termination in the 2-5 years interval compared to the 0-2 years after their initial termination. Teenage pregnancy, social deprivation, two or more previous livebirths or miscarriages at the time of the initial termination were identified as risk factors for repeat terminations. Post-termination contraception with implants and Depo-Provera® were associated with repeat termination 2-5 years after the first termination. Published by the BMJ Publishing Group Limited. For permission to use (where not

  16. Expression of leukemia inhibitory factor in human oviductal mucosa of tubal ectopic pregnancy%白血病抑制因子在妊娠输卵管黏膜中的表达

    Institute of Scientific and Technical Information of China (English)

    熊超; 周东旭; 刘帆; 朱成成; 何艳君; 晏长荣

    2013-01-01

    目的 探讨白血病抑制因子(UF)与输卵管妊娠的关系.方法 选择输卵管妊娠组25例、正常输卵管组28例及正常宫内早孕组30例,采用免疫组织化学染色技术及半定量病理图像分析系统检测输卵管妊娠黏膜组织、正常输卵管黏膜组织及正常宫内早孕组子宫蜕膜组织中LIF的表达.结果 LIF阳性表达在正常宫内早孕组最高,在输卵管妊娠组中较高,在正常输卵管组中最低,三组两两比较差异均有有统计学意义(P<0.05).结论 LIF可能参与了输卵管妊娠发病过程,且与输卵管妊娠缺乏蜕膜化反应有关.%Objective To explore the relationship between leukemia inhibitory factor gene(LIF) and tubal ectopic pregnancy. Methods Expression of LIF was detected by immunohistochemistry in oviductal mucosa in tubal ectopic pregnancy group (n= 25), in oviductal mucosa in normal oviduct group (n=28) and in decidua tissues in early pregnancy group (n=30), and the data were analyzed by semi-quantity pathologic image analysis. Results The positive expression of LIF in tubal ectopic pregnancy group was significantly stronger than that in normal human oviduct group (P<0.05), but was significantly weaker than that in early pregnancy group (P<0.05). Conclusion LIF may be involved in the tubal ectopic pregnancy, and be correlated with indistinct decidu-alization of tubal ectopic pregnancy.

  17. Related risk factors analysis and clinical diagnosis and treatment discussion of ectopic pregnancy%宫外孕相关危险因素分析及临床诊治探讨

    Institute of Scientific and Technical Information of China (English)

    朱晓娟

    2016-01-01

    目的:分析宫外孕的相关危险因素,探讨临床诊治。方法:200例宫外孕患者作为观察组,同期200例正常妊娠孕产妇作为对照组,筛选影响宫外孕的相关因素,探讨对应的临床措施。结果:观察组的年龄(是否≥30岁)、妇科炎症、宫内节育器、人工流产、药物流产、剖宫产≥2次、妊娠次数≥2次、腹部手术史、人工受孕等数据比例明显高于对照组(P<0.05)。结论:妇科炎症、人工流产、药物流产、宫内节育器、妊娠次数、剖宫产次数是导致发生宫外孕的因素,应该避免这些因素,降低宫外孕的发病率。%Objective:To analyze the related risk factors of ectopic pregnancy,and to discuss the clinical diagnosis and treatment. Methods:200 patients with ectopic pregnancy were as the observation group.200 normal pregnant women were as the control group at the same time.The related factors of ectopic pregnancy were screened.The corresponding clinical measures were explored. Results:In the age (whether was greater than or equal to 30 years old),gynecological inflammation,intrauterine device,artificial abortion,medical abortion and cesarean section was more than or equal to 2 times,pregnancy number was more than or equal to 2 times,abdominal surgery history,artificial insemination,the data proportions of the observation group were significantly higher than those of the control group(P<0.05).Conclusion:The gynecological inflammation,artificial abortion,medical abortion,intrauterine device,pregnancy number,cesarean section number are the factors leading to the occurrence of ectopic pregnancy.We should avoid these factors to reduce the incidence rate of ectopic pregnancy.

  18. Cut-off value of initial serum β-hCG level predicting a successful MTX therapy in tubal ectopic pregnancy: a retrospective cohort study.

    Science.gov (United States)

    Helmy, S; Bader, Y; Pablik, E; Tiringer, D; Pils, S; Laml, T; Kölbl, H; Koch, M

    2014-08-01

    To determine the optimal serum β-hCG cut-off level to predict MTX treatment success in tubal ectopic pregnancy (EP). Data of 240 women, who presented between 2003 and 2011 at the Department of Gynecology and Obstetrics, Medical University of Vienna, with tubal EP and who received MTX as primary treatment, were retrieved from the hospital information system (KIS). 198 patients could be included for final evaluation. Statistical analysis included area under the ROC curve, maximal Euclidean and Youden index, chi-squared and a five-fold cross validation. The serum β-hCG level cut-off value was calculated at 2121mlU/ml with a specificity of 76.54% and sensitivity of 80.56% (AUC 0.789; phCG level below 2121mlU/ml (n=131) experienced MTX treatment failure in 5.3% (n=7), compared to 43.3% (n=29) of patients with an initial serum β-hCG level equal to or above 2121mlU/ml (n=67). There was no statistically significant correlation between clinical symptoms and the MTX therapy outcome (p=0.580; likelihood quotient p=0.716). The correct decision of therapy in patients with tubal ectopic pregnancy still represents a challenge. In this study we can conclude that, according to our results there is no endpoint of initial serum β-hCG levels, which can be clearly used as cut-off value for the optimal management of tubal EP. However, an initial serum β-hCG level of less than 2121mlU/ml seems to be a good value to expect a successful MTX treatment. Limitations are the retrospective study design and the inability of classifying clinical symptoms like pain as an objective parameter. Wider implications of the findings may include more detailed patient information and more accurate selection of suitable patients for MTX therapy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Gravidez ectópica após uso de contracepção de emergência: relato de caso Ectopic pregnancy after use of hormonal emergency contraception: a case report

    Directory of Open Access Journals (Sweden)

    Renato Monteiro Zucchi

    2004-10-01

    Full Text Available Gravidez ectópica é a implantação e o desenvolvimento do ovo fora da cavidade uterina; impõe diagnóstico precoce e assistência de urgência. Gravidez ectópica com corpo lúteo contralateral presume ocorrência de transmigração do zigoto para a tuba uterina do lado oposto, o que pode ser responsável pela sua ocorrência. Em 1994, o levonorgestrel teve sua eficácia comprovada como superior à dos outros métodos para contracepção de emergência. É relatado caso de paciente de 27 anos que apresentou gravidez ectópica, de localização tubária, com corpo lúteo contralateral, após uso de contracepção de emergência por falha do método anticoncepcional de escolha (preservativo masculino. Foi realizado tratamento cirúrgico conservador por videolaparoscopia, com boa evolução após a cirurgia.Ectopic pregnancy is the implantation and development of the ovum outside the uterine cavity; it needs a quick diagnosis and an urgent treatment. The presence of the corpus luteum in the ovary that is contralateral to the ectopic pregnancy is presumptive evidence for ovum transmigration, which may be the cause of ectopic pregnancy. In 1994, a multinational clinical trial proved the superiority of levonorgestrel over the existing emergency contraceptive products. In the present study, we describe the case of a 27-year-old woman with ectopic pregnancy and a contralateral corpus luteum after use of hormonal emergency contraception (levonorgestrel, because of failure of the used contraception method (condom. The patient was treated with laparoscopic surgery that was successful.

  20. Bilateral Ectopic Pregnancy. A Case Report and a Literature Review Embarazo ectópico bilateral. Presentación de un caso y revisión de la literatura

    Directory of Open Access Journals (Sweden)

    Yarisdey Corrales Hernández

    2012-05-01

    Full Text Available

    Ectopic pregnancy is a condition that causes frequent direct maternal deaths. We report the case of a bilateral ectopic pregnancy in a 39 years old patient, who attended the Dr. Gustavo Aldereguía Lima General University Hospital of Cienfuegos. She referred pain and amenorrhea in a previous period of 7 weeks. Physical and ultrasonographic examinations were performed and the patient was diagnosed with ectopic pregnancy. Laparotomy was performed and a bilateral ectopic pregnancy was found. Surgical treatment was performed. This presentation is rare, that is why we decided to have this case published.

    El embarazo ectópico es una afección ginecológica que causa frecuentemente muertes maternas directas. Se presenta el caso de un embarazo ectópico bilateral, en una paciente de 39 años de edad, que acudió al Hospital General Universitario Dr. Gustavo Aldereguía Lima, de Cienfuegos, refiriendo dolor y amenorrea de 7 semanas. Se realizó examen físico y ultrasonográfico mediante los que se le diagnosticó un embarazo ectópico. Se practicó laparotomía y se encontró un embarazo ectópico bilateral. Se realizó tratamiento quirúrgico. Su presentación es rara, por lo cual se decidió la publicación de este caso.


     

  1. 异位妊娠患者焦虑抑郁情绪分析%Analysis of depression and anxiety level of ectopic pregnancy patients

    Institute of Scientific and Technical Information of China (English)

    洪琼; 章一涓

    2012-01-01

    对接收调查的异位妊娠患者80例及对照组60例进行焦虑抑郁问卷及艾森克人格问卷调查,采用SPSS 16.0统计软件对数据进行统计分析.异位妊娠患者的抑郁、焦虑均数与对照组比较差异有统计学意义(P<0.05).在影响因素上,患者的婚姻状况、有无生育要求,焦虑抑郁差异有统计学意义(P<0.05),而治疗方式差异无统计学意义.人格特质与焦虑抑郁状况的相关性研究显示维度E与焦虑抑郁具有相关性(P<0.05).%Eighty ectopic pregnancy patients who corresponded with entering standards were tested with anxiety depression seale and Eysenck Personality Questionnaire, compared with sixty early pregnancy women in the outpatient clinic at the same period. The SPSS 16. 0 software were used for statistical analysis. The average of depression had statistical significance( P < 0. 05 ) compared with the control group. The anxiety depression influence factors of the patients were marital statusa and had fertility requirements( P <0. 05 ). The different treatments were no statistically significant. The dimension E showed there were correlation between personality traits and anxiety depression( P < 0. 05 ).

  2. Methotrexate and mifepristone combined treatment of ectopic pregnancy clinical effect observation%米非司酮与甲氨蝶呤联合治疗异位妊娠的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    金小芳

    2014-01-01

    目的:分析米非司酮与甲氨蝶呤联合治疗异位妊娠效果。方法:将62例异位妊娠患者分为每组31例的观察组(米非司酮联合甲氨蝶呤)和对照组(甲氨蝶呤),分析治疗效果。结果:观察组治疗成功率高于对照组,血β-HCG恢复时间少于对照组(P<0.05)。结论:米非司酮联合甲氨蝶呤治疗异位妊娠疗效确切。%Objective: Analysis of mifepristone and methotrexate in the treatment of ectopic pregnancy effect.Methods: 62 cases of ectopic pregnancy were divided into observation group (31 cases mifepristone combined with methotrexate (MTX)) and the control group, curative effect analysis.Results: The treatment group the treatment success rate is higher than that of the control group, the blood β -HCG recovery time is less than that of the control group (P<0.05).Conclusion: Mifepristone Combined with methotrexate in treatment of ectopic pregnancy curative effect.

  3. Teenage Pregnancy: Impact of the Integral Attention Given to the Pregnant Teenager and Adolescent Mother as a Protective Factor for Repeat Pregnancy

    Directory of Open Access Journals (Sweden)

    Maria José Carvalho Sant'Anna

    2007-01-01

    Full Text Available The purpose of this study was to evaluate the impact of the integral attention to the health of pregnant adolescents and adolescent mothers, having follow-up from the Integral Support Program for the Pregnant Teen (ISPPT, with the intention to determine quality of life and prevent repeat pregnancy. A prospective study comprised 85 adolescents attended by the ISPPT between January 2002 and June 2006 who participated in meetings during pregnancy with a multidisciplinary team that provided orientation concerning family planning, self-esteem, pregnancy prevention, motivation to continue education and/or work, and evaluate the postpartum mother-child relationship. The following were analyzed: education level, marital status, contraceptive use, thoughts and attempts at abortion, repeat pregnancy. This study was approved by the Human Research Ethics Committee. The Epi-Info v6.0b software was used for data and result evaluation using the means and the chi-squared test. The mean age of the adolescents was 15.7 years, 3.52% had repeat pregnancy within a mean follow-up of 23 months after childbirth, the mean education level was 8.1 years, 30.5% dropped out of school, with 79.4% occurring before pregnancy, 64.6% used no contraceptives, 68.3% were single, and 81.3% had a positive role model. One year after birth, 67.5% studied, 50% worked, 55.1% lived with the partner, 77% correctly used contraceptives, every child lived with their mothers and their vaccinations were up to date. The results demonstrate that the global attention given to the health of adolescent mothers and pregnant adolescents is a protective factor for pregnancy relapse and quality of life.

  4. Teenage pregnancy: impact of the integral attention given to the pregnant teenager and adolescent mother as a protective factor for repeat pregnancy.

    Science.gov (United States)

    Sant'Anna, Maria José Carvalho; Carvalho, Kepler Alencar Mendes; Melhado, Amanda; Coates, Verônica; Omar, Hatim A

    2007-02-09

    The purpose of this study was to evaluate the impact of the integral attention to the health of pregnant adolescents and adolescent mothers, having follow-up from the Integral Support Program for the Pregnant Teen (ISPPT), with the intention to determine quality of life and prevent repeat pregnancy. A prospective study comprised 85 adolescents attended by the ISPPT between January 2002 and June 2006 who participated in meetings during pregnancy with a multidisciplinary team that provided orientation concerning family planning, self-esteem, pregnancy prevention, motivation to continue education and/or work, and evaluate the postpartum mother-child relationship. The following were analyzed: education level, marital status, contraceptive use, thoughts and attempts at abortion, repeat pregnancy. This study was approved by the Human Research Ethics Committee. The Epi-Info v6.0b software was used for data and result evaluation using the means and the chi-squared test. The mean age of the adolescents was 15.7 years, 3.52% had repeat pregnancy within a mean follow-up of 23 months after childbirth, the mean education level was 8.1 years, 30.5% dropped out of school, with 79.4% occurring before pregnancy, 64.6% used no contraceptives, 68.3% were single, and 81.3% had a positive role model. One year after birth, 67.5% studied, 50% worked, 55.1% lived with the partner, 77% correctly used contraceptives, every child lived with their mothers and their vaccinations were up to date. The results demonstrate that the global attention given to the health of adolescent mothers and pregnant adolescents is a protective factor for pregnancy relapse and quality of life.

  5. Clinical comparison of transabdominal and transvaginal color doppler ultrasound in diagnosis of early ectopic pregnancy%经腹及经阴道彩超诊断早期异位妊娠的临床对比分析

    Institute of Scientific and Technical Information of China (English)

    刘波

    2014-01-01

    目的:对比分析经腹及经阴道彩色多普勒超声在早期异位妊娠临床诊断中的应用价值。方法回顾我院2012年3月至2014年1月期间98例疑似异位妊娠患者临床资料、经腹彩色多普勒超声(tacds)检查结果、经阴道彩色多普勒超声(tVcds)检查结果及手术病理诊断结果。结果98例疑似异位妊娠患者,经手术病理确诊异位妊娠96例, tacds 检查诊断61例,符合率63.54%;tVcds 检查诊断88例,符合率91.67%。结论 tVcds 较 tacds 早期异位妊娠诊断率高,应在临床中推广应用。%Objective to investigate the clinical diagnosis value of transabdominal and transvaginal color doppler ultrasound in diagnosis of early ectopic pregnancy. Methods clinical data of 98 patients with suspected ectopic pregnancy in our hospital from March 2012 to January 2014 were reviewed including test results of transabdominal color doppler ultrasound (tacds),transvaginal color doppler ultrasound (tVcds) and surgical pathology. Results 98 patients with suspected ectopic pregnancy were confirmed 96 cases of ectopic pregnancy with pathologically . TACDS diagnosed 61 cases , in line with the rate of 63.54%; tVcds diagnosed 88 cases , in line with the rate of 91.67%.Conclusion compared tacds ,tVcds in early diagnosis of ectopic pregnancy has higher diagnosis rate, clinical application should be promoted.

  6. Baoan district migrant workers ectopic pregnancy risk factors and the relationship between sexual health education%外来务工人员异位妊娠发病因素与社区性健康促进的关系

    Institute of Scientific and Technical Information of China (English)

    邹桂花; 章柏花; 谢秋萌

    2015-01-01

    Objective: Baoan district migrant workers ectopic pregnancy (EP) related factors of the disease, explore the feasible interventions. Methods: For 1690 ectopic pregnancy migrant workers patients that diagnosed by Baoan Xixiang hospital,we conducted the investigation and analysis of related factors. Results: Migrant workers incidence of ectopic pregnancy accounted 85.92% of our total ectopic pregnancy, the related factors are: lack of knowledge of sexual health and disease knowledge, without preventing sexual behavior lead to abortion; Impurity sexual life, no fixed sexual partners, these behaviors lead to various genital infection. Conclusion: To enhance education for migrant workers of sexual idea, sexual health knowledge and disease knowledge,take prevent action can reduce the rate of ectopic pregnancy for Baoan district migrant workers.%目的:探讨宝安区外来务工人员异位妊娠(EP)发病的相关因素,探索出切实可行干预措施。方法:对在宝安区医疗单位确诊的1690例外来务工异位妊娠患者,进行发病相关因素和社区性健康促进的调查分析。结果:外来务工人员异位妊娠发病率占异位妊娠总数的85.92%,发病相关因素有:对性卫生知识及疾病知识缺乏,性行为无防范;不洁的性行为以及不固定的性伴侣导致不同程度的生殖器感染。结论:对外来务工人员加强系统性、计划性的性观念、社区性健康促进和相关疾病知识的教育,有效地从源头预防,可降低宝安区外来务工人员异位妊娠的发病率。

  7. Effect of Repeated Stress Treatments During the Follicular Phase and Early Pregnancy on Reproductive Performance of Gilts

    NARCIS (Netherlands)

    Soede, N.M.; Roelofs, J.B.; Verheijen, R.J.E.; Schouten, W.G.P.; Hazeleger, W.; Kemp, B.

    2007-01-01

    In pig husbandry, stress is being considered an important cause of impaired reproductive performance. Therefore, an experiment was performed to quantify effects of repeated stressors during the follicular phase and/or during early pregnancy on reproductive performance of gilts. Eighty-one cyclic

  8. Autocorrelation and cross-correlation between hCGβ and PAPP-A in repeated sampling during first trimester of pregnancy

    DEFF Research Database (Denmark)

    Nørgaard, Pernille; Wright, Dave; Ball, Susan;

    2013-01-01

    Theoretically, repeated sampling of free β-human chorionic gonadotropin (hCGβ) and pregnancy associated plasma protein-A (PAPP-A) in the first trimester of pregnancy might improve performance of risk assessment of trisomy 21 (T21). To assess the performance of a screening test involving repeated...

  9. Ectopic decidual reaction mimicking irritable bowel syndrome: a case report.

    Directory of Open Access Journals (Sweden)

    Soraya Salehgargari

    2014-01-01

    Full Text Available Ectopic decidualization with gross involvement of the peritoneum is one of the rare findings in pregnant women particularly when ectopic decidualization disseminated as an asymptomatic intra-abdominal nodule. We present here a case of an ectopic decidualization in a 33-year-old pregnant woman with symptoms of irritable bowel syndrome during pregnancy.

  10. 异位妊娠的MRI表现及其病理基础%Magnetic resonance imaging and pathological features of ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    江魁明; 王亚; 麦慧; 李水婷; 侍丽; 肖湘生

    2012-01-01

    Objective To investigate the magnetic resonance imaging (MRI) manifestations and pathological features of ectopic pregnancy (EP).Methods Profiles of 37 cases with EP confirmed by surgery and pathology were retrospectively analyzed.All the patients were subjected to plain and contrastenhanced pelvic MRI prior to surgery.The endometrial thickness was assessed for comparison with 35 normal controls who had early intrauterine pregnancy (EIUP).Results Of 37 cases with EP diagnosed as tubal pregnancy,25 were right-sided and 12 were left-sided.Thirty-five cases with EP were confirmed as spontaneous pregnancy,and 2 developed heterotopic pregnancy following assisted conception.All ectopic gestational sacs were featured by cystic sac-like structures or solid mass,with a diameter of(3.6±1.8) cm.Soft tissue structures,suggested by normal T1 and prolonged T2 signals,were shown in 22 cases.Transient T1 and T2 signals were present within or surrounding the gestational sacs in 27 cases,who were characterized by continuous or interrupted ring-shaped decidua-like enhancement on TIWI scanning.The contrast-enhanced layered gestational sacs were identified in 26 cases.There was no marked difference in the endometrial thickness between 35 cases with EP[(0.36±0.11) cm] and those with EUIP [(0.40±0.10) cm].Pathologic findings,including massive hemorrhagic clots,placental villi and trophocytes,were noticeable in 37 cases with EP,of whom 6 cases presented amniotic sacs and embryonic structures in the incised fallopian tubes.Conclusion Tubal pregnancy,featured by parametrial cystic sac-like structures or solid mass,acute hemorrhage,continuous or interrupted layering decidua-like enhancement of heterotopic gestational sac walls and impressive uterine decidual response on MRI,may be readily diagnosed prior to the surgery.%目的 探讨异位妊娠的MRI表现及其病理基础.方法 回顾分析37例经手术、病理证实的异位妊娠(EP)的临床资料.所有病例确诊EP后均于

  11. 异位妊娠期待治疗成功的因素分析%Relative factors of expectant management of ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    齐向营; 苏士利; 董白桦

    2013-01-01

    Objective To analyze select patients of ectopic pregnancy for expectant management.Methods Retrospective analyses were conducted for the relative factors of 180 cases of ectopic pregnancy with expectant management at Department of Family Planning of our hospital from August 2004 to January 2012.Their general clinical data,clinical manifestations and laboratory tests were collected.The cases requiring neither surgery nor drug therapy belonged to the cure group while the rest fell into the failure group.Results A total of 140 patients were successfully managed with a cure rate of 75.27%.There was no significant difference between two groups in size of mass on ultrasonography (P > 0.05).The cases with gestational sac of mass on ultrasonography had statistical difference between two groups (P <0.05).Statistical difference existed between two groups (P < 0.01) in initial blood beta-human chorionic gonadotropin (β-hCG),initial bloodβ-hCG and D3-5/D0 (ratio of bloodβ-hCG at day 3-5 and initial)were the variables for predicting the likelihood of successful expectant management under the ROC curve.The Youden Index was the largest at an initial bloodβ-hCG of 634 IU/L or D3-5/D0 of 0.711.Conclusion At blood β-hCG≤634 IU/L or D3-5/D0 < 0.711,expectant management may be offered.And mass with gestational sac on ultrasonography is a relative factor of expectant management.%目的 对异位妊娠期待治疗成功的因素进行回顾性分析.方法 对山东大学齐鲁医院计划生育科2004年8月至2012年1月186例异位妊娠期待治疗病例进行回顾性分析,不需要手术或药物治疗为治愈组,需要手术或药物治疗的为失败组.结果 140例期待治疗成功,治愈率75.27%;治愈组与失败组包块大小经秩和检验,差异无统计学意义(P>0.05);两组包块有囊性结构患者例数差异有统计学意义(P<0.05).两组初始血β-人绒毛膜促性腺激素(hCG)差异有统计学意义(P<0.01),初始血β-h

  12. Diagnostic accuracy of the ultrasonography in complicated pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Kyung Soo; Kim, Kun Sang; Park, Soo Soung [Chungang University College of Medicine, Seoul (Korea, Republic of)

    1983-12-15

    Ultrasonography is an invaluable diagnostic method in Obstetrics. It provides safe, speedy and repeatable way to obtain image of normal and abnormal pregnancy. The ultrasonograms of 167 patients with suspicion of complicated pregnancy were analyzed. The results were as follows. 1. 86 patients showed normal ultrasonogram(50.9%). 100% in intrauterine fetal death and gross fetal anomaly, 100% in abnormal fetal position and number, 95% in pregnancy with pelvic mass, 83% in ectopic pregnancy, 81% in abortion, 78% in molar pregnancy, 74% in plancenta previa. 3. Ultrasonic diagnosis of abrupto placenta was difficult. 4. Diagnostic accuracy was 80% in bicornuate uterus and double vagina

  13. [Ectopic calcification].

    Science.gov (United States)

    Fukumoto, Seiji

    2014-02-01

    Calcium deposition can be observed in many tissues in addition to bones and teeth which physiologically calcify. This unphysiological calcification can damage several organs. It has been shown that vascular calcification which is a risk factor for cardiovascular events develops through similar mechanisms to physiological calcification. Further studies to clarify detailed mechanisms of calcification are necessary to develop measures that inhibit unphysiological ectopic calcification without affecting physiological calcification in bones and teeth.

  14. 异位妊娠药物保守治疗的疗效观察%Drug Curative Effect Observation of Conservative Treatment of Ectopic Pregnancy

    Institute of Scientific and Technical Information of China (English)

    李南欣

    2013-01-01

    Objective:To observe the clinical efficacy of drug in the conservative treatment of ectopic pregnancy. Method:56 patients with medicine conservative treatment of ectopic pregnancy were randomly divided into group A(methotrexate,MTX)combined with mifepristone)and Group B (MTX). After seven days,observed the bloodβ-hCG values and the cure rate,the efficiency rate,the invalid rate,the adverse reaction rate. Result:A group of seven days after treatment,serumβ-hCG decreased more than 15%in 26 cases,in which the cure rate was 92.9%(26/28),efficiency of 3.6%(1/28),the inefficiency of 3.6%(1/28 ),incidence of adverse reactions 17.9%(5/28). Group B,the first seven days after treatment,bloodβ-hCG decreased by more than 15%of 21 cases;wherein the cure rate was 75%(21/28),efficiency of 14.3%(4/28),10.7%inefficiency(3/28),the incidence of adverse reactions of 32.1%(9/28). Two sets of blood β-hCG decreased more than 15% of the number of cases the difference was statistically significant(P<0.05). The differences of cure,efficient and inefficient in the two groups were statistically significant(P<0.05). Incidence of adverse reactions compared the two groups was statistically difference(P<0.05). Conclusion:MTX combined with mifepristone can be used for the treatment of ectopic pregnancy with high successful rate and little side effects. It can significantly reduce the level ofβ-hCG,and reduce adverse reactions.%目的:探讨异位妊娠药物保守治疗后的临床疗效。方法:选取本院药物保守治疗的异位妊娠患者56例,随机均分为A组(甲氨蝶呤联合米非司酮治疗)和B组(甲氨蝶呤治疗)。监测治疗后第7天血β-hCG值、疗效及治疗中不良反应发生率。结果:A组治疗后第7天血β-hCG下降高于15%者26例,其中治愈率为92.9%(26/28)、有效率3.6%(1/28)、无效率3.6%(1/28),不良反应发生率17.9%(5/28)。B组治疗后第7天血β-hCG下降高于15%者共21

  15. 体外受精-胚胎移植后异位妊娠20例临床分析%Clinical analysis on 20 cases with ectopic pregnancy after in vitro fertilization and embryo transfer

    Institute of Scientific and Technical Information of China (English)

    莫有敏; 杨菁; 赵庆红; 邹宇洁

    2013-01-01

    Objective: To explore the incidence rate, high risk factors, and treatment of ectopic pregnancy after in vitro fertilization and embryo transfer (IVF-ET) . Methods: Twenty patients with ectopic pregnancy after IVF/intracytoplasmic sperm injection (IC-SI) from February 2009 to February 2011 were analyzed retrospectively, and 100 women with normal intrauterine pregnancy after IVF/ICSI were randomly selected as control group. Results: There were 1 434 IVF/ICSI cycles totally, 645 cases got clinical pregnancy, the clinical pregnancy rate was 44. 98% ( 645/1 434) , 20 cases got ectopic pregnancy, the incidence rate was 3. 10% ( 20/645 ) , 2 cases got intrauterine pregnancy and ectopic pregnancy simultaneously, 2 cases got interstitial tubal pregnancy, and one case got angular pregnancy. Among 20 cases with ectopic pregnancy, 16 cases were found with tubal factors, 3 cases were found with polycystic ovary syndrome (PCOS) , 3 cases were found with endometrial polyp, 4 eases were found with endometriosis, 8 cases had history of ectopic pregnancy, and 7 cases had history of abortion. There was no statistically significant difference in age, duration of infertility, infertile types, body mass index (BMI) , patterns of assisted reproduction, ET types, estradiol and luteinizing hormone levels on the day of human chorionic gonadotropin ( HCG) injection, and depth of endometrium between the two groups (P > 0. 05 ) , but there were statistically significant differences in progestogen level on the day of HCG injection and ratio of estradiol/progestogen between the two groups (P <0. 05) . Conclusion: Tubal lesions and pelvic inflammation are high risk factors of ectopic pregnancy after assisted reproduction, vaginal ultrasonography combined with blood 3 - HCG detection is the most effective diagnostic measure, laparoscopic salpingectomy is a good method to treat ectopic pregnancy at present.%目的:探讨体外受精-胚胎移植后异位妊娠的发生率、高危因素及处

  16. Does sequential embryo transfer improve pregnancy rate in patients with repeated implantation failure? A randomized control study

    Directory of Open Access Journals (Sweden)

    Wael A. Ismail Madkour

    2015-12-01

    Full Text Available Background: Repeated failure of in vitro fertilization treatment is frustrating to the patients and their clinicians. Various treatment plans and a change of protocol have been suggested for “low responders”; however, patients who fail treatment repeatedly inspite of good quality embryos pose a special therapeutic challenge. Additional challenge would be imposed on that particular group when the local IVF regulating low does not permit surplus embryo freezing. Objective: To examine whether sequential transfer of embryos on day 3 and on day 5 after ovum pick-up improves IVF/ET success rates in patients with repeated consecutive IVF failures (⩾ 3 trials compared to day 3 alone, with the background that local regulation prohibits embryo freezing. Study design: Randomized controlled study. Women scheduled for IVF/ET with repeated consecutive IVF failures (⩾ 3 trials were randomized to either sequential transfer of embryos on day 3 and on day 5 after ovum pick-up (Group I = 74 or conventional day 3 transfer (Group II = 73 as a control. The primary outcome measures were clinical pregnancy rate and implantation rate. The secondary outcome measures were ongoing pregnancy rate and early pregnancy loss. Results: Baseline and cycle characteristics were comparable in both groups. Clinical pregnancy rate (per embryo transfer was significantly higher in sequential ET group (37. 8% compared to that in day 3 group (21.9% (P value <0.05. Also, implantation rate (per embryos transferred was significantly higher in sequential ET group (17.1% compared to that in control group (10.5% (P value <0.01. Similarly, ongoing pregnancy (per embryo transfer was significantly higher in sequential ET group (33. 8% compared to that in day 3 group (19.2% (P value <0.05. Conclusions: Patients with repeated implantation failures, treatment with the sequential embryo transfer approach had significantly improved pregnancy outcomes compared to regular day 3 transfers

  17. 甲氨蝶呤联合米非司酮治疗异位妊娠临床疗效及安全性%Clinical Efficacy and Safety of Methotrexate Combined With Mifepristone in the Treatment of Ectopic Pregnancy

    Institute of Scientific and Technical Information of China (English)

    蒋永骊

    2016-01-01

    目的:分析甲氨蝶呤联合米非司酮治疗异位妊娠临床疗效及安全性。方法选取我院收治的异位妊娠患者46例,采用甲氨蝶呤治疗为常规组,采用甲氨蝶呤联合米非司酮治疗为试验组,各23例,对两组患者的治疗效果进行比较。结果试验组患者治疗有效率及β-HCG恢复时间短于常规组(P <0.05)。结论异位妊娠患者采用甲氨蝶呤联合米非司酮治疗后不良反应少,效果良好。%Objective To analyze the clinical efficacy and safety of methotrexate combined with mifepristone in the treatment of ectopic pregnancy. Methods Selected were treated in our hospital from ectopic pregnancy in 46 patients, treated with methotrexate as routine group, using mifepristone combined with methotrexate therapy as experimental group, 23 cases in each. The treatment effect of two groups of patients were compared. Results The effective rate of treatment and recovery time of beta -HCG were shorter in the experimental group than in the conventional group (P<0.05). Conclusion The patients with ectopic pregnancy were treated with methotrexate combined with mifepristone, the adverse reaction was less, and the effect was good.

  18. Clinical Observation of Mifepristone Combined With Methotrexate in Treatment of Ectopic Pregnancy%米非司酮联合甲氨蝶呤保守治疗宫外孕临床观察

    Institute of Scientific and Technical Information of China (English)

    林红光

    2015-01-01

    目的:评价米非司酮联合甲氨蝶呤保守治疗宫外孕临床现状。方法选择2014年3月~2015年3月在辽宁省凤城市妇幼保健院接受诊治的60例宫外孕病患,均分成两组。对照组选择甲氨蝶呤,实验组以米非司酮联合甲氨蝶呤保守治疗为主。结果两组病患临床效果差异有统计学意义(P <0.05)。结论以米非司酮联合甲氨蝶呤保守治疗为主要方案治疗宫外孕病患能够提升其临床效果。%Objective To evaluate the clinical status of mifepristone combined with methotrexate in treatment of ectopic pregnancy. Methods 60 cases of ectopic pregnancy disease patients were divided into two groups 2014 March 2015 March in Fengcheng City, Liaoning Province Maternal and child health care hospital. The control group experimental group with methotrexate, mifepristone combined with methotrexate therapy. Results Two groups of patients with clinical effect is obvious difference (P<0.05). Conclusion Mifepristone combined with methotrexate in conservative treatment as the main scheme treatment ectopic pregnancy disease patients can improve the clinical effect.

  19. Mifepristone Combine with Methotrexate in Treating Ectopic Pregnancy in 54 Cases%米非司酮联合甲氨蝶呤治疗宫外孕54例

    Institute of Scientific and Technical Information of China (English)

    杨红英; 曾凡清; 吴南顺; 殷娟; 康楷

    2013-01-01

    Objective To investigate the effect of mifepristone combine with methotrexate in treating ectopic pregnancy. Methods The clinical data of 105 patients with ectopic pregnancy between May 2010 and May 2012 were analyzed. Among them, 51 cases treated by methotrexate (control group), and 54 cases treated by mifepristone combine with methotrexate (treat group), then the effects and complication was observed. Results The effective power in treat group and control group were 74.51% and 81.48% espectively. And the effective power in treat group was higher than that in control group ( P 0. 05). Conclusion The combination of mifepristone with methotrexate is effective for treating ectopic pregnancy.%目的 研究米非司酮联合甲氨蝶呤治疗宫外孕的疗效和不良反应,探讨其临床应用价值.方法 回顾分析2010年5月至2012年5月间105例宫外孕患者的临床资料,其中甲氨蝶呤治疗51例(对照组),米非司酮联合甲氨蝶呤治疗54例(治疗组),比较两组疗效和不艮反应.结果 对照组和治疗组有效率分别是74.51%和81.48%,治疗组疗效高于对照组(P0.05).结论 米非司酮联合甲氨蝶呤治疗宫外孕疗效确切,值得临床推广.

  20. 异位妊娠患者使用甲氨喋呤和米非司酮的效果探讨%Patients with ectopic pregnancy with methotrexate and mifepristone effect is discussed in this paper

    Institute of Scientific and Technical Information of China (English)

    鹿全梅

    2014-01-01

    Objective to observe mifepristone combined methotrexate for the treatment of ectopic pregnancy clinical curative effect.Methods 20 patients with ectopic pregnancy were randomly divided into treatment group and observation group (n = 10.Treatment group using methotrexate combined therapy with mifepristone and methotrexate alone in the control group.Observe two groups of the cure rate and drug side effects.Results the treatment group cure rate was 90% in the control group is significantly higher than 70%, significant difference, but in terms of adverse drug reactions, there was no statistically significant difference between groups (P > 0.05).Conclusion methotrexate in combination with mifepristone in the treatment of ectopic pregnancy clinical curative effect is superior to methotrexate alone, is worthy of popularization and application.%目的:观察米非司酮联合甲氨喋呤治疗异位妊娠的临床疗效。方法:将20例异位妊娠患者随机分为治疗组和观察组各10例。治疗组采用甲氨喋呤联合米非司酮治疗,对照组单用甲氨喋呤。观察两组治愈率及药物副反应。结果:治疗组的治愈率为90%显著高于对照组的70%,差异显著,而在药物不良反应方面,组间差异无统计学意义(P>0.05)。结论:甲氨喋呤联合米非司酮治疗异位妊娠的临床疗效明显优于单用甲氨喋呤,值得推广应用。

  1. 腹部B超与阴道B超在异位妊娠诊断中的比较分析%A Comparative Analysis of Transabdominal and Transvaginal Ultrasonography in the Diagnosis of Ectopic Pregnancy

    Institute of Scientific and Technical Information of China (English)

    陈绍敏

    2012-01-01

    Objective; To evaluate the transabdominal and transvaginal ultrasonography in the diagnosis of ectopic pregnancy. Method: 52 cases of abdominal ectopic pregnancy were used transabdominal and transvaginal ultrasonography diagnosis. Result; Of transabdominal B-ultrasound-positive diagnosis rate was 73% ; transvaginal B-ultrasound-positive diagnosis rate was 95% , the difference was statistically significant ( P <0. 05 ). Transvaginal B-ultrasound of the adnexal mass, germ, cardiovascular volatility, fake intrauter-ine gestational sac was higher than abdominal B-ultrasound detection rate (P <0. 05). Conclusion; Transvaginal B-ultrasound diagnosis of ectopic pregnancy with a fast, safe, painless, and the diagnostic yield compared with abdominal B-ultrasound is superior.%目的:探讨经腹部B超检查与经阴道B超检查在异位妊娠诊断中的价值.方法:对我院52例异位妊娠患者分别采用腹部B超与阴道B超检查.结果:经腹部B超检查阳性确诊率为73%;经阴道B超检查阳性确诊率为95%,两者差异具有统计学差异(P<0.05).经阴道B超检查对附件包块、胚芽、心血管搏动、宫内假孕囊的检出率明显高于经腹部B超检查的检出率(P<0.05).结论:经阴道B超检查诊断异位妊娠具有快速、安全、无痛等优点,且诊断阳性率较经腹部B超检查更为优越.

  2. Clinical Study on Treatment of Ectopic Pregnancy After Cesarean Section%剖宫产术后异位妊娠的临床处理方式研究

    Institute of Scientific and Technical Information of China (English)

    曲卫红

    2015-01-01

    目的:探讨剖宫产术后异位妊娠的临床处理疗效。方法选择剖宫产术后异位妊娠10例,随机分为两组,即宫腔内注射治疗组和子宫动脉灌注化疗栓塞术联合超声引导下低负压吸宫治疗组。结果两组比较,子宫动脉灌注化疗栓塞术联合超声引导下低负压吸宫治疗组血清β-HCG恢复时间明显优于宫腔内注射治疗组,P<0.05。结论子宫动脉灌注化疗栓塞术联合超声引导下低负压吸宫治疗更有利于剖宫产术后异位妊娠的恢复。%Objective To evaluate the clinical efficacy of treatment of ectopic pregnancy after cesarean section.Methods There were 10 cases who were diagnosed with ectopic pregnancy after caesarean operation were divided into Uterine cavity injection group and uterine artery infusion chemotherapy and embolization combined with low negative pressure suction evacuation under ultrasound-guided technique group.Results Comparison after treatment showed that the effects of the β-HCG in uterine artery infusion chemotherapy and embolization combined with low negative pressure suction evacuation under ultrasound-guided technique group were better than the effects in uterine cavity injection group,P<0.05.Conclusion Uterine artery infusion chemotherapy and embolization combined with low negative pressure suction evacuation under ultrasound-guided technique more conducive to the recovery of patients with ectopic pregnancy after Caesarean operation.

  3. The Value of Conservative Treatment of Ectopic Pregnancy by “Promoting Blood Circulation to Dissipate Blood Stasis Method”%论“活血化瘀止血法”保守治疗异位妊娠的价值

    Institute of Scientific and Technical Information of China (English)

    胡道敏

    2016-01-01

    Ectopic pregnancy is one common acute abdominal pain of the obstetrics and gynecology .With advanced science and technology , the diagnosis of ectopic pregnancy is obviously improved , and provides a time and opportunity for the conservative treatment .Many clinical studies report Chinese medicine alone or with Western medicine in the conservative treatment of ectopic pregnancy has a unique curative effect, and side effect is small .This paper aimed to preliminarily discuss the clinical value of “promoting blood circulation to remove blood stasis” conservative treatment of ectopic pregnancy .%异位妊娠( ectopic pregnancy )是妇产科常见的急腹症之一。随着科学技术的发达,异位妊娠的早期诊断率显著提高,为保守治疗提供了时间和机会。临床上有多篇研究报道中药单独或联合西药保守治疗异位妊娠具有独特疗效,不良作用小。现初步探讨“活血化瘀止血法”保守治疗异位妊娠的临床价值。

  4. Effects of Depot Medroxyprogesterone Acetate Injection Timing on Medical Abortion Efficacy and Repeat Pregnancy: A Randomized Controlled Trial.

    Science.gov (United States)

    Raymond, Elizabeth G; Weaver, Mark A; Louie, Karmen S; Tan, Yi-Ling; Bousiéguez, Manuel; Aranguré-Peraza, Ana Gabriela; Lugo-Hernández, Elba M; Sanhueza, Patricio; Goldberg, Alisa B; Culwell, Kelly R; Kaplan, Clair; Memmel, Lisa; Sonalkar, Sarita; Jamshidi, Roxanne; Winikoff, Beverly

    2016-10-01

    To evaluate the effects of timing of depot medroxyprogesterone acetate injection on medical abortion outcome and risk of repeat pregnancy within the subsequent 6 months. In a multinational randomized trial, we assigned women undergoing medical abortion who wanted depot medroxyprogesterone acetate to administration either with mifepristone (Quickstart group) or after the abortion (Afterstart group). We ascertained abortion outcome, pregnancies, and contraception use over 7 months. From August 2013 to March 2015, we enrolled 461 participants with pregnancy durations of 75 days or less. Of participants included in the abortion outcome analyses, 14 of 220 (6.4%) and 12 of 226 (5.3%) in the Quickstart and Afterstart groups, respectively, had surgery to complete the abortion; the upper 90% confidence limit on this difference was 4.9%, within our prestipulated 5% noninferiority margin. Ongoing pregnancy after initial abortion treatment was significantly more common in the Quickstart group (8/220 [3.6%]) than in the Afterstart group (2/226 [0.9%]); the difference was 2.7% (90% confidence interval 0.4-5.6%). By 6 months, 5 of 213 (2.3%) and 7 of 217 (3.2%) in the Quickstart and Afterstart groups, respectively, became pregnant (exact log-rank test, P=.64). Use of highly effective contraceptives was significantly more common in the Quickstart group at 31 days (P<.001), but no difference was apparent at 6 months. The Quickstart group was significantly more satisfied with group assignment. Depot medroxyprogesterone acetate administration with mifepristone did not appreciably increase the risk of surgery after medical abortion but did increase the risk of ongoing pregnancy. It enhanced patient satisfaction, but we found no evidence that it decreased 6-month risk of repeat pregnancy. ClinicalTrials.gov, https://clinicaltrials.gov, NCT01902485.

  5. Efficacy Analysis of Influences of Methotrexate Joint Mifeprestone on Ectopic Pregnancy%甲氨蝶呤联合米非司酮保守治疗异位妊娠疗效分析

    Institute of Scientific and Technical Information of China (English)

    曹爽

    2013-01-01

    目的:探讨甲氨蝶呤联合米非司酮保守治疗异位妊娠的临床疗效。方法将我院近两年180例异位妊娠患者分为两组,每组90例,对照组单用甲氨蝶呤肌注治疗,观察组用甲氨蝶呤联合米非司酮治疗,回顾性分析两种保守治疗方法的疗效。结果两组在血清β-HCG降至正常所需天数、包块减小所需天数、住院天数上比较,观察组明显优于对照组,差异有显著性,P<0.05。结论甲氨蝶呤联合米非司酮保守治疗异位妊娠疗效确切,安全可靠,可适当放宽异位妊娠保守治疗指征。%Objective: To explore the efficacy of methotrexate combined with mifeprestone in the treatment of ectopic pregnancy. Method: 180 cases of patients diagnosed as ectopic pregnancy in our hospital in recent two years were divided into two groups of 90 cases. The patients in control groups were injected with methotrexate alone. The patients in experimental group were injected with methotrexate combined with mifeprestone. We analyse the efficacy of the two conservative treatment through a retrospective cohort. Result: We analyse the serum β-HCG、the package block size and the hospitalized time. There were significantly difference in the normal serum β-HCG time of restoration, hospital time and lump size compared treat group with control group (P< 0.05) . Conclusion: Methotrexate combined with mifeprestone in the conservative treatment of ectopic pregnancy was effective and safe. It was safe to appropriately broaden the indication of conservative treatment of ectopic pregnancy.

  6. 阴道B超与腹部B超异位妊娠中诊断的效果对比%Vaginal B ultrasound and abdominal B ultrasound contrast in diagnosis ectopic pregnancy effect

    Institute of Scientific and Technical Information of China (English)

    郭建红

    2014-01-01

    目的:探讨阴道 B 超与腹部 B 超诊断异位妊娠的临床效果。方法分析了我院收治并经手术或病理确诊的136例异位妊娠患者的资料。分为观察组和对照组,观察组采用阴道 B 超检查,对照组用腹部 B 超检查,比较两组诊断异位妊娠的准确率等情况。结果观察组诊断符合率(95.59%)明显高于对照组(79.41%),比较差异有统计学意义(P <0.05),观察组平均显示孕囊(或包块)时间及手术时间比对照组分别早7、8天。结论阴道 B 超诊断异位妊娠的临床效果较好,具备快捷、方便、准确率高等诸优点,值得临床推广。%Objective to explore the clinical effect of vaginal and abdominal B ultrasound B ultrasound diagnosis of ectopic pregnancy. Methods in our hospital were analyzed and confirmed by operation or pathological diagnosis of 136 patients with ectopic pregnancy data. divided into the observation group and the control group, the observation group by vaginal B ultrasound examination, the control group with abdominal B ultrasound examination, compared two groups of ectopic pregnancy diagnosis accurate rate etc.. Results the diagnostic coincidence rate (95.59%) of the observation group was obviously higher than that of control group (79.41%), and compare the difference was statistically significant (P < 0.05), the observation group average display gestation sac (or mass) time and operation time 7, 8 day earlier than the control group respectively.Conclusion vaginal ultrasound diagnosis of ectopic pregnancy clinical effect is good, have fast, all the advantages of convenience, high accuracy, worth clinical promotion.

  7. 128例腹腔镜手术治疗异位妊娠的临床疗效%128 Cases of Laparoscopic Surgery for the Treatment of Ectopic Pregnancy Clinical Curative Effect

    Institute of Scientific and Technical Information of China (English)

    韩娜

    2014-01-01

    Objective To explore the take the curative effect of laparoscopic surgery in patients with ectopic pregnancy.Methods In December, December 2010~December 2013 in our hospital for treatment of 128 cases of ectopic pregnancy patients as observation group, choose the laparotomy surgery in our hospital from 128 cases of ectopic pregnancy patients as control group, compared the effect of two kinds of surgery. Results The observation group of hospitalization time, ambulation time, surgical blood loss, operating time is better than the control group. Control the incidence of complications was 15.6%, the incidence of complications of observation group was 2.3%, the incidence of complications of observation group is lower than control group.Conclusion The implementation of laparoscopic surgery in patients with ectopic pregnancy curative effect is distinct, high safety, is worth promoting.%目的:探究对异位妊娠患者采取腹腔镜手术的疗效。方法选择2010年12月~2013年12月在我院接受治疗的128例异位妊娠患者作为观察组,选择同期在我院接受开腹手术的128例异位妊娠患者作为对照组,对比两种手术的效果。结果观察组的住院时间、下床活动时间、手术出血量、手术时间优于对照组。对照组的并发症发生率为15.6%,观察组的并发症发生率为2.3%,观察组的并发症发生率比对照组低。结论对异位妊娠患者实施腹腔镜手术疗效显著,安全性高,值得推广。

  8. Analysis the Value of Ultrasound Measure Endometrial Thickness in Differential Diagnosis Early Phase Ectopic Gestation and Uterine Pregnancy%超声测定子宫内膜厚度在鉴别诊断早期异位妊娠与宫内妊娠中的价值分析

    Institute of Scientific and Technical Information of China (English)

    李一冰

    2015-01-01

    Objective To analysis the value of ultrasound in the differential diagnosis of early ectopic pregnancy and intrauterine pregnancy.Methods Selected 15 cases of pregnant women in early pregnancy and 25 cases of early ectopic pregnancy, and the thickness of endometrial thickness and serum β-HCG level were measured by ultrasound.Results Compared the thickness of the endometrium between the intrauterine pregnancy group and the ectopic pregnancy group,P<0.05, had difference statistically significance.Conclusion The ultrasonic measurement of endometrial thickness during early pregnancy can predict the pregnancy, and improve the diagnosis accuracy of ectopic pregnancy and intrauterine pregnancy.%目的:分析超声测定子宫内膜厚度在鉴别诊断早期异位妊娠与宫内妊娠中的价值。方法选取早孕期宫内未形成孕囊患者25例及早期异位妊娠15例,均经超声测定子宫内膜厚度、血β-HCG水平。结果宫内妊娠组的子宫内膜厚度与异位妊娠组子宫内膜厚度对比,P<0.05,差异具有统计学意义。结论超声测定早期妊娠期间子宫内膜厚度,可预测妊娠着床情况,提高异位妊娠以及宫内妊娠诊断准确性。

  9. 腹腔镜手术与药物保守治疗异位妊娠的疗效比较%Comparison of curative effects of laparoscopic surgery and drug conservative therapy in treatment of ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    周晓红

    2012-01-01

    Objective: To compare the clinical efficacies of laparoscopic surgery and drug conservative therapy in treatment of ectopic pregnancy. Methods: One hundred and fifty patients with ectopic pregnancy who were treated in the hospital from March 2010 to March 2011 were selected, then they were divided into laparoscopic surgery group and drug conservative therapy group randomly. The patients in the two groups were treated with laparoscopic surgery and drug conservative therapy, respectively; the clinical efficacies in the two groups were compared. Results: Compared with drug conservative therapy group, the hospitalization time and serum human chorionic gonadotropin (HCG) level at discharge in laparoscopic surgery group decreased significantly (P 0. 05 ) . Conclusion: Laparoscopic surgery has the advantages of minimal injury, short hospitalization time, rapid recovery, and high intrauterine pregnancy rate, which is one of ideal therapies for the patients with ectopic pregnancy.%目的:比较腹腔镜手术与药物保守治疗异位妊娠的临床疗效.方法:2010年3月~2011年3月异位妊娠患者150例,随机分为腹腔镜手术组和药物保守治疗组.两组患者分别给予腹腔镜手术和药物保守治疗,对两组患者的临床疗效进行对比.结果:与药物保守治疗组相比,腹腔镜手术组的住院时间和出院时HCG值均显著降低(P<0.05),住院费用则显著提高(P<0.05),再次宫内妊娠率显著提高,盆腔炎的发生率则显著降低(P<0.05);同时,再次异位妊娠率有所降低,但未呈现出统计学差异(P>0.05).结论:腹腔镜手术在异位妊娠治疗中具有创伤性小、住院时间短、术后恢复快、宫内妊娠率高等优势,是异位妊娠患者较为理想的治疗方法之一.

  10. 体外授精—胚胎移植后异位妊娠相关因素研究进展%Related Factors of Ectopic Pregnancy after in Vitro Fertilization and Embryo Transfer

    Institute of Scientific and Technical Information of China (English)

    王桂玲; 任春娥

    2013-01-01

    近年来,随着体外授精一胚胎移植(IVF-ET)技术的蓬勃开展,IVF-ET后异位妊娠(EP)的发病率也随之升高.IVF-ET后EP发生的相关危险因素包括输卵管因素、子宫内膜异位症、授精方式、胚胎移植技术及控制性超排卵等,其中最主要的危险因素是由输卵管因素引起的输卵管功能紊乱.对具有以上危险因素的患者,在行IVF-ET治疗前,应尽量减少危险因素的影响,以提高临床妊娠率,并减少异位妊娠的发生率.本文就近年来对IVF-ET后EP发生的相关危险因素的研究作一综述.%With the development of in vitro fertilization — embryo transfer (1VF— ET), the incidence of ectopic pregnancy (EP) after IVF—ET is increased. The related risk factors for EP after IVF—ET included tubal factor, endometriosis, fertilization, embryo transfer technology and controlled ovarian hyperstimulation and so on, which the major risk factors are caused by fallopian tubal dysfunction. In order to improve the clinical pregnancy rate, and reduce the incidence of ectopic pregnancy, before IVF—ET treatment, for patients with these risk factors, should minimize the impact of risk factors. This article covers the related risk factors of EP after IVF—ET.

  11. Repeated pregnancy in a woman with uterine prolapse from a rural area in Nepal.

    Science.gov (United States)

    Pantha, Sandesh

    2011-05-01

    Pelvic organ prolapse is common in rural women in Nepal. Pregnancy in a woman with pelvic organ prolapse is uncommon and rarely continues beyond the second trimester. If it proceeds after that, the uterus usually ascends with progression of pregnancy and becomes abdominal, leaving little trace of prolapse. Pregnancy continuing to term with uterine prolapse is very rare. The case reported here is of a pregnant woman from a remote district in Nepal who had nine pregnancies and at 38 weeks of pregnancy presented at the district hospital with severe uterine prolapse, a large cervical ulcer and the baby's foot protruding from the cervix. Air transport was the only means of reaching the nearest hospital with emergency obstetric care, 200 km away. The baby was delivered stillborn at the airport by the auxiliary nurse-midwife who accompanied her. Her husband was counselled for and had a vasectomy. The woman was fitted with a ring pessary but could not afford to go to the nearest town for surgery for the prolapse. People in remote areas of Nepal often seek medical advice very late. This and the lack of education, low utilisation of family planning services, and lack of skilled birth attendance and safe delivery centres at local level contribute to high maternal morbidity and mortality. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  12. Twelve-month contraceptive continuation and repeat pregnancy among young mothers choosing postdelivery contraceptive implants or postplacental intrauterine devices.

    Science.gov (United States)

    Cohen, Rebecca; Sheeder, Jeanelle; Arango, Natalia; Teal, Stephanie B; Tocce, Kristina

    2016-02-01

    To compare discontinuation rates and incidence of repeat pregnancy within 1 year among young mothers choosing postplacental intrauterine devices (IUDs) versus postpartum contraceptive implants. We enrolled a prospective cohort of postpartum adolescents and young women who chose either postplacental IUDs or postpartum contraceptive implants prior to hospital discharge. We used chart review and phone interviews to assess device discontinuation (by request or expulsion) and pregnancy within 12 months. Of the 244 13-22 year-old participants, 82 chose IUDs (74 levonorgestrel IUDs and 8 copper IUDs), and 162 chose implants. Both groups had participant-requested discontinuation rates of 14% (9/67 IUD; 19/135 implant) within 1 year. Participants choosing IUDs had a 25% (17/67) expulsion rate. Median time to expulsion was 4.1 weeks (range: 0.4-29.3 weeks, 16/17 within 12 weeks), and participants recognized 15/17 expulsions. IUD initiators had significantly higher pregnancy rates by 12 months (7.6% vs. 1.5%, p=0.04). Most pregnancies occurred when women discontinued their initial device and did not start alternative contraception. Participant-requested discontinuation was similar in both groups. Differences in overall device discontinuation rates were due to IUD expulsions. Pregnancy rates by 12 months postpartum were lower than previously reported in this age group in both implant initiators and IUD initiators. Young mothers who choose postplacental IUDs or postpartum contraceptive implants are unlikely to request removal within the first year. Clinicians should counsel postplacental IUD users that early expulsion is common (25%) and may be unrecognized (11% of expulsions). Patients should have a plan for contraceptive management should expulsion occur. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Incidental Detection of Interstitial Pregnancy on CT Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Byung Seok [Chungnam National University Hospital, Daejeon (Korea, Republic of); Park, Mi Hyun [Dankook University Hospital, Cheonan (Korea, Republic of)

    2010-02-15

    Ectopic pregnancy is a potentially life-threatening condition. Detection of ectopic pregnancy on CT images is rare. In this case, we describe the CT findings of interstitial pregnancy both before and after rupture. If CT images demonstrate the presence of a strong enhancing ring-like mass in the pelvis, ectopic pregnancy should be considered

  14. Repeated measures of urinary oxidative stress biomarkers during pregnancy and preterm birth.

    Science.gov (United States)

    Ferguson, Kelly K; McElrath, Thomas F; Chen, Yin-Hsiu; Loch-Caruso, Rita; Mukherjee, Bhramar; Meeker, John D

    2015-02-01

    The purpose of this study was to investigate oxidative stress as a mechanism of preterm birth in human subjects; we examined associations between urinary biomarkers of oxidative stress that were measured at multiple time points during pregnancy and preterm birth. This nested case-control study included 130 mothers who delivered preterm and 352 mothers who delivered term who were originally recruited as part of an ongoing prospective birth cohort at Brigham and Women's Hospital. Two biomarkers that included 8-hydroxydeoxyguanosine (8-OHdG) and 8-isoprostane were measured in urine samples that were collected at up to 4 time points (median 10, 18, 26, and 35 weeks) during gestation. Urinary concentrations of 8-isoprostane and 8-OHdG decreased and increased, respectively, as pregnancy progressed. Average levels of 8-isoprostane across pregnancy were associated with increased odds of spontaneous preterm birth (adjusted odds ratio, 6.25; 95% confidence interval, 2.86-13.7), and associations were strongest with levels measured later in pregnancy. Average levels of 8-OHdG were protective against overall preterm birth (adjusted odds ratio, 0.19; 95% confidence interval, 0.10-0.34), and there were no apparent differences in the protective effect in cases of spontaneous preterm birth compared with cases of placental origin. Odds ratios for overall preterm birth were more protective in association with urinary 8-OHdG concentrations that were measured early in pregnancy. Maternal oxidative stress may be an important contributor to preterm birth, regardless of subtype and timing of exposure during pregnancy. The 2 biomarkers that were measured in the present study had opposite associations with preterm birth; an improved understanding of what each represents may help to identify more precisely important mechanisms in the pathway to preterm birth. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. 异位妊娠发生的危险因素分析%Clinical analyses of risk factors related to ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    陈静; 邱骏; 滕银成; 邹文燕; 杨弋

    2014-01-01

    Objective To conduct an epidemiological survey on the relevant risk factors of ectopic pregnancy (EP) and provide scientific rationales for prevention and reducing its incidence.Methods During June 2010 to December 2011 at three local hospitals,a total of 800 patients with a diagnosis of EP responded to a questionnaire survey for understanding the risk factors of EP.And another 700 cases of normal early pregnancy women were selected as control group.Both multi and uni-factorial regression analyses were performed for the acquired clinical data.And the high-risk factors of EP were screened.Results Among them,the age distribution was ≤ 25 years (n =175,25.5%),26-30 years (n =302,37.8%) and 31-35 years (n =213,26.6%).No contraceptive measure was adopted for 259 women (32.4%).The risk factors related to EP included oral emergency contraceptives,intrauterine device (IUD),pelvic inflammatory disease,infertility history,previous EP,smoking and age,etc.Based upon multivariate Logistic regression analysis of screening results,the decreasing odds rations were infertility,EP history,smoking history,emergency contraceptive use,history of EP,IUD,pelvic inflammatory disease and age.Conclusion The risks of EP are affected by many factors,including infertility,EP history,smoking history,emergency contraceptive use,history of EP,IUD,pelvic inflammatory disease and age.%目的 调查异位妊娠发生的相关危险因素,为进一步预防及减少异位妊娠的发病提供科学依据.方法 对2010年6月至2011年12月在上海市三家医院确诊为异位妊娠的800例住院患者,通过问卷调查的方式,了解异位妊娠的相关发病因素.并随机选取700例同期正常早期妊娠者作为对照组,采集相关临床资料分别进行单因素、多因素回归分析,筛选出异位妊娠发病的高危因素.结果 800例中年龄≤25岁175例,占25.5%;26—30岁302例,占37.8%;31~ 35岁213例,占26.6%;无避孕措施259例,占32.4%;异位

  16. Methotrexate and Mifepristone for the Treatment of Ectopic Pregnancy%甲氨蝶呤与米非司酮治疗宫外孕的效果研究

    Institute of Scientific and Technical Information of China (English)

    霍丽艳

    2016-01-01

    目的:分析研究宫外孕患者应用甲氨蝶呤与米非司酮治疗的临床效果。方法选取2013年5月~2016年2月在我院接受治疗的宫外孕患者104例,随机分为对照组(51例)和实验组(53例),观察并比较单纯甲氨蝶呤治疗与甲氨蝶呤联合米非司酮治疗两种不同方式的效果。结果实验组痊愈率和治疗总有效率高于对照组,盆腔包块消失时间以及血β-HCG转阴时间均短于对照组,差异具有统计学意义(P<0.05)。结论宫外孕患者应用甲氨蝶呤与米非司酮治疗的临床效果十分满意,安全有效。%Objective To analysis the clinical effect of methotrexate and mifepristone to treat patients with ectopic pregnancy.Methods Selected 104 cases of ectopic pregnancy patients who received treatment in our hospital from May 2013 to February 2016 and randomly divided into control group(51) and the experimental group(53), observed and compared the effect of methotrexate treatment with methotrexate and mifepristone. Results The cure rate and total effective treatment in patients were significantly higher than the control group, pelvic mass disappear time and blood beta HCG turning negative time were significantly shorter than the control group, the difference between group was statistically signiifcant by t test (P<0.05).Conclusion Patients with ectopic pregnancy using methotrexate and mifepristone is satisifed with the clinical effect of treatment, it is safe and effective.

  17. The Efficacy Observation of Mifepristone Combined With Methotrexate in Treatment of Ectopic Pregnancy%米非司酮联合甲氨蝶呤治疗宫外孕的效果观察

    Institute of Scientific and Technical Information of China (English)

    于宏

    2015-01-01

    Objective The treatment efficacy of mifepristone combined with methotrexate treatment in ectopic pregnancy is to be observed.MethodsChoose 75 patients with ectopic pregnancy who are treated in hospital from August 2013 to August 2014 and separate them into group A and group B according to visitation date number (odd and even number). 36 patients in group A are given methotrexate treatment only,while 39 patients in group B are given mifepristone combined with methotrexate treatment,and then observe and compare the treatment efficacy of two groups.Results Compared to group A,the treatment efficacy in group B is much higher and the side effects are less,there is a treatment differential between the two groups,such a differential has statistic value(P<0.05).Conclusion Mifepristone combined with methotrexate treatment is rather effective to cure patients with ectopic pregnancy with less side-effect. Therefore,it is quite worthy to be promoted and applied.%目的:观察米非司酮联合甲氨蝶呤对宫外孕的治疗效果。方法搜集2013年8月~2014年8月我院接收的宫外孕75例患者,按照就诊日期单双号分为甲组和乙组。给予甲组36例甲氨蝶呤,给予乙组39例米非司酮联合甲氨蝶呤。观察甲组和乙组的治疗效果,并对比分析。结果与甲组相比,乙组治疗有效率较高,不良反应较少,有明显差异,有统计学意义(P<0.05)。结论米非司酮联合甲氨蝶呤对宫外孕的治疗效果较好,临床有效率高,且不良反应发生率低。

  18. Methotrexate selection on curative effect of ectopic pregnancy administration%甲氨喋呤给药方式选择对异位妊娠的疗效影响

    Institute of Scientific and Technical Information of China (English)

    何静

    2015-01-01

    目的:分析研究甲氨喋呤不同给药方式的选择对于异位妊娠治疗效果的影响。方法:选取我院确诊收治的150例异位妊娠患者,以随机方式分为三组。A组给予单次肌肉注射甲氨喋呤,50mg/m2;B组给予分次注射甲氨喋呤0.4mg/kg.d,5d为一疗程;C组给予单次肌肉注射甲氨喋呤,50mg/m2并同时口服米非司酮600mg。结果:经治疗,A组患者治疗有效率78.0%,B组患者治疗有效率78.5%,C组患者治疗有效率94.0%,三者对比差异在统计学上有意义(P<0.05)。结论:甲氨喋呤不同给药方式对于异位妊娠均有一定治疗效果,但联合用药效果更佳,值得在临床上广泛推广使用。%Objective To study the different ways of administration of methotrexate for treatment effect of ectopic pregnancy. Methods 150 cases of ectopic pregnancy admitted to our hospital were randomly divided into three groups. Group A was given a single intramuscular injection of methotrexate, 50mg/m2;group B given injections of methotrexate 0.4mg/kg.d 5D for a course of treatment;group C received a single intramuscular injection of methotrexate, 50 mg/m2) and at the same time oral mifepristone 600mg. Results After treatment, the effective rate of A group was 78%, the effective rate of B group was 78.5%, the effective rate of C was 94%, the difference of the three was statistically significant (P<0.05). Conclusion Different methotrexate administration for ectopic pregnancy were a certain therapeutic effect, but combination effect is better, it is worth widely used in clinic.

  19. Effect Observation of Mifepristone Combined With Methotrexate in the Treatment of Ectopic Pregnancy%甲氨蝶呤联合米非司酮治疗宫外孕的效果观察

    Institute of Scientific and Technical Information of China (English)

    李宏

    2015-01-01

    Objective To observe on the clinical effect of mifepristone combined with methotrexate in treatment of ectopic pregnancy. Methods 48 patients of ectopic pregnancy who were treated in hospital from February 2014 to March 2015 were chosen and the patients were randomly divided into treatment group and control group. Clinical observation of the therapeutic effect of methotrexate and mifepristone combined with methotrexate. And then compared treatment effects between two groups. Results The cure rate of the treatment group were significantly higher than that of control group. The mass diameter,β-HCG,progesterone and the incidence of adverse reactions of treatment group were significantly lower than of the control group. The difference was significant,the result is statistical y significant(P<0.05). Conclusion Mifepristone combined with methotrexate in treatment of ectopic pregnancy has a significant effect. This method can keep patients with fertility and it is safe and effective.%目的:对甲氨蝶呤联合米非司酮治疗宫外孕的临床效果进行观察研究。方法选取于2014年2月~2015年3月在我院接受治疗的48例宫外孕患者,将患者随机分为对照组和治疗组进行对照研究,观察甲氨蝶呤和甲氨蝶呤联合米非司酮的临床治疗效果。结果治疗组患者的治愈率高于对照组,包块直径、血β-HCG、血孕酮以及不良反应发生率均低于对照组,差异有统计学意义(P<0.05)。结论米非司酮联合甲氨蝶呤治疗宫外孕有显著疗效,能够保持患者的生育能力并且安全有效。

  20. 米非司酮联合甲氨蝶呤治疗输卵管异位妊娠的临床研究%Clinical research on the effect of mifepristone combined with methotrexate treatment for tubal ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    潘九林

    2012-01-01

    目的 对比单独使用甲氨蝶呤与米非司酮联合甲氨蝶呤治疗输卵管异位妊娠的疗效.方法 2009年5月-2011年12月入院的240例患者,随机分为实验组和对照组,每组120例.对照组只进行甲氨蝶呤的注射治疗.20 mg/次肌肉注射,1次/d,治疗5 d.实验组为米非司酮和甲氨蝶呤联合治疗.米非司酮采取空腹口服的方式,100 mg/次,2次/d.甲氨蝶呤的使用方法同对照组.结果 实验组有效117例(97.5%),平均治疗天数为(14.8±5.07)d; 对照组有效109例(90.8%),平均治疗天数为(21.17±5.88)d.两组比较差异有统计学意义(P<0.05).结论 米非司酮联合甲氨蝶呤治疗输卵管异位妊娠疗效优于单用甲氨蝶呤.%Objective To compare the effect of methotrexate combined with mifepristone treatment for tubal ectopic pregnancy. Methods 240 cases of tubal ectopic pregnancy patients admitted to hospital from May 2009 to December 2011 were randomly divided into experimental group and control group, 120 cases each group. The control group was only given methotrexate,20 mg each time,by intramuscular injection, once a day, lasting 5 d. Experimental group was given mifepristone combined with methotrexate therapy. Mifepristone was taken oral, 100 mg each time,2 times a day. The use of methotrexate was the same as control group. Results The effective cases of experimental group were 117 cases( 97. 5% ), and its average treatment time was( 14. 8 ± 5. 07 )d;the effective cases of control group were 109 patients( 90. 8% ),and its average treatment time was( 21. 17 ± 5. 88 )d. There was significant difference between the two groups( P < 0. 05 ). Conclusion The efficacy of mifepristone combined with methotrexate treat- ment for tubal ectopic pregnancy is superior to methotrexate treatment only.

  1. 腹腔镜治疗有妇产科手术史的异位妊娠76例%Department of Obstetrics and Gynecology Laparoscopic Treatment of Ectopic Pregnancy in 76 Cases Operation Histor

    Institute of Scientific and Technical Information of China (English)

    熊亚平

    2015-01-01

    目的:探讨腹腔镜治疗有妇产科手术史的异位妊娠患者的可行性和安全性。方法研究对象为126例有妇产科手术史、并再次接受腹腔镜治疗的异位妊娠患者,其中有1次妇产科手术史者84例,有2次及以上妇产科手术史者42例。比较1次手术史、2次及以上手术史患者术中情况及术后并发症。结果126例患者中,手术成功112例,中转开腹14例,发生并发症7例。结论腹腔镜治疗有妇产科手术史的异位妊娠手术成功率高,1次手术史有效性与安全性更高。%Objective To study the laparoscopic treatment of patients with a history of ectopic pregnancy surgery of obstetrics and gynecology of the feasibility and safety.Methods The object of study for 126 cases with history of surger-y, and obstetrics and gynecology laparoscopic treatment of patients with ectopic pregnancy again, there are 1 time in his-tory, 84 cases of surgery, obstetrics and gynecology more than 2 times and 42 cases of gynecology and obstetrics surgery. Compare one surgery history, two or more patients with history of intraoperative and postoperative complications.Results Of 126 cases, 112 cases of successful operation transit open 14 cases, 7 cases of complications.Conclusions Lapa-roscopic treatment has a history of obstetrics and gynecology operation of ectopic pregnancy surgery success rate is high, the higher one surgery, effectiveness and safety.

  2. CLINICAL ANALYSIS OF FAMILY PLANNING OPERATION AND ECTOPIC PREGNANCY%计划生育手术与异位妊娠相关因素的临床分析

    Institute of Scientific and Technical Information of China (English)

    史莉; 司守娜; 柳书勤; 王婉

    2011-01-01

    [目的]探讨计划生育手术与异位妊娠的相关性及影响因素.[方法] 68例异位妊娠患者均经详细的妇科体检、病史询问和辅助性检查,检查方法包括:超声影像,血孕酮检测,后穹窿穿刺,阴道分泌物样本病理检查等.经过计划生育手术者48例,列为研究组,未经过者20例,列为对照组.[结果]在68例异位妊娠患者中,存在计划生育手术史患者占70.59% (48/68),未经计划生育手术者占29.41% (20/68),两组数据经统计学比较差异有统计学意义(P< 0.05);研究组患者患有宫内炎症72.92%明显高于对照组患者15% (P<0.05).[结论]计划生育手术,尤其是人工流产和宫内节育是妇女发生异位妊娠的危险因素.%[Objective] To discuss the relationship and affecting factors of family planning operation and ectopic pregnancy. [Methods] 68 cases with ectopic pregnancy were given the gynecological check, case history inquire, and secondary check, including ultrasonography, blood progesterone testing, culdocentesis, and pathological examination of vaginal secretions. 48 cases with family planning operation were in study group and other 20 cases were in control group. [Results] 70.59% (48/68) patients were treated by family planning operation and 29.41% (20/68) had no family planning operation in 68 cases, the data had significantly difference (P< 0.05). Patients with intiauterine inflammation in study group (72.92%) were significantly more than control group (15%)(P< 0.05). [Conclusion] Family planning operation, especially abortion and in-trauterine contraceptive are the risk factors of ectopic pregnancy.

  3. The risk factors of ectopic pregnancy and its relation with the history of pelvic operation%异位妊娠的高危因素及其与盆腔手术史的关系

    Institute of Scientific and Technical Information of China (English)

    王建英

    2012-01-01

    OBJECTIVE To investigate the risk factors of eclopic pregnancy and its relation with the history of pelvic operation. METHODS A retrospective analysis was carried out in 483 patients with ectopic pregnancy from August 2008 to December 2010 in our hospital. The trained staff collected patients' data, then analyzed and compared the different risk factors on the effect of ectopic pregnancy. RESULTS The patients of ectopic pregnancy occurred at different ages, < 20 years old in 12 cases, accounting for 2.5%; 20-9 years old in 243 cases, accounting for 50.3%; 30 -39 years old in 220 cases, accounting for 45.5%; more than 40 years in 8 cases, accounting for 1.7%. Analysis of risk factors showed pelvic infection history, history of abortion, IUD, infertility, history of cesarean section, history of ectopic pregnancy, tubal ligation operation and other smoking were major risk factors, among which the most important was the history of pelvic infection, accounting for 44.9%; history of abortion patients, accounting for 34.6% ; there appeared the history of infertility, 20.2%. 118 patients had pelvic operation, including 63 cases of pelvic inflammation history, accounting for 53.4%; and 365 cases were with pelvic operation, 129 cases with pelvic inflammation, accounting for 35.3%, compared two, the difference was statistically significant, P < 0.05. CONCLUSION Ectopic pregnancy has a close relation with history of pelvic infection, abortion history, history of abdominal operation. It should pay attention to the interventions on risk factors in life, which has important clinical significance in the prevention of incidence of ectopic pregnancy%目的 探讨异位妊娠的高危因素及其与盆腔手术史的关系.方法 回顾性分析2008年8月~2010年12月在某院住院治疗的异位妊娠患者483例,由受过专业培训的工作人员收集患者资料,分析比较不同危险因素对异位妊娠的影响.结果 不同年龄段异位妊娠发生情况,<20

  4. Repeated validation of parental self-reported smoking during pregnancy and infancy

    DEFF Research Database (Denmark)

    Christensen, Anne E; Tobiassen, Mette; Jensen, Tina K

    2004-01-01

    -reported smoking among parents during pregnancy and early childhood in a cohort of children at high risk for allergy development by measurement of exhaled carbon monoxide (CO). The cohort comprised 117 families enrolled from the general population of pregnant women at admission to antenatal care. Data on parental...... tobacco smoking were obtained by interview and exhaled CO was measured (Micro-Smokerlyzer(R)) in parents twice during pregnancy and when the child was 6 and 18 months old. The median (range) exhaled CO levels were 3 (0-10) parts per million (ppm) for non-smokers and 15 (1-39) ppm for smokers (P ...Exposure to environmental tobacco smoke (ETS) during fetal life and infancy is closely related to the smoking habits of the parents. Estimates of exposure to ETS require valid and detailed information on changes in cigarette smoking over time. The objective was to test the validity of self...

  5. Repeated Validation of Parental Selfreported Smoking during Pregnancy and Infancy

    DEFF Research Database (Denmark)

    Estmann, Anne; Tobiassen, Mette; Jensen, Tina Kold

    2004-01-01

    -reported smoking among parents during pregnancy and early childhood in a cohort of children at high risk for allergy development by measurement of exhaled carbon monoxide (CO). The cohort comprised 117 families enrolled from the general population of pregnant women at admission to antenatal care. Data on parental...... tobacco smoking were obtained by interview and exhaled CO was measured (Micro-Smokerlyzer(R)) in parents twice during pregnancy and when the child was 6 and 18 months old. The median (range) exhaled CO levels were 3 (0-10) parts per million (ppm) for non-smokers and 15 (1-39) ppm for smokers (P ...Exposure to environmental tobacco smoke (ETS) during fetal life and infancy is closely related to the smoking habits of the parents. Estimates of exposure to ETS require valid and detailed information on changes in cigarette smoking over time. The objective was to test the validity of self...

  6. 异位妊娠保守治疗方案的优化与临床分析%Optimization and Clinical Analysis of Conservative Treatment of Ectopic Pregnancy

    Institute of Scientific and Technical Information of China (English)

    商文金; 胡玉玲; 杨国华

    2015-01-01

    目的:评价甲氨蝶呤配伍中药、米非司酮配伍中药和米非司酮联合甲氨蝶呤配伍中药保守治疗异位妊娠的临床疗效.方法:回顾性分析2011年6月~2014年10月我院妇科确诊为异位妊娠并有保守治疗指征的患者360例,将其随机分成三组,米非司酮+中药组108例;甲氨蝶呤+中药组117例;甲氨蝶呤+米非司酮+中药135例.结果:米非司酮+中药组成功率为72.22%(78/108);甲氨蝶呤+中药组成功率为84.61%(99/117);甲氨蝶呤+米非司酮+中药成功率为95.56%(129/135).结论:甲氨蝶呤联合米非司酮配伍中药疗法用于保守治疗异位妊娠优于其他两种治疗方案,方法简便,疗效高,疗程短,副作用小,可保留生育功能,患者易于接受,是药物保守治疗异位妊娠的首选可靠治疗方法.%Objective: To evaluate the compatibility of traditional Chinese medicine methotrexate,mifepristone combined with traditional Chinese medicine and mifepristone combined with methotrexate and traditional Chinese medicine conservative treatment of ectopic pregnancy clinical effect.Methods:Retrospective analysis of 2011 June to 2014 October in our hospital were diagnosed as ectopic pregnancy and gynecological conservative treatment 360 cases of fingersyndrome patients,divided into three groups randomly,mifepristone plus traditional Chinese medicine group of 108 cases; methotrexate plus traditional Chinese medicine group of 117 cases;135 cases of methotrexate and mifepristone in combination with traditional Chinese medicine.Results:Mifepristone plus traditional Chinese medicine composition of power of 72.22% (78/108); methotrexate plus traditional Chinese medicine composition of power of 84.61% (99/117); the success rate of methotrexate and mifepristone plus traditional Chinese medicine was 95.56% (129/135).Conclusion:Combination of methotrexate and mifepristone combined with traditional Chinese medicine therapy for treatment of ectopic pregnancy is better than

  7. 阴道B型超声在诊断早期宫外孕中的效果评价%Evaluation of Transvaginal B-ultrasound in the Early Diagnosis of Ectopic Pregnancy

    Institute of Scientific and Technical Information of China (English)

    龚丽霞; 李霞

    2012-01-01

    Objective To evaluate transvaginal B-ultrasound in the early diagnosis of ectopic pregnancy. Methods We retrospectively analyzed the clinical data of 78 patients with ectopic pregnancy treated in our hospital between May 2011 and March 2012. They underwent either transvaginal B-ultrasound or abdominal B-ultrasound examination. The clinical efficacy of these two examination methods were compared. Results For the 78 cases of ectopic pregnancy, the accuracy the diagnostic accuracy rate of transvaginal B-ultrasound and abdominal B-ultrasound was 97.44% and 61.54% respectively, between which there was a significant difference (X2=6.472, P < 0.05). Transvaginal B-ultrasound detection rate of adnexal mass, fake intrauterine gestational sac, cardiovascular volatility, germ, and pelvic effusion was significantly higher than abdominal B-ultrasound detection rate (P < 0.05). Conclusions Transvaginal B-ultrasound has absolute superiorities in the early diagnosis of ectopic pregnancy. It is simple and fast with no side effects or any need to fill the bladder, which provides clinicians with more convenient and quicker diagnostic tool, and can alleviate the suffering of patients and improve the accuracy of diagnosis.%目的 探讨经阴道B型超声(B超)在诊断早期宫外孕中的临床应用价值.方法 回顾分析201 1年5月-2012年3月应用阴道B超与腹部B超对78例宫外孕患者进行对比检查的临床资料并回顾性分析,评价两种检查方法的临床效果.结果 78例宫外孕患者,应用经阴道B超检查诊断准确率为97.44%,应用腹部B超准确率为61.54%,差异具有统计学意义(x2=6.472,P<0.05);经阴道B超检查诊断附件包块、宫内假孕囊、心血管搏动、胚芽、盆腔积液的检出率明显高于经腹部B超检查的检出率(P<0.05).结论 阴道B超具有操作简单、快速、无副作用、无需充盈膀胱等优点,在宫外孕的早期诊断中具有绝对的优越性,为临床提供了更方便

  8. 如何在宫外孕术前评估是否应用自体血回输%Clinical application of autologous blood transfusion in operation of ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    刘颖

    2011-01-01

    目的 探讨如何在宫外孕术前根据患者彩色超声检查结果,来正确评估术中是否应用自体血回输.方法 对192例宫外孕开腹手术患者根据术前彩色超声提示的盆腔积液深度予以分组后,比较盆腔出血量、术后1d复查血常规的贫血患者病例数.结果 192例患者中自体血回输88例,104例患者未采用自体血回输.术前彩色超声提示盆腔积液深度>40mm的患者中,术中应用自体血回输可使术后出现贫血的例数明显减少(P<0.01);而术前彩色超声提示盆腔积液深度≤40mm的患者,术中是否应用自体血回输对于患者术后贫血无影响.结论 宫外孕患者手术前如彩色超声提示盆腔积液深度>40 mm术中应该应用自体血回输,当盆腔积液深度≤40mm可不必应用.%Objective To discuss how to make a correct assessment preoperatively by color Doppler ultrasound examination to use autologous blood transfusion in the operation of ectopic pregnancy. Methods According to the fluid depth in pelvic cavity shown in preoperative examinations of color Doppler ultrasound, 192 cases with laparotomy for ectopic pregnancy were divided into different groups to compare the amount of blood hemorrhage in pelvic cavity,and one day after the operation, routine blood examination was carried out to count the number of patients with anemia. Results Autologous blood transfusion was applied in 88 cases and not used in 104 cases in the laparotomy for ectopic pregnancy. In the patients whose fluid depth of pelvic cavity shown in the preoperative color Doppler ultrasound examination was over 40 mm,the rate of patients with anemia after operation was significantly reduced with the use of autologous blood transfusion in operation (P<0. 01); in the patients whose fluid depth of pelvic cavity in the preoperative examination was ≤40 mm, the autologous blood transfusion in operation or not did not have any effect on the rate of cases with anemia after the

  9. Application experience of autologous blood transfusion in emergency ectopic pregnancy operation%自体输血在急诊宫外孕手术中的应用体会

    Institute of Scientific and Technical Information of China (English)

    潘建芬

    2014-01-01

    Objective:To explore the application experience of autologous blood transfusion in emergency ectopic pregnancy operation.Methods:45 cases with ectopic pregnancy operation were selected from January 2002 to December 2007.They were all given autologous blood transfusion treatment.The clinical curative effect was observed.Results:The intranperative general conditions of 45 cases were all improved.They were without the occurrence of transfusion reaction,and no obvious infection, hepatic and renal damage.Conclusion:Autologous blood transfusion is an effective method for rescuing patients with bleeding.It is easy operation,no need special equipment and materials.It is worthy to be popularized in basic level hospital.%目的:探讨自体输血在急诊宫外孕手术中的应用体会。方法:2002年1月-2007年12月收治宫外孕手术患者45例,给予术中自体输血治疗,观察其临床疗效。结果:45例患者术中一般情况均好转,未发生输血反应,术后亦无明显感染,肝、肾功能无损害。结论:自体输血是抢救内出血患者的一种有效方法,操作简单,无需特殊的器械、材料,在基层医院值得推广。

  10. 经阴道联合经腹部超声检查对早期宫外孕的诊断价值%Combined transvaginal and abdominal ultrasound in the diagnosis of early ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    俞红; 施春霞

    2015-01-01

    Objective To observe the accuracy of abdominal ultrasound combined with transvaginal ultra-sound in the early diagnosis of ectopic pregnancy,thus to provide reference for clinical diagnosis of ectopic pregnancy. Methods The clinical data of 68 patients,who pathologically confirmed or conservative treatment with clinical diag-nosis of ectopic pregnancy,were retrospectively analyzed.All patients were treated with abdominal ultrasound,vaginal ultrasound examination.The accuracy and missed ectopic pregnancy rate of transvaginal ultrasound and abdominal B ultrasound and joint inspection were observed.And the presence or absence of abnormal ovarian uterus were recorded. Results By comparison with pathological diagnosis,joint diagnosis of 32 cases of ectopic pregnancy,the diagnosis rate was 94.1 %,missed 2cases,accounted for 5.9%;Transvaginal ultrasound diagnosis were 26 cases,accounted for 76.5%,missed by 8 cases,accounted for 23.5%;Abdominal ultrasound diagnosis were 24 cases,accounted for 70.6%,missed 1 0 cases,accounted for 29.4%.Joint inspection diagnosis rate was significantly higher than abdominal or vaginal ultrasound(χ2 =1 6.75,1 4.38,all P 0.05).Transvaginal ultrasound detected primitive heart tube pulse,mass,blood flow and gestational sac -like structures within the mass were significantly higher than the probability of abdominal ultra-sound(χ2 =26.71 ,7.1 8,1 0.25,50.28,25.69,6.39,all P <0.05).Conclusion United abdominal ultrasound and transvaginal ultrasound can significantly improve the early detection rate of ectopic pregnancy,which can provide refer-ence for clinical diagnosis and treatment.%目的:观察采用腹部超声联合经阴道超声检查临床诊断早期宫外孕的准确性,为临床宫外孕诊断提供参考依据。方法回顾性分析51例经手术病理或经保守治疗确诊为宫外孕患者临床资料;所有患者均采用腹部超声、阴道超声检查,观察阴道超声和经腹部 B 超及联合检查宫外孕的准

  11. 近30年异位妊娠发病相关因素的变迁分析%Correlation Factors’ Changes of Ectopic Pregnancy Onset in Thirty Years

    Institute of Scientific and Technical Information of China (English)

    赵海燕; 蔡叶萍; 李洁

    2013-01-01

      目的:探讨近30年异位妊娠的变化趋势及发病相关因素的变迁特点。方法:收集1978-2007年期间发生在肇庆市端州妇幼保健院、肇庆市第一人民医院、肇庆市医学高等专科学校附属医院、肇庆市端州区人民医院的1968例异位妊娠病例,进行回顾性分析,将1968例异位妊娠患者按发生时间为顺序,每10年一个阶段划分,统计异位妊娠的发病率,统计如下发病相关因素:异位妊娠发病率、年龄、婚育史、孕产史、教育程度、既往病史:宫内节育器、生殖道感染病史、前次异位妊娠史、下腹部手术史、宫颈治疗史、吸烟史、避孕史、辅助生育技术的应用。结果:近年来,异位妊娠的发病率一直呈上升趋势。异位妊娠患者未婚、未育、孕产次数多比例明显上升。前期组异位妊娠的既往病史主要为宫内节育器史,中期组主要为生殖道感染史,而后期组异位妊娠患者的既往病史为前次异位妊娠史、下腹部手术史和生殖道感染史。后期组中宫颈治疗史,吸烟史,避孕史,辅助生育技术使用史均高于前期组和中期组。结论:近三十年异位妊娠发病相关因素发生变化,针对不同的发病相关因素采取切实可行的干预措施,更好地预防异位妊娠的发生,从而降低发病率。%Objective:To study the characters and the trend of correlation factors’ changes of ectopic pregnancy onset in 30 years.Method:1968 cases are collected from Duanzhou Maternal and Child Health Hospital,Zhaoqing No.1 Hospital,Zhaoqing Medical College Hospital and Zhaoqing Duanzhou People’s Hospital,and implemented a retrospective analysis.The cases are ranked according to time sequence that are sorted by every 10 years, and the ages,ectopic pregnancy incidences,marital histories,reproductive histories,education backgrounds,abdominal operation histories,cervical treatment histories

  12. Mediation of the Relationship between Maternal Phthalate Exposure and Preterm Birth by Oxidative Stress with Repeated Measurements across Pregnancy.

    Science.gov (United States)

    Ferguson, Kelly K; Chen, Yin-Hsiu; VanderWeele, Tyler J; McElrath, Thomas F; Meeker, John D; Mukherjee, Bhramar

    2017-03-01

    Mediation analysis is useful for understanding mechanisms and has been used minimally in the study of the environment and disease. We examined mediation of the association between phthalate exposure during pregnancy and preterm birth by oxidative stress. This nested case-control study of preterm birth (n = 130 cases, 352 controls) included women who delivered in Boston, Massachusestts, from 2006 through 2008. Phthalate metabolites and 8-isoprostane, an oxidative stress biomarker, were measured in urine from three visits in pregnancy. We applied four counterfactual mediation methods: method 1, utilizing exposure and mediator averages; method 2, using averages but allowing for an exposure-mediator interaction; method 3, incorporating longitudinal measurements of the exposure and mediator; and method 4, using longitudinal measurements and allowing for an exposure-mediator interaction. We observed mediation of the associations between phthalate metabolites and all preterm birth by 8-isoprostane, with the greatest estimated proportion mediated observed for spontaneous preterm births specifically. Fully utilizing repeated measures of the exposure and mediator improved precision of indirect (i.e., mediated) effect estimates, and including an exposure-mediator interaction increased the estimated proportion mediated. For example, for mono(2-ethyl-carboxy-propyl) phthalate (MECPP), a metabolite of di(2-ethylhexyl) phthalate (DEHP), the percent of the total effect mediated by 8-isoprostane increased from 47% to 60% with inclusion of an exposure-mediator interaction term, in reference to a total adjusted odds ratio of 1.67 or 1.48, respectively. This demonstrates mediation of the phthalate-preterm birth relationship by oxidative stress, and the utility of complex regression models in capturing mediated associations when repeated measures of exposure and mediator are available and an exposure-mediator interaction may exist. Citation: Ferguson KK, Chen YH, VanderWeele TJ, Mc

  13. Impact of Counseling on Repeated Unplanned Pregnancy and Contraceptive Behavior in Low SES Abortion Population.

    Science.gov (United States)

    Burnhill, Michael S.; And Others

    High numbers of repeat abortions at a medical school clinic prompted clinic personnel to develop an experimental fertility control counseling program. Counseling objectives included the following: (1) to engender rapport and trust; (2) to assess the patient's past contraceptive use and psychosocial history; (3) to improve patient's knowledge of…

  14. right ectopic gestation following íjv vitro fertilisation

    African Journals Online (AJOL)

    2006-06-01

    Jun 1, 2006 ... ectopic pregnancy resulted following an intra-uterine zygote transfer, ... death, accounting for about 4% of approximately 20 ... Abdominal examination revealed multiple ... bleeding and adnexal mass, being present in only.

  15. Repeated measures of inflammation and oxidative stress biomarkers in preeclamptic and normotensive pregnancies.

    Science.gov (United States)

    Ferguson, Kelly K; Meeker, John D; McElrath, Thomas F; Mukherjee, Bhramar; Cantonwine, David E

    2017-05-01

    Preeclampsia is a prevalent and enigmatic disease, in part characterized by poor remodeling of the spiral arteries. However, preeclampsia does not always clinically present when remodeling has failed to occur. Hypotheses surrounding the "second hit" that is necessary for the clinical presentation of the disease focus on maternal inflammation and oxidative stress. Yet, the studies to date that have investigated these factors have used cross-sectional study designs or small study populations. In the present study, we sought to explore longitudinal trajectories, beginning early in gestation, of a panel of inflammation and oxidative stress markers in women who went on to have preeclamptic or normotensive pregnancies. We examined 441 subjects from the ongoing LIFECODES prospective birth cohort, which included 50 mothers who experienced preeclampsia and 391 mothers with normotensive pregnancies. Participants provided urine and plasma samples at 4 time points during gestation (median, 10, 18, 26, and 35 weeks) that were analyzed for a panel of oxidative stress and inflammation markers. Oxidative stress biomarkers included 8-isoprostane and 8-hydroxydeoxyguanosine. Inflammation biomarkers included C-reactive protein, the cytokines interleukin-1β, -6, and -10, and tumor necrosis factor-α. We created Cox proportional hazard models to calculate hazard ratios based on time of preeclampsia diagnosis in association with biomarker concentrations at each of the 4 study visits. In adjusted models, hazard ratios of preeclampsia were significantly (Pinflammation biomarkers that were measured at visit 2 (median, 18 weeks; hazard ratios, 1.31-1.83, in association with an interquartile range increase in biomarker). Hazard ratios at this time point were the most elevated for C-reactive protein, for interleukin-1β, -6, and -10, and for the oxidative stress biomarker 8-isoprostane (hazard ratio, 1.68; 95% confidence interval, 1.14-2.48) compared to other time points. Hazard ratios for

  16. Fallopian Tubes: Is Pregnancy Possible with Only One?

    Science.gov (United States)

    ... for an infection, a tumor or a past ectopic pregnancy. Occasionally, some women are born with only one ... Pruthi, M.D. References Lentz GM, et al. Ectopic pregnancy. In: Comprehensive Gynecology. 6th ed. Philadelphia, Pa.: Mosby ...

  17. 异位妊娠的诊治研究进展%Progress of Laparoscopic Diagnosis and Treatment of Ectopic Pregnancy

    Institute of Scientific and Technical Information of China (English)

    周应芳

    2006-01-01

    异位妊娠(Ectopic Pregnancy)指受精卵着床于正常子宫体腔以外的任何部位.异位妊娠可危及生命,是一种常见妇科急症,一直受到临床医生的普遍重视.异位妊娠已成为全世界流行性疾病,在美国100次妊娠中大约2例即为异位妊娠.

  18. 腹腔镜手术治疗休克型异位妊娠的护理分析%Nursing analysis of laparoscopic surgery in the treatment of ectopic pregnancy with hypovolemic shock

    Institute of Scientific and Technical Information of China (English)

    杨素娟; 周黎华; 李梅

    2012-01-01

    Objective To analyze and explore the nursing situations of laparoscopic surgery in the treatment of ectopic pregnancy with hypovolemic shock. Methods Seventy - six ectopic pregnant patients with hypovolemic shock from January 2009 to January 2012 were randomly selected,and they were divided into control group and observation group. Laparoscopic surgery was performed to both groups. After the surgery,general surgical nursing was given to the control group while the nursing intervention measures were given to the observation group. The comparison and analysis of the therapeutic effects were conducted between two groups,and the nursing experience of laparoscopic surgery in the treatment of ectopic pregnancy with hypovolemic shock was summarized. Results After treatment,the two groups obtained preferable therapeutic effect,and no adverse reactions and complications were observed in the two groups. However,the efficiency of the observation group was significantly higher than that of the control group (P < 0.05). Conclusion There are noticeable advantages by using laparoscopic surgery in the treatment of ectopic pregnancy with hypovolemic shock,and postoperative nursing intervention measures can obviously improve the therapeutic effect. Thus it is worthy of recommendation and promotion in the clinical practice.%目的 对采用腹腔镜手术治疗休克型异位妊娠的护理状况进行分析与探讨.方法 随机抽取在2009年1月~2012年1月时间段内收治的休克型异位妊娠患者76病例,将其分成对照组和观察组,2组患者均采用腹腔镜手术进行治疗,术后分别给予一般手术护理和护理干预措施,最后对2组患者的治疗效果进行比较分析,同时对腹腔镜手术治疗休克型异位妊娠的护理体会进行总结.结果 2组患者经腹腔镜手术治疗后均获得了较好的治疗效果,2组患者术后均未发生任何不良反应和并发症.但就其有效率而言,观察组患者显著有对照组(P<0

  19. 异位妊娠术后盆腔炎Ⅰ号方保留灌肠再次异位妊娠的风险%Study on the recurrence risk of retaining enema with pelvic inflammatory disease Ⅰ formula after ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    杨晓梅

    2011-01-01

    Objective: To study the recurrence risk of retaining enema with pelvic inflammatory disease Ⅰ formula after ectopic pregnancy surgery. Methods: Study group were retained enema with pelvic inflammatory disease Ⅰ formula after ectopic pregnancy in the first month three days after menstruation, fried gravy 100 ml, 40 Celsius, gave retention enema before bedtime, ten days for a course, a total of three courses. Control group were given conventional intravenous antibiotics after surgery for a week or so, discharged after abdominal incision healed well and vital signs were stable. The two groups were not taken contraceptive measures, the situation in patients with pregnancy was observed at 6, 12, 18, 24 months. Results: Study group of 550 patients were reviewed or followed after ectopic pregnancy at 6, 12, 18, 24 months, 8 cases (1.45%) described mild lower abdominal pain, were not given special treatment because of stable vital signs, 10 cases ( 1.82% ) of ectopic pregnancy again, a total of 376 cases of natural conception (68.36%) . Control group of 550 patients were reviewed or followed after ectopic pregnancy at 6, 12, 18, 24 months, 27 cases (4. 91% ) described lower abdominal pain, were given anti - inflammatory treatment, 53 cases (9. 64% ) of ectopic pregnancy again, a total of 201 cases of natural conception (36. 55% ) . The recurrence rate of ectopic pregnancy of the study group was significantly less than the control group ( P < 0. 05) . Conclusion: Retain enema with pelvic inflammatory disease Ⅰ formula after ectopic pregnancy surger can reduce the recurrence rate of ectopic pregnancy and achieve better effect%目的:探讨异位妊娠术后盆腔炎Ⅰ号方保留灌肠再次异位妊娠的风险.方法:研究组:于术后1个月月经干净后3天,给予盆腔炎Ⅰ号方,煎汤,煎成浓汁100 ml,温度40℃,睡前给予保留灌肠1次,每日1剂,10天为1个疗程,共3个疗程.对照组:术后常规给予抗生素静脉滴注1周,

  20. The Flexibility of Ectopic Lipids

    Directory of Open Access Journals (Sweden)

    Hannah Loher

    2016-09-01

    Full Text Available In addition to the subcutaneous and the visceral fat tissue, lipids can also be stored in non-adipose tissue such as in hepatocytes (intrahepatocellular lipids; IHCL, skeletal (intramyocellular lipids; IMCL or cardiac muscle cells (intracardiomyocellular lipids; ICCL. Ectopic lipids are flexible fuel stores that can be depleted by physical exercise and repleted by diet. They are related to obesity and insulin resistance. Quantification of IMCL was initially performed invasively, using muscle biopsies with biochemical and/or histological analysis. 1H-magnetic resonance spectroscopy (1H-MRS is now a validated method that allows for not only quantifying IMCL non-invasively and repeatedly, but also assessing IHCL and ICCL. This review summarizes the current available knowledge on the flexibility of ectopic lipids. The available evidence suggests a complex interplay between quantitative and qualitative diet, fat availability (fat mass, insulin action, and physical exercise, all important factors that influence the flexibility of ectopic lipids. Furthermore, the time frame of the intervention on these parameters (short-term vs. long-term appears to be critical. Consequently, standardization of physical activity and diet are critical when assessing ectopic lipids in predefined clinical situations.

  1. The Flexibility of Ectopic Lipids.

    Science.gov (United States)

    Loher, Hannah; Kreis, Roland; Boesch, Chris; Christ, Emanuel

    2016-09-14

    In addition to the subcutaneous and the visceral fat tissue, lipids can also be stored in non-adipose tissue such as in hepatocytes (intrahepatocellular lipids; IHCL), skeletal (intramyocellular lipids; IMCL) or cardiac muscle cells (intracardiomyocellular lipids; ICCL). Ectopic lipids are flexible fuel stores that can be depleted by physical exercise and repleted by diet. They are related to obesity and insulin resistance. Quantification of IMCL was initially performed invasively, using muscle biopsies with biochemical and/or histological analysis. ¹H-magnetic resonance spectroscopy (¹H-MRS) is now a validated method that allows for not only quantifying IMCL non-invasively and repeatedly, but also assessing IHCL and ICCL. This review summarizes the current available knowledge on the flexibility of ectopic lipids. The available evidence suggests a complex interplay between quantitative and qualitative diet, fat availability (fat mass), insulin action, and physical exercise, all important factors that influence the flexibility of ectopic lipids. Furthermore, the time frame of the intervention on these parameters (short-term vs. long-term) appears to be critical. Consequently, standardization of physical activity and diet are critical when assessing ectopic lipids in predefined clinical situations.

  2. Humoral and cellular autoimmunity in women with recurrent pregnancy losses and repeated implantation failures: A possible role of vitamin D.

    Science.gov (United States)

    Kwak-Kim, Joanne; Skariah, Annie; Wu, Li; Salazar, Dinorah; Sung, Nayoung; Ota, Kuniaki

    2016-10-01

    Women with recurrent pregnancy losses (RPL) and repeated implantation failures (RIF) have auto- and cellular immune abnormalities. Approximately, 20% of women with RPL have autoimmune abnormalities, particularly antiphospholipid antibodies (APA). In addition, these women have a higher prevalence of antinuclear antibody, anti-thyroperoxidase and anti-thyroglobulin antibodies, and other non-organ-specific autoantibodies. In women with RPL, the presence of autoimmunity is often associated with cellular immune abnormalities, such as increased NK cell levels and Th1/Th2 cell ratios. Vitamin D (VD) plays a major role in regulation of auto- and cellular immune abnormalities. VD deficiency is prevalent in women with RPL, and women with VD deficiency have increased auto- and cellular immune abnormalities as compared with women with normal VD levels. VD has immune regulatory effects on various immune effectors including T, B and NK cells. Potential therapeutic application of VD for RPL and RIF with auto- and cellular immune abnormalities should be explored.

  3. Pregnancy Outcomes of Repeat Cesarean Section in Peking Union Medical College Hospital

    Institute of Scientific and Technical Information of China (English)

    Liang-kun Ma; Na Liu; Xu-ming Bian; Li-rong Teng; Hong Qi; Xiao-ming Gong; Jun-tao Liu; Jian-qiu Yang

    2009-01-01

    Objective To evaluate the effect of elective repeat cesarean section on the maternal and neonatal outcomes.Methods A retrospective clinic-and hospital-based survey was designed for comparing the maternal and neonatal outcomes of elective repeat cesarean section [RCS group(one previous cesarean section)and MRCS group(two or more previous cesarean sections)] and primary cesarean section(FCS group)at Peking Union Medical College Hospital from January 1998 to December 2007.Results The incidence of repeat cesarean section increased from 1.26% to 7.32% .The mean gestational age at delivery in RCS group(38.1±1.8 weeks)and MRCS group(37.3±2.5 weeks)were significantly shorter than that in FCS group(38.9±2.1 weeks,all P<0.01).The incidence of complication was 33.8% and 33.3% in RCS group and MRCS group respectively,and was significantly higher than that in FCS group(7.9% ,P<0.05).Dense adhesion(13.5% vs.0.4% ,OR=7.156,95% CI:1.7-30.7,P<0.01)and uterine rupture(1.0% vs.0,P<0.05)were commoner in RCS group compared with FCS group.Neonatal morbidity was similar among three groups(P>0.05).Conclusions Repeat cesarean section is associated with more complicated surgery technique and increased frequency of maternal morbidity.However,the incidence of neonatal morbidity is similar to primary cesarean section.

  4. The value of transvaginal three-dimensional power Doppler ultrasound detecting the corpus luteum blood flow in the diagnosis of ectopic pregnancy%阴道三维能量多普勒超声检测妊娠黄体血流对异位妊娠的诊断价值

    Institute of Scientific and Technical Information of China (English)

    王琦; 陈莹莹

    2012-01-01

    目的 应用阴道三维能量多普勒超声对异位妊娠黄体和宫内妊娠黄体进行对比分析.方法 临床拟诊宫外孕患者30例,手术前行阴道超声检查.使用三维能量多普勒超声观察异位妊娠黄体血流分布,并对同期31例宫内妊娠黄体进行观察.采集三维能量多普勒血流图并测量相应的血管参数:血管形成指数(VI)、血流指数(FI)、血管形成-血流指数(VFI).比较异位妊娠黄体与宫内妊娠黄体血流分布及血管参数差异,评价其在异位妊娠鉴别诊断中的意义.结果 异位妊娠黄体血流信号低于宫内妊娠黄体,异位妊娠黄体血管参数VI、VFI值低于宫内妊娠黄体,差异均有统计学意义(P<0.05),异位妊娠黄体FI值低于宫内妊娠黄体,但无统计学差异.结论 阴道三维能量多普勒超声检测妊娠黄体血流信息,可为异位妊娠的诊断提供有价值信息.%Objective To compare the ectopic pregnancy corpus luteum with the gravid corpus luteum in transvaginal power Doppler ultrasound( PDUS ). Methods The transvaginal ultrasound was done to the 30 cases whoes clinical diagnosis was ectopic pregnancy before surgery. We use the three-dimensional PDUS( 3-D PDUS )to record the blood flow of the ectopic pregnancy corpus luteum, and meanwhile record the features of gravid corpus luteum. We check and collect the rheogram in 3-D PDUS and the corresponding vascularity index such as vascularization index( VI ),blood flow index( FI )and vascularization-blood flow index( VFI ). We compare the blood flow and vascularity index between the ectopic pregnancy corpus luteum and gravid corpus luteum, to evaluate its meaning in the differential diagnosis of ectopic pregnancy. Results The blood flow signal in ectopic pregnancy corpus luteum was less than gravid corpus luteum. The value of VI, VFI in ectopic pregnancy was lower than in gravid corpus luteum and there were significantly statistical differences( P < 0. 05 ). The value of FI

  5. Ectopic parathyroid adenoma in the soft palate: a case report.

    Science.gov (United States)

    Chang, Brent A; Sharma, Anil; Anderson, Donald W

    2016-10-18

    Ectopic parathyroid adenomas can occur in numerous anatomic locations. While ectopic parathyroid adenomas can rarely occur in the pharyngeal region, this has not previously been described in the soft palate. We report the first case of ectopic parathyroid adenoma within the soft palate. A 59 year old woman presented with hyperparathyroidism. She remained persistently hyperparathyroid after initial parathyroidectomy. Repeat exploration for a lesion suspicious on PET-CT for an ectopic parathyroid adenoma in the parapharyngeal region was unsuccessful in treating the hyperparathyroidism. An ectopic adenoma in the soft palate was eventually discovered. Removal through a transoral approach was successful in treating the hyperparathyroidism. Ectopic parathyroid adenomas can occur in various anatomical locations that may be missed even with the use of the various imaging modalities. The soft palate should be added to the list of possible ectopic locations high in the neck.

  6. Clinical Observation on Termination of Early Pregnancy of 213 Cases after Caesarian Section with Repeated Use of Mifepristone and Misoprostol

    Institute of Scientific and Technical Information of China (English)

    高佩佩; 汪平

    1999-01-01

    Objective To investigate the efficacy and safety in women after caesarian section for termination of early pregnancies by treatment, or repeated treatment with mifepristone and misoprostot.Subjects and Methods A total of 213 pregnant women with amenorrhea of 34-69d after caesarian section who asked for medical abortion were recruited,including 63 cases undergoing their second medical abortion.A total amount of mi feprisstone of 150 mg given in separate doses(25 mg×4 and 50 mg at the first time)was administered orally within 3d, followed by misoprostot of 0.6 mg orally in the morning of d 3.Results The complete abortion rate was 92.5%,incomplete abortion was 4.7% and failure was 2.8%.Conclusion The sequential use of mifepristone and misoprostol could be successfully and repeatedly used for induced abortion in those women with a caesarian section histo-ry.Its efficacy was similar to that for ordinary population.Its safety and effec-tiveness were satisfactory.

  7. A case of spontaneous tubal pregnancy with caesarean scar pregnancy.

    Science.gov (United States)

    Zhu, Jie; Shen, Yue-Ying; Zhao, Yu-Qing; Lin, Ru; Fang, Fang

    2014-01-01

    Tubal pregnancy with caesarean scar pregnancy is rare. Early, accurate diagnosis and treatment for this kind of ectopic pregnancy can lead to a decrease of maternal morbidity and mortality. Here, we report a rare case of spontaneous tubal pregnancy co-existing with caesarean scar pregnancy. After timely emergency laparoscopy and curettage, the patient was cured.

  8. Heterotopic pregnancy in HIV women.

    Science.gov (United States)

    Savasi, Valeria; Antonazzo, Patrizio; Personeni, Carlo

    2016-01-01

    Heterotopic pregnancy occurs when intrauterine and ectopic pregnancy are concomitant; overall rate rises from 1/30.000 to 1.5/1000 in assisted reproductive technology pregnancies. HIV (human immunodeficiency virus) patients are at increased risk of heterotopic pregnancies due to the greater frequency of assisted reproductive technology and pelvic inflammatory disease. We report the first case of heterotopic pregnancy in HIV woman.

  9. The Application of Methotrexate Combined with Mifepristone in the Treatment of Ectopic Pregnancy%甲氨蝶呤联合米非司酮治疗异位妊娠的临床观察

    Institute of Scientific and Technical Information of China (English)

    何静; 杨洋; 李华丽

    2012-01-01

    Objective:To evaluate the efficacy of methotrexate combined with mifepristone in the treatment of ectopic pregnancy, and to explore new conservative treatment alternatives for ectopic pregnancy. Methods:70 cases of patients diagnosed as ectopic pregnancy in our hospital from January 2010 to December 2011 were randomly divided into two groups, the methotrexate group (control), and the methotrexate combined with mifepristone group (experimental). Results:In both groups,after 2 weeks treatment,the serum HCG level decreased significantly, and the mass average diameter significantly reduced too (P < 0. 05 and P<0. 01,respectively). The success rate of methotrexate (control) group and the methotrexate combined with mifepristone group (experimental) were 91.67% and 76.47% respectively,and the difference was significant. Conclusions:The treatment effect in the methotrexate combined with mifepristone group is better than that of methotrexate group. And there are other advantages,such as higher effective rate,lower side effects, shorter duration of therapy, and significantly reducing the economic burden of the patients. Therefore,the methotrexate combined with mifepristone treatment method is a good method to be explored.%目的:探讨甲氨蝶呤联合米非司酮治疗异位妊娠的治疗效果及安全性,为药物保守治疗异位妊娠寻找新的方法.方法:将2010年1月至2011年12月在我院确诊为异位妊娠并符合保守治疗条件的70例患者随机分为两个治疗组,以单用甲氨蝶呤治疗34例为对照组,甲氨蝶呤联合米非司酮治疗36例为研究组,观察比较两组的治疗效果.结果:两组均于治疗后2周血β-HCG明显下降,包块平均直径明显缩小,与治疗前比较差异有统计学意义(P <0.05,P<0.01).研究组及对照组治愈率分别为91.67%和76.47%,两组比较差异有统计学意义(P<0.05).研究组胃肠道反应发生率低于对照组,差异有统计学意义(P<0.05).结论:甲氨蝶呤

  10. 经腹与经阴道超声对诊断早期不同部位异位妊娠价值的比较%The comparison of transabdominal and transvaginal ultrasonography in the diagnosis of early ectopic pregnan-cy

    Institute of Scientific and Technical Information of China (English)

    叶细容; 江峰; 张颖

    2014-01-01

    目的:探索经腹部超声( TAS)与经阴道超声( TVS)对早期不同部位的异位妊娠的诊断价值。方法:观察就诊的126例异位妊娠患者行经腹超声和经阴道超声检查,并与手术结果、非手术者药物治疗后β-HCG值下降并复查超声检查(经腹部超声及经阴道超声)结果进行对比分析。结果:输卵管妊娠经腹部超声检测63例,诊断符合率58%,经阴道超声检测106例,诊断符合率98.1%,输卵管以外其他部位异位妊娠TVS检出率亦高于TAS检出率。输卵管异位妊娠的TAS、TVS图像表现为附件区非特异性包块,TAS检出附件包块的敏感性与包块的大小相关,对鉴别胎囊型和直径较小包块型宫外孕的检出能力,TVS较TAS检测准确性高。但两者可以相互结合应用,进一步提高宫外孕的诊断准确率。%Objective To explore the value of transabdoninal ultrasound( TAS)and transvaginal sonography( TVS)in early diagnosis of ectopic pregnancy in different parts. Method 126 cases of ectopic pregnancy underwent transabdoninal ultrasound and transvaginal ul-trasonography were observed,and conparing of operation result,drug treatnent ofβ -HCG decreased results. Results After abdoninal ul-trasonography detected 63 cases of ectopic pregnancy,diagnosis coincidence rate was 58%,transvaginal ultrasound detected 106 cases of ec-topic pregnancy,diagnosis coincidence rate was 98. 2%. TVS detection rate of Ectopic pregnancy was higher that TAS detection rate in other parts of the fallopian tube. Conclusion The inage of Ectopic pregnancy by TAS and TVS showed adnexal nonspecific nass. The size of TAS detection sensitivity and nass adnexal,exanining of TVS in differential diagnosis of gestational sac and the dianeter of a snall piece of extrauterine pregnancy detection,TVS detection is nore accurate than TAS in diagnosis of early ectopic pregnancy,but both can be con-bined with each other,to further inprove the

  11. Pregnancy

    DEFF Research Database (Denmark)

    Palmer, Keith T; Bonzini, Matteo; Bonde, Jens Peter Ellekilde

    2013-01-01

    Most pregnant women are exposed to some physical activity at work. This Concise Guidance is aimed at doctors advising healthy women with uncomplicated singleton pregnancies about the risks arising from five common workplace exposures (prolonged working hours, shift work, lifting, standing and heavy...... on pregnancy. Moreover, moderate physical exercise is thought to be healthy in pregnancy and most pregnant women undertake some physical work at home. The guidelines provide risk estimates and advice on counselling....

  12. Influence of Methotrexate conservative treatment on ectopic pregnancy Outcome%甲氨蝶呤保守治疗方案对异位妊娠治疗结局的影响

    Institute of Scientific and Technical Information of China (English)

    张海鹰; 张志红

    2015-01-01

    目的:探讨甲氨蝶呤(Methotrexate MTX)保守治疗采用不同的治疗方案对异位妊娠治疗结局的影响。方法选取我院2010年1月~2015年3月收治的临床诊断为异位妊娠可保守治疗的患者共108例,治疗方式采用甲氨蝶呤单次剂量妊娠囊内注射和多次小剂量肌肉注射治疗,按照治疗方式不同分为两组,比较两组患者血清βhCG值的变化,异位妊娠包块缩小的程度,并记录不良反应。结果两组保守治疗成功率的比较差异无统计学意义(69.0%vs 66.0%,P>0.05);血βhCG下降率和异位妊娠包块直径变化比较差异无统计学意义(P>0.05);单次剂量妊娠囊内注射组不良反应的发生率低于分次剂量组(17.2%vs 30.0%,P0.05);And there was no statistical significance differences between blood beta hCG decline rate and blot size change after ectopic pregnancy treatment (P>0.05);Incidence of adverse effects in the single dose group was lower than that in the multiple doses group (17.2%vs 30.0%, P<0.05) and also adverse effects was mainly gastrointestinal reaction and leucocyte decrease. Conclusion The cure rate between two groups was the same, but adverse effects in multiple doses group is more obvious. so a single gestational sac injection was recommended when conservative therapy was used in ectopic pregnancy patients.

  13. Ovarian pregnancy: an unusual presentation

    Directory of Open Access Journals (Sweden)

    Ayesha Arif Hussain

    2016-08-01

    Full Text Available Ovarian pregnancy is a rare type of ectopic pregnancy and usually, it ends with rupture before the end of the first trimester. The clinical picture generally mimics that of ruptured tubal ectopic pregnancy and hemorrhagic ovarian cyst. Transvaginal sonography may be helpful. We report a rare primary ruptured ovarian pregnancy in a 23 years lady. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2888-2890

  14. Clinical Analysis on Transabdominal and Transvaginal Color Doppler Ultrasound Diagnosis in Early Ectopic Pregnancy%经腹和经阴道彩色多普勒超声检查诊断早期异位妊娠的临床分析

    Institute of Scientific and Technical Information of China (English)

    佘颖; 张蒂荣; 王玥; 张雁; 曲侠; 薛敏; 韩燕妮; 傅朝

    2014-01-01

    To compare transabdominal and transvaginal color Doppler ultrasonography in the diagnosis and treatment of ectopic pregnancy application value to improve further the diagnosis of ectopic pregnancy.Methods:Randomly selected from June 2012 to July 2013 in our hospital obstetrics and gynecology clinic,76 cases with pathologically diagnosed patients with ectopic pregnancy were taken transabdominal and transvaginal color Doppler ultrasound,and then compare the color multi-Doppler findings and clinical pathology results and the consistent rate of diagnosis.Results:76 cases by transabdominal diagnosed as ectopic pregnancy diagnosed 60 cases of postoperative pathology,diagnosis consistent rate was 78.95%,including 55 cases of ectopic pregnancy,cervical pregnancy in one case,one case of rudimentary uterine horn pregnancy,one case of abdominal pregnancy,one case of uterine horn pregnancy,one case of ovarian pregnancy,misdiagnosed was 16 cases and the misdiagnosis rate was 21.05%.76 cases by transvaginal diagnosed as ectopic pregnancy diagnosed 74 cases of postoperative pathology,the diagnosis consistent was 97.37%,including 60 cases of ectopic pregnancy,cervical pregnancy in four cases,two cases of rudimentary uterine horn pregnancy,four cases of abdominal pregnancy,one uterine horn pregnancy,three cases of ovarian pregnancy,misdiagnosed was two cases,the misdiagnosis rate was 2.63%.The diagnosis consistent rate of ectopic pregnancy by transvaginal group was significantly superior to transabdominal group,the difference was statistically significant (P<0.05).Conclusion:Clinical application of transvaginal color Doppler ultrasound can significantly improve the diagnosis consistent rate of ectopic pregnancy,and convenient,worthy of clinical application.%目的:比较经腹和经阴道彩色多普勒超声检查在异位妊娠诊疗中的应用价值,进一步提高异位妊娠的诊断水平。方法:随机抽取2012年6月~2013年7月来我院妇产科就诊的76

  15. To Investigate the Efficacy of Methotrexate Combined With Mifepristone and Traditional Chinese Medicine in the Treatment of Ectopic Pregnancy%甲氨蝶呤联合米非司酮及中药治疗异位妊娠的临床探讨

    Institute of Scientific and Technical Information of China (English)

    王兴新

    2015-01-01

    Objective To observe and discuss the clinical curative effect of ectopic pregnancy methotrexate combined with mifepristone and traditional Chinese medicine treatment.Methods The control group was treated with methotrexate. The observation group was treated with mifepristone combined with methotrexate and traditional Chinese medicine. The curative effects were compared.ResultsIn the observation group in the treatment of ectopic pregnancy success rate reached 94.29%, higher than that of the control group, the difference between the two groups has obvious statistical significance (P<0.05).Conclusion Methotrexate + mifepristone + traditional Chinese medicine in the treatment of ectopic pregnancy, efficacy significantly.%目的:观察并探讨甲氨蝶呤联合米非司酮及中药治疗异位妊娠的临床疗效。方法对照组采用甲氨蝶呤,观察组用甲氨蝶呤联合米非司酮及中药治疗,比较治疗效果。结果观察组治疗异位妊娠成功率达到94.29%,高于对照组,两组差异具有统计学意义(P<0.05);结论甲氨蝶呤+米非司酮+中药治疗异位妊娠,临床疗效明确。

  16. Smoking and Pregnancy

    OpenAIRE

    1982-01-01

    SUMMARY. Maternal smoking during pregnancy is considered to be one of the most significant causes of complications in pregnancy and is associated with an unfavourable outcome in childbirth compared with pregnancy in non-smokers. Specifically, smoking during pregnancy increases the likelihood of placenta praevia, abruptio placentae, ectopic gestation and premature rupture of the membranes (PRM). In addition, research has established that smoking during pregnancy increases the rates of low birt...

  17. Development of Some Organs Derived from the Three Embryonic Germ Layer in a Degus Ectopic Pregnancy and Presence of a Cytotrophoblast That Mimics Human Chorionic Placenta

    Directory of Open Access Journals (Sweden)

    C. Bosco

    2014-01-01

    Full Text Available This report describes a case of abdominal pregnancy in an adult female degu from which we recovered two large tissular masses from the peritoneal cavity. The bigger one showed a number of thin vascular connections to the serosa layer of the small intestine. It was also directly connected to the smaller mass by a thin membranous process. The surface of the bigger mass facing the small intestine wall showed the presence of chorionic villous that resembled a villous human chorionic placenta, rather than the hemomonochorial labyrinthine placenta, characteristic of this species. This unusual finding leads us to postulate that in the degu’s uterus the cytotrophoblast is exposed to a number of factors that will activate cascades of cellular and molecular events that ultimately will be signaling the cytotrophoblast to develop into a labyrinthine hemomonochorial placenta. In absence of the proper uterine environment, as is the case of the abdominal pregnancy in the peritoneal cavity reported here, the lack of signaling will lead the cytotrophoblast to develop into a villous chorionic placenta, similar to that observed in human.

  18. The Value of β-human Chorionic Gonadotropin, Progesterone, Endometrial Thickness combined Detection in the Early Diagnosis of Ectopic Pregnancy%三种指标联合检测在早期异位妊娠诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    张铭艳; 曾杰; 谢伟涵

    2015-01-01

    目的:探讨β-人绒毛膜促性腺激素(β-HCG)、孕酮、子宫内膜厚度联合检测在早期异位妊娠诊断中的价值。方法选择2005年11月至2012年11月潍坊市妇幼保健医院收治的疑似早期异位妊娠患者164例,根据妊娠结局分为异位妊娠组(异位妊娠组,64例),宫内妊娠流产组(宫内妊娠流产组,38例),正常宫内妊娠组(正常宫内妊娠组,62例),采用经阴道超声测量其子宫内膜厚度,并测定患者的血清孕酮及β-HCG值,比较3组子宫内膜厚度及血β-HCG、孕酮水平。结果异位妊娠组子宫内膜厚度(0.65±0.30) cm、β-HCG(1846±655) U/L及孕酮(20±3) nmol/L水平明显低于宫内妊娠流产组(1.04±0.32) cm、(2580±1216) U/L、(33±4) nmol/L 及正常宫内妊娠组(1.38±0.19) cm、(3211±1405) U/L、(60±14) nmol/L(P<0.05);在三组中子宫内膜厚度及血β-HCG、孕酮联合诊断的准确率(95.3%、92.1%、98.4%)差异均无统计学意义 P>0.05),而单项指标判断早期异位妊娠差异有统计学意义( P<0.05)。相关性分析结果显示,在异位妊娠及宫内妊娠中,子宫内膜厚度与孕酮及β-HCG值均呈正相关( P<0.05)。结论血清孕酮及β-HCG值可判定妊娠发生,但对异位妊娠与宫内未形成孕囊的早早孕鉴别较难,配合超声检查子宫内膜厚度,可以判定孕囊的着床部位,对早期鉴别异位妊娠有重要意义。%Objective To investigate the value of β-human chorionic gonadotropin(β-HCG) ,progester-one,endometrial thickness combined detection in the early diagnosis of ectopic pregnancy.Methods A total of 164 cases with suspected ectopic pregnancy admitted to Weifang City Maternal and Child Health Hospital from Nov.2005 to Nov.2012 were divided into ectopic pregnancy group(64 cases),intrauterine pregnancy abortion group(38 cases

  19. 放松训练及心理护理对输卵管妊娠保守治疗后再次异位妊娠病人的影响%Influence of relaxation training and psychological care on again ectopic pregnancy patients after tubal pregnancy conservative treatment

    Institute of Scientific and Technical Information of China (English)

    周昕; 李斌

    2015-01-01

    [目的]探讨放松训练及心理护理对输卵管妊娠保守治疗后再次异位妊娠病人的影响。[方法]输卵管妊娠保守治疗后再次异位妊娠病人70例,利用随机数字表分为观察组和对照组各35例,两组都采用腹腔镜下手术治疗与常规护理,在此基础上观察组采用放松训练与心理护理。[结果]观察组的有效率为97.1%,对照组有效率为80.0%,观察组的有效率明显高于对照组( P<0.05)。观察组食欲减退、恶心、呕吐、腹泻等不良反应发生率明显低于对照组(P<0.05)。两组干预前状态焦虑得分对比差异无统计学意义,干预后得分都明显降低(P<0.05),干预后观察组得分明显低于对照组(P<0.05)。干预后观察组主观支持、客观支持与对支持利用度评分均明显高于对照组(P<0.05)。[结论]积极的放松训练与心理护理能有效缓解输卵管妊娠保守治疗后再次异位妊娠病人的焦虑情况,改善预后,提高社会支持度。%Objective:To probe into the influence of relaxation training and psychological care on again ectopic pregnancy patients after tubal pregnancy conservative treatment .Methods:A total of 70 cases of again ectopic pregnancy patients after tubal pregnancy conservative treatment were divided into observation group and control group ,by using random number table 35 cases in each .Patients in both groups received laparoscopic operation and routine nursing .On the basis of it ,patients in observation group received relaxation training and psychologi‐cal care .Results:The effective rate in observation group was 97 .1% ,80 .0% in control group .The effective rate in observation group was higher than that in control group(P<0 .05) .The incidences of adverse reactions in‐clnding anorexia ,nausea ,vomiting and diarrhea in observation group were significantly lower than that in con‐trol group(P<0 .05) .There were no

  20. [Abdominal pregnancy, institutional experience].

    Science.gov (United States)

    Bonfante Ramírez, E; Bolaños Ancona, R; Simón Pereyra, L; Juárez García, L; García-Benitez, C Q

    1998-07-01

    Abdominal pregnancy is a rare entity, which has been classified as primary or secondary by Studiford criteria. A retrospective study, between January 1989 and December 1994, realized at Instituto Nacional de Perinatología, found 35,080 pregnancies, from which 149 happened to be ectopic, and 6 of them were abdominal. All patients belonged to a low income society class, age between 24 and 35 years, and average of gestations in 2.6. Gestational age varied from 15 weeks to 32.2 weeks having only one delivery at term with satisfactory postnatal evolution. One patient had a recurrent abdominal pregnancy, with genital Tb as a conditional factor. Time of hospitalization varied from 4 to 5 days, and no further patient complications were reported. Fetal loss was estimated in 83.4%. Abdominal pregnancy is often the sequence of a tubarian ectopic pregnancy an when present, it has a very high maternal mortality reported in world literature, not found in this study. The stated frequency of abdominal pregnancy is from 1 of each 3372, up to 1 in every 10,200 deliveries, reporting in the study 1 abdominal pregnancy in 5846 deliveries. The study had two characteristic entities one, the recurrence and two, the delivery at term of one newborn. Abdominal pregnancy accounts for 4% of all ectopic pregnancies. Clinical findings in abdominal pregnancies are pain, transvaginal bleeding and amenorrea, being the cardinal signs of ectopic pregnancy.

  1. Pregnancy

    DEFF Research Database (Denmark)

    Palmer, Keith T; Bonzini, Matteo; Bonde, Jens Peter Ellekilde;

    2013-01-01

    Most pregnant women are exposed to some physical activity at work. This Concise Guidance is aimed at doctors advising healthy women with uncomplicated singleton pregnancies about the risks arising from five common workplace exposures (prolonged working hours, shift work, lifting, standing and heavy...... physical workload). The adverse outcomes considered are: miscarriage, preterm delivery, small for gestational age, low birth weight, pre-eclampsia and gestational hypertension. Systematic review of the literature indicates that these exposures are unlikely to carry much of an increased risk for any...... on pregnancy. Moreover, moderate physical exercise is thought to be healthy in pregnancy and most pregnant women undertake some physical work at home. The guidelines provide risk estimates and advice on counselling....

  2. Transvaginal removal of ectopic pregnancy tissue and repair of uterine defect for cesarean scar pregnancy:Experience in 7 cases%经阴道子宫下段切开取胚联合瘢痕缺陷修补术7例体会

    Institute of Scientific and Technical Information of China (English)

    丁锦; 倪观太

    2014-01-01

    Objective:To assess the clinical efficacy of transvaginal removal of ectopic pregnancy tissue and repair of uterine defect for caesarean scar preg-nancy( CSP) .Methods:The clinical data were retrospectively examined in 7 patients with CSP undergone treatment by transvaginal removal of ectopic pregnancy tissue and repair of uterine defect during December 2012 and November 2013.Results:The operation was successful for the total 7 patients,and no complications occurred.Mean operation time was (75.71 ±25.73)min,mean intraoperative blood loss was (45.00 ±35.24)ml,and mean hospital stay was (12.29 ±5.82) days.Blood β-HCG level recovery occurred on (23.17 ±9.91) days on average,and the mean postoperative vaginal bleeding was (4.43 ±1.51)days.Follow-up showed no prolonged menstrual or endless dripping or menstrual quantity change and other abnormality.Conclusion:Trans-vaginal removal of ectopic pregnancy tissue and repair of uterine defect,a new treatment option,appears safe,minimally invasive,effective and economical for patients with CSP.Importantly,this approach may protect the reproductive function of the patients besides treatment of scar pregnancy by repairing uter-ine defect.%目的:探讨经阴道子宫下段切开取胚联合瘢痕缺陷修补术治疗剖宫产切口瘢痕妊娠( CSP)的临床疗效。方法:回顾性分析2012年12月~2013年11月在我院行经阴道子宫下段切开取胚合并瘢痕缺陷修补术治疗的7例剖宫产切口瘢痕妊娠患者的临床资料。结果:7例手术均成功,无并发症发生,平均手术时间(75.71±25.73)min、术中平均出血(45.00±35.24) ml、平均住院天数(12.29±5.82)d、血清β-HCG恢复正常天数平均(23.17±9.91)d,术后阴道流血天数平均(4.43±1.51)d;随诊7例患者均未出现月经淋漓不尽、月经量改变等异常情况。结论:经阴道子宫下段切开取胚联合瘢痕缺陷修补术是一种治疗CSP的

  3. Clinical effect of conservative drug treatment for ectopic pregnancy and the influencing factors%异位妊娠药物保守治疗效果及其影响因素分析

    Institute of Scientific and Technical Information of China (English)

    李婵娟; 凌斌

    2013-01-01

    目的 分析影响异位妊娠药物保守治疗效果的因素.方法 对我院妇产科2008年6月至2011年6月收治的100例异位妊娠患者进行药物保守治疗,将所有患者根据药物治疗是否成功分为成功组与失败组,比较两组患者的停经时间、腹痛天数、血HCG水平、血孕酮水平、彩超结果,并用Logistic回归分析影响异位妊娠药物治疗成功率的因素.结果 单因素分析显示,停经时间、血HCG水平、血孕酮水平、彩超显示包块大小影响药物保守治疗的成功率,停经时间越短、血HCG水平与孕酮水平越低,包块直径越小成功率越高(P<0.05);腹痛时间、盆腔积液量对药物治疗成功率影响不明显(P>0.05).Logistic多因素分析显示,血HCG水平、包块大小是影响药物保守治疗成功率的因素.结论 患者血HCG水平、停经天数、包块大小是影响药物保守治疗成功与否的关键因素,停经时间也是因素之一,治疗时应根据患者临床表现及辅助检查结果选择治疗方案,提高成功率,以免给患者造成不必要的负担.%Objective To analyze the factors influencing the clinical effect of conservative drug treatment for ectopic pregnancy. Methods One hundred patients with ectopic pregnancy admitted in our hospital from June, 2008 to June, 2011 received conservative drug treatment, which were divided into the success group and the fail group according to the outcome of treatment The days of amenorrhea, days of pain, levels of human chorionic gonadotrophin (HCG) and blood progesterone, as well as the sonographic results were compared between the two groups. The factors influencing the clinical effect of the treatment were analyzed by logistic regression analysis. Results Single factor analysis showed mat days of amenorrhea, HCG level, mass diameter, progesterone level were the factors that influence the outcome of die treatment The success of the treatment was correlated with shorter

  4. Pregnancy

    Science.gov (United States)

    ... occur between 34 and 36 weeks—these are late-preterm births. 5 Infants born in the 37th and 38th ... NICHD News and Spotlights Common tests for preterm birth not useful for ... in treating mildly low thyroid function in pregnancy, NIH Network study finds ...

  5. Comparison of the effect of ectopic pregnancy tubal resection or retention on female endocrine%异位妊娠输卵管切除或保留对患者内分泌的影响比较

    Institute of Scientific and Technical Information of China (English)

    陈素琴; 邓霞

    2016-01-01

    Objective To investigate the effect of ectopic pregnancy tubal resection or common disease retention on female reproductive endocrine and menstrual traits.Methods 286 patients with ectopic pregnancy lapa-roscopic operation were selected.According to the different treatment methods,the patients were divided into resection group (n =199),retention group 87 cases,in surgical operation on the third day and the thirtieth day and tested for female reproductive hormone (P,LH,FSH,E2 )and human chorionic gonadotropin (hCG).Results Resection group in the third day after surgery of FSH[(8.5 ±4.9)IU /mL]was significantly higher than that of preserving group[(3.9 ± 0.9)IU /mL],with significant difference (t =5.44,P 0.05).30 days after the surgery,there was no significant difference between the two groups in FSH,LH,E2 ,P and HCG (t =0.92,0.77,1.02,0.65,all P >0.05),but at the age of more than 40 years old and bilateral absence of fallopian tube in patients with,menorrhagia and menstrual cycle change obviously,and female ovarian endocrine function to reduce the clinical symptoms.Conclusion Tube resection has some influence on the ovarian function of tubal ectopic pregnancy,especially older,lack of bilateral fallopian tube.%目的:探讨异位妊娠输卵管切除或保留后对患者生殖内分泌及月经性状的影响。方法选取286例异位妊娠腹腔镜手术的患者,按照治疗方式的不同将患者分为切除组199例,保留组87例,切除组行输卵管切除手术,保留组行输卵管保留手术,在手术后第3天及手术后第30天,检测并比较两组孕激素(P)、黄体生成素(LH)、促卵泡生成素(FSH)、雌二醇(E2)及人绒毛膜促性腺激素(HCG)水平差异。结果切除组在手术后第3天的 FSH[(8.5±4.9)IU /mL]明显高于保留组[(3.9±0.9)IU /mL],差异有统计学意义(t =5.44,P <0.05),两组 LH、E2、P、HCG 水平比较差异均无统计学意义(t

  6. Rh Factor: How It Can Affect Your Pregnancy

    Science.gov (United States)

    ... has had any of the following during pregnancy: Amniocentesis Chorionic villus sampling (CVS) Bleeding during pregnancy Manual ... After a miscarriage, abortion, or ectopic pregnancy After amniocentesis or chorionic villus sampling What if I am ...

  7. Interventions to Prevent Unintended and Repeat Pregnancy Among Young People in Low- and Middle-Income Countries: A Systematic Review of the Published and Gray Literature.

    Science.gov (United States)

    Hindin, Michelle J; Kalamar, Amanda M; Thompson, Terri-Ann; Upadhyay, Ushma D

    2016-09-01

    Adolescent pregnancy, particularly unintended pregnancy, can have lasting social, economic, and health outcomes. The objective of this review is to identify high-quality interventions and evaluations to decrease unintended and repeat pregnancy among young people in low- and middle-income countries. PubMed, Embase, PsycInfo, Cinahl Plus, Popline, and the Cochrane Databases were searched for all languages for articles published through November 2015. Gray literature was searched by hand. Reference tracing was utilized, as well as unpacking systematic reviews. Selected articles were those that were evaluated as having high-quality interventions and evaluations using standardized scoring. Twenty-one high-quality interventions and evaluations were abstracted. Nine reported statistically significant declines in pregnancy rates (five cash transfer programs, one education curriculum, two life-skills curricula, and a provision of contraception intervention), seven reported increases in contraceptive use (three provision of contraception interventions, two life-skills curricula, a peer education program, and a mass media campaign), two reported decreases in sexual activity (a cash transfer program and an education and life-skills curriculum), and two reported an increase in age of sexual debut (both cash transfer programs). The selected high quality, effective interventions included in this review can inform researchers, donors, and policy makers about where to make strategic investments to decrease unintended pregnancy during young adulthood. Additionally, this review can assist with avoiding investments in interventions that failed to produce significant impact on the intended outcomes. The diversity of successful high-quality interventions, implemented in a range of venues, with a diversity of young people, suggests that there are multiple strategies that can work to prevent unintended pregnancy.

  8. Unusual gestational choriocarcinoma arising in an interstitial pregnancy

    Directory of Open Access Journals (Sweden)

    Sawsen Meddeb

    2014-01-01

    CONCLUSION: The current trend of the treatment of ectopic pregnancy by conservative surgery requires adequate monitoring of βhCG and careful examination of pathologic specimens to avoid misdiagnosis of ectopic gestational trophoblastic disease.

  9. 甲氨蝶呤联合米非司酮与单用甲氨蝶呤治疗异位妊娠的疗效评价%Combination of methotrexate and mifepristone versus methotrexate alone for patients with ectopic pregnancy: a systematic review

    Institute of Scientific and Technical Information of China (English)

    罗丹; 钟玲; 赵腾飞

    2011-01-01

    combination of methotrexate and mifepristone than in methotrexate alone (RR=1.20, 95%CI=1.14 to 1.26, P<0. 000 01); the time of HCG resolution (MD=-7. 57, 95%CI=-8. 42 to -6.73, P<0. 000 01),disappearance of the mass (MD=-9. 11, 95%CI=-16. 39 to -3. 43, P=0. 003) and length of stay (MD=-4. 0, 95%CI=-6. 84 to -1. 16, P=0. 006) were less than in methotrexate alone, the rate of repeated use of drug was lower than in methotrexate alone (RR=0. 56, 95%CI=0. 35 to 0. 92, P=0. 02). There was no significant difference in adverse reaction between the two treatment groups. Conclusion The combination of methotrexate and mifepristone is safe and effective, and better than methotrexate alone for treating ectopic pregnancy.

  10. Duodenal lipoma associated with ectopic duodenal glands

    Directory of Open Access Journals (Sweden)

    Dianbo Cao

    2011-12-01

    Full Text Available Duodenal lipomas are relatively uncommon and are rarely responsible for clinical symptoms. Occasionally, searching for aetiology of gastrointestinal bleeding leads to the final diagnosis of duodenal lipomas. Here, we present the case of a 68-year-old woman who suffered with repeated melena and weight loss. Endoscopy, abdominal computed tomography (CT and histopathological outcomes are described in this case of duodenal lipoma with ectopic duodenal glands.

  11. Ectopic Hidradenoma Papilliferum

    Directory of Open Access Journals (Sweden)

    Aristóteles David Neiva Rosmaninho

    2010-01-01

    Full Text Available Hidradenoma papilliferum is a rare tumor that occurs almost exclusively in females on the anogenital area. Rare cases of ectopic (nongenital hidradenoma papilliferum have been described. The lesions usually present as an asymptomatic slow-growing, red, firm, mobile, well-delimitated nodule that grows for a long time before resection. We describe a case of an 26-year-old man that presented with an enlarging nodule on his right eyelid. The histological findings revealed a hidradenoma papilliferum. So far, among the very few reports of ectopic hidradenoma papilliferum, only a very small number were localized to the eyelid.

  12. 阴道超声结合血清β-hCG、孕酮测定对诊断早期输卵管妊娠的价值%Value of transvaginal sonography combined with serumβ-hCG and progesterone and in early diagnosis of ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    任翠云; 李婉

    2015-01-01

    目的:探讨阴道超声结合血清人绒膜促性腺激素(β-hCG)、孕酮检测在宫内妊娠与异位妊娠鉴别诊断中的价值,同时分析3种检测方法对诊断符合率的关系。方法根据妊娠结局将176例患者分为宫内正常妊娠组57例、宫内妊娠流产组34例、异位妊娠组85例,比较各组血清β-hCG、孕酮水平,并结合阴道超声进行分析。结果异位妊娠组的血清β-hCG值显著低于正常妊娠组(t=4.887,P<0.01),异位妊娠组和宫内妊娠流产组的血清β-hCG值差异无统计学意义(t=0.866,P>0.05);异位妊娠组的孕酮水平显著低于正常妊娠组(t=12.601,P<0.01),异位妊娠组和流产组的孕酮水平差异无统计学意义(t=0.610, P>0.05);异位妊娠组的子宫内膜厚度显著低于正常妊娠组和流产组( t值分别为14.740、2.732,均P<0.05)。血清β-hCG、孕酮及阴道超声3者联合检测诊断异位妊娠符合率达94.9%,OR值是两者联合符合率的2~3倍,是单个诊断的3~7倍。结论阴道超声结合血清β-hCG、孕酮测定,可以极大地提高临床诊治早期异常妊娠疾病的准确率,对辅助诊断异位妊娠具有重要意义。%Objective To analyze the value of serum β-hCG, progesterone and transvaginal sonography in early diagnosis of ectopic pregnancy and the coincidence rate of three methods.Methods According to pregnant outcomes 176 patients were divide into normal intrauterine pregnancy group (57 cases) , intrauterine pregnancy abortion group (34 cases) and ectopic pregnancy group (85 cases) .The serumβ-hCG and progesterone level were compared among different groups, and they were analyzed with vaginal ultrasound.Results The serumβ-HCG value in ectopic pregnancy group was lower than that of normal intrauterine pregnancy group (t=4.887,P0.05).The progesterone level in ectopic pregnancy group was significantly

  13. 正常进食对急诊宫外孕手术腰硬联合麻醉的危险及相关性分析%Risk and Correlation Analysis of Emergency Ectopic Pregnancy Operation CSEA in Normal Eating

    Institute of Scientific and Technical Information of China (English)

    梁玉华

    2015-01-01

    目的:分析正常进食对急诊宫外孕手术腰硬联合麻醉的危险及相关性。方法:选择2009年7月至2013年7月行CSEA宫外孕手术110例患者进行研究,其中70例正常进食宫外孕手术手术患者作为研究组,将ASAⅠ~Ⅱ级40例宫外孕手术患者作为对照组,两组患者均行CSEA,分别对研究组、对照组患者术中出现危险进行比较及相关性分析。结果:研究组恶性、呕吐发病率高于对照组,但是没有统计学意义,对照组低血压发病率高于研究组,有统计学意义( P<0.05)。研究组使用胃复安的患者恶心、呕吐的发病率降低。结论:术前及术中使用胃复安可明显减低正常进食患者恶心、呕吐的发病率。%Objective:To explore risk and correlation of emergency ectopic pregnancy operation com-bined spinal epidural anesthesia ( CSEA ) after normal eating .Method: A respective study was conducted from Jul.2009 to Jul.2013 in the selection, 110 patients underwent CSEA operation of ectopic pregnancy were studied , 70 cases of normal eating inpatients with ectopic pregnancy operation as the study group , ASAⅠ~II in 40 cases of ectopic pregnancy operation patients as the control group , two group of patients were performed CSEA .Result:Malignant , vomiting incidence rate was higher in research group than the control group, but no statistical significance , study group was higher than that in control group , the incidence of hy-potension was statistical significance (P<0.05).The incidence of nausea and vomiting in study group used metoclopramide was reduced the rate of occurrance .Conclusion:Preoperative and intraoperative use of meto-clopramide is significantly lower in patients with nausea , vomiting after eating a normal .

  14. 输卵管组织LIF和LIFR的表达与慢性输卵管炎和输卵管异位妊娠的关系%Expressions of LIF and LIFR in oviduct and its relation with chronic salpingitis and ectopic pregnancies

    Institute of Scientific and Technical Information of China (English)

    李咏; 赵丹梅; 孙丽洲; 欧阳俊; 向梅; 王明玉

    2012-01-01

    目的:探讨白血病抑制因子(LIF)及其受体(LIFR)与慢性输卵管炎和输卵管异位妊娠的关系.方法:采用免疫组化技术检测15例正常非孕妇女、20例慢性输卵管炎患者和40例输卵管异位妊娠患者的输卵管组织中LIF和LIFR的表达水平,半定量分析其在各组间的表达差异.结果:LIF和L1FR在各组输卵管腺上皮和间质细胞均有表达,且主要定位于腺上皮细胞胞浆.无论是月经分泌期还是增生期,慢性输卵管炎组输卵管腺上皮和间质细胞中LIF的表达明显强于正常组和输卵管妊娠组(P<0.05).慢性输卵管炎组输卵管腺上皮中LIFR的表达显著高于输卵管妊娠组和正常非孕组(P<0.05);而在输卵管间质中,LIFR在正常非孕组的表达明显高于输卵管妊娠组和慢性输卵管炎组(P<0.01).结论:慢性输卵管炎的输卵管微环境改变可能是输卵管炎患者易发异位妊娠的原因.%Objective:To explore the roles of LIF and LIFR in the development of chronic salpingitis and ectopic pregnancies. Methods: Immunohistochemical analysis was em-ployed to probe the differential expression of LIF and LIFR in oviduct tissues from women with no pregnancy (n= 15),chronic salpingitis (n = 20) and ectopic pregnancy ( n = 40 ), respec-tively. Results: The expressions of LIF and LIFR were observed in both the epithelium and in-terstitial cells of oviduct tissues, mainly localized in the cytoplasm of the glandular epithelium cells. Significant elevated expression of LIF in the epithelium and interstitial cells were observed in the chronic inflammation group compared with that in the normal group and ectopic pregnan-cy group (P<0.05). The expression of LIFR in the glandular epithelium in the chronic inflam-mation group was significantly higher than that in the normal group and the ectopic pregnancy group(P<0. 05 ). However, in the interstitial cells, significant increased LIFR expression was found in normal group compared with

  15. Smoking and medication during pregnancy predict repeated unintentional injuries in early childhood but not single unintentional injuries

    NARCIS (Netherlands)

    Junger, M.; Japel, C.; Cote, S.; Xu, Q.; Boivin, M.; Tremblay, R.E.

    2013-01-01

    This study investigates prospectively the development of single and repeated unintentional injuries from birth to 42 months in a random population sample of new-born children in Quebec (Canada) (N = 1,770). The outcome measures are single unintentional injuries (SUI) and repeated unintentional injur