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Pregnancy of unknown location

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https://www.readbyqxmd.com/read/29874639/trends-in-the-management-of-nonviable-pregnancies-of-unknown-location-in-the-united-states
#1
Melissa A Parks, Kurt T Barnhart, David L Howard
BACKGROUND: When managing a nonviable pregnancy of unknown location (PUL), a debate has emerged in the literature whether to perform uterine curettage for definitive diagnosis of pregnancy location or administer methotrexate for a presumed ectopic pregnancy. The purpose of this study is to describe the treatment patterns when managing a PUL. METHODS: A prospective, anonymous Internet based-electronic survey of PUL case scenarios was administered to a random sample of physicians across the United States...
June 6, 2018: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/29679814/prediction-of-recurrent-ectopic-pregnancy-a-five-year-follow-up-cohort-study
#2
Mohamed Ellaithy, Mufareh Asiri, Ahmed Rateb, Ahmed Altraigey, Khaled Abdallah
OBJECTIVE: To evaluate the value of different clinical risk factors in the prediction of recurrent ectopic pregnancies (REP). STUDY DESIGN: This cohort study was carried out at a tertiary-care maternity hospital in Saudi Arabia, between January 2010 and June 2017. All women with a primary ectopic pregnancy (EP) were consecutively recruited, thoroughly assessed and followed up for a minimum duration of five-years (5.6 ± 0.61 years) to diagnose the nature and location of the subsequent pregnancies...
June 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29657689/successful-management-of-abdominal-pregnancy-two-case-reports
#3
Shabnam Saquib, Wafa Elhussein Mohammed Talha
Abdominal pregnancy is a rare, life-threatening condition defined as pregnancy in the peritoneal cavity exclusive of tubal, ovarian, or intraligamentary locations. It can be primarily located in the peritoneal cavity or secondary to a ruptured ectopic pregnancy or tubal abortion. We present two cases of abdominal pregnancy, one primary and another secondary, both diagnosed and successfully managed in our institution. The first patient, a para 2 at 14 weeks gestation, presented with abdominal pain, distension, and dizziness, which had started four days prior...
March 2018: Oman Medical Journal
https://www.readbyqxmd.com/read/29219200/prediction-of-tubal-ectopic-pregnancy-using-offline-analysis-of-3-dimensional-transvaginal-ultrasonographic-data-sets-an-interobserver-and-diagnostic-accuracy-study
#4
Fernando Infante, Mercedes Espada Vaquero, Tommaso Bignardi, Chuan Lu, Antonia C Testa, David Fauchon, Elisabeth Epstein, Francesco P G Leone, Thierry Van den Bosch, Wellington P Martins, George Condous
OBJECTIVES: To assess interobserver reproducibility in detecting tubal ectopic pregnancies by reading data sets from 3-dimensional (3D) transvaginal ultrasonography (TVUS) and comparing it with real-time 2-dimensional (2D) TVUS. METHODS: Images were initially classified as showing pregnancies of unknown location or tubal ectopic pregnancies on real time 2D TVUS by an experienced sonologist, who acquired 5 3D volumes. Data sets were analyzed offline by 5 observers who had to classify each case as ectopic pregnancy or pregnancy of unknown location...
December 8, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28972692/the-first-comparative-study-on-very-early-medical-termination-of-pregnancy-with-and-without-ultrasound-confirmation-of-an-intrauterine-pregnancy
#5
P Faucher
No abstract text is available yet for this article.
October 3, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28955749/structure-organization-and-tissue-expression-of-the-pig-slc13a1-and-slc13a4-sulfate-transporter-genes
#6
Samuel K Barnes, Yvonne A Eiby, Soohyun Lee, Barbara E Lingwood, Paul A Dawson
Sulfate is an obligate nutrient for fetal growth and development. In mice, the renal Slc13a1 sulfate transporter maintains high maternal circulating levels of sulfate in pregnancy, and the placental Slc13a4 sulfate transporter mediates sulfate supply to the fetus. Both of these genes have been linked to severe embryonal defects and fetal loss in mice. However, the clinical significance of SLC13A1 and SLC13A4 in human gestation is unknown. One approach towards understanding the potential involvement of these genes in human fetal pathologies is to use an animal model, such as the pig, which mimics the developmental trajectory of the human fetus more closely than the previously studied mouse models...
July 2017: Biochemistry and Biophysics Reports
https://www.readbyqxmd.com/read/28746265/prevalence-of-rubella-antibodies-among-children-in-the-democratic-republic-of-the-congo
#7
Vivian H Alfonso, Reena H Doshi, Patrick Mukadi, Stephen G Higgins, Nicole A Hoff, Ado Bwaka, Guillaume Ngoie Mwamba, Emile Okitolonda, Jean-Jacques Muyembe, Sue Gerber, Anne W Rimoin
BACKGROUND: While generally mild in children, rubella infection in early pregnancy can lead to miscarriage, fetal death or congenital rubella syndrome. Rubella vaccination is not yet available as a part of routine immunization in the Democratic Republic of the Congo (DRC), and the burden of infection is unknown. METHODS: In collaboration with the 2013-2014 DRC Demographic and Health Survey, a serosurvey was carried out to assess population immunity to vaccine-preventable diseases...
January 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28660799/factors-to-consider-in-pregnancy-of-unknown-location
#8
REVIEW
Shabnam Bobdiwala, Maya Al-Memar, Jessica Farren, Tom Bourne
The management of women with a pregnancy of unknown location (PUL) can vary significantly and often lacks a clear evidence base. Intensive follow-up is usually required for women with a final outcome of an ectopic pregnancy. This, however, only accounts for a small proportion of women with a pregnancy of unknown PUL location. There remains a clear clinical need to rationalize the follow-up of PUL so women at high risk of having a final outcome of an ectopic pregnancy are followed up more intensively and those PUL at low risk of having an ectopic pregnancy have their follow-up streamlined...
August 2017: Women's Health
https://www.readbyqxmd.com/read/28550508/metastatic-gestational-choriocarcinoma-a-masquerader-in-obstetrics
#9
REVIEW
C M McCarthy, J Unterscheider, C Burke, J Coulter
We describe a case of a 36-year-old woman presenting with vaginal bleeding and suboptimally rising serum human chorionic gonadotropin levels, who was investigated for a pregnancy of unknown location. Ultrasonography, laparoscopy and dilatation and curettage failed to reveal signs of an intra-uterine or intra-abdominal pregnancy. Following computed tomography imaging, a mediastinal mass was histologically determined to be a gestational choriocarcinoma. Following surgical resection and chemotherapy, the patient recovered and proceeded to have a successful intra-uterine pregnancy...
February 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28536231/pregnant-with-a-perforated-levonorgestrel-intrauterine-system-and-visible-threads-at-the-cervical-os
#10
David L Howard, Lauren M Beasley
We present a case in which a patient presented with a pregnancy of unknown location and normally rising human chorionic gonadotropin (hCG) levels but with a levonorgestrel intrauterine device (LNG-IUD) present. The LNG-IUD had been placed 4.5 years ago. Although unintended, this pregnancy was desired. Strings were clearly visible and initial 2D ultrasound suggested intrauterine location of the LNG-IUD. The LNG-IUD could not be removed however. The patient was managed expectantly with close follow-up, serial beta-hCGs and serial ultrasounds until definitive diagnosis of the location of the pregnancy...
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28483662/the-management-of-polyps-in-female-reproductive-organs
#11
REVIEW
Vasilios Tanos, Kelsey Elizabeth Berry, Jaana Seikkula, Elissa Abi Raad, Andreas Stavroulis, Zaki Sleiman, Rudi Campo, Stephan Gordts
Polyps of the lower reproductive tract are found in 7.8-50% of women. It has been hypothesized that cytogenetic modifications on chromosomes 6, 7 and 12 as well as epigenetic factors involving enzyme and metabolic activities may cause polyps to develop. Cervical polyps found in 2-5% of cases are of low clinical significance and can cause, although rarely, post coital bleedings. Cervical polyps grow during pregnancy and mucorrhoea. Trans vaginal ultrasound (TVU) provides an excellent diagnostic technique to diagnose the size and the anatomic location of endometrial polyps (EPs)...
July 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28454756/pregnancy-of-unknown-location-a-survey-based-evaluation-of-when-and-why-physicians-intervene
#12
Majed S Faden, Suhaib Khayat, Richard N Brown
INTRODUCTION: Management of pregnancies of unknown location (PUL) is a complex challenging clinical situation with possibilities for pitfalls. Obstetricians and gynaecologists of varied levels of training and experience from Canada and the Nordic countries were questioned about their approach when faced with PUL. METHOD: A 13-item web-based questionnaire was used to evaluate physicians' behaviors by surveying their management of a PUL encountered at different levels of human chorionic gonadotropin (hCG)...
May 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28433735/outpatient-endometrial-aspiration-an-alternative-to-methotrexate-for-pregnancy-of-unknown-location
#13
Iris G Insogna, Leslie V Farland, Stacey A Missmer, Elizabeth S Ginsburg, Paula C Brady
BACKGROUND: Pregnancies of unknown location with abnormal beta-human chorionic gonadotropin trends are frequently treated as presumed ectopic pregnancies with methotrexate. Preliminary data suggest that outpatient endometrial aspiration may be an effective tool to diagnose pregnancy location, while also sparing women exposure to methotrexate. OBJECTIVE: The purpose of this study was to evaluate the utility of an endometrial sampling protocol for the diagnosis of pregnancies of unknown location after in vitro fertilization...
August 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28422407/mutations-in-tgds-associated-with-additional-malformations-of-the-middle-fingers-and-halluces-atypical-catel-manzke-syndrome-in-a-fetus
#14
Katharina Schoner, Rainer Bald, Denise Horn, Helga Rehder, Uwe Kornak, Nadja Ehmke
Pierre-Robin sequence, radial deviation, and ulnar clinodactyly of the index fingers due to an additional phalangeal bone, as well as heart defects are the key features of Catel-Manzke syndrome. Although mutations in TGDS were identified as the cause of this disorder, the pathogenetic mechanism remains unknown. Here, we report on a fetus with severe heart defect, nuchal edema, talipes, Pierre-Robin sequence, and bilateral deviation and clinodactyly of the index and middle fingers. Pregnancy was terminated at the 22nd week of gestation...
June 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28414857/association-of-external-cephalic-version-before-term-with-late-preterm-birth
#15
RANDOMIZED CONTROLLED TRIAL
Kristie L Poole, Sarah D McDonald, Lauren E Griffith, Eileen K Hutton
INTRODUCTION: While evidence suggests that beginning an external cephalic version (ECV) before term (340/7 to 366/7 weeks) compared with after term may be associated with an increase in late preterm birth (340/7 to 366/7 weeks), it remains unknown what might account for this risk. The objective of the present study is to further investigate the association between ECV before term and late preterm birth. MATERIAL AND METHODS: Secondary analysis of data collected from the international, multicenter Early ECV trials...
August 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28315476/comparative-analysis-of-protein-evolution-in-the-genome-of-pre-epidemic-and-epidemic-zika-virus
#16
COMPARATIVE STUDY
Arunachalam Ramaiah, Lei Dai, Deisy Contreras, Sanjeev Sinha, Ren Sun, Vaithilingaraja Arumugaswami
Zika virus (ZIKV) causes microcephaly in congenital infection, neurological disorders, and poor pregnancy outcome and no vaccine is available for use in humans or approved. Although ZIKV was first discovered in 1947, the exact mechanism of virus replication and pathogenesis remains unknown. Recent outbreaks of Zika virus in the Americas clearly suggest a human-mosquito cycle or urban cycle of transmission. Understanding the conserved and adaptive features in the evolution of ZIKV genome will provide a hint on the mechanism of ZIKV adaptation to a new cycle of transmission...
July 2017: Infection, Genetics and Evolution
https://www.readbyqxmd.com/read/28195383/morphological-ultrasound-types-known-as-blob-and-bagel-signs-should-be-reclassified-from-suggesting-probable-to-indicating-definite-tubal-ectopic-pregnancy
#17
B Nadim, F Infante, C Lu, N Sathasivam, G Condous
OBJECTIVE: In a recent consensus statement on early pregnancy nomenclature by Barnhart, a definite ectopic pregnancy (EP) was defined morphologically on transvaginal sonography (TVS) as an extrauterine gestational sac with yolk sac and/or embryo, with or without cardiac activity, whilst a probable EP was defined as an inhomogeneous adnexal mass ('blob' sign) or extrauterine sac-like structure ('bagel' sign). This study aims to determine whether these ultrasound markers used to define probable EP can be used to predict a definite tubal EP...
April 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28166987/transuterine-embryo-migration-distribution-of-sexes-within-uterine-horns-and-fetometry-in-nellore-bos-indicus-cattle
#18
Gabriel B O Borges, Rodrigo A Oliveira, Ivo Pivato
There is no consensus about the occurrence of transuterine embryo migration under natural breeding circumstances, neither data related to this phenomenon for zebu cattle. In this study, 5431 reproductive tracts of Nellore cows and heifers were evaluated in an abattoir in the state of Mato Grosso do Sul. A total of 1030 animals (19.0%) were pregnant at the time of slaughter (including 2 twin pregnancies). Regarding singleton pregnancies (n = 1028), 39.5% of them, the fetus was located in the left uterine horn and the remaining 60...
March 1, 2017: Theriogenology
https://www.readbyqxmd.com/read/28120289/access-to-obstetric-care-and-children-s-health-growth-and-cognitive-development-in-vietnam-evidence-from-young-lives
#19
Tina Lavin, David B Preen, Elizabeth A Newnham
Background The impact of birth with poor access to skilled obstetric care such as home birth on children's long term development is unknown. This study explores the health, growth and cognitive development of children surviving homebirth in the Vietnam Young Lives sample during early childhood. Methods The Young Lives longitudinal cohort study was conducted in Vietnam with 1812 children born in 2001/2 with follow-up at 1, 5, and 8 years. Data were collected on height/weight, health and cognitive development (Peabody Picture Vocabulary test)...
June 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28099694/evaluation-of-sonographic-endometrial-patterns-and-endometrial-thickness-as-predictors-of-ectopic-pregnancy
#20
Poonam Yadav, Anshuja Singla, Anu Sidana, Amita Suneja, Neelam B Vaid
OBJECTIVE: To evaluate whether endometrial patterns and thickness could be used for the prediction of ectopic pregnancy (EP). METHODS: A prospective study was conducted in a center in India between October 2007 and December 2008. It included 100 women with an early pregnancy confirmed by urine pregnancy testing but for whom an intrauterine gestational sac was not visualized on transvaginal ultrasonography (TVS). The women were divided into an EP group and an intrauterine pregnancy (IUP) group depending on the final diagnosis...
January 2017: International Journal of Gynaecology and Obstetrics
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