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Pregnancy of unknown location

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https://www.readbyqxmd.com/read/28746265/prevalence-of-rubella-antibodies-among-children-in-the-democratic-republic-of-the-congo
#1
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 (CRS). 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 (DHS), a serosurvey was carried out to assess population immunity to vaccine preventable diseases...
July 19, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28660799/factors-to-consider-in-pregnancy-of-unknown-location
#2
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
#3
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...
May 26, 2017: 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
#4
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
#5
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)...
May 5, 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
#6
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
#7
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
#8
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
#9
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 (34(0/7) to 36(6/7) weeks) compared with after term may be associated with an increase in late preterm birth (34(0/7) to 36(6/7) 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
#10
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...
March 14, 2017: Infection, Genetics and Evolution
https://www.readbyqxmd.com/read/28195383/the-morphological-ultrasound-types-known-as-blob-and-bagel-signs-should-be-reclassified-from-probable-to-definite-ectopic-pregnancy
#11
Batool Nadim, Fernando Infante, Chuan Lu, Nalayini Sathasivam, George Condous
OBJECTIVES: In a recent consensus statement on early pregnancy nomenclature by Barnhart 2011, a definite ectopic pregnancy(EP) was defined morphologically on transvaginal ultrasound (TVS) as an extra-uterine gestational sac(GS) with yolk sac and/or embryo(with or without cardiac activity) whilst a probable EP defined as an inhomogeneous adnexal mass("blob" sign) or extra-uterine sac-like structure("bagel" sign). This study aims to determine whether the ultrasound markers used to define probable EP can be used to predict a definite tubal EP...
February 13, 2017: 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
#12
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
#13
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)...
January 24, 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
#14
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
https://www.readbyqxmd.com/read/28079767/primary-gastric-choriocarcinoma-presenting-as-a-pregnancy-of-unknown-location
#15
Alyssa Larish, Amanika Kumar, Sarah Kerr, Carrie Langstraat
BACKGROUND: Pregnancy of unknown location presents a diagnostic challenge, in rare occasions leading to the diagnosis of malignancy. We describe a case of β-hCG-secreting nongestational primary gastric choriocarcinoma presenting as a pregnancy of unknown location. CASE: A 37-year-old woman, gravida 4 para 3013, presented with several days of vaginal bleeding and rising β-hCG level without ultrasound localization of pregnancy. The diagnosis of pregnancy of unknown location was made and methotrexate administered at a β-hCG level of 7,779 milli-international units/mL...
February 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27873370/the-magnitude-of-change-in-the-fetal-cerebroplacental-ratio-in-the-third-trimester-and-the-risk-of-adverse-pregnancy-outcome
#16
Christopher Flatley, Ristan M Greer, Sailesh Kumar
OBJECTIVE: The primary aim of this study was to evaluate if the magnitude of change in the cerebro-placental ratio (CPR) after 30 weeks gestation was better predictive of adverse pregnancy outcome compared to a single measurement at 35-37 weeks. A secondary aim was to evaluate whether the utility of CPR measured at 35-37 weeks was enhanced after adjusting for the gestational change. METHODS: This was a retrospective cohort study of women who had had at least two ultrasound scans between 30-37 weeks gestation with the final scan taking place at 35-37 weeks...
November 22, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27854392/association-between-three-dimensional-transvaginal-sonographic-markers-and-outcome-of-pregnancy-of-unknown-location-a-pilot-study
#17
S Reid, B Nadim, T Bignardi, C Lu, W P Martins, G Condous
OBJECTIVE: To assess the accuracy of three-dimensional (3D) transvaginal sonographic (TVS) parameters in predicting the evolution of a pregnancy of unknown location (PUL). METHODS: This was a prospective observational study performed at the early pregnancy unit of a university hospital from September 2008 to June 2012. Women with a positive pregnancy test without any signs of intra- or extrauterine pregnancy at their first TVS examination were considered eligible and a 3D dataset containing the entire uterus was acquired...
November 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27819282/characterization-of-t-follicular-helper-cells-in-allogeneic-normal-pregnancy-and-pdl1-blockage-induced-abortion
#18
Weihong Zeng, Zhicui Liu, Siming Zhang, Jiabin Ren, Xiaoling Ma, Chuanmei Qin, Fuju Tian, Yan Zhang, Yi Lin
A deeper understanding of the immunological events during pregnancy will provide novel insights into the pathogenesis of pregnancy complications. The fundamental function of T follicular helper (Tfh) cells is to provide cognate help to B cells. Dysregulations of Tfh-cell function and/or development can result in various immunological diseases. However, the role and characteristics of Tfh cells during pregnancy remain unknown. Herein, an allogeneic-normal-pregnant mouse model was used, and we found that the CD4(+) T cells residing at the uterus and placenta (UP) displayed a Tfh-like phenotype; and the UP-derived CD4(+)CXCR5(hi)PD-1(hi) and CD4(+)CXCR5(hi)ICOS(hi) Tfh cells, which showed a memory/activation phenotype, reached their peak at mid-pregnancy...
November 7, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27818118/-medical-induced-abortion
#19
REVIEW
K Bettahar, A Pinton, T Boisramé, V Cavillon, S Wylomanski, I Nisand, D Hassoun
OBJECTIVE: Updated clinical recommendations for medical induced abortion procedure. METHODS: A systematic review of French and English literature, reviewing the evidence relating to the provision of medical induced abortion was carried out on PubMed, Cochrane Library and international scientific societies recommendations. RESULTS: The effectiveness of medical abortion is higher than 95% when the protocols are adjusted to gestational age (EL1)...
December 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27814980/-role-of-ultrasound-in-elective-abortions
#20
REVIEW
S Wylomanski, N Winer
Ultrasound plays a fundamental role in the management of elective abortions. Although it can improve the quality of post-abortion care, it must not be an obstacle to abortion access. We thus studied the role of ultrasound in pregnancy dating and possible alternatives and analyzed the literature to determine the role of ultrasound in post-abortion follow-up. During an ultrasound scan, the date of conception is estimated by measurement of the crown-rump length (CRL), defined by Robinson, or of the biparietal diameter (BPD), as defined by the French Center for Fetal Ultrasound (CFEF) after 11 weeks of gestation (Robinson and CFEF curves) (grade B)...
December 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
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