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Medical Treatment Ectopic Pregnancy

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https://www.readbyqxmd.com/read/28523313/correlation-of-clinical-and-biological-evidence-a-dominant-therapeutic-element-of-succeeding-in-ectopic-pregnancy
#1
Simona Daniela NeamŢu, Damian DiŢescu, Maria ForŢofoiu, Liliana Stanca, Cristian Tigae, Mihaela Niculescu, Cristian Ovidiu NeamŢu, Maria Magdalena Manolea, Mirela Anişoara Siminel, Leontina Eugenia Şurtea, Adela Valeria NeamŢu, Marius Bogdan Novac, Liviu Vasile, Adrian Gluhovschi
Tubal pathology, smoking, pelvic inflammatory disease, miscarriage, medical or surgical abortion, usage of intrauterine devices (IUDs) for women with salpingitis latent injuries, older than 40 years, are risk factors for ectopic pregnancy. The objective of this study concerns the correlation of the clinical and biological evidence for the early diagnosis of the ectopic pregnancy and, as soon as possible, for the estimation for eventual risk of complications that may appear. The transvaginal ultrasound test, minimal increases in serum beta-human chorionic gonadotropin (β-hCG) dynamics and blood counts are investigations of choice in achieving our objective...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28523060/management-options-for-interstitial-ectopic-pregnancies-a-case-series
#2
Ilker Kahramanoglu, Zahid Mammadov, Hasan Turan, Aslihan Urer, Abdullah Tuten
OBJECTIVE: Ectopic pregnancy in the interstitial part of the Fallopian tubes can be life-threatining considering the thin myometrial tissue surrounding the gestational sac and highly vascularization which may result in catastrophic haemorrhage when interstitium is ruptured. The diagnosis and management is challenging. Conservative, medical, and surgical treatment options should be considered based on individual patient factors. METHODS: Four women were diagnosed with interstitial pregnancy in last five years in our tertiary center...
March 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28288882/clinical-outcomes-of-patients-with-heterotopic-pregnancy-after-surgical-treatment
#3
Yiqi Guan, Caihong Ma
STUDY OBJECTIVE: This study aimed to review surgical management and clinical outcomes of patients with heterotopic pregnancy (HP) who underwent in vitro fertilization and embryo transfer (IVF-ET) and surgical treatment at the Assisted Reproductive Technology Center of Peking University Third Hospital from January 2010 to December 2015. DESIGN: We retrospectively analyzed 56 patients' general characteristics, diagnostic features, surgical management, and clinical outcomes according to medical records and follow-up telephone interviews...
March 10, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28288792/disparities-in-the-management-of-ectopic-pregnancy
#4
Jennifer Y Hsu, Ling Chen, Arielle R Gumer, Ana I Tergas, June Y Hou, William M Burke, Cande V Ananth, Dawn L Hershman, Jason D Wright
BACKGROUND: 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. OBJECTIVE: We examined the patterns of care and outcomes for women with ectopic pregnancy...
March 10, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28285056/unilateral-salpingectomy-and-methotrexate-are-associated-with-a-similar-recurrence-rate-of-ectopic-pregnancy-in-patients-undergoing-in%C3%A2-vitro-fertilization
#5
Mohamad Irani, Alex Robles, Vinay Gunnala, Steven D Spandorfer
STUDY OBJECTIVE: To determine whether different treatment approaches of ectopic pregnancy (EP), particularly unilateral salpingectomy and methotrexate, affect its recurrence rate in patients undergoing in vitro fertilization (IVF). DESIGN: A retrospective cohort study (Canadian Task Force classification II-2). SETTING: An academic medical center. PATIENTS: Patients with a history of a previous EP who achieved pregnancy after IVF cycles between January 2004 and August 2015 were included...
March 8, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28217676/pretreatment-serum-human-chorionic-gonadotropin-cutoff-value-for-medical-treatment-success-with-single-dose-and-multi-dose-regimen-of-methotrexate-in-tubal-ectopic-pregnancy
#6
Junhwan Kim, Young Mi Jung, Da Yong Lee, Byung Chul Jee
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...
January 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28214759/the-role-of-hcg-increment-in-the-48h-prior-to-methotrexate-treatment-as-a-predictor-for-treatment-success
#7
Aviad Cohen, Benny Almog, Yoni Cohen, Guy Bibi, Eli Rimon, Ishai Levin
OBJECTIVE: To evaluate the role HCG change in the 48h prior to methotrexate treatment as a predictor for treatment success. STUDY DESIGN: Medical records of all women who were diagnosed with ectopic pregnancy between January 2001 and June 2013 were reviewed. Four hundred and nine patients received methotrexate due to ectopic pregnancy. The "single dose" methotrexate protocol with 50mg/m(2) was administered to patients with progressing ectopic pregnancy. HCG levels in days 1, 4 and 7 were used to evaluate methotrexate treatment success...
February 9, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28179198/cesarean-scar-ectopic-pregnancy-laparoscopic-resection-and-total-scar-dehiscence-repair-a-case-report
#8
Sara Mahgoub, Victor Gabriele, Emilie Faller, Bruno Langer, Arnaud Wattiez, Lise Lecointre, Cherif Akladios
STUDY OBJECTIVE: Illustrate laparoscopic technique for resection of cesarean scar ectopic pregnancy, associated with isthmocele repair. DESIGN: Case report SETTING: Tertiary referral centre in Strasbourg, France. The study was approved by the local IRB. BACKGROUND: 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...
February 4, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28127836/clinical-characteristics-of-persistent-ectopic-pregnancy-after-salpingostomy-and-influence-on-ongoing-pregnancy
#9
Yongli Zhang, Jinhong Chen, Wen Lu, Bilan Li, Guiqiang Du, Xiaoping Wan
AIM: The aim of this study was to assay the clinical characteristics of persistent ectopic pregnancy (PEP) and its influence on ongoing pregnancy. METHODS: 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...
March 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28003928/ectopic-pregnancy-in-a-cesarean-section-scar-successful-management-using-vacuum-aspiration-under-laparoscopic-supervision-mini-review-of-current-literature
#10
Mustafa Koplay, Nasuh Utku Dogan, Mesut Sivri, Hasan Erdogan, Selen Dogan, Cetin Celik
A cesarean scar ectopic pregnancy (CSEP) is a fairly uncommon presentation wherein the conceptus is implanted deep in the myometrium and at the exact scar site of the previous cesarean section. There are various CSEP management options that range from medical treatment to surgical interventions such as dilatation and curettage, laparoscopic excision, resection by laparotomy, or, sometimes, a combination of these modalities. Establishing a diagnosis of CSEP can be challenging. Given the relatively rare incidence of CSEP, its management is controversial and current standards of therapy have been derived from data obtained from a limited number of patients...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27936449/methotrexate-treated-ectopic-pregnancy-beta-human-chorionic-gonadotropin-serum-changes-as-a-success-predictor-using-a-mathematical-model-validation
#11
Aleksandra Kovaleva, Natalia Irishina, Augusto Pereira, Tatiana Cuesta-Guardiola, Luis Ortiz-Quintana
BACKGROUND: Surgical rescue of methotrexate-treated ectopic pregnancy is necessary when tubal rupture or medical therapy failure is detected during post-therapeutic monitoring. It is known that an increased beta human chorionic gonadotropin (β-hCG) concentration is the most important factor associated with treatment failure. Therefore, we suggested that relative changes in serum β-hCG could predict a successful result of medical treatment, leading to facilitation of the decision to forgo the prospect of possible surgical rescue...
March 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27932439/management-of-splenic-ectopic-pregnancy-presenting-with-massive-haemoperitoneum
#12
Alissa Greenbaum, Richard Miskimins, Brittany Coffman, Jasmeet Paul
Abdominal ectopic pregnancy (EP) accounts for only 1.3% of EPs and occurs when a fertilised ovum implants in an extrapelvic peritoneal location. Primary splenic pregnancy is a rare type of abdominal EP, with only 16 cases previously reported in the literature. Early diagnosis is essential as delay in treatment carries significant potential for morbidity and mortality. We present the case of a 27-year-old woman presenting with left upper quadrant abdominal pain, elevated human chorionic gonadotropin levels, absence of intrauterine gestational sac and massive haemoperitoneum on transvaginal ultrasound...
December 8, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27893595/the-impact-of-prescriptions-on-sex-partner-treatment-using-expedited-partner-therapy-for-chlamydia-trachomatis-infection-new-york-city-2014-2015
#13
Ashley Oliver, Meighan Rogers, Julia A Schillinger
BACKGROUND: Chlamydia trachomatis reinfections, often resulting from resuming sex with untreated partners, can increase the risk of pelvic inflammatory disease, infertility, and ectopic pregnancy. Expedited partner therapy (EPT) has been shown to prevent reinfection when provided as medication (Medication-EPT) that patients give to sex partners; however, EPT is often provided as a prescription (Prescription-EPT). We compared partner treatment outcomes for Medication-EPT versus Prescription-EPT...
November 2016: Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/27888702/predictive-factors-for-the-methotrexate-treatment-outcome-in-ectopic-pregnancy-a-comparative-study-of-400-cases
#14
COMPARATIVE STUDY
Lucie Bonin, Cécile Pedreiro, Stéphanie Moret, Gautier Chene, Pascal Gaucherand, Géry Lamblin
OBJECTIVE: 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. STUDY DESIGN: 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 <13 and who were treated according to a 1mg/kg intramuscular single-dose methotrexate protocol...
January 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27844211/morbid-obesity-and-outcome-of-ectopic-pregnancy-following-capped-single-dose-regimen-methotrexate
#15
Luis R Hoyos, Mokerrum Malik, Marvin Najjar, Javier Rodriguez-Kovacs, Mazen Abdallah, Gustavo Vilchez, Awoniyi O Awonuga
PURPOSE: Evaluate whether morbid obesity influenced resolution, number of doses or ultimately surgical management of tubal ectopic pregnancy (TEP) when treated with single-dose regimen methotrexate (SDR-MTX) capped at 100 mg. METHODS: Retrospective cohort study of patients with a diagnosis of TEP who underwent MTX treatment from 2000 to 2013. Patients were excluded if initial β-hCG <1000 mIU/mL, did not have β-hCG follow-up or were not treated with SDR-MTX...
November 14, 2016: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/27818118/-medical-induced-abortion
#16
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/27731538/single-dose-systemic-methotrexate-vs-expectant-management-for%C3%A2-treatment%C3%A2-of%C3%A2-tubal%C3%A2-ectopic%C3%A2-pregnancy-%C3%A2-a%C3%A2-placebo-controlled-randomized-trial
#17
D Jurkovic, M Memtsa, E Sawyer, A N A Donaldson, A Jamil, K Schramm, Y Sana, M Otify, L Farahani, N Nunes, G Ambler, J A Ross
OBJECTIVE: Methotrexate is used routinely worldwide for the medical treatment of clinically stable women with a tubal ectopic pregnancy. This is despite the lack of robust evidence to show its superior effectiveness over expectant management. The aim of our multicenter randomized controlled trial was to compare success rates of methotrexate against placebo for the conservative treatment of tubal ectopic pregnancy. METHODS: This study took place in two early-pregnancy units in the UK between August 2005 and June 2014...
February 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27680029/intrauterine-administration-of-hcg-immediately-after-oocyte-retrieval-and-the-outcome-of-icsi-a-randomized-controlled-trial
#18
N Navali, A Gassemzadeh, L Farzadi, S Abdollahi, M Nouri, K Hamdi, F Mallah, F Jalilvand
STUDY QUESTION: Does the intrauterine administration of hCG immediately after oocyte retrieval in antagonist cycles with ICSI and fresh embryo transfer (ET) influence the implantation rate or chemical and clinical pregnancy rates? SUMMARY ANSWER: The intrauterine administration of hCG after oocyte retrieval increases the implantation rate and chemical and clinical pregnancy rates. WHAT IS KNOWN ALREADY: Over half of IVF/ICSI cycles fail due to implantation failure...
November 2016: Human Reproduction
https://www.readbyqxmd.com/read/27651650/laparoscopic-management-of-interstitial-ectopic-using-simple-and-safe-technique-case-series-and-review-of-literature
#19
Tamer Hanafy Said
BACKGROUND AND OBJECTIVE: To determine the safety and sustainability of operative laparoscopy in surgical management of cornual and interstitial ectopic pregnancy using a simple and practical method. DESIGN: Case series of five consecutive cases. SETTING: Endoscopy unit in Alexandria University Hospital and Alexandria New Medical Center. PATIENTS: Between July 2013 and May 2015, five women with interstitial and cornual ectopic pregnancies were admitted for laparoscopic surgical treatment...
October 2016: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/27582596/cesarean-scar-pregnancy-managed-with-conservative-treatment
#20
Aysen Boza, Barıs Boza, Murat Api
Cesarean scar pregnancy (CSP) is a rare, but life-threatening type of ectopic pregnancy. An exact and early diagnosis of CSP is very important for prognosis. The aim of the present study was to describe 4 women with CSP and discuss their clinical presentations, diagnoses, and various management options along with the published literature. Four women with a suspicion of CSP or cervical pregnancy were referred to our hospital between August 2013 and January 2014. All the patients were counseled about medical management options...
September 2016: Iranian Journal of Medical Sciences
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