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Medical Treatment Ectopic Pregnancy

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https://www.readbyqxmd.com/read/27932439/management-of-splenic-ectopic-pregnancy-presenting-with-massive-haemoperitoneum
#1
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
#2
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
#3
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...
November 19, 2016: 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
#4
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
#5
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-versus-expectant-management-for-treatment-of-tubal-ectopic-pregnancy-a-placebo-controlled-randomised-trial
#6
D Jurkovic, M Memtsa, E Sawyer, Ana Donaldson, A Jamil, K Schramm, Y Sana, M Otify, L Farahani, N Nunes, G Ambler, J A Ross
OBJECTIVE: Methotrexate is routinely used worldwide for medical treatment of clinically stable women with tubal ectopic pregnancies. This is despite the lack of robust evidence to show its superior effectiveness over expectant management. The aim of our multicentre randomised trial study was to compare the success rates of methotrexate with placebo for the conservative treatment of tubal ectopic pregnancies. METHODS: The study was multicentre; it took place in three UK early pregnancy units between January 2006 and June 2014...
October 12, 2016: 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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/27578991/pelvic-inflammatory-disease-improving-awareness-prevention-and-treatment
#10
REVIEW
Breanne B Das, Jocelyn Ronda, Maria Trent
PURPOSE: Pelvic inflammatory disease (PID) is a common disorder of the reproductive tract that is frequently misdiagnosed and inadequately treated. PID and its complications, such as infertility, ectopic pregnancy, and chronic pelvic pain, are preventable by screening asymptomatic patients for sexually transmitted infections (STIs) and promptly treating individuals with STIs and PID. RECENT FINDINGS: The rates of adverse outcomes in women with PID are high and disproportionately affect young minority women...
2016: Infection and Drug Resistance
https://www.readbyqxmd.com/read/27572300/overview-and-guidelines-of-off-label-use-of-methotrexate-in-ectopic-pregnancy-report-by-cngof
#11
REVIEW
Henri Marret, Arnaud Fauconnier, Gil Dubernard, Hélène Misme, Laurence Lagarce, Magali Lesavre, Hervé Fernandez, Camille Mimoun, Claire Tourette, Sandra Curinier, Benoit Rabishong, Aubert Agostini
Our objective is to describe off-label use of methotrexate in ectopic pregnancy treatment using evidence based medicine. The patient group includes all women with a pregnancy outside the usual endometrium, or of unknown location. Method used was a Medline search on ectopic pregnancy managed using methotrexate treatment; evidence synthesis was done based on this current literature analysis. Level of evidence (LE) were given according to the centre for evidence base medicine rules. Grade was proposed for guidelines but no recommendation was possible as misoprostol is off label use for all the indications studied...
October 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27500331/surgical-management-of-a-heterotopic-cesarean-scar-pregnancy-with-preservation-of-an-intrauterine-pregnancy
#12
Monica Hagan Vetter, Joseph Andrzejewski, Alan Murnane, Christopher Lang
BACKGROUND: Spontaneously conceived heterotopic pregnancies are rare. A heterotopic cesarean scar pregnancy involves an intrauterine pregnancy and a second pregnancy in the cesarean scar. Treatment approaches include both medical and surgical management. We present a surgical approach to the treatment of a heterotopic cesarean scar pregnancy with preservation of an intrauterine gestation. CASE: A 29-year-old woman, gravida 4 para 1021, presented at 5 weeks of gestation with spotting...
September 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27457397/-use-of-methotrexate-in-the-ectopic-pregnancy-and%C3%A2-pregnancy-of-unknown-location
#13
J Racková, D Driák, H Neumannová, K Hurt, B Sehnal, M Halaška
OBJECTIVE: There are only a few gynaecological departments in the Czech Republic that use medical treatment of the ectopic pregnancy (EP) or persistent pregnancy of unknown location (PUL). We have started using this method in 2008 at our clinic. The aim of this study was to assess the success rate of conservative medical treatment with methotrexate (MTX) in the dose of 1 mg/kg intramuscularly in patients with ectopic pregnancy or persistent pregnancy of unknown location and to compare the results of clinical history, clinical finding and laboratory results in a group of successful and a group of unsuccessful treatment...
April 2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27377845/methotrexate-treatment-in-progressive-tubal-ectopic-pregnancies-and-hcg-related-clinicosurgical-implications
#14
Askin Dogan, Ibrahim Gulhan, Ibrahim Uyar, Atalay Ekin, Cenk Gezer, Muzaffer Bilgin, Cüneyt E Taner, Ibrahim E Ertas
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/m(2) 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...
June 2016: Kaohsiung Journal of Medical Sciences
https://www.readbyqxmd.com/read/27371354/medical-management-of-ectopic-pregnancy-with-single-dose-and-two-dose-methotrexate-protocols-human-chorionic-gonadotropin-trends-and-patient-outcomes
#15
Michelle C Mergenthal, Suneeta Senapati, Jarcy Zee, Lynne Allen-Taylor, Paul G Whittaker, Peter Takacs, Mary D Sammel, Kurt T Barnhart
BACKGROUND: Ectopic pregnancy, though rare, is an important cause of female morbidity and mortality and early, effective treatment is critical. Systemic methotrexate has become widely accepted as a safe and effective alternative to surgery in the stable patient. As the number and timing of methotrexate doses differ in the three main medical treatment regimens, one might expect trends in serum human Chorionic Gonadotropin and time to resolution to vary depending on protocol. Furthermore, human Chorionic Gonadotropin trends and time to resolution may predict ultimate treatment success...
June 28, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27311171/-a-second-trimester-ovarian-ectopic-pregnancy-a-case-report
#16
Marco Antonio Avila-Vergara, Alma Rita Peña-Ayón, Luis Enrique Guzmán-Gutiérrez, Jesús Everardo Valenzuela-Verduzco, Carmen Beatriz Caballero-Rodríguez, Felipe Vadillo-Ortega
BACKGROUND: Ovarian pregnancy (OP) is a low-frequency pathology but with devastating effects on women reproductive health. It is often difficult to distinguish from tubal or abdominal pregnancy. Diagnostic procedures and actual medical approaches to the treatment of OP are still a challenge. CLINICAL CASE: In this paper we present a 21 years old woman, seen at the Hospital as emergency abdominal pain and hypovolemic shock, with a pregnancy of 14 weeks of gestational age...
November 2015: Ginecología y Obstetricia de México
https://www.readbyqxmd.com/read/27282007/adolescent-gynecologic-emergencies
#17
REVIEW
Sophia Yen, Monika K Goyal, Paula Hillard
Adolescent females frequently present to the ED with complaints that may be caused by a gynecologic emergency. Differentiating and excluding some of the common and most serious gynecologic emergencies reviewed in this article are critical. Timely and effective treatment of these conditions, once diagnosed, can result in better health outcomes.
December 2015: Adolescent Medicine: State of the Art Reviews
https://www.readbyqxmd.com/read/27216957/methotrexate-treatment-for-ectopic-pregnancy-after-assisted-reproductive-technology-a-case-control-study
#18
A Ohannessian, P Crochet, B Courbiere, A Gnisci, A Agostini
OBJECTIVES: Ectopic pregnancy (EP) occurs in 2% to 5.6% of pregnancies achieved by assisted reproductive technology (ART). EP treatment options include medical treatment by uses of methotrexate (MTX) systemic injection. The objective of this study was to compare MTX treatment effectiveness for EP occurring spontaneously or following ART. METHODS: A case-control study performed in the department of obstetrics and gynecology at a tertiary health care center in France...
May 20, 2016: Gynécologie, Obstétrique & Fertilité
https://www.readbyqxmd.com/read/27203166/-pregnancy-outcome-after-preconceptional-exposure-to-methotrexate-for-ectopic-pregnancy
#19
Laurence Lagarce, Nathalie Bernard, Patrick Carlier, Silviana Phelipot-Lates, Marie-Christine Perault-Pochat, Guillaume Drablier, Delphine Bourneau-Martin, Pascale Lainé-Cessac
INTRODUCTION: Methotrexate (MTX) is a known teratogenic drug used off-label in the treatment of ectopic pregnancies (EP). As MTX polyglutamated derivatives remains into the cells during several weeks, it is recommended to avoid conception during 3 to 6 months following MTX therapy. We report the follow-up of pregnancies after preconceptional exposure to MTX for EP. MATERIAL/METHODS: Prospective cases of pregnancy occurring within 3 months after MTX injection for an EP recorded in the Terappel database were analyzed...
September 2016: Thérapie
https://www.readbyqxmd.com/read/27155903/caesarean-section-surgical-techniques-3-year-follow-up-of-the-coronis-fractional-factorial-unmasked-randomised-controlled-trial
#20
RANDOMIZED CONTROLLED TRIAL
E Abalos, V Addo, P Brocklehurst, M El Sheikh, B Farrell, S Gray, P Hardy, E Juszczak, J E Mathews, S Naz Masood, E Oyarzun, J Oyieke, J B Sharma, P Spark
BACKGROUND: The CORONIS trial reported differences in short-term maternal morbidity when comparing five pairs of alternative surgical techniques for caesarean section. Here we report outcomes at 3 years follow-up. METHODS: The CORONIS trial was a pragmatic international 2 × 2 × 2 × 2× 2 non-regular fractional, factorial, unmasked, randomised controlled trial done at 19 sites in Argentina, Chile, Ghana, India, Kenya, Pakistan, and Sudan. Pregnant women were eligible if they were to undergo their first or second caesarean section through a planned transverse abdominal incision...
July 2, 2016: Lancet
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