Ectopic pregnancy

Selected twin research papers that are classic, provocative, and/or influential are surveyed. Many papers meet these criteria, so those chosen reflect the opinion of the author. Reviews of recent research on twin pregnancies with and without polycystic ovary syndrome, ectopic pregnancy, sex differences in cognition and maternal cardiac hemodynamics follow. Newsworthy twin-based items, including President Obama's portrait artist, the financial activities of the Winkelvoss twins, a set of triplet fashion models and the experience of seeing oneself in a painting, are summarized...

BACKGROUND: Heterotopic pregnancies are rare in spontaneous conceptions. Nonetheless, when it does occur, the intrauterine pregnancy is usually viable. We herein present a true rarity of the coexistence of a blighted ovum and an ectopic pregnancy. CASE PRESENTATION: A 25 year old G2P1001 married seamstress of African ethnicity at 8 weeks of amenorrhoea presented to our health facility with a 4 day history of lower abdominal pains and vaginal bleeding for which physical examination revealed a closed cervix...

Cesarean scar pregnancy (CSP), often considered the rarest form of ectopic pregnancy, is a result of implantation of the gestational sac into the fibrous tissue scar of a previous cesarean section. With an increase in the rate of cesarean sections, along with better awareness and improvement in sonographic diagnosis, the number and detection of scar pregnancies are on the rise. Because of its early invasion of the myometrium, usually in the first trimester, CSP is considered to be potentially lethal, leading to high risks of uterine rupture...

Epilepsy is a neurological disorder often associated with seizure that affects ∼0.7% of pregnant women. During pregnancy, most epileptic patients are prescribed antiepileptic drugs (AEDs) such as valproic acid (VPA) to control seizure activity. Here, we show that prenatal exposure to VPA in mice increases seizure susceptibility in adult offspring through mislocalization of newborn neurons in the hippocampus. We confirmed that neurons newly generated from neural stem/progenitor cells (NS/PCs) are integrated into the granular cell layer in the adult hippocampus; however, prenatal VPA treatment altered the expression in NS/PCs of genes associated with cell migration, including CXC motif chemokine receptor 4 ( Cxcr4 ), consequently increasing the ectopic localization of newborn neurons in the hilus...

This retrospective study evaluated the association between frozen donor sperm used for intrauterine insemination and clinical and neonatal outcomes, including 304 singleton pregnancies resulting from artificial insemination by the husband (AIH) and 173 singleton pregnancies resulting from artificial insemination by a donor (AID). The clinical outcomes for AID showed no increased risk of abortion, ectopic pregnancy or pregnancy complications compared to those for AIH. There were no differences in gender, gestational age or prematurity of live births between the two groups...

Introduction: Before the advent of assisted reproductive technologies, the incidence of heterotopic pregnancy was estimated to be in 1 out of 30,000 pregnancies in the United States. With interstitial pregnancy comprising only 2.4% of ectopic pregnancies, spontaneous heterotopic interstitial pregnancies are exceedingly rare. Case: A 27-year-old pregnant woman (gravida 3 para 1011) with a history of one prior term vaginal delivery and a spontaneous abortion in the first trimester presented to the emergency department with abdominal pain and a positive home pregnancy test...

Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy. Because CSP carries a high risk of uterine rupture and life-threatening bleeding, the pregnancy should be terminated upon confirmation of diagnosis. There have been few reports of CSP with successful delivery. We present a case of CSP under expectant management, with delivery via planned cesarean section at 35 weeks of gestation. This report suggests that successful pregnancy outcome can be achieved in some women with uterine cesarean scar, but further analysis and additional studies are required in order to describe the optimal protocol of expectant management in CSP...

No abstract text is available yet for this article.

Cornual (interstitial) ectopic pregnancy is an uncommon type of ectopic pregnancy which is located in the interstitial part of the fallopian tube. It accounts for 2%-4% of all ectopic pregnancies. Cornual pregnancies often pose a diagnostic and therapeutic challenge with a significant high morbidity and mortality as a result of massive intraperitoneal bleeding. A case of unruptured cornual ectopic pregnancy in a patient with abnormal uterine bleeding is reported which was successfully managed laparoscopically...

We report the case of two patients with newly diagnosed primary hyperparathyroidism: a 40-year-old woman during pregnancy and a 60-year-old man with initial hypercalcaemic crisis. In the first case, a bilateral neck exploration with parathyroidectomy during the second trimester of pregnancy was unsuccessful and the patient remained hypercalcaemic. Postpartum imaging assessment with technetium (99m Tc)-sestamibi scintigraphy could not supply conclusive diagnostic results. The use of18 F-fluorocholine (FCH) positron emission tomography (PET)/CT provided the accurate localisation of an ectopic parathyroid adenoma in the anterior mediastinum which was successfully resected by a thoracoscopic approach...

BACKGROUND: Although the levonorgestrel-releasing intrauterine device (LNG-IUD) is one of the most reliable methods of contraception, it is associated with an increased risk of ectopic pregnancy in case of unintended pregnancy. A rare form of ectopic pregnancy is the caesarean scar pregnancy (CSP), with a high risk of serious maternal morbidity, such as uterine rupture, massive haemorrhage and resulting infertility. This report describes the first case of a viable CSP at 13 weeks of gestation in association with the use of a LNG-IUD...

INTRODUCTION: To compare ultrasound-guided local methotrexate (MTX) versus systemic methotrexate in uterine ectopic pregnancy regarding the beta human chorionic gonadotropin (hCG) clearance duration. MATERIAL AND METHODS: Patients with interstitial pregnancy, cervical pregnancy or cesarean scar pregnancy were included. Methotrexate was administered locally ultrasound-guided (25mg methotrexate fixed dose) or systemically (intramuscular; 50mg/m2 body weight). Beta hCG clearance duration in days formed the main outcome measure...

Despite the purported advantages of ultrasound guidance during embryo transfer, and the large number of clinical trials published on this topic, recommendations for the use of this technique in daily clinical practice are still under debate. We designed a meta-analysis based exclusively on evidence from published randomized controlled trials, with the aim of analysing the effect of trans-abdominal ultrasound guidance during embryo transfer versus clinical touch and of transvaginal ultrasound guidance (TV-US) versus the trans-abdominal approach on IVF outcomes...

BACKGROUND: Anaemia affects as many as half of all pregnant women in low-income and middle-income countries, but the burden of disease and associated maternal mortality are not robustly quantified. We aimed to assess the association between severe anaemia and maternal death with data from the WHO Multicountry Survey on maternal and newborn health. METHODS: We used multilevel and propensity score regression analyses to establish the relation between severe anaemia and maternal death in 359 health facilities in 29 countries across Latin America, Africa, the Western Pacific, eastern Mediterranean, and southeast Asia...

Ectopic pregnancy is an extrauterine pregnancy, and 98% of which occur in the fallopian tube. The incidence of twin tubal pregnancy is rare but is increasing due to assisted reproductive technology. Spontaneous unilateral twin tubal pregnancy is extremely rare, and only a small number of case reports have been made. We herein report a rare case of spontaneous unilateral twin tubal pregnancy with both fetuses presenting with heart activities and a literature review. Right salpingectomy was performed in this case...

A positive urine pregnancy test (UPT) with adnexal mass in ectopic pregnancy is not the ultimate diagnosis. The incidence of ectopic pregnancy is about 27 per 1000 pregnancies [1]. On average, about 6-16% will present to an emergency department with first-trimester bleeding and abdominal pain [2]. On presenting with these symptoms with the simultaneous presence of an adnexal mass and an empty uterus, a UPT is of paramount importance to determine whether the symptoms are pregnancy related or not. When the UPT is positive, an ectopic pregnancy is not the only diagnosis as the rare entity of non-gestational ovarian choriocarcinoma (NGOC) should be considered...

OBJECTIVE: The aim of this study was to provide a three-dimensional (3D) microscopic reconstruction of morphological modifications of the fallopian tube (FT) following surgical sterilization (including tuboperitoneal fistula) and ectopic pregnancy (EP) using confocal microtomography (micro-CT). METHODS: Six specimens of FT from elective and emergency surgeries were selected: three remnants of the FT (RFT) from surgical sterilization, including one presenting tuboperitoneal fistula, and three FTs with EP...

Two patients with placenta percreta underwent uterine artery embolization (UAE) for abnormally invasive placenta (AIP) in the first trimester. Patient 1 had a 9-week cervical ectopic, while Patient 2 had a 9-week cesarean scar pregnancy. Elective termination of pregnancy was performed in both patients. UAE was performed with tris-acryl gelatin microspheres as well as gelfoam until stasis and was repeated in cases of revascularization. Both patients were followed with US/MRI/MRA scans and β-hCG levels. Revascularization occurred in both patients following UAE, requiring multiple embolizations to achieve complete placental involution...

Abdominal pregnancies represent 1.4% of extrauterine pregnancies. A literature search of six cases involving bowel ectopic pregnancies provided anecdotal treatment options. This case involves a woman admitted at 6 weeks gestation with right iliac fossa and shoulder tip pain. An ultrasound scan revealed an empty uterus with free fluid in both adnexa and a 31×21 mm heterogenous mass adjacent to the right ovary. At laparoscopy, an ectopic pregnancy was identified at the hepatic flexure. The patient received two doses of methotrexate and monitored until the beta human chorionic gonadotropin reduced...

BACKGROUND: In order to overcome the low effectiveness of assisted reproductive technologies (ART) and the high incidence of multiple births, metabolomics is proposed as a non-invasive method to assess oocyte quality, embryo viability, and endometrial receptivity, and facilitate a targeted subfertility treatment. OBJECTIVES: To evaluate the effectiveness and safety of metabolomic assessment of oocyte quality, embryo viability, and endometrial receptivity for improving live birth or ongoing pregnancy rates in women undergoing ART, compared to conventional methods of assessment...