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Ectopic pregnancy

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https://www.readbyqxmd.com/read/29470343/acog-practice-bulletin-no-193-tubal-ectopic-pregnancy
#1
(no author information available yet)
Ectopic pregnancy is defined as a pregnancy that occurs outside of the uterine cavity. The most common site of ectopic pregnancy is the fallopian tube. Most cases of tubal ectopic pregnancy that are detected early can be treated successfully either with minimally invasive surgery or with medical management using methotrexate. However, tubal ectopic pregnancy in an unstable patient is a medical emergency that requires prompt surgical intervention. The purpose of this document is to review information on the current understanding of tubal ectopic pregnancy and to provide guidelines for timely diagnosis and management that are consistent with the best available scientific evidence...
March 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29470339/acog-practice-bulletin-no-193-summary-tubal-ectopic-pregnancy
#2
(no author information available yet)
Ectopic pregnancy is defined as a pregnancy that occurs outside of the uterine cavity. The most common site of ectopic pregnancy is the fallopian tube. Most cases of tubal ectopic pregnancy that are detected early can be treated successfully either with minimally invasive surgery or with medical management using methotrexate. However, tubal ectopic pregnancy in an unstable patient is a medical emergency that requires prompt surgical intervention. The purpose of this document is to review information on the current understanding of tubal ectopic pregnancy and to provide guidelines for timely diagnosis and management that are consistent with the best available scientific evidence...
March 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29464052/epigenetic-changes-found-in-uterine-decidual-and-placental-tissues-can-also-be-found-in-the-breast-cancer-microenvironment-of-the-same-unique-patient-description-and-potential-interpretations
#3
Miguel H Bronchud, Francesc Tresserra, Bernat Serra Zantop
Microenvironmental properties are thought to be responsible for feto-maternal tolerance. Speculatively, ectopic expression of placental gene programs might also be related to cancer cells' ability to escape from immune vigilance mechanisms during carcinogenesis and cancer progression. Recently, we published the first human genomic evidence of similar immune related gene expression profiles in both placenta (placenta and decidual tissue) and cancer (both primary and metastatic) in the same patient with lymph-node positive breast carcinoma during pregnancy...
January 19, 2018: Oncotarget
https://www.readbyqxmd.com/read/29451847/appropriate-use-of-prophylactic-antibiotic-agents-in-gynecologic-surgeries-at-a-midwestern-teaching-hospital
#4
Locke Uppendahl, Caitlin Chiles, Stephanie Shields, Fanglong Dong, Elizabeth Kraft, Jennifer Duong, James Delmore
BACKGROUND: The purpose of this study was to establish compliance with guidelines published by the American College of Obstetricians and Gynecologists (ACOG) regarding prophylactic antibiotic use in gynecologic surgery at our institution, and define areas of improvement to promote antibiotic stewardship. PATIENTS AND METHODS: This was a retrospective cohort study at a single, large tertiary care and teaching hospital in Kansas. Patients who underwent inpatient or outpatient gynecologic surgery during 2013 were included...
February 16, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29448014/intrauterine-inflammation-reduces-postnatal-neurogenesis-in-the-hippocampal-subgranular-zone-and-leads-to-accumulation-of-hilar-ectopic-granule-cells
#5
Michael S Hester, Natalia Tulina, Amy Brown, Guillermo Barila, Michal A Elovitz
Prenatal inflammation is associated with poor neurobehavioral outcomes in exposed offspring. A common route of exposure for the fetus is intrauterine infection, which is often associated with preterm birth. Hippocampal development may be particularly vulnerable to an inflammatory insult during pregnancy as this region remains highly neurogenic both prenatally and postnatally. These studies sought to determine if intrauterine inflammation specifically altered hippocampal neurogenesis and migration of newly produced granule neurons during the early postnatal period...
February 12, 2018: Brain Research
https://www.readbyqxmd.com/read/29445925/tubal-restorative-surgery-for-hydrosalpinges-in-women-due-to-in-vitro-fertilization
#6
Xiaoming Yu, He Cai, Xingbang Zheng, Junyan Feng, Jing Guan
OBJECTIVE: The study was carried out to clarify the IVF outcome after laparoscopic neosalpingostomy for infertile patients affected by hydrosalpinx stage III. MATERIALS AND METHODS: From January 2010 to June 2015, 91 subjects of hydrosalpinx stage III were treated in out center by laparoscopic surgery before IVF cycle. 43 underwent neosalpingostomy (group 1) and the remaining 48 underwent salpingestomy (group 2). We compared these patients and their IVF outcomes after two different surgical techniques...
February 14, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29442402/ectopic-pregnancy-in-women-with-recurrent-miscarriage
#7
Carlo Ticconi, Maria V Capogna, Federica Martelli, Barbara Borelli, Valentina Bruno, Raffaella Ergasti, Roberto Sorge, Emilio Piccione, Adalgisa Pietropolli
AIM: The aim of this study was to investigate the possible association between recurrent miscarriage (RM) and ectopic pregnancy (EP). METHODS: In this case-control retrospective study, the clinical cards of women followed as outpatients in the RM and low-risk pregnancy offices of the Obstetrics and Gynecology Unit at the Policlinico Tor Vergata University Hospital were carefully reviewed for the occurrence of EP. RESULTS: Overall, 598 women with RM and 2043 normal women without RM (controls) were included in the study...
February 14, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29436119/laparoscopic-diagnosis-and-treatment-of-an-isolated-epithelioid-trophoblastic-tumor-in-recto-uterine-pouch
#8
Fang Jiang, Yang Xiang, Li-Na Guo
A 30-year-old Chinese woman with irregular vaginal bleeding was admitted to our department. Serum β-human chorionic gonadotropin (β-hCG) was moderately elevated, and ultrasound and magnetic resonance imaging revealed an irregular, retro-uterine lesion without intrauterine pregnancy. Ectopic pregnancy was the primary consideration, with trophoblastic tumor being another possibility. Laparoscopy revealed a 2 × 3 × 3 cm3 irregular, infiltrating, yellow-white lesion in the left recto-uterine pouch, which was completely resected without rectal damage...
February 13, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29433363/to-douche-or-not-to-douche-hygiene-habits-may-have-detrimental-effects-on-vaginal-microbiota
#9
Erdogan Aslan, Nadia Bechelaghem
The importance of a healthy vaginal micro-flora is indisputable. Therefore, intravaginal practices, such as vaginal douching (VD), may inhibit or lower the colonisation of beneficial Lactobacilli strains. Although the results of disrupted vaginal microbiota have been widely reported in the literature, direct microbicidal effects of products used for VD have been rarely studied. Moreover, there are certain studies advocating the beneficial effects of VD. This in vitro study was designed to provide more evidence to help health care givers in disseminating the knowledge that VD might have detrimental effects on vaginal microbiota...
February 13, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29429891/vinorelbine-potently-induces-placental-cell-death-does-not-harm-fertility-and-is-a-potential-treatment-for-ectopic-pregnancy
#10
Roxanne Hastie, Elgene Lim, Pavel Sluka, Lisa Campbell, Andrew Horne, Lenore Ellett, Natalie J Hannan, Fiona Brownfoot, Tu'uhevaha J Kaitu'u-Lino, Stephen Tong
Ectopic pregnancies complicate 1-2 pregnancies and are a leading cause of maternal death. An effective oral drug therapy that replaces surgery might make its treatment safer, cheaper, simpler and therefore more widely accessible. The only current medical treatment offered to women is intramuscular methotrexate, but this only reliably resolves smaller ectopic pregnancies. As such, many ectopic pregnancies require surgical excision. We show that vinorelbine, an orally available chemotherapeutic agent, potently induced placental cell death but did not harm fertility in mice...
February 2, 2018: EBioMedicine
https://www.readbyqxmd.com/read/29425721/using-a-mobile-smartphone-to-perform-laparoscopy
#11
Ioannis Chatzipapas, Nikolaos Kathopoulis, Athanasios Protopapas, Dimitrios Loutradis
Laparoscopy has gradually expanded its use in gynecologic surgery over the last three decades. In this report, a new laparoscopic setup is presented using a mobile smartphone that allows for a low-cost, portable laparoscopic viewing system. The setup was created with the coupling of a rigid 0 degrees, 10-mm diameter laparoscope via a commercially available adaptor with a smartphone. The light source used was also a portable and rechargeable light-emitting diode (LED) cold light source. We completed 17 diagnostic laparoscopies for different pathologies such as ectopic pregnancy, ovarian torsion, luteal hemorrhagic cyst, and disseminated ovarian cancer...
February 6, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29420399/appendiceal-endometriosis-and-ectopic-pregnancy-occurring-simultaneously
#12
Anat Chemerinski, Daniel Lubin, Sevelle Holder, Divya Shah
BACKGROUND: In the setting of a known ectopic pregnancy, severe abdominal pain with clinical concern for rupture is an indication for emergency surgery. In rare cases, appendiceal pathology may occur simultaneously. CASE: A woman with a known ectopic pregnancy presented to the emergency department with a clinical picture consistent with its rupture. At the time of surgery, an appendectomy also was performed owing to concern for concurrent appendicitis; histopathologic examination revealed appendiceal endometriosis...
February 5, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29417013/determinants-of-menstrual-hygiene-among-school-going-adolescent-girls-in-a-rural-area-of-west-bengal
#13
Ishita Sarkar, Madhumita Dobe, Aparajita Dasgupta, Rivu Basu, Bhaskar Shahbabu
Background: Menstrual hygiene is a neglected issue in rural India. Lack of menstrual hygiene in adolescent girls can make them susceptible to various morbidities, for example, reproductive tract infection and urinary tract infection and their long-term consequences, for example, cervical cancer, infertility, and ectopic pregnancy. This study aims to find out the determinants of menstrual hygiene among the school going adolescent girls in a rural area of West Bengal. Objectives: To elicit the menstrual hygiene practices among the study population and to find out the association of poor menstrual hygiene practices with sociodemographic factors, such as age, occupation and education of the parents, housing, and presence of sanitary toilet...
July 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29409858/cost-of-unintended-pregnancy-in-sweden-a-possibility-to-lower-costs-by-increasing-larc-usage
#14
Sara Engstrand, Helena Kopp Kallner
OBJECTIVES: The objective of this study was to determine the cost of unintended pregnancy (UP) in Sweden and savings generated by a switch of 5% of women from short acting reversible contraception (SARC) and other methods to long acting reversible contraceptives (LARCs). STUDY DESIGN: We constructed an economic model to estimate the number and costs of UPs and contraceptive use over a 1-year period. The population consisted of all women aged 15-44years requiring reversible contraception and at risk of UP...
February 1, 2018: Contraception
https://www.readbyqxmd.com/read/29409847/cost-effectiveness-of-emergency-contraception-options-over-one-year
#15
Brandon K Bellows, Casey R Tak, Jessica N Sanders, David K Turok, Eleanor B Schwarz
BACKGROUND: The copper intrauterine device is the most effective form of emergency contraception and can also provide long-term contraception. The levonorgestrel intrauterine device has also been studied in combination with oral levonorgestrel for women seeking emergency contraception. However, intrauterine devices have higher upfront costs than oral methods, such as ulipristal acetate and levonorgestrel. Healthcare payers and decision makers (e.g., healthcare insurers, government programs) with financial constraints must determine if the increased effectiveness of intrauterine device emergency contraception methods are worth the additional costs...
January 31, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29408754/elective-abortion-clinical-practice-guidelines-from-the-french-college-of-gynecologists-and-obstetricians-cngof
#16
REVIEW
Christophe Vayssière, Adrien Gaudineau, Luisa Attali, Karima Bettahar, Sophie Eyraud, Philippe Faucher, Patrick Fournet, Danielle Hassoun, Marie Hatchuel, Christian Jamin, Brigitte Letombe, Teddy Linet, Marie Msika Razon, Alexandra Ohanessian, Hélène Segain, Solène Vigoureux, Norbert Winer, Sophie Wylomanski, Aubert Agostini
The number of elective abortions has been stable for several decades. Many factors explain women's choice of abortion in cases of unplanned pregnancies. Early initiation of contraceptive use and a choice of contraceptive choices appropriate to the woman's life are associated with lower rates of unplanned pregnancies. Reversible long-acting contraceptives should be favored as first-line methods for adolescents because of their effectiveness (grade C). Ultrasound scan before an elective abortion must be encouraged but should not be obligatory (professional consensus)...
January 26, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29404418/intravaginal-administration-of-interleukin-12-during-genital-gonococcal-infection-in-mice-induces-immunity-to-heterologous-strains-of-neisseria-gonorrhoeae
#17
Yingru Liu, Julianny Perez, Laura A Hammer, Heather C Gallagher, Magdia De Jesus, Nejat K Egilmez, Michael W Russell
It has previously been shown that genital tract infection with Neisseria gonorrhoeae in mice does not induce a state of protective immunity against reinfection but instead suppresses the development of adaptive immune responses against N. gonorrhoeae dependent on transforming growth factor beta (TGF-β) and interleukin 10 (IL-10). Intravaginal administration during gonococcal infection of IL-12 encapsulated in biodegradable microspheres (IL-12/ms) reverses the immunosuppression and promotes the production of gamma interferon (IFN-γ) and of specific antibodies in serum and genital secretions and accelerates clearance of the infection...
January 2018: MSphere
https://www.readbyqxmd.com/read/29400114/outcomes-in-subsequent-pregnancies-after-wedge-resection-for-interstitial-ectopic-pregnancy-a-retrospective-cohort-study
#18
Luis R Hoyos, Gustavo Vilchez, Jenifer E Allsworth, Mokerrum Malik, Javier Rodriguez-Kovacs, Henry Adekola, Awoniyi O Awonuga
OBJECTIVE: To evaluate pregnancy outcomes in patients with a history of wedge resection for interstitial ectopic pregnancy (WRIEP). METHODS: Retrospective cohort study of pregnancies with a history of WRIEP from 2000-2013 at two inner city hospitals in Detroit, MI. Pregnant matched controls (1:3) were selected and included patients with history of surgically treated tubal ectopic pregnancy and delivered patients without history of ectopic pregnancy. Pregnancy outcomes, including a composite, were compared among the groups...
February 4, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29390363/ruptured-secondary-abdominal-pregnancy-after-primary-laparoscopic-treatment-for-tubal-pregnancy-a-case-report
#19
Duoduo Zhang, Anxia Chen, Yu Gu
INTRODUCTION: Most secondary abdominal pregnancies happen after spontaneous abortion of tubal pregnancy or ruptured intrauterine pregnancy. However, we presented a case of ruptured secondary abdominal pregnancy after primary laparoscopic treatment of tubal pregnancy. CASE REPORT: The ectopic pregnant lesion in the affected tube was thoroughly removed in the primary laparoscopy, and nothing abnormal was detected in abdomen or pelvis. Beta human chorionic gonadotropin levels dropped significantly after surgery, but the patient came back again for severe abdominal pain with beta human chorionic gonadotropin increasing, and free peritoneal fluid in the pouch of Douglas was detected at ultrasonography...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29389968/inferring-pregnancy-episodes-and-outcomes-within-a-network-of-observational-databases
#20
Amy Matcho, Patrick Ryan, Daniel Fife, Dina Gifkins, Chris Knoll, Andrew Friedman
Administrative claims and electronic health records are valuable resources for evaluating pharmaceutical effects during pregnancy. However, direct measures of gestational age are generally not available. Establishing a reliable approach to infer the duration and outcome of a pregnancy could improve pharmacovigilance activities. We developed and applied an algorithm to define pregnancy episodes in four observational databases: three US-based claims databases: Truven MarketScan® Commercial Claims and Encounters (CCAE), Truven MarketScan® Multi-state Medicaid (MDCD), and the Optum ClinFormatics® (Optum) database and one non-US database, the United Kingdom (UK) based Clinical Practice Research Datalink (CPRD)...
2018: PloS One
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