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First trimester vaginal bleeding

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https://www.readbyqxmd.com/read/28299234/different-sonographic-faces-of-ectopic-pregnancy
#1
Charu Chanana, Nishant Gupta, Itisha Bansal, Kusum Hooda, Pranav Sharma, Mohit Gupta, Darshan Gandhi, Yogesh Kumar
Vaginal bleeding in the first trimester has wide differential diagnoses, the most common being a normal early intrauterine pregnancy, with other potential causes including spontaneous abortion and ectopic pregnancy. The incidence of ectopic pregnancy is approximately 2% of all reported pregnancies and is one of the leading causes of maternal mortality worldwide. Clinical signs and symptoms of ectopic pregnancy are often nonspecific. History of pelvic pain with bleeding and positive β-human chorionic gonadotropin should raise the possibility of ectopic pregnancy...
2017: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/28295285/tolosa-hunt-syndrome-presenting-during-pregnancy-following-progesterone-administration
#2
Charles E Litwin, Annie S O Leung
Tolosa-Hunt syndrome (THS) is a rare disease with an estimated incidence of 1 case per 1 million people per year [1]. A 24 year-old woman (G2 P0 A1 ) at 37(+3) weeks of pregnancy presented at the study institution reporting a 2-week unilateral headache on the left side, worsening nausea, and 1 day of progressively worsening left eye diplopia and photophobia. No significant medical or surgical history was reported, and the index pregnancy had been uncomplicated with the exception of some first-trimester bleeding that resulted in the patient being prescribed vaginal progesterone as part of a clinical trial...
March 10, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28252463/colorectal-cancer-diagnosed-during-pregnancy-systematic-review-and-treatment-pathways
#3
Gianluca Pellino, Constantinos Simillis, Christos Kontovounisios, Daniel L Baird, Stella Nikolaou, Oliver Warren, Paris P Tekkis, Shahnawaz Rasheed
The aim of this study was to identify the mode of presentation and incidence of colorectal cancer in pregnancy (CRC-p), assess the outcomes of the mother and foetus according to gestational age, treatment delivered and cancer features and location. A systematic review of the literature was carried out to identify studies reporting on CRC-p and pooled analysis of the reported data. Seventy-nine papers reporting on 119 patients with unequivocal CRC-p were included. The calculated pooled risk is 0.002% and age at diagnosis has decreased over time...
March 1, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28246515/efficacy-of-prophylactic-uterine-artery-embolization-before-obstetrical-procedures-with-high-risk-for-massive-bleeding
#4
Heung Kyu Ko, Ji Hoon Shin, Gi Young Ko, Dong Il Gwon, Jin Hyung Kim, Kichang Han, Shin-Wha Lee
OBJECTIVE: To evaluate the safety and efficacy of prophylactic uterine artery embolization (UAE) before obstetrical procedures with high risk for massive bleeding. MATERIALS AND METHODS: A retrospective review of 29 female patients who underwent prophylactic UAE from June 2009 to February 2014 was performed. Indications for prophylactic UAE were as follows: dilatation and curettage (D&C) associated with ectopic pregnancy (cesarean scar pregnancy, n = 9; cervical pregnancy, n = 6), termination of pregnancy with abnormal placentation (placenta previa, n = 8), D&C for retained placenta with vascularity (n = 5), and D&C for suspected gestational trophoblastic disease (n = 1)...
March 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/28144719/pitfalls-and-tips-in-the-diagnosis-of-ectopic-pregnancy
#5
REVIEW
E Mausner Geffen, C Slywotzky, G Bennett
Women of reproductive age with pelvic pain, vaginal bleeding, and a positive pregnancy test often require evaluation with pelvic ultrasound. In these situations, the primary role of pelvic ultrasound is to differentiate an ectopic pregnancy from either a normal or abnormal intrauterine pregnancy. While an accurately performed and interpreted pelvic ultrasound results in rapid diagnosis and management, numerous diagnostic pitfalls can lead to negative outcomes. Therefore, familiarity with the appropriate laboratory tests, sonographic technique, and imaging features of ectopic pregnancy is essential for all radiologists...
January 31, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28127150/ruptured-ectopic-pregnancy-with-a-negative-urine-pregnancy-test
#6
Mallory Hughes, Andrew Lupo, Adrianne Browning
Ectopic pregnancy is commonly seen as a differential diagnosis of first-trimester vaginal bleeding. Often the diagnosis is made based on a combination of exam findings, transvaginal ultrasound, and a positive pregnancy test. Our case describes a patient with a history of ectopic pregnancy treated with methotrexate and serial human chorionic gonadotropin measurements that were decreasing appropriately. At the time of evaluation, her urine pregnancy test was negative; however, she was confirmed to have a ruptured tubal ectopic pregnancy...
January 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28115056/the-clinical-outcome-of-cesarean-scar-pregnancies-implanted-on-the-scar-versus-in-the-niche
#7
Andrea Kaelin Agten, Giuseppe Cali, Ana Monteagudo, Johana Oviedo, Joanne Ramos, Ilan Timor-Tritsch
BACKGROUND: The term cesarean scar pregnancy refers to placental implantation within the scar of a previous cesarean delivery. The rising numbers of cesarean deliveries in the last decades have led to an increased incidence of cesarean scar pregnancy. Complications of cesarean scar pregnancy include morbidly adherent placenta, uterine rupture, severe hemorrhage, and preterm labor. It is suspected that cesarean scar pregnancies that are implanted within a dehiscent scar ("niche") behave differently compared with those implanted on top of a well-healed scar...
January 20, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28093002/predictive-value-of-some-hematological-parameters-for-non-invasive-and-invasive-mole-pregnancies
#8
Cigdem Abide Yayla, Enis Özkaya, Ilter Yenidede, Ahmet Eser, Evrim Bostancı Ergen, Ahter Tanay Tayyar, Mehmet Baki Şentürk, Ates Karateke
AIM: The aim of this study was to discriminate mole pregnancies and invasive forms among cases with first trimester vaginal bleeding by the utilization of some complete blood count parameters conjunct to sonographic findings and beta human chorionic gonadotropin concentration. MATERIALS AND METHODS: Consecutive 257 cases with histopathologically confirmed mole pregnancies and 199 women without mole pregnancy presented with first trimester vaginal bleeding who admitted to Zeynep Kamil Women and Children's Health Training Hospital between January 2012 and January 2016 were included in this cross-sectional study...
February 2, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28079767/primary-gastric-choriocarcinoma-presenting-as-a-pregnancy-of-unknown-location
#9
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/27846865/hysteroscopic-management-of-a-heterotopic-pregnancy-following-uterine-artery-embolization-a-case-report
#10
Jigyasa Subedi, Min Xue, Xin Sun, Dabao Xu, Xinliang Deng, Kenan Yu, Xi Yang
BACKGROUND: Intra-uterine pregnancy coexisting with cervical pregnancy (heterotopic pregnancy) is a rare condition and its management is challenging because of the massive bleeding associated with cervical pregnancy. Uterine artery embolization followed by hysteroscopic removal of cervical and intra-uterine products of conception can theoretically prevent massive bleeding and provide a direct view during the removal. Hysteroscopic management following uterine artery embolization of heterotopic pregnancy after in vitro fertilization and embryo transfer is rarely reported...
November 15, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27832075/is-a-self-assessed-questionnaire-useful-for-the-diagnosis-of-ectopic-pregnancy-in-hospitalized-patients
#11
Camille Mimoun, Arnaud Fauconnier, Catalina Varas, Cyrille Huchon
BACKGROUND: Delayed diagnosis of ectopic pregnancy (EP) is responsible for maternal morbidity and mortality. Our objective was to develop and validate decision rules for the diagnosis of EP, in patients in their first trimester of pregnancy with symptoms, based solely on a self-assessment questionnaire. METHODS: From September 2006 to March 2008, 574 patients, who have consulted for acute pelvic pain at the gynecologic emergency department (ED) of five hospitals, completed a Self-Assessment Questionnaire for Gynecological Emergencies (SAQ-GE)...
2016: PloS One
https://www.readbyqxmd.com/read/27821982/comparative-study-of-mifepristone-with-vaginal-misoprostol-for-first-trimester-termination-of-pregnancy-at-different-gestational-ages
#12
Seema Rani Meena
METHODS: This study for medical abortion was conducted in the Department of Obstetrics and Gynaecology, Zenana Hospital, SMS Medical College, Jaipur during 2011-2012. In total 280 cases were taken for the study and divided into two groups, among whom there were six defaulters in each group who failed to present for follow-up. OBJECTIVES: The objectives of this study were to (1) compare the success rates of abortion at different gestational ages, (2) study the side effects of the drugs, and (3) study the acceptability in both the groups...
December 2016: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/27818118/-medical-induced-abortion
#13
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/27677317/intrauterine-hematomas-in-the-second-and-third-trimesters-associated-with-adverse-pregnancy-outcomes-a-retrospective-study
#14
Wanqing Ji, Weidong Li, Shanshan Mei, Ping He
OBJECTIVE: To carry out a retrospective study of the clinical features of patients with intrauterine hematoma in the second and third trimesters, and discuss the risk factors for poor pregnancy outcomes. METHODS: A total of 398 patients who underwent routine examination in our hospital from January 2011 to December 2015 were classified into normal pregnancy (NP) group (N = 265) and adverse pregnancy (AP) group (N = 133), according to their pregnancy outcomes...
October 19, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27663202/recurrence-of-second-trimester-miscarriage-and-extreme-preterm-delivery-at-16-27%C3%A2-weeks-of-gestation-with-a-focus-on-cervical-insufficiency-and-prophylactic-cerclage
#15
Kirstine Sneider, Ole B Christiansen, Iben B Sundtoft, Jens Langhoff-Roos
INTRODUCTION: The objective of this study was to describe recurrence rates of second trimester miscarriage and extreme preterm delivery by phenotype and use of prophylactic cerclage in a register-based cohort. MATERIAL AND METHODS: We included women with a first second trimester miscarriage or extreme preterm delivery (16(+0) to 27(+6) gestational weeks) in Denmark in 1997-2012 (n = 9602) by combined use of the Danish Medical Birth Register and the Danish National Patient Register...
December 2016: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/27646709/ep25-02-does-pregnancy-outcome-in-the-first-trimester-correlate-with-the-amount-of-vaginal-bleeding-and-pain-a-preliminary-study
#16
M Al-Memar, S Bobdiwala, G Nikolic, D Popovic, S Saso, C Stalder, S Sur, B De Moor, D Timmerman, T Bourne
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27625583/clinical-presentation-and-treatment-outcome-of-molar-pregnancy-ten-years-experience-at-a-tertiary-care-hospital-in-dammam-saudi-arabia
#17
Ayman A Al-Talib
OBJECTIVES: To study the clinical presentation and treatment outcome of molar pregnancy at a Tertiary Care Hospital in Dammam, Saudi Arabia. MATERIALS AND METHODS: Reviewed medical records of all molar pregnancy cases among all the deliveries at a tertiary care hospital in Dammam from 2005 to 2014, after approval by institutional ethical review committee. Data abstracted included patient's age, parity, presenting symptoms, gestational age at diagnosis, uterine size, ultrasonographic findings, BhCG level at the time of diagnosis and at follow-up after evacuation, and blood loss during evacuation...
September 2016: Journal of Family & Community Medicine
https://www.readbyqxmd.com/read/27617440/two-cases-of-true-uterine-artery-aneurysms-diagnosed-during-pregnancy
#18
Jacob Mørup Schlütter, Gry Johansen, Rikke Bek Helmig, Olav Bjørn Petersen
We report 2 cases of true uterine artery aneurysms diagnosed during pregnancy. Both cases presented with nonspecific symptoms such as urethral obstruction, minimal vaginal bleeding and lower abdominal pain in the 2nd trimester. Both aneurysms were diagnosed by color Doppler ultrasound. In the first case labor was induced at 37 + 4 weeks of gestation. However, due to sudden fetal distress and maternal abdominal pain, an emergency Caesarean section was performed during labor, and 3 liters of intra-peritoneal blood were encountered upon laparotomy, secondary to a ruptured uterine artery aneurysm...
2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/27608805/maternal-morbidity-associated-with-violence-and-maltreatment-from-husbands-and-in-laws-findings-from-indian-slum-communities
#19
Jay G Silverman, Donta Balaiah, Julie Ritter, Anindita Dasgupta, Sabrina C Boyce, Michele R Decker, D D Naik, Saritha Nair, Niranjan Saggurti, Anita Raj
BACKGROUND: Intimate partner violence (IPV) victimization is linked to a broad range of negative maternal health outcomes. However, it is unclear whether IPV is directly related to poor maternal outcomes or whether IPV is a marker for other forms of chronic, mundane maltreatment of women that stem from the culture of gender inequity that also gives rise to IPV. To determine the prevalence of non-violent forms of gender-based household maltreatment by husbands and in-laws (GBHM), and violence from in-laws (ILV) and husbands (IPV) against women during the peripregnancy period (during and in the year prior to pregnancy); to assess relative associations of GBHM, ILV and IPV with maternal health...
September 8, 2016: Reproductive Health
https://www.readbyqxmd.com/read/27590953/first-trimester-complications-in-pregnancy-with-diabetes
#20
Bishwajit Bhowmik
Diabetes is the most prevalent medical condition complicating pregnancy in the world. It carries both acute and long-term health consequences for the mother and her offspring. Both preexisting (type 1 and type 2) and gestational diabetes are a high-risk state for miscarriage, stillbirths and congenital malformations in early pregnancy. Like normal pregnancy, vaginal bleeding, urinary tract infection, abdominopelvic pain, nausea, and vomiting are common presenting symptoms in early pregnancy with preexisting and gestational diabetes...
September 2016: JPMA. the Journal of the Pakistan Medical Association
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