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First trimester vaginal bleeding

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https://www.readbyqxmd.com/read/29056745/sex-hormone-metabolism-and-threatened-abortion
#1
Qianhua Xu, Juan Chen, Zhaolian Wei, Theodore R Brandon, David T Zava, Yuenian Eric Shi, Yunxia Cao
BACKGROUND The aim of this study was to evaluate changes in sex hormone metabolism in patients with threatened miscarriage. MATERIAL AND METHODS We recruited 73 women in early pregnancy (6-8 weeks of gestation) and divided them into the following 2 groups based on whether they had vaginal bleeding: group A (n=34), the threatened abortion group; and group B (n=39), the normal pregnancy group. Human chorionic gonadotrophin (hCG), estradiol (E2), progesterone (P4), and testosterone (T) serum levels were tested and sex hormone metabolites in the urine were detected using gas chromatography-triple quadrupole mass spectrometry (GC-MS/MS)...
October 23, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28969481/delivery-through-cervicovaginal-fistula-literature-review-and-case-report
#2
Rafał Watrowski, Burghardt Babbel, Gerald Gitsch
Less than 10 deliveries via cervicovaginal fistula (CVF) with closed cervical os were reported so far. In the majority of cases, the patients had a history of induced abortions. The CVF was usually recognized due to postpartum hemorrhage. The facilitating role of prostaglandins used for labor induction was supposed. In all cases, the babies remained unaffected by the delivery route. We report a new case of a 37-year-old gravida 2, para 0, with a history of a paracervical tear following a first trimester abortion 11 years ago...
October 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28948411/first-trimester-emergencies-a-radiologist-s-perspective
#3
REVIEW
Catherine H Phillips, Jeremy R Wortman, Elizabeth S Ginsburg, Aaron D Sodickson, Peter M Doubilet, Bharti Khurana
The purpose of this article is to help the practitioner ensure early diagnosis and response to emergencies in the first trimester by reviewing anatomy of the developing embryo, highlighting the sonographic appearance of common first-trimester emergencies, and discussing key management pathways for treating emergent cases. First-trimester fetal development is a stepwise process that can be challenging to evaluate in the emergency department (ED) setting. This is due, in part, to the complex anatomy of early pregnancy, subtlety of the sonographic findings, and the fact that fewer than half of patients with ectopic pregnancy present with the classic clinical findings of a positive pregnancy test, vaginal bleeding, pelvic pain, and tender adnexa...
September 25, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28935219/medical-abortion-can-be-provided-safely-and-effectively-by-pharmacy-workers-trained-within-a-harm-reduction-framework-nepal
#4
Anand Tamang, Mahesh Puri, Sazina Masud, Deepak Kumar Karki, Diksha Khadka, Minal Singh, Poonam Sharma, Subash Gajurel
OBJECTIVES: To examine the treatment efficacy, safety and satisfaction of women using medical abortion (MA) pills provided by pharmacists following an education intervention based on a harm reduction approach. STUDY DESIGN: This was an operations research study over a six-month period in 2015, using a non-inferiority design. We provided training to dispense MA pills, based on a harm reduction approach, to a group of pharmacy workers in Makwanpur district (GROUP 2)...
September 18, 2017: Contraception
https://www.readbyqxmd.com/read/28819516/a-severed-ip-ligament-as-a-cause-for-trans-vaginal-uterine-bleeding-post-termination-of-pregnancy-a-case-report
#5
Madeeha Dean, Nicole Stamatopoulos, Thierry Vancaillie
Uterine perforation is an uncommon yet serious complication of surgical management of first and second trimester termination of pregnancies. The rate of uterine perforation is under reported, as patients are usually asymptomatic. Although uncommon, uterine perforation can cause life-threatening complications for some patients. This case report discusses a second trimester surgical termination resulting in uterine perforation and haemorrhage secondary to an avulsion of the infundibulopelvic ligament and prolapse of the left fallopian tube and ovary into the uterine cavity...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28738745/is-ultrasound-guided-suction-curettage-a-reliable-option-for-treatment-of-cesarean-scar-pregnancy-a-cross-sectional-retrospective-study
#6
Hüseyin Çağlayan Özcan, Mete Gurol Uğur, Özcan Balat, Seyhun Sucu, Aynur Mustafa, Neslihan Bayramoğlu Tepe, Berna Kaya Uğur
PURPOSE: The purpose of our study is to present clinical courses and outcomes of 50 first-trimester cesarean scar pregnancy (CSP) cases, which are managed either with transabdominal ultrasound (TAUS)-guided suction curettage alone or abdominal hysterotomy. METHODS: We retrospectively analyzed our records from 2011 to 2016 at a single-center. TAUS-guided suction curettage alone was preferred in hemodynamically stable patients when the myometrial thickness was ≥3 mm and there was no vascular invasion...
August 1, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28712177/analysis-of-two-years-cases-of-ectopic-pregnancy
#7
Ansa Islam, Aneesa Fawad, Azmat Ali Shah, Humaira Jadoon, Iram Sarwar, Aziz-Un-Nisa Abbasi
BACKGROUND: Ectopic pregnancy is the leading cause of pregnancy related deaths in the first trimester. The aim of this study was to evaluate the frequency of risk factors, clinical presentation, diagnostic methods and site of ectopic pregnancy. METHODS: This descriptive cross sectional study was conducted in Gynaecology and Obstetrical Unit-A of Ayub Teaching Hospital Abbottabad from 1st October 2013 to 31st October 2015. All women diagnosed with ectopic pregnancy were included in the study...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28661021/outcome-of-cesarean-scar-pregnancy-a-systematic-review-and-meta-analysis
#8
REVIEW
Giuseppe Calì, Ilan E Timor-Trisch, Josè Palacios-Jaraquemada, Ana Monteaugudo, Danilo Buca, Francesco Forlani, Alessandra Familiari, Giovanni Scambia, Ganesh Acharya, Francesco D'Antonio
OBJECTIVE: To explore the outcome of women managed expectantly following a diagnosis of caesarean scar pregnancy (CSP). METHODS: The outcomes observed were: severe first trimester vaginal bleeding, clinical symptoms (abdominal pain, vaginal bleeding) requiring treatment, uncomplicated miscarriage, complicated miscarriage requiring intervention, first or second trimester uterine rupture, first or second trimester hysterectomy, third trimester bleeding, third trimester uterine rupture, third trimester hysterectomy, maternal death, occurrence of abnormally invasive placenta (AIP), prevalence of placenta percreta, ultrasound signs suggestive of AIP, liveborn fetuses...
June 29, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28622635/management-of-parturients-with-factor-xi-deficiency-10year-case-series-and-review-of-literature
#9
REVIEW
Lynda Verghese, Efterpi Tingi, Jecko Thachil, Charles Hay, Louise Byrd
This is an article reviewing the management of pregnant women with factor XI (FXI) deficiency. Retrospective review of the electronic records of 67 pregnancies in 25 women with FXI deficiency over a ten-year period was undertaken. All women received care at St Mary's Tertiary Referral Obstetric/Haematology Clinic for some or all of their pregnancies. Outcome measures included antenatal complications, mode of delivery, anaesthesia provided and postpartum haemorrhage (PPH) and management required. A positive bleeding history was identified in 50% of women prior to pregnancy...
August 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28559097/von-willebrand-disease-type-2-in-pregnancy-a-critical-clinical-association
#10
REVIEW
Anca A Simionescu, Natalia F Buinoiu, Nicoleta Berbec
Von Willebrand disease (vWD) is the most common inherited bleeding disorder. Its association with pregnancy is infrequent. Here we report three cases of vWD associated with pregnancy. The clinical features of this combination are very suggestive. However, difficulties are still encountered during the diagnosis process. The first case was diagnosed for the first time during the patient's second pregnancy despite several episodes of vaginal bleeding and suggestive clinical symptomatology. The second case was diagnosed during childhood and the patient was properly managed during this pregnancy...
June 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28556269/cervical-varices-an-unusual-source-of-first-trimester-hemorrhage
#11
Joseph R Wax, Angelina Cartin, Christian Litton, Kelley Conroy, Michael G Pinette
Endocervical varices are a rare cause of obstetrical hemorrhage. Usually presenting in the second and third trimesters, bleeding varices often require pregnancy termination or indicated preterm birth via cesarean delivery. Our patient experienced variceal hemorrhage at 12 weeks' gestation in a dichorionic twin pregnancy conceived through in vitro fertilization. A low-lying placenta resolved at 19 weeks followed by variceal regression at 22 weeks' gestation. Endocervical varices causing first-trimester hemorrhage may regress with resolution of a coexisting low placental implantation, permitting planned vaginal delivery, despite progressive hemodynamic changes of pregnancy...
May 29, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28462593/the-predictive-role-of-stweak-levels-in-pregnant-women-with-first-trimester-vaginal-bleeding
#12
Burcu Kasap, Ümmühani Özel Türkçü, Eren Akbaba, Behiye Sarıyıldız, Mert Küçük, Nilgün Öztürk Turhan, Gökalp Öner, Aykut Özcan
PURPOSE: To investigate the relationships of TNF-related weak inducer of apoptosis (sTWEAK), a cytokine related to the TNF superfamily, its newly described soluble receptor sCD163, and the sTWEAK/sCD163 ratio with perinatal outcomes in women with first-trimester vaginal bleeding. MATERIALS AND METHODS: Seventy (41 threatened abortion and 29 control) gestational-age-matched (6-14 weeks) pregnant women were included in the study. Antenatal complications (gestational diabetes, preeclampsia, intrauterine growth restriction, oligohydramniosis, polyhydramniosis), and perinatal outcomes (delivery mode, birth weight, delivery week) were recorded...
May 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28461175/in-office-hysteroscopic-extraction-of-intrauterine-devices-in-pregnant-patients-who-underwent-prior-ultrasound-guided-extraction-failure
#13
Shlomo B Cohen, Jerome Bouaziz, Alexandra Bar-On, Eyal Schiff, Motti Goldenberg, Roy Mashiach
STUDY OBJECTIVE: To determine an effective method of intrauterine device (IUD) retrieval from pregnant women who had previous unsuccessful ultrasound-guided IUD extraction failure. DESIGN: A retrospective cohort study (Canadian task force classification II-1). SETTING: A gynecology department of an outpatient clinic. PATIENTS: Pregnant patients in their first trimester with IUD in situ who underwent prior unsuccessful ultrasound-guided IUD extraction...
July 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28299234/different-sonographic-faces-of-ectopic-pregnancy
#14
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
#15
Charles E Litwin, Annie S O Leung
No abstract text is available yet for this article.
June 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28252463/colorectal-cancer-diagnosed-during-pregnancy-systematic-review-and-treatment-pathways
#16
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...
July 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
#17
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
#18
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...
May 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28127150/ruptured-ectopic-pregnancy-with-a-negative-urine-pregnancy-test
#19
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
#20
MULTICENTER STUDY
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...
May 2017: American Journal of Obstetrics and Gynecology
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