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First trimester vaginal bleeding

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https://www.readbyqxmd.com/read/29742672/fetal-growth-patterns-in-pregnancies-with-first-trimester-bleeding
#1
Alaina M Bever, Sarah J Pugh, Sungduk Kim, Roger B Newman, William A Grobman, Edward K Chien, Deborah A Wing, Hanyun Li, Paul S Albert, Katherine L Grantz
OBJECTIVE: To assess the relationship between first-trimester vaginal bleeding and fetal growth patterns. METHODS: We conducted a secondary analysis of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies-Singletons, a prospective cohort study of low-risk, nonobese women with healthy lifestyles. Duration of bleeding was self-reported at enrollment (10 0/7 to 13 6/7 weeks of gestation) and categorized as 0, 1, or more than 1 day...
May 7, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29724428/acr-appropriateness-criteria-%C3%A2-first-trimester-vaginal-bleeding
#2
Douglas L Brown, Ann Packard, Katherine E Maturen, Sandeep Prakash Deshmukh, Kika M Dudiak, Tara L Henrichsen, Benjamin J Meyer, Liina Poder, Elizabeth A Sadowski, Thomas D Shipp, Lynn Simpson, Therese M Weber, Carolyn M Zelop, Phyllis Glanc
Vaginal bleeding is not uncommon in the first trimester of pregnancy. The majority of such patients will have a normal intrauterine pregnancy (IUP), a nonviable IUP, or an ectopic pregnancy. Ultrasound (US) is the primary imaging modality in evaluation of these patients. US, along with clinical observations and serum human chorionic gonadotropin levels, can usually distinguish these causes. Although it is important to diagnose ectopic pregnancies and nonviable IUPs, one should also guard against injury to normal pregnancies due to inappropriate treatment with methotrexate or surgical intervention...
May 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29661236/clinical-analysis-of-50-patients-with-heterotopic-pregnancy-after-ovulation-induction-or-embryo-transfer
#3
Zaigui Wu, Xinmei Zhang, Ping Xu, Xiufeng Huang
OBJECTIVES: The purpose of this study was to evaluate the clinical characteristics, prenatal diagnosis, and management of patients with heterotopic pregnancy after ovulation induction or embryo transfer. METHODS: This was a retrospective study of fifty cases with heterotopic pregnancy, in which the fertilization way, type and number of embryo transferred, gestational age, clinical presentation and outcome of intrauterine, ultrasound presentation and site of ectopic pregnancy, bilateral fallopian tube and treatment were evaluated...
April 16, 2018: European Journal of Medical Research
https://www.readbyqxmd.com/read/29558344/a-positive-urine-pregnancy-test-upt-with-adnexal-mass-ectopic-pregnancy-is-not-the-ultimate-diagnosis
#4
Mohd Faizal Ahmad, Muhammad Azrai Abu, Kah Teik Chew, Kun Leng Sheng, Mohd Asyraf Zakaria
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...
March 20, 2018: Hormone Molecular Biology and Clinical Investigation
https://www.readbyqxmd.com/read/29405964/new-insights-in-the-pathophysiology-of-complete-hydatidiform-mole
#5
Eric Jauniaux, Maria Memtsa, Jemma Johns, Jackie A Ross, Davor Jurkovic
OBJECTIVE: The majority of complete hydatidiform moles (CHM) are detected on ultrasound examination by the end of the first trimester when they present as multiple sonolucent cysts. To better understand the pathophysiology of this unique placental pathology and improve its prenatal diagnosis and management we have reviewed the ultrasound features of CHM before the appearance of cystic changes. STUDY DESIGN: We searched our database to identify all women diagnosed with a complete hydatidiform mole confirmed by histopathology who had an ultrasound examination before 9 weeks' gestation...
February 2018: Placenta
https://www.readbyqxmd.com/read/29375147/letrozole-vs-placebo-pretreatment-in-the-medical-management-of-first-trimester-missed-miscarriage-a-randomized-controlled-trial
#6
Haitham A Torky, Heba Marie, ElSayed ElDesouky, Samy Gebreel, Osama Raslan, Asem A Moussa, Ali M Ahmad, Eman Zain, Mohamed N Mohsen
Introduction: Misoprostol is used for the medical management of miscarriage as it is more effective in the early stages of pregnancy. Letrozole has an anti-estrogen effect and is used for the pretreatment of miscarriage with misoprostol. Aim: The aim of this study was compare the efficacy and safety of letrozole with placebo pretreatment in the medical management of first trimester missed miscarriage. Design: This was a prospective randomized case-control study...
January 2018: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/29246235/comparative-satisfaction-of-receiving-medical-abortion-service-from-nurses-and-auxiliary-nurse-midwives-or-doctors-in-nepal-results-of-a-randomized-trial
#7
Anand Tamang, Iqbal H Shah, Pragya Shrestha, I K Warriner, Duolao Wang, Kusum Thapa, N T My Huong, Olav Meirik
BACKGROUND: Early first-trimester medical abortion (MA) service (≤ 63 days) has been provided by doctors and nurses under doctors' supervision since 2009 in Nepal. This paper assesses whether MA services provided by specifically trained and certified nurses and auxiliary nurse-midwives independently from doctors' supervision, is considered as satisfactory by women as those provided by doctors. METHODS: The data come from a multi-center, randomized, controlled equivalence trial conducted between April 2009 and March 2010 in five district hospitals in Nepal...
December 16, 2017: Reproductive Health
https://www.readbyqxmd.com/read/29056745/sex-hormone-metabolism-and-threatened-abortion
#8
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
#9
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
#10
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...
February 2018: 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
#11
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)...
February 2018: 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
#12
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
#13
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
#14
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-managed-expectantly-systematic-review-and-meta-analysis
#15
REVIEW
G Calì, I E Timor-Tritsch, J Palacios-Jaraquemada, A Monteaugudo, D Buca, F Forlani, A Familiari, G Scambia, G Acharya, F D'Antonio
OBJECTIVE: To explore the outcome in women managed expectantly following the diagnosis of Cesarean scar pregnancy (CSP). METHODS: An electronic search of MEDLINE, EMBASE and ClinicalTrials.gov databases was performed utilizing combinations of relevant medical subject headings for 'Cesarean scar pregnancy' and 'outcome'. Reference lists of relevant articles and reviews were hand-searched for additional reports. Observed outcomes included: 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 or hysterectomy; third-trimester bleeding, uterine rupture or hysterectomy; maternal death; incidence of abnormally invasive placenta (AIP); prevalence of placenta percreta; ultrasound signs suggestive of AIP; and live birth...
February 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28622635/management-of-parturients-with-factor-xi-deficiency-10year-case-series-and-review-of-literature
#16
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
#17
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
#18
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...
March 2018: 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
#19
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
#20
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
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