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First trimester vaginal bleeding

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https://www.readbyqxmd.com/read/28622635/management-of-parturients-with-factor-xi-deficiency-10year-case-series-and-review-of-literature
#1
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...
June 6, 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
#2
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...
May 18, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28556269/cervical-varices-an-unusual-source-of-first-trimester-hemorrhage
#3
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
#4
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 2, 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
#5
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...
April 28, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28299234/different-sonographic-faces-of-ectopic-pregnancy
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28093002/predictive-value-of-some-hematological-parameters-for-non-invasive-and-invasive-mole-pregnancies
#13
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
#14
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
#15
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
#16
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
#17
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
#18
REVIEW
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
#19
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
#20
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
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