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Anembryonic gestation

Courtney A Schreiber, Mitchell D Creinin, Jessica Atrio, Sarita Sonalkar, Sarah J Ratcliffe, Kurt T Barnhart
BACKGROUND: Medical management of early pregnancy loss is an alternative to uterine aspiration, but standard medical treatment with misoprostol commonly results in treatment failure. We compared the efficacy and safety of pretreatment with mifepristone followed by treatment with misoprostol with the efficacy and safety of misoprostol use alone for the management of early pregnancy loss. METHODS: We randomly assigned 300 women who had an anembryonic gestation or in whom embryonic or fetal death was confirmed to receive pretreatment with 200 mg of mifepristone, administered orally, followed by 800 μg of misoprostol, administered vaginally (mifepristone-pretreatment group), or 800 μg of misoprostol alone, administered vaginally (misoprostol-alone group)...
June 7, 2018: New England Journal of Medicine
Jude Moutchia-Suh, Dave-King Moutourou Mouemba, Calypse Asangbe Ngwasiri
BACKGROUND: Progestin-only subdermal implants are one of the most effective contraceptive methods. Anembryonic pregnancy is not reported as a possible outcome in cases of contraceptive failure of these products. We present a rare case of anembryonic pregnancy occurring in a woman with levonorgestrel-releasing implant (JADELLE®). CASE PRESENTATION: A 31-year-old Cameroonian (black African) housewife with a JADELLE® implant for 13 months, consulted at our hospital for a 1-month history of pelvic pain, prolonged menstrual bleeding, and spotting...
April 29, 2018: Journal of Medical Case Reports
C V Bishop, R L Stouffer, D L Takahashi, E C Mishler, M C Wilcox, O D Slayden, C A True
STUDY QUESTION: What are the impacts of elevated testosterone (T) and an obesogenic western-style diet (WSD), either independently or together, on fertility and metabolic adaptations of pregnancy in primates? SUMMARY ANSWER: Testosterone increases the time to achieve pregnancy, while a WSD reduces overall fertility, and the combination of testosterone and WSD additionally impairs glucose tolerance and causes pregnancy loss. WHAT IS KNOWN ALREADY: Both hyperandrogenemia and obesity are hallmarks of polycystic ovary syndrome, which is a leading cause of infertility among women worldwide...
April 1, 2018: Human Reproduction
A Fernlund, L Jokubkiene, P Sladkevicius, L Valentin
OBJECTIVE: To compare vaginal misoprostol treatment with expectant management in early non-viable pregnancy with vaginal bleeding with regard to complete evacuation of the uterine cavity within 10 days after randomization. METHODS: This was a parallel randomized controlled, open-label trial conducted in Skåne University Hospital, Sweden. Patients with anembryonic pregnancy or early fetal demise (crown-rump length ≤ 33 mm) and vaginal bleeding were randomly allocated to either expectant management or treatment with a single dose of 800 μg misoprostol administered vaginally...
January 2018: Ultrasound in Obstetrics & Gynecology
Courtney A Schreiber, Veronica Chavez, Paul G Whittaker, Sarah J Ratcliffe, Ebony Easley, Frances K Barg
OBJECTIVE: To describe the factors patients and physicians prioritize during first-trimester miscarriage management and assess what drives satisfaction with care. METHODS: We conducted a mixed-methods study of clinically stable women seeking surgical, medical, or expectant miscarriage treatment. Women with first-trimester fetal demise or anembryonic gestation (N=55) completed demographic and psychosocial surveys. Using purposive sampling, 45 (82%) completed in-depth interviews...
December 2016: Obstetrics and Gynecology
George Alexandru Filipescu, Andreea Gratiana Boiangiu, Nicoleta Clim, Florin Andrei
Hydatidiform mole represents an abnormal form of conception that occurs in about one in 500-1000 pregnancies. It is a subtype of gestational trophoblastic disease. Hydatidiform moles should be regarded as premalignant lesions because 15-20% of complete hydatidiform moles (CHMs) and 1% of partial hydatidiform moles (PHMs) undergo malignant transformation into invasive moles, choriocarcinomas, or, in rare cases, placental-site trophoblastic tumors (PSTTs). We will illustrate the case of a 26-year-old nulliparous with a seven weeks amenorrhea, positive immunological pregnancy test, a β-HCG value of 136 000 mIU÷mL and minor vaginal bleeding...
2014: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Junaid Rafi, Haroona Khalil
Objective. To find out the success rate of conservative management of complete two weeks for miscarriage in view of NICE Guideline 154. Design. Prospective observational study. Setting. Early pregnancy assessment units of District General Hospital in the United Kingdom. Participants. Women of less than 14 weeks' gestation, with a diagnosis of miscarriage (missed miscarriage/anembryonic or incomplete miscarriage). Interventions. Expectant management for two weeks. Main Outcome Measure. (1) Efficacy of 2-week expectant management, that is, complete resolution of miscarriage based either on self-reporting of patient after passing products of conception at home between D0 and D14 of expectant management or confirmation on scan at D14, and (2) short-term complications needing strong analgesia, blood transfusion, and antibiotics...
2014: Journal of Pregnancy
Aysel Derbent, Zerrin Yılmaz, Serap Simavlı, Ozge Ozer, Nilgün Öztürk Turhan
Ultrasound examination in early pregnancy has steadily gained importance and is now routine for most women in the first trimester. The sonographic features of early trisomy 7 pregnancies are not well characterized. We present a case of trisomy 7 in which early pregnancy ultrasound revealed a gestational sac featuring cystic spaces and no visible embryo. Based on comparison with a previously reported case of trisomy 7 featuring a multicystic anembryonic gestational sac we suggest that this ultrasonographic finding may be a sign of trisomy 7...
2010: Journal of the Turkish German Gynecological Association
Valeria Colleselli, Courtney A Schreiber, Elisabeth D'Costa, Stephanie Mangesius, Ludwig Wildt, Beata E Seeber
PURPOSE: To evaluate the efficacy of a combined protocol of mifepristone and misoprostol in the management of early pregnancy failure (EPF) and the average time to expulsion of tissue and rate of side effects. METHODS: Retrospective chart review of all consecutive women treated with primary medical management for EPF at our institution from 2006 to 2012. RESULTS: 168 patients were included in the present study. The overall success rate, defined as the absence of the need for surgical intervention, was 61 % and did not differ by calendar year...
June 2014: Archives of Gynecology and Obstetrics
Ashish Anantrao Jadhav, Anuradha Jain
Adenosine deaminase (ADA) is an enzyme of purine salvage pathway and has two important isoenzymes ADA1 and ADA2. The activity of ADA has been changed in diseases characterized by altered cell-mediated immunity. It was observed that total serum ADA activity was decreased during normal pregnancy compared with non-pregnant women. However, total serum ADA activity and serum ADA2 activity was increased in hyperemesis gravidarum and pre-eclampsia in pregnant women. Less information is available regarding role of ADA in abortions (recurrent and missed) and anembryonic pregnancies...
May 2013: Archives of Physiology and Biochemistry
Aneta Zwierzchowska, Michał Głuszak, Zoulikha Jabiry-Zieniewicz, Agnieszka Banaszek-Wysoczańska, Wojciech Dziadecki, Ewa Barcz
OBJECTIVES: The aim of our study was to assess the efficacy and safety of medical treatment of non-viable first trimester pregnancy. MATERIAL AND METHODS: We analyzed 50 cases of women diagnosed with non-viable first trimester pregnancy: missed abortion (79.6%) or anembryonic pregnancy (20.4%), who were admitted and treated at the First Clinic of Obstetrics and Gynecology Medical University of Warsaw, between June 2011 and February 2012. The diagnosis was made after two ultrasound examinations, performed at least one week apart...
October 2012: Ginekologia Polska
Nadia Huancahuari
First-trimester vaginal bleeding and abdominal pain are common complaints in the emergency department. The differential diagnosis is broad, ranging from benign conditions to life-threatening complications. This is a difficult topic because it is charged not only with immediate emotional connotations but also with potential long-term effects on the patient's ability to become pregnant again. This article reviews the presentation, diagnosis, and management of implantation bleeding, subchorionic hemorrhage, spontaneous abortion, ectopic pregnancy, heterotopic pregnancy, anembryonic pregnancy, hyperemesis gravidarum, gestational trophoblastic disease, and round ligament syndrome...
November 2012: Emergency Medicine Clinics of North America
Sevki Celen, Necmiye Dover, Berna Seckin, Ufuk Goker, Okan Yenicesu, Nuri Danisman
We showed the utility of first trimester ultrasonography before 11 weeks of gestation for antenatal followup. We retrospectively analyzed 1295 records of patients who underwent first trimester ultrasonography (transvaginal/abdominal) in our antenatal clinic in Ankara, Turkey. Maternal age, parity, gestational age, and maternal gestational history were compared with ultrasonographic findings. Patients were divided into 12 groups based on ultrasonographic diagnoses in the first ultrasonographic scan, and called for a control examination within 10 days if the diagnostic findings were abnormal...
2012: ISRN Obstetrics and Gynecology
Alberto Salamanca, Purificación Fernández-Salmerón, Estanislao Beltrán, Nicolás Mendoza, Jesús Florido, Juan Mozas
PURPOSE: To provide additional information about embryo morphology sonographic assessment and its correlation with yolk sac. METHODS: A systematic study in 200 consecutive cases of missed abortion <10 weeks diagnosed by transvaginal ultrasound. RESULTS: In 104 gestations of embryos with morphological abnormalities, 88 (84.6 %) were at least 1 week smaller than expected for gestational age and 16 (15.4 %) were the expected size. From 32 normal morphologic embryos, 7 (21...
January 2013: Archives of Gynecology and Obstetrics
Caroline Robberecht, Anne Pexsters, Jan Deprest, Jean-Pierre Fryns, Thomas D'Hooghe, Joris Robert Vermeesch
OBJECTIVE: Our knowledge about miscarriages mainly concerns pregnancies of at least 8 weeks' gestation. Information about the morphology and the genetic determinants of early aborted embryos remains limited. In addition, it is known that aneuploidies account for less than half of recurrent spontaneous abortions. We hypothesized that (recurrent) early pregnancy losses might have other genetic causes. METHOD: Products of conception from 51 couples with at least one previous miscarriage were collected by hystero-embryoscopy...
October 2012: Prenatal Diagnosis
Linda W Prine, Honor MacNaughton
The management of early pregnancy loss used to be based largely in the hospital setting, but it has shifted to the outpatient setting, allowing women to remain under the care of their family physician throughout the miscarriage process. Up to 15 percent of recognized pregnancies end in miscarriage, and as many as 80 percent of miscarriages occur in the first trimester, with chromosomal abnormalities as the leading cause. In general, no interventions have been proven to prevent miscarriage; occasionally women can modify their risk factors or receive treatment for relevant medical conditions...
July 1, 2011: American Family Physician
Nasira Tasnim, Ghazala Mahmud, Saba Fatima, Mohsina Sultana
OBJECTIVE: To compare the efficacy, safety and cost-effectiveness of Manual vacuum aspiration (MVA) with Electrical vacuum aspiration (EVA) in the management of first trimester pregnancy loss. METHODS: A single-centre randomized controlled trial (RCT) was conducted at Maternal and Child Health Centre (MCHC), Unit-I, Pakistan Institute of Medical Sciences (PIMS), Islamabad from April 2007-Dec 2008. A total of 176 cases with early pregnancy loss at < 12 weeks gestation, with a diagnosis of anembryonic pregnancy, incomplete, missed or septic induced abortion and molar pregnancy were randomly allocated to either MVA or EVA in the operation theatre...
February 2011: JPMA. the Journal of the Pakistan Medical Association
Marwan Odeh, Rene Tendler, Mohamad Kais, Olga Maximovsky, Ella Ophir, Jacob Bornstein
BACKGROUND: The results of medical treatment for early pregnancy failure are conflicting. OBJECTIVES: To determine whether gestational sac volume measurement as well as other variables can predict the success rate of medical treatment for early pregnancy failure. METHODS: The study group comprised 81 women diagnosed with missed abortion or anembryonic pregnancy who consented to medical treatment. Demographic data were collected and beta-human chorionic gonadotropin level was documented...
June 2010: Israel Medical Association Journal: IMAJ
Fehmi Zeqiri, Myrvete Paçarada, Niltene Kongjeli, Vlora Zeqiri, Gyltene Kongjeli
BACKGROUND: Spontaneous abortion is categorized as threatened, inevitable, incomplete, complete, or missed. Abortion can be further categorized as sporadic or recurrent. By definition, a missed abortion is an in utero death of the embryo or fetus before the 20th week of gestation with retained conception products. Missed abortions may also be referred to as blighted ovum or an anembryonic pregnancy. MATERIALS AND METHODS: A prospective-pathological analysis of 100 missed abortion pregnancies that were diagnosed and treated at the obstetrics-gynecology clinic in Pristina were included...
2010: Medicinski Arhiv
Marwan Odeh, Rene Tendler, Mohamad Kais, Vitali Grinin, Ella Ophir, Jacob Bornstein
PURPOSE: To compare gestational sac (GS) volume (GSV) between normal pregnancies and missed abortions and anembryonic pregnancies and to determine at what gestational age differences in GS volume become evident. METHODS.: GSV in missed abortion and anembryonic pregnancy were measured using three-dimensional ultrasound and the results were compared with GSV in normal pregnancies. Pregnancies between 6 and 12(+6) gestational weeks of age according to last menstrual period were included in normal pregnancies, missed abortions, and anembryonic pregnancies...
September 2010: Journal of Clinical Ultrasound: JCU
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