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First trimester bleeding ultrasound evaluation

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https://www.readbyqxmd.com/read/27720100/ultrasound-evaluation-of-first-trimester-complications-of-pregnancy
#1
Lucie Morin, Yvonne M Cargill, Phyllis Glanc
OBJECTIVE: OUTCOMES:: EVIDENCE: A MEDLINE search and review of bibliographies identified articles was conducted. VALUES: The evidence collected was reviewed by the Diagnostic Imaging Committee of the Society of Obstetricians and Gynaecologists of Canada. The recommendations were made according to the guidelines developed by The Canadian Task Force on Preventive Health Care (Table 1). BENEFITS, HARMS, AND COSTS: Women presenting with first trimester bleeding may be incorrectly diagnosed with a missed abortion, may have an ectopic pregnancy overlooked, or may be inappropriately reassured about viability...
October 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27429697/check-the-head-emergency-ultrasound-diagnosis-of-fetal-anencephaly
#2
John W Hall, Nicolas Denne, Joseph J Minardi, Debra Williams, B J Balcik
BACKGROUND: Early pregnancy complaints in emergency medicine are common. Emergency physicians (EP) increasingly employ ultrasound (US) in the evaluation of these complaints. As a result, it is likely that rare and important diagnoses will be encountered. We report a case of fetal anencephaly diagnosed by bedside emergency US in a patient presenting with first-trimester vaginal bleeding. CASE REPORT: A 33-year-old patient at 10 weeks gestation presented with vaginal bleeding...
July 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26366818/effect-of-menstrual-age-on-failure-of-medical-management-in-women-with-early-pregnancy-loss
#3
Melissa Lavecchia, Haim A Abenhaim
OBJECTIVE: Women with failure of an early pregnancy and a gestational age of <8 weeks are considered good candidates for medical management. The purpose of our study was to evaluate the effect of menstrual age on the outcome of medical management in women with loss of a pregnancy at an estimated gestational age<8 weeks by ultrasound (US). METHODS: We conducted a retrospective cohort study of all women discharged from the emergency department (ED) between 2011 and 2013 with a diagnosis of early pregnancy failure who were managed with misoprostol and who had a gestational age of <8 weeks on US...
July 2015: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/26254150/maximum-peak-systolic-velocity-and-management-of-highly-vascularized-retained-products-of-conception
#4
Thierry Van den Bosch, Dominique Van Schoubroeck, Dirk Timmerman
OBJECTIVES: The purpose of this study was to evaluate blood loss and procedure-related complications during and after surgical removal of retained products of conception with high-velocity enhanced myometrial vascularity. METHODS: We conducted a prospective study of 18 consecutive women with a diagnosis of retained products of conception and enhanced myometrial vascularity, with a peak systolic velocity (PSV) higher than 60 cm/s. All underwent ultrasound-guided surgical removal of the retained products under general anesthesia...
September 2015: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/25852787/omental-pregnancy-case-report-and-review-of-literature
#5
REVIEW
Antonio Maiorana, Domenico Incandela, Laura Giambanco, Walter Alio, Luigi Alio
Pregnancy, the implantation of a fertilized ovum outside the endometrial cavity, occurs in 1.5%-2% of pregnancies. It is one of the major causes (about 6%) of maternal death during the first trimester of pregnancy. The remaining 5% implant in the ovary, peritoneal cavity, within the cervix, and the omental pregnancy is the least common form of abdominal pregnancies. A review of the literature on Medline for the period 1958-2012 reported only 16 cases of omental pregnancy. Here we report a case of primary omental pregnancy in a nulliparous woman...
2014: Pan African Medical Journal
https://www.readbyqxmd.com/read/25457572/pearls-and-pitfalls-in-first-trimester-obstetric-sonography
#6
REVIEW
Fernanda S Mazzariol, Jeffrey Roberts, Sarah K Oh, Zina Ricci, Mordecai Koenigsberg, Marjorie W Stein
Ultrasound is the primary imaging modality used in the evaluation of first-trimester vaginal bleeding and pelvic pain. This article will summarize the ultrasound findings in normal first-trimester pregnancy, failed pregnancy, ectopic pregnancy, subchorionic hemorrhage, retained products of conception, and gestational trophoblastic disease. Mastery of the spectrum of sonographic findings in the normal and abnormal first-trimester pregnancy allows the radiologist to make accurate diagnoses and helps to appropriately guide patient management...
March 2015: Clinical Imaging
https://www.readbyqxmd.com/read/25314282/evaluation-of-waiting-times-and-sonographic-findings-in-patients-with-first-trimester-vaginal-bleeding-at-the-university-hospital-of-the-west-indies-can-emergency-department-ultrasound-make-a-difference
#7
S French, T Henry, E W Williams
BACKGROUND: Pregnant female patients with vaginal bleeding in the first trimester are seen commonly in the Emergency Department (ED) at the University Hospital of the West Indies (UHWI), Kingston, Jamaica. The protocol for the management of these patients requires that they have a sonographic evaluation performed for the purpose of localizing the pregnancy where possible, to assist with determining the risk for an ectopic pregnancy. The ultrasound examinations are performed in the radiology department...
June 2014: West Indian Medical Journal
https://www.readbyqxmd.com/read/24616750/diagnosis-of-emergencies-urgencies-in-gynecology-and-during-the-first-trimester-of-pregnancy
#8
Stefano Zucchini, Elena Marra
Several surgical and/or medical emergencies/urgencies may occur in gynecologic patients and in pregnant women during the first trimester. Particularly, ectopic pregnancies, ruptured or hemorrhagic ovarian cysts, ovarian or adnexal torsions, threatened or inevitable miscarriages, phlogistic gynecological disorders, complications involving the uterine fibroids, endometriosis, and spontaneous uterine rupture are possible acute complications. The diagnosis is suspected on the basis of symptoms (acute pelvic and/or abdominal pain, with or without vaginal bleeding or discharge, until acute abdomen with peritonitis), by means physical evaluation (abdominal, pelvic, and bimanual gynecological examinations), by means of transabdominal (TAS) and/or transvaginal (TVS) sonography, and laboratory tests...
March 2014: Journal of Ultrasound
https://www.readbyqxmd.com/read/24597253/threatened-miscarriage-in-the-first-trimester-and-retrochorial-hematomas-sonographic-evaluation-and-significance
#9
V Soldo, N Cutura, M Zamurovic
BACKGROUND: Vaginal bleeding during the first half of pregnancy occurs in approximately 25% of women and about half of these pregnancies terminate in abortion. In many instances a retrochorial hematoma (RCH) is sonographically found. OBJECTIVE: The aim of the present study was to determine the frequency of a RCH in the group of threatened miscarriages and to examine the possible relationship of parity, previous miscarriages, hematoma size and localization, and duration of vaginal bleeding to pregnancy outcome...
2013: Clinical and Experimental Obstetrics & Gynecology
https://www.readbyqxmd.com/read/23997954/pitfalls-in-emergency-department-focused-bedside-sonography-of-first-trimester-pregnancy
#10
Kerri Layman, Michael Antonis, Jonathan E Davis
Background. Bedside sonography performed by emergency physicians is frequently utilized for real-time clinical decision-making in the emergency department (ED) setting. This includes the sonographic evaluation of pain or bleeding in the first trimester of pregnancy. The detection of intrauterine pregnancy (IUP) or life-threatening conditions, including ectopic pregnancy, is critical. Objectives. This paper will review several important pearls and avoidable pitfalls of this diagnostic modality by brief presentation of illustrative cases followed by discussion of key principles...
2013: Emergency Medicine International
https://www.readbyqxmd.com/read/23980057/external-validation-of-models-and-simple-scoring-systems-to-predict-miscarriage-in-intrauterine-pregnancies-of-uncertain-viability
#11
MULTICENTER STUDY
S Guha, V Van Belle, C Bottomley, J Preisler, V Vathanan, A Sayasneh, C Stalder, D Timmerman, T Bourne
STUDY QUESTION: Does a logistic regression model and scoring system to predict viability of an intrauterine pregnancy of uncertain viability (PUV) perform as well in an independent patient group as the original patient group? SUMMARY ANSWER: The model and scoring system showed good performance on external validation confirming their value for the prediction of miscarriage/viability in PUV patients up to 11-14 weeks of gestation. WHAT IS KNOWN ALREADY: Several individual ultrasound and demographic factors have been described as predictors for miscarriage...
November 2013: Human Reproduction
https://www.readbyqxmd.com/read/23665531/acr-appropriateness-criteria%C3%A2-first-trimester-bleeding
#12
Barton F Lane, Jade J Wong-You-Cheong, Marcia C Javitt, Phyllis Glanc, Douglas L Brown, Theodore Dubinsky, Mukesh G Harisinghani, Robert D Harris, Nadia J Khati, Donald G Mitchell, Pari V Pandharipande, Harpreet K Pannu, Anne E Podrasky, Thomas D Shipp, Cary Lynn Siegel, Lynn Simpson, Darci J Wall, Carolyn M Zelop
Vaginal bleeding is not uncommon in the first trimester of pregnancy. Ultrasound is the foremost modality for evaluating normal development of the gestational sac and embryo and for discriminating the causes of bleeding. While correlation with quantitative βHCG and clinical presentation is essential, sonographic criteria permit diagnosis of failed pregnancies, ectopic pregnancy, gestational trophoblastic disease and spontaneous abortion. The American College of Radiology Appropriateness Criteria guidelines have been updated to incorporate recent data...
June 2013: Ultrasound Quarterly
https://www.readbyqxmd.com/read/23405996/a-prediction-model-for-viability-at-the-end-of-the-first-trimester-after-a-single-early-pregnancy-evaluation
#13
Jennifer Oates, Ishwari Casikar, Anna Campain, Samuel Müller, Jean Yang, Shannon Reid, George Condous
OBJECTIVE: The aim was to develop a new model to predict the outcome at the end of the 1st trimester after a single visit to the early pregnancy unit (EPU). METHODS: Prospective observational study in the EPU at Nepean Hospital, between November 2006 and February 2009. Data were collected from all women in the 1st trimester of their pregnancy who had a live intrauterine pregnancy (IUP) at the 1st transvaginal ultrasound scan (TVS). 29 historical, clinical and ultrasound end points were recorded...
February 2013: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/22921048/clinical-policy-critical-issues-in-the-initial-evaluation-and-management-of-patients-presenting-to-the-emergency-department-in-early-pregnancy
#14
Sigrid A Hahn, Eric J Lavonas, Sharon E Mace, Anthony M Napoli, Francis M Fesmire
This clinical policy from the American College of Emergency Physicians is the revision of the 2003 Clinical Policy: Critical Issues in the Initial Evaluation and Management of Patients Presenting to the Emergency Department in Early Pregnancy.(1) A writing subcommittee reviewed the literature to derive evidence-based recommendations to help clinicians answer the following critical questions: (1) Should the emergency physician obtain a pelvic ultrasound in a clinically stable pregnant patient who presents to the emergency department (ED) with abdominal pain and/or vaginal bleeding and a beta human chorionic gonadotropin (β-hCG) level below a discriminatory threshold? (2) In patients who have an indeterminate transvaginal ultrasound, what is the diagnostic utility of β-hCG for predicting possible ectopic pregnancy? (3) In patients receiving methotrexate for confirmed or suspected ectopic pregnancy, what are the implications for ED management? Evidence was graded and recommendations were developed based on the strength of the available data in the medical literature...
September 2012: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/22333281/-clinical-analysis-of-20-pregnant-women-with-venous-thromboembolic-disease
#15
Ping Sun, Dian-ning Dong
OBJECTIVE: To evaluate the clinical features, diagnostic methods and treatment of venous thromboembolic disease (VTE) during pregnancy. METHODS: From June 2006 to June 2011, a total of 20 pregnant women were diagnosed VTE at the Department of Obstetrics and Gynaecology, Qilu Hospital of Shandong University. Clinical data of these patients were analyzed retrospectively. RESULTS: (1) Characteristics of patients:the symptoms of all the 20 patients commenced in pregnancy...
December 2011: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/22306395/accuracy-of-emergency-physicians-using-ultrasound-measurement-of-crown-rump-length-to-estimate-gestational-age-in-pregnant-females
#16
Caitlin Bailey, Jennifer Carnell, Farnaz Vahidnia, Sachita Shah, Michael Stone, Mickeye Adams, Arun Nagdev
STUDY OBJECTIVE: The objective of this study is to evaluate the accuracy of emergency providers (EPs) of various levels of training in determination of gestational age (GA) in pregnant patients using bedside ultrasound measurement of crown-rump length (CRL). METHODS: We conducted a prospective, cross-sectional, observational study of patients in obstetrical care at an urban county hospital. We enrolled a convenience sample of women at 6 to 14 weeks gestation as estimated by last menstrual period...
October 2012: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/22302719/effect-of-letrozole-on-uterine-artery-doppler-flow-indices-prior-to-first-trimester-termination-of-pregnancy-a-randomized-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
V C Y Lee, T W Y Yeung, O S Tang, E H Y Ng, W S B Yeung, P C Ho
OBJECTIVE: We previously demonstrated that a sequential regimen of letrozole and misoprostol resulted in a marked reduction in the serum estradiol concentration and in a higher efficacy of first-trimester termination of pregnancy than misoprostol alone. The aim of this study was to evaluate the effect of letrozole on uterine artery Doppler flow indices during early pregnancy. METHODS: This was a randomized controlled trial. Thirty women requesting termination of pregnancy up to 63 days' gestation were randomized into two groups: a letrozole group receiving 10 mg of letrozole, daily, for 3 days, and a control group receiving a placebo for 3 days...
October 2012: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/22133802/sonographic-cervical-length-vaginal-bleeding-and-the-risk-of-preterm-birth
#18
Devon M Ramaeker, Hyagriv N Simhan
OBJECTIVE: We sought to evaluate the contributions of vaginal bleeding and cervical length to the risk of preterm birth. STUDY DESIGN: This was a secondary analysis of a cohort study designed to study predictors of preterm birth. The study included 2988 women with singleton gestations. Women underwent midtrimester transvaginal ultrasound assessment of cervical length and were queried regarding first- and second-trimester vaginal bleeding. RESULTS: There was a significant second-order relation between cervical length and preterm birth (P < ...
March 2012: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/21860144/clinical-pattern-of-gynecological-early-pregnancy-complaints-and-the-outcome-of-pelvic-sonography-in-a-private-diagnostic-center-in-ilorin
#19
A E Oguntoyinbo, A P Aboyeji
BACKGROUND: Gynecological and early pregnancy complaints (GEPC)/lower abdominal complaints (LAC) are common in female patients seeking medical advice or treatments. Clinical limitations of GEPC or LAC are better resolved through appropriate laboratory and imaging investigation, among which the ultrasound examination (USS) is one. AIM: To determine the distribution/clinical pattern of female patients with GEPC/LAC, and to evaluate the correlation between the clinical and sonographical diagnoses, as seen in a private diagnostic center in the Ilorin metropolis...
April 2011: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/21719231/fetal-outcomes-in-first-trimester-pregnancies-with-an-indeterminate-ultrasound
#20
Michael L Juliano, Bettina M Sauter
BACKGROUND: Pregnant women commonly present to the Emergency Department (ED) for evaluation during their first trimester. These women have many concerns, one of which is the viability of their pregnancy and the probability of miscarriage. STUDY OBJECTIVES: We sought to determine fetal outcomes of women with an indeterminate ultrasound who present to the ED during the first trimester of pregnancy. METHODS: A retrospective analysis of consecutive ED patient encounters from December 2005 to September 2006 was performed to identify patients who were pregnant and who had an indeterminate transvaginal ultrasound performed by an emergency physician or through the Radiology Department during their ED visit...
September 2012: Journal of Emergency Medicine
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