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Ultrasound evaluation first trimester pregnancy complications

Francesco Cosentino, Cristiano Rossitto, Luigi Carlo Turco, Salvatore Gueli Alletti, Carmine Vascone, Lavinia Di Meglio, Giovanni Scambia, Mario Malzoni
CASE REPORT OBJECTIVE: To show the surgical management in laparoscopy of a particular localization of an extra-uterine pregnancy misunderstood until 12 week of EG complicated by hemoperitoneum and abortion. BACKGROUND: The prevalence of ectopic pregnancy among women who go to an emergency department with first trimester bleeding, pain, or both ranges from 1 to 16 percent [1]. The most common localization of ectopic pregnancy are the Fallopian tubes while abdominal pregnancy represent at least 1 percent of extra-uterine pregnancies...
February 4, 2017: Journal of Minimally Invasive Gynecology
İlker Murat Arer, Songül Alemdaroğlu, Hasan Yeşilağaç, Hakan Yabanoğlu
BACKGROUND: Acute appendicitis (AA) is the most common cause of acute abdomen during pregnancy. Most of the signs of appendicitis are also found during normal pregnancy period, however, and diagnosis of appendicitis during pregnancy remains challenging. The aim of the current study was to report our clinical experience of AA during pregnancy and investigate optimal management of this difficult situation. METHODS: Records of 20 pregnant women with diagnosis of AA who underwent appendectomy between 2005 and 2015 were included in this study...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Susanna Holmlund, Tommi Kauko, Jaakko Matomäki, Miia Tuominen, Juha Mäkinen, Päivi Rautava
BACKGROUND: To date, several studies concerning the effects of induced abortion (IA) on women's later psychosocial well-being and future delivery complications have been published. However, the lack of reports on woman's physical well-being during their first full-term pregnancy occurring after IA is what inspired the current study. Here, we evaluate the physical well-being and use of maternity services of first-time mothers with a history of IA. METHODS: Finnish National Birth Registry data from 2008 to 2010 were linked with the Induced Abortion Registry data from 1983 to 2007...
October 24, 2016: BMC Pregnancy and Childbirth
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
Roberto Negro, Roberto Attanasio, Franco Grimaldi, Rinaldo Guglielmi, Enrico Papini
BACKGROUND: Patients suffering from Graves' disease (GD) are quite frequent in endocrine clinical practice. In particular, overt hyperthyroidism may be complicated by serious adverse events and requires careful treatment, but its management has changed over the years in both the USA and European Union (EU). OBJECTIVES: To evaluate the current diagnosis and management of patient's with GD in Italy, and compare results with those obtained in previous similar surveys in the USA and EU...
July 2016: European Thyroid Journal
Manisha Kumar, Shalini Singh, Karuna Sharma, Ritu Singh, V Ravi, J Bhattacharya
AIMS AND OBJECTIVES: To evaluate the predictive value of first trimester biomarkers and ultrasound in determining adverse fetal outcomes in a low risk Asian population. MATERIAL AND METHOD: All low risk, singleton pregnancies between 11 and 14 weeks gestation underwent ultrasound with uterine artery Doppler along with PAPP-A and free β-hCG estimation, and were followed till delivery to observe the outcome. The adverse fetal outcomes detected were structural anomaly, aneuploidy, intrauterine growth restriction, preterm birth and stillbirth (SB)...
August 10, 2016: Journal of Maternal-fetal & Neonatal Medicine
Jiri D Sonek, Karl Oliver Kagan, Kypros H Nicolaides
First-trimester pregnancy evaluation using fetal and maternal parameters not only allows for diagnoses to be made early in gestation but can also assess the risk of complications that become clinically evident later in pregnancy. This evaluation makes it possible for pregnancy care to be individualized. In select cases, treatment that reduces the risk of complications can be started early in pregnancy. Even though cell free DNA is a significant advance in diagnosing fetal aneuploidy, the combination of first-trimester ultrasound and maternal serum biochemistries casts a much wider diagnostic net; therefore, the 2 technologies are best used in combination...
June 2016: Clinics in Laboratory Medicine
A T Papageorghiou, B Kemp, W Stones, E O Ohuma, S H Kennedy, M Purwar, L J Salomon, D G Altman, J A Noble, E Bertino, M G Gravett, R Pang, L Cheikh Ismail, F C Barros, A Lambert, Y A Jaffer, C G Victora, Z A Bhutta, J Villar
OBJECTIVE: Accurate gestational-age (GA) estimation, preferably by ultrasound measurement of fetal crown-rump length before 14 weeks' gestation, is an important component of high-quality antenatal care. The objective of this study was to determine how GA can best be estimated by fetal ultrasound for women who present for the first time late in pregnancy with uncertain or unknown menstrual dates. METHODS: INTERGROWTH-21(st) was a large, prospective, multicenter, population-based project performed in eight geographically defined urban populations...
December 2016: Ultrasound in Obstetrics & Gynecology
Puyu Yang, Jun Zhang, Yanna Li, Hui Wang, Jun Zheng
OBJECTIVE: To evaluate the clinical characteristics of aortic dissection in pregnant patients with Marfan syndrome and the maternal and fetal outcomes in cardiovascular surgery. METHODS: Seven pregnant women with Marfan syndrome with aortic dissection were identified, who were treated in Beijing Anzhen Hospital Affiliated to Capital Medical University between January 2012 and September 2014. Patient charts were reviewed for cardiovascular surgery, occurrence of complications, clinical features and the maternal and fetal outcomes...
May 2015: Zhonghua Fu Chan Ke za Zhi
Ashraf F Hefny, Fathima T Kunhivalappil, Ritu Nambiar, Masoud O Bashir
INTRODUCTION: Bicornuate uterus (BU) is a rare uterine anomaly result from incomplete fusion of the two Müllerian ducts during embryogenesis. BU very rarely can lead to rupture of the uterus during the early pregnancy with high mortality and morbidity rates. PRESENTATION OF CASE: A primigravida in the first trimester (9 weeks) presented complaining of epigastric pain and vomiting for one day. Ultrasound scan was performed at the 7th week of pregnancy and showed a BU with single intrauterine gestational sac in the right horn...
2015: International Journal of Surgery Case Reports
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
Mohammed Malak, Stephanie Klam
Primary fallopian tube cancer in pregnancy is rare and is even more so for the clear cell variant. Our case is the third case of primary fallopian tube cancer in pregnancy and the first case of clear cell adenocarcinoma of the fallopian tube in pregnancy. The patient presented with increasing pelvic pain starting in the second trimester. Serial ultrasound evaluations were performed and revealed a rapidly growing complex adnexal mass adjacent to the uterus. Her pregnancy was further complicated by spontaneous preterm labor and she delivered prematurely per vaginam at 31 weeks...
2015: Case Reports in Obstetrics and Gynecology
Nova L Panebianco, Frances Shofer, J Matthew Fields, Kenton Anderson, Alessandro Mangili, Asako C Matsuura, Anthony J Dean
BACKGROUND: For patients with early intrauterine pregnancy (IUP), the sonographic signs of the gestation may be below the resolution of transabdominal ultrasound (TAU); however, it may be identified by transvaginal ultrasound (TVU). We sought to determine how often TVU performed in the emergency department (ED) reveals a viable IUP after a nondiagnostic ED TAU and the impact of ED TVU on patient length of stay (LOS). METHODS: This was a retrospective cohort study of women presenting to our ED with complications of early pregnancy from January 1, 2007 to February 28, 2009 in a single urban adult ED...
June 2015: American Journal of Emergency Medicine
Zachary DelProposto, Matthew Rheinboldt
First trimester ultrasound is commonly performed to establish dates or evaluate early pregnancy complications. With improvement in ultrasound technology, visualization of fetal structures has improved. While the emergent evaluation does not typically focus on detailed fetal anatomic evaluation (since this is typically performed at 18-20 weeks), various fetal structural abnormalities can now be visualized, especially during the late first trimester and early second trimester. We present a pictorial review of potential pitfalls encountered in early obstetric ultrasound with an emphasis on fetal structural abnormalities as well as normal fetal anatomy that can be confused with developmental abnormalities...
October 2015: Emergency Radiology
Akiko Yamashita, Keisuke Ishii, Nobuhiro Hidaka, Naoto Yonetani, Shusaku Hayashi, Makoto Takeuchi, Nobuaki Mitsuda
In this report, we present a case of twin-twin transfusion syndrome in the presence of the thick dividing wall of each sac in dichorionic twins. The dichorionic diagnosis was based on the presence of the lambda sign at the first-trimester ultrasound evaluation. In addition to fetoscopic and pathological investigation, DNA typing confirmed that the twin set was monochorionic and monozygotic. This case illustrates that although extremely uncommon, the presence of lambda sign does not exclude monochorionic pregnancy...
2015: Fetal Diagnosis and Therapy
Peter M Doubilet
Ultrasound is a valuable diagnostic test throughout the first trimester of pregnancy. Early in this trimester, it is used to distinguish between normal intrauterine, failed intrauterine, and ectopic pregnancies. Later it can be used with maternal blood tests to screen for trisomy 21 and other forms of aneuploidy, and in some centers to assess fetal anatomy and diagnose structural anomalies. First trimester sonography is also useful for accurate assessment of gestational age. This article reviews these applications, the approach to establishing diagnoses, and ways to avoid diagnostic mistakes that can lead to serious errors in patient management and adverse pregnancy outcome...
November 2014: Radiologic Clinics of North America
Lauren H Theilen, Vincent M Mellnick, Ryan E Longman, Methodius G Tuuli, Anthony O Odibo, George A Macones, Alison G Cahill
OBJECTIVE: The purpose of this study was to estimate the rate and risk of appendix nonvisualization and alternative diagnoses made with magnetic resonance imaging (MRI) for suspected appendicitis in pregnant women. STUDY DESIGN: We performed a retrospective cohort study of consecutive pregnant women who underwent MRI for suspected appendicitis at a single center from 2007-2012. Data on clinical presentation, imaging, and surgical pathologic evidence were extracted from electronic medical records...
March 2015: American Journal of Obstetrics and Gynecology
Małgorzata Gietka-Czernel, Marzena Dębska, Piotr Kretowicz, Wojciech Zgliczyński, Mariusz Ołtarzewski
INTRODUCTION: To evaluate the usefulness of measuring maternal anti-TSH receptor antibodies (TRAbs) and foetal ultrasound (US) monitoring in cases of current or past maternal hyperthyroidism. MATERIAL AND METHODS: 77 pregnant women suffering from hyperthyroidism or with a history of Graves' hyperthyroidism were observed prospectively. Maternal serum TSH, fT4, fT3, TRAbs, and foetal US were performed at baseline and repeated every 2-4 weeks when needed. Neonatal thyroid status was assessed based on serum TSH, fT4 and fT3 obtained in the first days of life...
2014: Endokrynologia Polska
Kenneth J Moise
Until recently, all twin pregnancies were treated in a similar fashion. Ultrasounds were undertaken every 3 to 4 weeks to assess serial fetal growth. Monochorionic (MC) twins comprise only 20% of all twin pregnancies yet unique complications such as twin-twin transfusion syndrome (TTTS), twin reversed arterial perfusion sequence, twin anemia-polycythemia sequence, and selective intrauterine growth restriction can occur. In addition, the in utero death of one twin of a MC pair poses significant risks for death or severe neurologic morbidity in the cotwin...
September 2014: American Journal of Perinatology
João L G Teixeira, Paola Rabaioli, Ricardo F Savaris
OBJECTIVE: To evaluate the performance of a commercial urinary test to screen for abnormal first trimester pregnancies in women presenting to an emergency room. STUDY DESIGN: In this prospective observational cohort, women with a confirmed first trimester pregnancy (gestational age <12 weeks) provided a urine sample for diagnosing the viability of their gestation. Pregnancy viability and location testing were confirmed by ultrasound and/or laparoscopy. RESULTS: From 815 eligible patients for the study, 12 were excluded for not having a confirmed pregnancy (n = 6) or were lost to follow-up (n = 6)...
January 2015: American Journal of Obstetrics and Gynecology
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