BACKGROUND: Prior to the availability of modern laparoscopic surgical techniques and equipment, ectopic pregnancy was managed predominately by laparotomy. An alternative surgical approach, by posterior colpotomy, was advocated as a diagnostic and a therapeutic approach that often avoided laparotomy. CASES: We report two recent cases in which ectopic pregnancies were ...

To evaluate three strategies for diagnosis of women at risk for ectopic pregnancy based on information collected at initial presentation. Strength of association for risk factors, signs, and symptoms obtained at initial presentation of women with pain, bleeding, or both in a first-trimester pregnancy and a nondiagnostic ultrasound examination were ...

PURPOSE: To investigate the incidence of Tubal Ectopic Pregnancies (TEP) in IVF-ET patients with respect to the status of the fallopian tubes after a previous TEP. MATERIAL AND METHODS: This retrospective study compares patients undergoing 481 IVF-ET cycles after conservatively or surgically treated TEP(s) with a Control Group (idiopathic or ...

When in evolutionary history did long-range projectile weapons become an important component of hunting toolkits? The archeological evidence for the development of projectile weaponry is complex and generally indirect, and has led to different conclusions about the origin and spread of this technology. Lithic evidence from the Middle Stone Age ...

Ultrasound has remained the primary modality for investigating the pelvis of women in the reproductive age group, especially in an emergency setting. Recognition of different sonographic presentations, including typical and atypical findings of ectopic pregnancy, is important to determine surgical or nonsurgical management. This pictorial review article will exemplify different ...

Ectopic pregnancy accounts for approximately 2% of all pregnancies and is the most common cause of pregnancy-related mortality in the first trimester. Initial evaluation consists of hormonal assays and pelvic ultrasonography (US). A history of pelvic pain along with an abnormal beta human chorionic gonadotropin level should trigger an evaluation ...

BACKGROUND: Pregnancy is a well-known risk factor for central serous chorioretinopathy (CSCR). METHODS: Patients were examined using slit-lamp biomicroscopy, fundus examination, fundus photography, and optical coherence tomography, making note of best-corrected visual acuity. RESULTS: All patients had resolution of CSCR. INTERPRETATION: We present CSCR in 3 consecutive pregnant women without ...

PURPOSE OF REVIEW: Ectopic pregnancy continues to be an important cause of morbidity and mortality in women. Tubal damage is the likely cause of ectopic pregnancy. Healthcare providers who care for adolescents must screen for and treat sexually transmitted diseases like Chlamydia in order to decrease the risk of tubal ...

Acute pelvic pain in the female patient can have myriad presentations and, depending on the diagnosis, profound consequences. In the pregnant patient with pelvic pain or bleeding, an ectopic pregnancy must be first excluded. Ultrasound is important in determining the size and location of the ectopic pregnancy, and presence of ...

The introduction of highly sensitive methods, such as transvaginal sonography and measurement of serum b-human chorionic gonadotropin, has dramatically improved ectopic pregnancy diagnosis in recent years. Early diagnosis is the key to successful and conservative management of women with ectopic pregnancy; however, approximately 50 percent of such women are initially ...

Without fibrinogen replacement, pregnancies in patients with congenital afibrinogenemia end in miscarriage between 6 and 8 weeks of gestation. Studies in animal models suggest that disturbance of the embryo's decidual attachment contributes to miscarriage in afibrinogenemia. Ectopic pregnancy in human congenital afibrinogenemia has not been previously documented. We present a ...

BACKGROUND: The present study aims to investigate the predictive power of serum CA-125 and lactate dehydrogenase (LDH) for evaluating the outcome of first trimester pregnancies with beta human chorionic gonadotropin levels below discriminatory zone (<or=1,000 mIU/mL). METHODS: A total of 107 women with tubal ectopic pregnancies (30 ruptured and 77 ...

INTRODUCTION: Ectopic pregnancy is a significant cause of maternal morbidity and mortality. The widely used features to establish the diagnosis of ectopic pregnancy are not always sufficient to predict rupture. PROBLEM: To determine the risk factors for rupture of an ectopic pregnancy to help physicians identify those women who are ...

A pregnancy of unknown location (PUL) is a descriptive term used to classify a woman when she has a positive pregnancy test but no intra- or extra-uterine pregnancy is visualized on transvaginal sonography. Expectant management has been shown to be safe for the majority of women with a PUL. Serum ...

Heterotopic pregnancy is the simultaneous existence of intrauterine and ectopic gestations. Heterotopic pregnancy is an extremely rare entity in natural cycle; however, it is increasing due to widespread use of assisted reproductive techniques. Early diagnosis and intervention are crucial in avoiding short- and long-term morbidity and mortality. Unfortunately, early diagnosis ...

OBJECTIVE: To compare the size of the genital hiatus in women wearing a pessary for pelvic organ prolapse after consistent pessary use, describe characteristics of patients who continue use, and assess change in pelvic floor symptoms. METHODS: This was an observational cohort study of 90 women seeking nonsurgical management of ...

Early pregnancy failure and ectopic pregnancy are common clinical diagnoses for which ultrasound can provide useful information. This review explores the use of ultrasound to diagnose early pregnancy failure and ectopic pregnancy. By documenting the developmental milestones of early normal pregnancy using ultrasound, clinicians can distinguish normal from abnormal intrauterine ...

OBJECTIVE: To present a case and management of an early ectopic pregnancy on the portio. DESIGN: Case study and literature review. SETTING: Hospital outpatient clinic. PATIENT(S): A 38-year-old woman who presented in the outpatient clinic with a 2-week history of painless acyclic vaginal bleeding. INTERVENTION(S): Excision of the ectopic pregnancy ...

The parkinsonian variant of multiple system atrophy (MSA-P) can be difficult to differentiate from Parkinson's disease (PD). This Practice Point commentary discusses a multicenter study performed by the European MSA Study Group that sought to determine whether certain clinical features could serve as 'red flags', or warning signs, to assist ...

BACKGROUND: Recurrence of ectopic pregnancy is usually associated with assisted reproductive techniques, being less likely to occur after natural conception. CASE: We report the case of a patient who had three consecutive ectopic pregnancies on the ipsilateral side after natural conception and was treated surgically in each case with partial ...

We set out to evaluate the effect of a programme introduced in January 2003 to make operative laparoscopy the standard surgical treatment for women requiring surgery for ectopic pregnancy. This was a retrospective and prospective clinical data analysis performed at The Whipps Cross University Hospital in London, with a comparison ...

Not much more than a century ago, a ruptured ectopic pregnancy was a death sentence. In 1876, John Parry wrote in his book on this subject: 'Here is a wife in the most useful period of her existence, which good authorities have said is never cured; and for which, even ...

Vaginal bleeding is the most common cause of presentation to the emergency department in the first trimester. Approximately half of patients with first trimester vaginal bleeding will lose the pregnancy. Clinical assessment is difficult, and sonography is necessary to determine if a normal fetus is present and alive and to ...

Ectopic pregnancy in the interstitial part of the fallopian tube is a rare event. This condition presents a challenge for clinical as well as radiological diagnosis. Although routine two-dimensional ultrasound can be suggestive, three-dimensional ultrasound is highly accurate in diagnosis. Hence, the authors report a rare case of interstitial ectopic ...

Heterotopic pregnancy (HP) is the co-existence of intrauterine and ectopic pregnancies; it is said to be rare. We report the case of a 22 year old woman with HP after unsuccessful attempts at abortion. This report illustrates the treatment difficulties encountered in a delayed presentation, and the nature HP is ...

To study the surgical morbidity associated with laparoscopic management of tubal ectopic pregnancy compared with that of open laparotomy. A retrospective study in an academic tertiary obstetrics and gynecology referral center was conducted from 2005 through 2007. Forty-nine patients who had pathology-confirmed tubal ectopic pregnancies were divided into 2 groups, ...

OBJECTIVES: The aim of this study was to investigate gray matter volume changes in narcolepsy. MATERIALS AND METHODS: An optimized voxel-based morphometry was conducted for 17 young adults with a sole diagnosis of human leukocyte antigen DQB(1) 0602 positive narcolepsy with cataplexy (26.6 +/- 5.2 years old) and 17 comparison ...

An ectopic pregnancy after a hysterectomy is a rare event, with about 40 reported cases since it was first identified by Wendeler in 1895. There are even fewer cases reported of an ectopic pregnancy occurring years after a hysterectomy has been performed. This case illustrates the sonographic and computed tomographic ...

Human endometrium undergoes modifications in preparation for embryonic implantation. This study investigated in vivo the endocrine effects of pregnancy on the endometrium, using the model of ectopic pregnancy. Endometrial biopsies from 9 subjects with ectopic pregnancy (Preg) were compared with 8 and 6 samples of mid and late secretory endometrium, ...

OBJECTIVE: We report an unusual case of recurrent ectopic pregnancy in the distal remnant after partial salpingectomy. CASE REPORT: A 23-year-old woman underwent laparoscopic right partial salpingectomy because of right tubal pregnancy. She returned to our hospital 2 years later with a positive pregnancy test and lower abdominal pain. Transvaginal ...

Abdominal pregnancy is a rare event that occurs in western countries in 1.3% of ectopic gestations. Delayed diagnosis and attempted removal of the fetus have occasionally resulted in massive and even fatal intraperitoneal hemorrhage. We present a case of an ectopic pregnancy at the intraabdominal surface of the left diaphragm, ...

BACKGROUND: Concurrent ectopic pregnancy and acute appendicitis is rarely encountered. Since 1960, only 22 cases have been reported. No case of concurrent interstitial ectopic pregnancy and appendicitis has ever been reported. CASE: A 24-year-old, African American woman, gravida 4, para 3, had a right interstitial ectopic pregnancy. She was managed ...

Ultrasound technology and in particular the use of transvaginal imaging has taken the guesswork out of ectopic pregnancy diagnosis. The vast majority of ectopic pregnancies can and should be diagnosed with a high degree of certainty before management is commenced. More and more women with ectopic pregnancy are eligible for ...

Omental pregnancy is a rare form of ectopic pregnancy, and can be seen primarily or secondary to a tubal pregnancy. A 25-year-old woman presented with abdominal distention with pain and anemia without vaginal bleeding. After a provisional diagnosis of ruptured ectopic pregnancy, laparotomy was performed. On surgical exploration, the bilateral ...

Ovarian pregnancy is a rare variant of ectopic gestation. The diagnosis is often made at surgery and requires histological confirmation. The condition has not been reported locally and its diagnosis is easily missed. A case of an ovarian ectopic pregnancy in a 41 year old para 1 + 1 with ...

CONTEXT: Ectopic pregnancy is common but remains difficult to diagnose accurately. There is no serum test to differentiate ectopic from intrauterine gestation. OBJECTIVE: Our objective was to investigate differential gene expression in decidualized endometrium of ectopic pregnancy. DESIGN: Tissue and serum analysis informed by microarray study was performed. SETTING: The ...

OBJECTIVES: To assess the diagnostic process, laparoscopic treatment and postoperative period in patients hospitalized with a suspicion of ectopic pregnancy. MATERIALS AND METHODS: 211 women who underwent a typical laparoscopic surgery due to ectopic pregnancy, from 1993 through to 2006, were included in the study. The diagnosis was based on ...

Nephrogenic systemic fibrosis (NSF) is a recently recognized clinicopathologic entity. It is believed to be related to exposure to gadolinium-containing magnetic resonance imaging agents with gadolinium deposition in the tissues, including skin and other organs. It mainly affects patients on dialysis therapy. Pregnancy in dialysis patients is a rare occurrence. ...

OBJECTIVE: To describe a case of ruptured ectopic pregnancy and contralateral adnexal torsion after spontaneous conception. DESIGN: Case report. SETTING: Tertiary university medical center. PATIENT(S): A 23-year-old multiparous female with severe bilateral pelvic pain and a positive pregnancy test. INTERVENTION(S): Operative laparoscopy with detorsion of left adnexa, drainage of left ...

The current management of ectopic pregnancy in a main teaching hospital was reviewed in the lead up to the amalgamation of the services of three maternity hospitals. A retrospective analysis of 54 women treated surgically for suspected ectopic pregnancy from January 2005 to May 2006 was carried out. The diagnosis ...

Heterotropic pregnancy is reported infrequently in Nigeria. Two cases were managed within the span of five years with the successful delivery of a live term baby in one of the patients. A high clinical index of suspicion is required because an intra uterine gestation does not rule out a co-existing ...

OBJECTIVE: To present two cases of ectopic twin pregnancy in a Cesarean section scar following IVF-embryo transfer. DESIGN: Case report. SETTING: Tertiary referral case center. PATIENT(S): Two women who had ectopic twin pregnancy in a Cesarean section scar, in both cases following IVF and embryo transfer. INTERVENTION(S): Three-dimensional power Doppler ...

This is a retrospective case note analysis of 105 suspected cases of ectopic pregnancies that underwent laparoscopy within a stipulated 12-month period, September 2001 to August 2002. The management and care of these women was reviewed using the Royal College of Obstetricians and Gynaecologists' (RCOG) guidelines on management of ectopic ...

PURPOSE OF REVIEW: Genital Chlamydia trachomatis is common among young, sexually active people. Infections are most often asymptomatic but have potential long-term consequences for female reproductive health. The link between C. trachomatis and ectopic pregnancy is mainly based on early seroepidemiological case-control studies including women who had their sexual debut ...

BACKGROUND: Venous air embolism due to orogenital sex in pregnancy is an uncommon clinical event. CASE: A previously healthy, 29-week pregnant woman presented to the emergency room unconscious 1 hour after engaging in orogenital sex with her partner. The cardiology service was consulted due to troponin elevation. Assessment was that ...

The spread of Foam Sclerotherapy has resulted in the renaissance of sclerotherapy as a non-invasive treatment method for varicosis. The use of sclerosant foam for various forms of varicosis has now become established world-wide as safe and effective. An expanded European expert committee meeting in April 2006, in Tegernsee was ...

BACKGROUND: Ectopic pregnancy in a cesarean scar is a rare but well-recognized potential complication of cesarean delivery. Multiple risk factors exist, including prior uterine surgery, a history of uterine infections such as endomyometritis, and a brief interval between uterine surgery and subsequent conception. It is important to recognize such cases ...

PROBLEM: This prospective study was aimed to evaluate whether non-invasive clinical and serologic parameters of tubal disease are predictive for subsequent spontaneous conception and pregnancy outcome after first episode of ectopic pregnancy (EP). METHOD OF STUDY: Overall, 144 women aged <35 years were enrolled. Outcome of subsequent spontaneous conception was ...

BACKGROUND: Expeditionary military facilities care for deployed military personnel. They deploy with limited equipment and personnel to austere environments. Female military personnel are deployed forward in a support capacity. Under these conditions, ectopic pregnancy continues to be a potential catastrophe leading to maternal death. CASES: We report three cases of ...

BACKGROUND: To determine a pattern of symptoms and/or risk factors that distinguishes transient ischemic attack (TIA) from nonischemic causes of transient neurologic attacks (NI-TNA). METHODS: We reviewed demographic, clinical, and hospital data on 100 consecutive patients with transient focal neurologic episode(s) lasting less than 24 h and in whom the ...