OBJECTIVE: To study the value of creatine kinase in ectopic pregnancy with reference to tubal histopathology. DESIGN: Prospective controlled study. SETTING: Academic tertiary-care institution. POPULATION: Thirty-two women with ectopic pregnancy and 20 controls with intrauterine pregnancies. METHODS: Creatine kinase and beta-hCG levels were measured on admission. Ectopic pregnancies were removed ...

OBJECTIVE: To assess the incidence of ectopic pregnancy (EP) in hospitals in Conakry, the capital of Guinea, West Africa. Data on EP incidence in developing countries are rare and often out of date, particularly in Africa. METHODS: A retrospective study was carried out, examining all cases of EP registered in ...

Ectopic pregnancy is a leading cause of pregnancy-related deaths; its incidence has progressively increased in recent years. Spontaneous twin ectopic pregnancy, however, is extremely rare. Among more than 100 reported cases of twin tubal pregnancies, only 5 cases in which fetal cardiac motion has been visualized in both embryos have ...

Intramural pregnancy is the rarest type of ectopic pregnancy and almost always is diagnosed intraoperatively. It constitutes less than 1% of ectopic pregnancies and the world literature contains only 33 cases. We present an additional case of an uncomplicated intramural pregnancy in a patient with extensive adenomyosis, which is the ...

We report two cases of unruptured tubal pregnancy that were evaluated on MRI at 5 weeks' gestation. In both cases, MRI revealed gestational sac-like structures surrounded by thickened walls outside the ovaries. At the periphery of gestational sac-like structures, small amounts of fresh blood were also identified. These findings highly ...

OBJECTIVE: It has been reported that elevation in creatine kinase may be used as an indicator of ectopic pregnancy as a consequence of trophoblast invasion of the smooth muscle layer of the Fallopian tube. In this study, we attempt to verify this observation and establish the sensitivity and positive predictive ...

BACKGROUND CONTEXT: Some biomechanical studies have demonstrated that bone mineral density of the lumbar spine (BMD) affects the stability of pedicle screws in vitro. PURPOSE: To investigate influence of BMD on loosening and related failure of pedicle screws in vivo. STUDY DESIGN/SETTING: A clinical study of 52 patients who underwent ...

During the last three decades, ectopic pregnancy rates have increased considerably in different parts of the world including Australia. Recent reports, however, suggest that the incidence is decreasing or at least stabilising. An analysis of the New South Wales Inpatient Statistics Data collected during the period between 1990 and 1998 ...

The objective was to determine correlation between vital signs and hemoperitoneum in ruptured ectopic pregnancy. A retrospective chart review of ectopic pregnancies at our urban county hospital between 1990 and 1998 was conducted. Fifty-one cases met inclusion criteria. Mean minimum systolic blood pressure (SBP) 89mmHg (range 40-118), mean maximum heart ...

BACKGROUND: On the basis of clinical impression that the number of cases of ectopic pregnancy seen in the City and Hackney Health District, London, was changing, a retrospective study of the years between 1990 and 1999 was carried out. METHODS: From the histopathology databases, cases of ectopic pregnancy and early ...

BACKGROUND: Younger patients are having total hip arthroplasty now, and a woman who has had such a procedure may want to become pregnant. The purposes of this study were to report on a series of women who had completed a pregnancy after a total hip arthroplasty and to determine if ...

OBJECTIVES: This study was designed (1) to identify characteristics of patients and their treatment and aspects of care that may be associated with satisfaction, and (2) to investigate the way these factors contribute to the degree of satisfaction expressed after treatment of ectopic pregnancy. Our ultimate goal in so doing ...

OBJECTIVE: To compare laparoscopy versus laparotomy management of tubal pregnancy and the reproductive outcome. METHODS: A retrospective chart review of 81 patients admitted for management of tubal pregnancy was carried out at Riyadh Armed Forces Hospital from January 1998 until January 2000. The patients were divided according to surgical procedure ...

OBJECTIVES: To determine if patients with abdominal pain and vaginal bleeding during the first trimester of pregnancy who have a low clinical likelihood of ectopic pregnancy are put at risk of adverse events by delaying ultrasonography 12-18 h after emergency department presentation. METHODS: A retrospective chart review of all surgically ...

We report here a 37-year-old woman who underwent ovulation induction and in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment because of infertility who developed vaginal bleeding at the 6th week of gestation. Abdominal ultrasonography was insufficient to distinguish the intrauterine gestational sac. Subsequently, vaginal doppler ultrasonography detected two ...

The dermatoses of pregnancy can be classified into the following 3 groups: physiologic skin changes in pregnancy, dermatoses and cutaneous tumors affected by pregnancy, and specific dermatoses of pregnancy. Correct diagnosis and classification are essential for the treatment of these disorders, when necessary. Laboratory investigations are required when the diagnosis ...

OBJECTIVE: To analyze the risk factors and assess the results of management with respect to maternal morbidity and mortality of ectopic pregnancy during the last three years. SETTING: Ziauddin Medical University Hospital, North Nazimabad campus (ZMUH), Karachi. RESULTS: Forty-three patients were admitted with ectopic pregnancy at ZMUH from 1st January ...

A case of an enlarged pelvic spleen, studied with MRI and MR angiography (MRA), is presented in a 32-year-old female wishing to become pregnant. An ectopic located spleen may be complicated by an acute abdomen due to torsion of the splenic vascular pedicle, resulting in splenic infarction. Displacement of the ...

Programmed cell death by apoptosis occurs in fetal and maternal tissues during early pregnancy and plays an important role during implantation, decidualization, and in fetal development. In the regulation of apoptosis, bcl-2 is one of the central controlling genes, and acts by protecting the cell against apoptosis. It is postulated ...

BACKGROUND: Intramural ectopic pregnancy is unusual, difficult to diagnose, and associated with a high rate of uterine rupture. CASE: A 35-year-old, gravida 3, para 0-0-2-0 was diagnosed with intramural ectopic pregnancy by ultrasound showing a gestational sac surrounded completely by myometrium. It was confirmed by laparoscopy. With expectant management, the ...

Persistent trophoblastic activity after salpingostomy for ectopic pregnancy implies the presence of intra-abdominal trophoblastic tissue, usually within the fallopian tube. We report a case of disseminated trophoblastic peritoneal implants, presenting as hemoperitoneum three weeks after laparoscopic salpingectomy. Only 23 such cases have been reported. Surgical treatment of ectopic pregnancy, especially ...

OBJECTIVE: Our purpose was to determine the utility of measuring serum leukemia inhibitory factor, a cytokine expressed in the process of pregnancy implantation, for the diagnosis of ectopic pregnancy. STUDY DESIGN: Serum samples from 40 patients with positive serum quantitative beta-human chorionic gonadotropin levels were used for leukemia inhibitory factor ...

The objective of this study was to evaluate the efficacy of endometrial arterial flow in the exclusion of ectopic pregnancy. From October 1997 to June 1999, 66 women with elevated beta-human chorionic gonadotropin titers and clinical indications of ectopic pregnancy were evaluated by endovaginal sonography. Women with a gestational sac ...

OBJECTIVE: The aim of this study was to analyze the fertility prognosis after conservative or radical surgery for ectopic pregnancy. Also, to identify any biological factors that may influence the fertility outcome after an ectopic pregnancy. METHODS: A retrospective study which was carried out by collating information from the patient's ...

OBJECTIVE: To determine whether the time to diagnosis and treatment of patients with ruptured ectopic pregnancy is significantly less for patients who had emergency department (ED) right upper quadrant (RUQ) ultrasound (US) compared with those who had US in the radiology department. METHODS: The authors conducted a retrospective review of ...

OBJECTIVE: To compare six published methods of diagnosing ectopic pregnancy. METHODS: Decision analysis compared six diagnostic algorithms involving combinations of clinical examination, transvaginal ultrasound, serum progesterone, serum hCG, and D&C. The population was composed of hemodynamically stable women who presented to a tertiary care university emergency department with abdominal pain ...

OBJECTIVE: To evaluate the reproductive outcome after ectopic pregnancy and to assess the contribution of risk factors to future fertility. DESIGN: Prospective follow-up in a population-based sample. SETTING: Register of ectopic pregnancies established in an urban area around Lille, France. PATIENT(S): Three hundred and twenty-eight women treated between April 1994 ...

OBJECTIVE: To determine pregnancy rates after laparoscopic salpingostomy in occlusive distal tubal disease. To evaluate the relative impact of various historical, physical, and operative factors on pregnancy outcome using a multivariate statistical analysis. DESIGN: Prospective cohort. SETTING: University-affiliated tertiary care infertility clinic. PATIENT(S): One hundred thirty-nine infertile women with occlusive ...

OBJECTIVE: To investigate if implementation of a non-invasive diagnostic work up of patients with suspected ectopic pregnancy, involving transvaginal sonography and serum human chorionic gonadotrophin (hCG) measurement decreases the likelihood of performing diagnostic laparoscopies. STUDY DESIGN: We interviewed 27 Dutch gynaecologists using 16 structured case summaries in a fractional factorial ...

PURPOSE: To determine whether the photopic negative response (PhNR) of the electroretinogram (ERG) is reduced in patients with primary open angle glaucoma (POAG). METHODS: ERGs were recorded with DTL electrodes from 62 normal subjects (16 to 82 years), 18 POAG patients (47 to 83 years) and 7 POAG suspects (46 ...

The classic triad of fever, headache, and characteristic rash occurring 1 to 2 weeks after a tick bite in an endemic area should raise suspicions for Rocky Mountain spotted fever (RMSF). All providers with primary care responsibility for women should be familiar with the diagnosis and treatment of this illness. ...

Paroxysmal AF has been known to be initiated by ectopic beats, especially in the pulmonary veins (PVs), and radiofrequency catheter ablation could cure it. We considered that the spontaneous transition from typical atrial flutter to AF also could be initiated by ectopic beats. Twenty patients (18 men, mean age 66 ...

OBJECTIVE: Classical growth hormone insensitivity syndrome (GHIS) comprises a dysmorphic phenotype, extreme short stature (height SDS < 3), normal GH and low IGF-I and IGFBP-3. Wide clinical variation is recognised with classical and atypical forms. We aimed to delineate features of the milder "atypical" GHIS phenotype, and to determine whether ...

A case of 35 year old gravida 4 para 2(+1) woman with heterotopic pregnancy is presented. She had total salpingectomy for the ectopic pregnancy and spontaneous vaginal delivery of a 3.25 kg live female infant of the intrauterine pregnancy. The need to maintain a high index of suspicion and to ...

OBJECTIVE: To determine if tubal rupture rates are decreased when a strict diagnostic algorithm is employed in the evaluation of women with suspected ectopic pregnancy as compared to individualized diagnostic methods. STUDY DESIGN: Between 1994 and 1996, a group of investigators at Charleston Area Medical Center employed a strict diagnostic ...

Determining the prognosis in nonconvulsive status epilepticus (NCSE) is complicated by several factors: under-recognition of NCSE with its spontaneous resolution (thus decreasing the "denominator" of total cases that will have a poor outcome); incorrect diagnosis of NCSE based on misinterpretation of EEG "epileptiform" activity; mis-classification of certain EEG patterns as ...

OBJECTIVE: To determine the long-term safety of nonsurgical sterilization with quinacrine. DESIGN: Observational cohort study. SETTING: Rural provinces in northern Vietnam. PATIENT(S): Two thousand eight hundred forty women who had had quinacrine insertions and an age-matched comparison group of 1,658 women who had an intrauterine device (IUD) insertion between 1989 ...

During the period from 1995 to 1999, 64 patients were treated for ectopic pregnancy. All patients admitted to the department passed the same procedure including (complete preoperative laboratory findings, Beta HCG, serum progesterone and transvaginal colour Doppler). In patients who had ultrasound finding typical for ectopic pregnancy in combination with ...

OBJECTIVE: To assess the factors that influence the reproductive performance in patients who had previous salpingectomy by laparotomy for ectopic pregnancy in the South-west Region of Saudi Arabia. METHODS: Fifty four patients who had pregnancies following salpingectomy for previous ectopic pregnancy were studied retrospectively at Abha Maternity Hospital in the ...

OBJECTIVE: To determine the incidence of positive pregnancy test on the day of laparoscopic sterilisation. DESIGN: Prospective longitudinal observational study. SETTING: Gynaecology unit in a UK teaching hospital. SAMPLE: Between 1 January 1997 and 31 December 1998, eight hundred and two consecutive women were admitted for laparoscopic sterilisation after assessment ...

This investigation was designed to evaluate the utility of maternal creatine phosphokinase (CPK) in predicting the presence of an ectopic pregnancy (EP) in an emergency department (ED) setting. Twenty-one patients with the diagnosis of EP were randomly matched (1:1) with pregnant patients who subsequently ruled-out for EP. Serum CPK values ...

Diagnosis of ectopic pregnancy continues to be an important challenge facing emergency physicians. The authors present a case of bilateral tubal ectopic pregnancy and discuss its clinical features and diagnostic difficulties. A review of the English-language literature on the subject is discussed. Suggestions are made on ways to increase diagnostic ...

OBJECTIVE: To evaluate the effects of different management strategies for ectopic pregnancy on fertility. STUDY DESIGN: Retrospective cohort study of 180 consecutive patients who were diagnosed with ectopic pregnancy between September 1988 and December 1995. The fertility rate after ectopic pregnancy treated with surgery was compared with that after expectant ...

This review addresses recent publications that investigate etiology, epidemiology and different modalities in diagnosis and therapy for ectopic pregnancy. A significant proportion of recent work has focused in the development of new diagnostic tools to aid in the early detection of ectopic pregnancy. Diagnostic modalities have included systemic and local ...

OBJECTIVE: Recent evidence suggests that matrix metalloproteinases (MMPs) and their inhibitors (TIMPs) are crucial for trophoblast implantation in normal pregnancy. To evaluate the expression of MMP-1, MMP2, and the tissue inhibitor of MMP-2 (TIMP-2) along the invasive pathway of trophoblast in ruptured and non-ruptured tubal ectopic pregnancies, we performed a ...

The goal of this study was to model the incidence of ectopic pregnancy and spontaneous abortion if pregnant women in the first 20 weeks of gestation were to remain aboard ship while at sea during deployments. Ectopic pregnancies and other pregnancy complications at sea can be life-threatening events. Data sources ...

The aim of this study was to elucidate the clinical presentation of ectopic pregnancy in the emergency department and highlight the atypical presentations and pitfalls in its diagnosis. This was a 4-year retrospective descriptive study carried out at a tertiary teaching hospital. Two hundred and seven cases of ectopic pregnancy ...

STUDY OBJECTIVE: Previous studies have suggested that serum markers of smooth muscle destruction have utility in predicting ectopic pregnancy. Our goal was to determine whether a novel marker of muscle destruction, smooth muscle heavy-chain myosin (SMHC), is elevated in the serum of patients with ectopic pregnancy. METHODS: We conducted a ...

The authors report a case of a 27-year-old female who was diagnosed as having a ruptured ectopic pregnancy approximately 12 hours after an elective termination of an intrauterine pregnancy (IUP) was performed. Multiple previous evaluations by an obstetrician for a chief complaint of abdominal pain revealed an IUP but did ...

OBJECTIVES: To determine the prevalence of antibodies to Chlamydia trachomatis in women presenting with ectopic pregnancies to Groote Schuur Hospital. METHODS: C. trachomatis antibody titres were measured using a modified micro-immunofluorescence test in women presenting with ectopic pregnancy. Control subjects were drawn from women with term pregnancies and an uneventful ...