BACKGROUND: The objective was to determine the incidence and volume of fetomaternal hemorrhage (FMH) in normal vaginal delivery and in delivery by cesarean section. Determination of these variables would enable optimalization of guidelines for D alloimmunization prophylaxis. STUDY DESIGN AND METHODS: In a prospective cohort study, a total of 3457 ...

Despite fertility-preserving initiatives, postcancer reproduction is expected to be lower than in the general population. Using data from the Cancer Registry and the Medical Birth Registry of Norway, postcancer pregnancy rates were analyzed in 27,556 survivors, and compared with those from a matched comparison group ("controls") from the general population. ...

Since ovarian cancer during pregnancy is rare, the decisions regarding pregnancy discontinuation or fertility preservation are often difficult. We report three ovarian cancer cases detected at early, mid and late pregnancy periods in which both babies and mothers were saved. In particular, case 2 is the first reported instance of ...

Many cases of ectopic pregnancy will spontaneously resolve, so that "watchful waiting" and β-hCG follow-up will separate true viable ectopic pregnancies from spontaneously resolving ectopic pregnancies. Withholding methotrexate in patients with spontaneously resolving ectopic pregnancies and administering it in only true viable ectopic pregnancies will no doubt decrease published success ...

To report our initial experience with isobaric (gasless) transumbilical laparoendoscopic single-site (LESS) surgery using a wound retractor for the management of ectopic pregnancy. Twelve consecutive cases of ectopic pregnancy were managed by isobaric LESS surgery with the subcutaneous abdominal wall-lift method. In each case, a wound retractor was used as ...

In this regional UK study across seven hospitals, we examined the potential barriers to undertaking a laparoscopic approach to the surgical management of ectopic pregnancies. Across the region 84% of surgically managed ectopic pregnancies were undertaken laparoscopically, although out of hours operating resulted in a higher rate of laparotomies. Trainees ...

Ectopic pregnancy is a common concern in emergency departments (EDs) and remains the leading cause of first-trimester mortality. Pelvic ultrasonography by emergency physicians has been investigated as a diagnostic test for ectopic pregnancy. We present a meta-analysis of the use of emergency physician ultrasonography in the evaluation of patients at ...

Intramural pregnancies are a rare form of ectopic pregnancy located within the myometrium separate from the endometrial cavity. In an effort to prevent potential complications, diagnosis should be made early when more conservative approaches can be performed to preserve reproductive potential. The diagnosis of ectopic pregnancies can be successfully accomplished ...

The coexistence of a cystadenoma with an ectopic pregnancy in the same fallopian tube is extremely rare. A 30-year-old gravid woman exhibited increasing human chorionic gonadotropin concentrations. Intramuscular methotrexate therapy was administered and ectopic precautions were taken. The patient eventually underwent diagnostic laparoscopy. After pathologic review, an ectopic pregnancy and ...

ectopic pregnancy is one of the recognised complications of in vitro fertilisation (IVF) and embryo transfer. to review cases of ectopic pregnancy following IVF at a fertility unit, with the aim of raising awareness towards its increased incidence and pattern of presentation. case records of patients who had ectopic pregnancy ...

Implantation in the interstitial part of the oviduct is frequently associated with severe fetal and maternal morbidity. We present a patient with primary interstitial and secondary retroperitoneal ectopic pregnancy. The suspicion of an ectopic pregnancy was raised after an ultrasound examination during the 18th week of pregnancy. An almost complete ...

To evaluate the use of a technique consisting of culdocentesis followed by saline solution-enhanced pelvic ultrasonography in cases suspect for ectopic pregnancy in which an accurate diagnosis could not be made using routine transvaginal ultrasound. Retrospective clinical study (Canadian Task Force classification III). Academic medical center. Twenty patients with an ...

Heterotopic triplets hardly take place, but nowadays the extended use of assisted reproductive technologies is increasing the ectopic pregnancies rate and subsequently the heterotopic pregnancies, leading to a potentially dangerous condition for the woman and the intrauterine pregnancy. Fourteen cases previously reported in the literature of patients presenting an intrauterine ...

There is an ongoing debate whether tubal ectopic pregnancy should be treated by salpingotomy or salpingectomy. It is unknown which treatment women prefer in view of the potentially better fertility outcome but disadvantages of salpingotomy. This study investigated women surgically treated for tubal ectopic pregnancy and subfertile women desiring pregnancy ...

The present study analyzed the epidemiology and outcome of ectopic pregnancy during a 9-year period on a total of 473 women. Our follow-up shows that laparoscopic salpingostomy, performed in 84.9% of the patients, is a safe and effective treatment for ectopic pregnancy.

Retroperitoneal ectopic pregnancies are extremely rare and a diagnostic and therapeutic challenge as an early diagnosis is difficult and all treatments entail a risk for severe bleeding. We present a case of a live completely retroperitoneal ectopic pregnancy in the right obturator fossa. Following 3D color Doppler vaginal ultrasonography to ...

A rare coexistence of an adenofibroma and ectopic pregnancy in the left fallopian tube is reported. Adenofibroma is a rare benign neoplasm of the fallopian tube, and the fallopian tube is the most common site of ectopic pregnancies. However, coexistence of such rare tumor and ectopic pregnancy is extremely rare. ...

This is a case report of an eccentrically located intrauterine pregnancy initially diagnosed as an interstitial ectopic pregnancy. Although interstitial ectopic pregnancy represents a well-known pitfall in first-trimester sonography, the common error is to misidentify the ectopic pregnancy as intrauterine, not the reverse. Such an error is potentially catastrophic because ...

To present a rare case of spontaneous ectopic pregnancy in a non-communicating heterotopic fallopian tube associated with unicornuate uterus without a rudimentary horn. Case report. Setting: Tertiary referral obstetrics and gynecology center. Patient: A 36-year-old woman in her fourth pregnancy (para 1, abortus 2) presented at 5th gestational week with ...

The laparoscopic management of three rare types of ectopic pregnancy, including rudimentary horn pregnancy, caesarean scar pregnancy, and interstitial pregnancy is described. All were managed with little morbidity. When the appropriate facilities and skills are available, laparoscopic surgery is the surgical treatment of choice for the various types of ectopic ...

The coexistence of intrauterine and ectopic pregnancy (heterotopic pregnancy) occurs in 1/30,000 of spontaneous pregnancies, 1/900 in Clomiphene citrate induced pregnancies and rises to 1% in assisted reproduction. It is a life-threatening condition with diagnostic and therapeutic complexities. There is strong association between infertility and ectopic pregnancy. Risk factors for ...

Preoperative diagnosis of chronic ectopic pregnancy is often difficult because of the high incidence of negative results on pregnancy tests as a consequence of the very small amount of live villi, subtle symptoms, and the poor specificity of ultrasonographic patterns. A 45-year-old woman was referred to our department for evaluation ...

OBJECTIVE: To estimate trends in the rates of diagnosis and treatment of ectopic pregnancy in the United States. METHODS: We analyzed data from a large administrative claims database of more than 200 U.S. commercial health plans, and estimated time trends in the rate and incidence of ectopic pregnancy among girls ...

Myometrial pregnancy represents a rare subtype of ectopic pregnancy. A history of uterine artery embolization (UAE) because of symptomatic uterine fibroids, and assisted reproductive treatment may predispose to this unusual implantation site. A 40-year-old woman with a history of uterine fibroids underwent a transfer of two embryos after intracytoplasmic sperm ...

OBJECTIVE: To determine whether ectopic pregnancy should be suspected in young women with abdominal pain even after hysterectomy. DESIGN: Case report. SETTING: The patient presenting with abdominal pain in the emergency department was referred to a tertiary care center. PATIENT(S): A young woman who had had a subtotal hysterectomy 3 ...

Our clinical impression is that the incidence of ectopic pregnancy in West Hertfordshire in the UK has been steadily rising to almost 'epidemic' proportions. On the basis of our clinical suspicion, a retrospective study was performed looking at the ectopic pregnancy rates in the region from 1993 to 2007. All ...

Ectopic pregnancy (EP) is a high-risk medical condition with an incidence of 1.9% in reported pregnancies, and has proven to be the most common cause of pregnancy-related deaths in the first trimester. The clinical symptoms can mimic non-EP conditions, thus creating a challenge for developing diagnostic criteria and new diagnostic ...

Fewer than 1 in 5 patients comply with the established follow-up protocol to treat presumed ectopic pregnancy medically in an urban clinic population. Institutions should consider tracking their patient compliance with follow-up to determine the efficacy of their treatment decisions.

Cornual (interstitial) ectopic pregnancy is an uncommon variant of ectopic pregnancy which often poses a diagnostic and therapeutic challenge with a significant risk of rupturing and bleeding. We present a ruptured right cornual pregnancy and explain how to deal with such a case laparoscopically.

To evaluate and compare the current approach to the management of ectopic pregnancy between the main two civil hospitals in the north of Jordan. A retrospective study. A retrospective review was made of the records of all patients with confirmed ectopic pregnancy admitted to Princess Badea Teaching Hospital (PBTH), and ...

Ectopic pregnancy is a potentially life-threatening condition. Detection of ectopic pregnancy on CT images is rare. In this case, we describe the CT findings of interstitial pregnancy both before and after rupture. If CT images demonstrate the presence of a strong enhancing ring-like mass in the pelvis, ectopic pregnancy should ...

PROBLEM: In ectopic pregnancy, increased levels of vascular endothelial growth factor are present. The aims of this study were to determine the association between -634C/G, -460T/C, and +936C/T vascular endothelial growth factor (VEGF) polymorphisms and ectopic pregnancy, and to determine whether serum levels of VEGF were affected by genetic factors. ...

The diagnosis of ectopic pregnancy in women presenting in early pregnancy is often protracted, relying on costly investigations that are psychologically burdensome to the patient. The aim of this study was to evaluate the financial costs to the health services in Scotland of the current methods used to diagnose and ...

OBJECTIVE: Our objective was to report transpositioning an ectopic ovary, successfully using the assisted reproduction technique (ART), with the outcome of retrieving an oocyte from the transpositioned ovary during ART. CASE REPORT: The couple, presenting with a history of 2 years of secondary infertility, was admitted to our hospital. Two ...

Spontaneous bilateral ectopic pregnancy is the rarest form of ectopic pregnancy. A 31-year-old patient with spontaneous bilateral tubal pregnancy was admitted after light vaginal bleeding, 42 days after her last menstruation. Ultrasonography showed a bilateral tubal ectopic pregnancy. A bilateral laparoscopic salpingectomy was performed without complication and the pathology report ...

OBJECTIVE: To determine the value of North York Hospital's Early Pregnancy Assessment Clinic (EPAC) in the management of early pregnancy complications and its effect on the number of emergency room (ER) visits. METHODS: The EPAC was opened in August 2005 at North York General Hospital. The number of patients being ...

Ectopic pregnancy is a common condition with the immediate risk of life-threatening hemorrhage and subsequent risks of infertility and recurrence. Despite remarkable advances in diagnosis and treatment, ectopic pregnancies account for 9% of all maternal deaths. Early diagnosis has led to the development of innovative surgical and nonsurgical options. The ...

Ectopic pregnancy is still the number one cause of maternal deaths in early pregnancy. The diagnostic capabilities of transvaginal ultrasound to confirm an EP are well founded. In fact, ultrasound technology, particularly the introduction of high-resolution transvaginal probes, has been the driving force behind the revolutionary change towards conservative management ...

OBJECTIVE: To report the use of laparoendoscopic single-site surgery for the management of ectopic pregnancy. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 25-year-old woman with a 7-week ectopic pregnancy and pelvic inflammatory disease. INTERVENTION(S): Laparoendoscopic single-site surgery and broad-spectrum antibiotics. MAIN OUTCOME MEASURE(S): Complete resolution of the ectopic pregnancy ...

Emergency department targeted ultrasonography (EDTU) offers the possibility of rapid exclusion of ectopic pregnancy in patients with first-trimester pelvic pain or bleeding. We sought to systematically review the evidence describing the diagnostic accuracy and clinical utility of EDTU in the first trimester of pregnancy, and to generate a pooled estimate ...

OBJECTIVE: To describe a rare case of a singleton 9-week cervical-isthmic pregnancy (CIP), treated by laparoscopic removal of the ectopic pregnancy and suturing of the uterine site of the ectopic pregnancy with single stitches. DESIGN: Case report. SETTING: Main general hospital. PATIENT(S): A 37-year-old woman was admitted for suspected singleton ...

Vaginal bleeding in the first trimester occurs in about one fourth of pregnancies. About one half of those who bleed will miscarry. Guarded reassurance and watchful waiting are appropriate if fetal heart sounds are detected, if the patient is medically stable, and if there is no adnexal mass or clinical ...

The chorionic bump, an irregular, convex bulge of the choriodecidual surface into the gestational sac (GS), is a recently described, uncommon abnormality of the 1st-trimester GS and is associated with a guarded prognosis for early pregnancy. The case of this 42-year-old female demonstrates a previously unreported relationship: a transvaginal sonographic ...

OBJECTIVE: Hemoperitoneum is accepted as an indication for surgery in women with tubal ectopic pregnancy. The aim of this pilot study was to evaluate the feasibility of managing such women non-surgically. METHODS: This was a prospective observational study. Women with tubal ectopic pregnancy and hemoperitoneum detected on transvaginal sonography (TVS) ...

We report a case of a twin ectopic pregnancy (EP) after in vitro fertilization and embryo transfer (IVF-ET). A 24-year-old nulligravida presented with lower abdominal pain and vaginal bleeding 4 weeks after embryo transfer. Serum beta-HCG levels were 40 IU/mL, 90 IU/mL, and 1970 IU/mL on ET days 12, 14, ...

OBJECTIVE: To investigate the production of inducible nitric oxide synthase (iNOS) in the fallopian tube (FT) during the menstrual cycle and whether epithelia from FTs bearing an ectopic pregnancy differ from healthy tubes in iNOS expression. DESIGN: Prospective study. SETTING: Academic unit of reproductive and developmental medicine. PATIENT(S): Fallopian tubes ...

OBJECTIVE: To present a case of a vital ectopic pregnancy after 8 weeks that was located in the right ovary. DESIGN: Case study and literature review. SETTING: Hospital outpatient clinic. PATIENT(S): A 29-year-old primigravida presented with lower abdominal pain and mild vaginal bleeding at 8 weeks after her last menstrual ...

Omental pregnancy is an extremely rare type of ectopic pregnancy. We present a case in which a 26-year-old woman was admitted to the emergency room with abdominal pain. She was diagnosed with a ruptured ectopic pregnancy after a positive urinary pregnancy test and transvaginal ultrasound. Laparoscopic surgery showed intact pelvic ...

We sought to determine the outcome of the laparoscopic management of ovarian ectopic pregnancy (OEP) in a United Kingdom district general hospital and reviewed the literature. We conducted a 5-year prospective cohort study of the management of OEP cases between January 2003 and January 2008. Twelve patients had OEP confirmed ...

OBJECTIVE: To review all reported cases of ectopic pregnancy after hysterectomy. DESIGN: Medline literature search 1966 to Jan 2009. Search terms included "ectopic pregnancy," "post hysterectomy ectopic pregnancy," "pregnancy after hysterectomy." The bibliography of all retrieved articles was searched for additional sources of data. SETTING: Academic medical center. PATIENT(S): Women ...