STUDY DESIGN: In this prospective, consecutive, controlled cohort study, the authors analyzed the impact of a differentiated, individual-based treatment program on sick leave during pregnancy for women experiencing lumbar back or posterior pelvic pain during pregnancy. OBJECTIVE: To identify patients with pain early in pregnancy and, by means of individual ...

OBJECTIVES: To describe the clinical characteristics and outcomes of a large group of women with symptom-giving pelvic girdle relaxation of pregnancy and postnatal pelvic joint syndrome. To determine if there is an increased incidence of developmental dysplasia of the hip in the children of women with such pelvic problems. METHODS: ...

Transient osteoporosis of the hip (TOH) is an uncommon condition. This painful regional osteoporosis affects previously healthy women in the third trimester of pregnancy. It is characterized by pain in the affected hip and pronounced osteopenia of the femoral head and neck. It has a relatively short clinical course (average ...

We report on a patient with an ectopic urethra opening into a septate vagina which was distended with urine. The anus and rectum were normal but separated from the urogenital sinus by a thin septum. After surgical repair the patient did well with the exception of recurrent urinary tract infections. ...

We describe a 39-year-old woman with an 8-month history of abdominal pain, diarrhea, and weight loss. Clinical and laboratory evaluation indicated the presence of a malabsorption syndrome. Endoscopy revealed multiple gastric ulcerations and an abnormal "picture" of the duodenal mucosa. At duodenal biopsy, necrosis confined to the distal parts of ...

Ciguatera (poisoning caused by eating fish contaminated with algal toxins) is usually diagnosed clinically. We describe a Queensland family of four (including a pregnant woman) with ciguatera, confirmed by bioassay of the implicated fish for ciguatoxin. All four recovered, illustrating the effectiveness of treatment with intravenous mannitol. At birth, the ...

Homozygous alpha-thalassaemia-1 is conventionally diagnosed by invasive testing on all at-risk pregnancies. We evaluated the diagnostic efficacy of non-invasive abdominal ultrasonographic cardiothoracic ratio measurement in 62 pregnancies at 13-14 weeks and 75 pregnancies at 17-18 weeks. This performed better than placental thickness measurement. Using a cardiothoracic ratio cut-off level of ...

OBJECTIVE: To evaluate and compare third trimester ultrasound measurements of fetal size and growth velocity in the prediction of intrapartum operative delivery for fetal distress and admission to the special care baby unit in a low risk antenatal population undergoing labour at term. DESIGN: Retrospective analysis of prospectively collected ultrasound ...

A 20-year-old woman with a 27-week intrauterine pregnancy was admitted to a Level II trauma center after a motor vehicle crash. She had a seat belt abrasion over her lower abdomen. Fetal death was established, and subsequent computed tomographic scanning detected uterine rupture with intra-abdominal displacement of the fetus. This ...

Advanced extrauterine pregnancy with a successful outcome is a rare event. A case is presented of a 34-year-old woman at 35 weeks gestation whose abdominal pregnancy was successfully managed. The diagnostic and management problems associated with abdominal pregnancy are discussed, and especially the controversial issues of the treatment of the ...

An 18-month-old Cameroon dwarf goat doe had chronic, bilateral hindlimb paresis and difficulty in rising two months after the birth of a normal kid. The doe was weak, pyrexic and had a purulent vaginal discharge. A large, firm mass was palpated in the caudodorsal abdomen. Abdominal ultrasonography revealed an ill-defined ...

The current legal position from which an advance directive operates is clarified. The practicalities of advance directives are considered and the issues concerning enalties explored. The patient's capacity to refuse treatment is discussed in relation to the issue of consent. Situations concerning cardio-pulmonary resuscitation, pregnancy and accident and emergency are ...

A questionnaire concerning musculoskeletal symptoms (MSS) and working environment was answered by 100% of 103 car mechanics in 12 different garages. Almost all the mechanics had been troubled with MSS at work the past year. The most common MSS were symptoms from the low back, neck, head and shoulders. When ...

OBJECTIVE: To determine if an intrapartum amniotic fluid index (IAFI) < or = 5.0 cm, or any other level, is associated with abdominal delivery for fetal intolerance to labor or Apgar scores < 7 at one and five minutes. STUDY DESIGN: Prospectively IAFI was obtained in the latent phase of ...

Overall, approximately 1% of ectopic pregnancies are abdominal pregnancies, which can be life-threatening even when surgical intervention with laparotomy is performed. We present a case in which abdominal pregnancy was successfully managed by operative laparoscopy. A 25 year old Japanese woman presented 6 weeks after her last menstruation with elevated ...

PURPOSE: Little has been written regarding the ultrasound imaging features that might allow prediction of fetal viability in abdominal pregnancies. Toward this goal, we present our experience with a series of 11 abdominal pregnancies. MATERIALS AND METHODS: From 1981 to 1993, 11 patients presented to Universidad Catolica, Santiago, and Universidad ...

BACKGROUND: We present the first case of abdominal pregnancy after in vitro fertilization and embryo transfer in a patient without oviducts. CASE: A 38-year-old woman, who previously had had two salpingectomies because of two tubal pregnancies, was admitted to our department with intermittent vaginal bleeding and abdominal pain, 21 days ...

OBJECTIVE: To evaluate the impact of abdominal metroplasty for symmetric uterine anomalies on reproductive performance. METHOD: A retrospective analysis of 24 patients who conceived following metroplasty for symmetric congenital anomalies during a 5-year period. RESULTS: In patients with poor obstetric histories before surgery, the overall fetal survival rate increased from ...

Abdominal pain is a common symptom in pregnancy. Its etiology is diverse and diagnosis often poses a problem. Inflammatory disorders of extra-uterine origin such as appendicitis should always be considered as a possible cause. Three cases of appendicitis complicating pregnancy managed at the Queen Elizabeth Hospital, Barbados during the year ...

We report a case of a 27-year-old pregnant patient who presented with severe colicky abdominal pain, diarrhoea and fever. She was initially treated for gastroenteritis. She later requested a termination of the pregnancy. Abdominal X-rays showed small bowel dilatation. A dynamic computed tomographic scan was performed and showed a splenic ...

An extended coverage anti-G suit, has been demonstrated to improve +Gz tolerance substantially. In some pilots/subjects, however, the abdominal bladder of the anti-G suit may expand excessively upward and inward causing discomfort and pain. This man-rating was performed to evaluate the effects on +Gz protection of an internal abdominal bladder ...

Megalourethra, a rare congenital disorder involving the anterior urethra, is subdivided into two types: Fusiform and scaphoid. Two cases of scaphoid type megalourethra are reported. The first patient, a 5-weeks-old infant diagnosed at birth as having the prune belly syndrome was admitted to the hospital with vomiting and failure to ...

STUDY DESIGN: An analysis was made of the self-reported medical histories of patients with peripartum pelvic pain. OBJECTIVES: To compile an inventory of the disabilities of patients with peripartum pelvic pain, analyze factors associated with the risk for development of the disease, and to formulate a hypothesis on pathogenesis and ...

The widespread use of fetal ultrasonography in routine antenatal care now allows the majority of abdominal wall defects to be identified prenatally, with subsequent opportunities for parental counseling, fetal intervention, and optimal perinatal management. Outcome is significantly affected by the presence of additional structural or chromosomal malformations; appropriate multidisciplinary counseling ...

During pregnancy, intestinal obstruction due to sigmoid volvulus is extremely rare. Only 73 cases have been reported. A 24-year-old black woman, gravida 2, para 1, presented during Week 36 of an otherwise uneventful pregnancy, with intermittent abdominal pain and constipation, and no history of nausea, vomiting, fever, chills, previous medical ...

The hypotheses are evaluated that in abdominal pregnancies 1) elevated MSAFP is due to an altered maternal-placental interface, and 2) differences in MSAFP levels may reflect placental location within the peritoneal cavity. A review of 1,193 ectopic pregnancies from 1983-1993 identified three cases of advanced abdominal pregnancy. All three had ...

STUDY DESIGN: A longitudinal, prospective, observational, cohort study. OBJECTIVES: To describe the natural history of back pain occurring during pregnancy and immediately after delivery. SUMMARY OF BACKGROUND DATA: Back pain during pregnancy is a frequent clinical problem even during the early stages of pregnancy. The cause is unclear. METHODS: A ...

Physicians who care for pregnant women must be prepared to evaluate and treat abdominal trauma during pregnancy. The evaluation and management of even minimal abdominal trauma in pregnancy is often problematic, and the use of laboratory tests, fetal monitoring, radiography and ultrasonography depends on the extent of the trauma and ...

OBJECTIVES: To analyze risks versus benefits of esophagogastroduodenoscopy (EGD) during pregnancy to the fetus and pregnant female. METHODS: Retrospective study of 83 consecutive pregnant patients who underwent EGD admitted to eight university teaching hospitals during a study period of up to 14 yr, with follow-up of fetal outcome. Controls included: ...

Previous criteria for primary reduction of the herniated viscera in newborn infants with gastroschisis included intraoperative respiratory rate, cardiac indices, degree of viscero-abdominal disproportion, size of defect, and lower extremity turgor. From 1976 through 1993, 129 neonates with gastroschisis were treated at Children's Hospital of Oklahoma. Intraoperative end-tidal carbon dioxide ...

A review of fetal gastrointestinal anomalies is presented. Normal abdominal development and anatomy, including basic embryology and recommended ultrasound techniques, are first outlined. Next is a more detailed discussion of the abnormal examination, including abdominal wall defects and intra-abdominal abnormalities. The goal of this work is to present a practical ...

A lithopaedion, or stone-child, is a dead fetus, usually the result of a primary or secondary abdominal pregnancy, that has been retained by the mother and subsequently calcified. This paper describes the earliest known case of this phenomenon. It was discovered in 1582, at the autopsy of a 68-year-old woman ...

We defined "fetal abdominal protuberance ratio" as the ratio between the abdominal circumference (AC) and the distance between the anterior border of the fetal aorta and the posterior surface of the fetal skin (AO-P) and measured it in a total of 358 fetuses between 13 and 40 weeks. The AC ...

Omental pregnancy is a rare form of abdominal pregnancy. In the 5 previously reported cases, primary implantation of the embryo to the omentum has been proposed as its etiology. We present a new case of omental pregnancy in a 31-year-old woman presenting with symptoms of ectopic pregnancy. After careful review ...

Exstrophy of the bladder is rare and the incidence of bladder exstrophy is calculated to be from 1 per 30,000 to 50,000 live births with male to female ratio ranging from 1.5-5 to 1(1-4). It was found that persistence or overgrowth of the cloacal membrane on the lower anterior abdominal ...

Arteriovenous malformations (AVM) are rare in the reproductive years of life. There is a paucity of data regarding AVMs in pregnancy. Pregnancy can influence both the development and the progression of AVMs. The tendency to bleed is unpredictable. Many AVMs undergo spontaneous postpartum regression. We report on a 30-year old ...

OBJECTIVE: To describe vaginal bleeding and associated pain in pregnancies terminated by childbirth. DESIGN: A descriptive study based on information obtained by questionnaires administered during pregnancy. SETTING: Antenatal care clinic at the Obstetrical Department, Aarhus University Hospital, Denmark. SUBJECTS: Women (n = 8714) with singleton pregnancies attending routine antenatal care ...

One hundred and twenty abdominal wall defects were notified to the Northern Region Fetal Abnormality Survey in the five years 1988 to 1992. Gastroschisis occurred in 56, exomphalos in 43, amnion rupture in 11, ectopia vesicae in seven and ectopia cordis in three. Ultrasound failed to identify gastroschisis in 14 ...

BACKGROUND: Recognition of advanced abdominal pregnancy and care of the patient afflicted with it may present formidable challenges. Aside from the difficulty of diagnosing the problem and thereby delaying necessary intervention, management can be difficult at best, even when the condition is relatively uncomplicated. When it is compounded by a ...

BACKGROUND: The usual course of osteoporosis of pregnancy is complete resolution without recurrence. We report the 10-year follow-up of two patients with osteoporosis of pregnancy and their offspring. CASES: A 30-year-old woman presented with right hip pain at 30 weeks' gestation. Single-photon absorptiometry of the distal radius showed osteopenia, which ...

Congenital chloride diarrhea (CCD) is a rare autosomal recessive disorder characterized by life-long watery diarrhea with a high fecal chloride concentration. We report the clinical and laboratory data in 20 Saudi infants with CCD admitted to our center between January 1986 and December 1991. In addition to diarrhea, there was ...

Gallbladder perforation is an infrequent but potentially fatal disease. It is extremely rare during pregnancy. We report two cases of gallbladder rupture in the immediate postpartum period and review the literature. The first patient was a 28-year-old polysubstance abuser who presented at 29 weeks' gestation with generalized abdominal pain and ...

The laparoscopic management of tubal pregnancies has become a standard form of treatment. We present, for the first time, a successful laparoscopic approach in the management of early abdominal pregnancy. Although it is difficult to reach conclusions from such limited published experience, it nevertheless appears that early abdominal pregnancies can ...

The post-delivery evaluation of the obstetric patient presenting with severe abdominal pain can be a challenge to the obstetrician, the internist, and the radiologist. Besides non-pregnancy-related causes of abdominal pain, several pregnancy-related complications should be included in the list of differential diagnoses. Based on pathogenesis, these conditions can be divided ...

Complications of pregnancy secondary to old abdominal burn scars are uncommon but have been reported. Common problems include failure of the scar to stretch (resulting in uterine displacement), maternal discomfort, and occasionally scar breakdown. We report the case of a 23-year-old patient who had a tight circumferential scar involving the ...

Although the mechanical and positional stresses of pregnancy are the primary inciting factors contributing to lumbosacral pain accompanying gestation, in approximately 1:10,000 cases a herniated disk (HNP) can be identified as the proximal cause of pain. Six patients are described, all of whom without antecedent history of pain presented with ...

Physically loading aspects of work may have adverse effects on the health of both the pregnant woman and the unborn child. Improving the fit between the pregnant woman and the workplace layout contributes to minimizing the load associated with given tasks. The aim of this paper is to evaluate two ...

The behavioural responses of Onchocerca lienalis microfilariae (mf) to tissue factors of the surrogate black fly host, Simulium vittatum, were studied using a novel in vitro bioassay. Mf accumulated towards thoracic tissues to a density 4 times higher than towards abdominal tissues, despite the larger surface area and volume of ...

We present a case that, as far as we know, is the first report of lower gastrointestinal haemorrhage as a complication of heterotopic pregnancy induced by artificial reproductive technology. The heterotopic abdominal pregnancy caused erosion of the intestinal wall and massive rectal bleeding, 8 weeks after in-vitro fertilization/embryo transfer. The ...

The anatomic and physiologic changes of pregnancy make the diagnosis and management of abdominal pain difficult. Abdominal conditions both related and unrelated to the pregnancy may be life threatening for mother or fetus; therefore, accurate diagnosis and proper management are essential. This article reviews the most common conditions presenting as ...