Here we report the complete recovery from Bell's palsy (BP) of a 27-year-old woman, 27 weeks pregnant, after 2 weeks of acupuncture treatment. BP in pregnancy is an acute idiopathic peripheral facial paralysis of unknown etiology. Treatment and management have not been well evaluated or documented in the literature. The ...

Cases of retroperitoneal ectopic pregnancy are very rare. To date, few published and unpublished reports are available and no clear or specific management guidelines have been defined. Despite concern for the risk of surgical resection of the gestational tissue and associated hemorrhage when these lesions are in close proximity to ...

On the basis of the documented racial disparities in ectopic pregnancy incidence and mortality we hypothesized that African-American women with ectopic pregnancy would be more likely than white women to have treatment failure with methotrexate. In this retrospective cohort study, a racial disparity in methotrexate effectiveness was not found, but ...

OBJECTIVE: The aim of the study was to determine the efficacy of uterine artery embolisation (UAE) combined with local methotrexate (MTX) for the treatment of caesarean scar pregnancy, compared with other traditional modalities, and to investigate the complications associated with this treatment. DESIGN: A retrospective cohort study. SETTING: A large ...

We report a case of posterior wall intramural pregnancy in a 36-year-old primigravida at 6 weeks gestation. Sonographic examination showed a viable intramural pregnancy distorting the contour of the uterus. The pregnancy was terminated by intrafetal injection of potassium chloride followed by intra-amniotic methotrexate injection.

To report a case of a triplet heterotopic caesarean scar pregnancy (CSP) with two gestational sacs implanted in the caesarean scar after in vitro fertilization-embryo transfer. Case report. Private reproductive medicine center and obstetric department of a university hospital. A 31-year-old woman with previous caesarean section affected by secondary infertility ...

OBJECTIVE: We sought to report the safety and effectiveness of bleeding control using a large amount of highly diluted vasopressin in laparoscopic management of interstitial pregnancy. STUDY DESIGN: This was an uncontrolled retrospective review of 20 patients who were laparoscopically treated for interstitial pregnancy using a large amount of highly ...

Cornual pregnancy refers to the implantation and development of a gestation in one of the upper and lateral portions of the uterus; authors report their experience in laparoscopic therapeutic procedures on three singleton cornual pregnancies. Three healthy women were admitted in General Hospitals with suspect of cornual pregnancies by clinical ...

PURPOSE: To assess the value of transcatheter intraarterial methotrexate infusion combined with selective uterine artery embolization (UAE) as a treatment option for cervical pregnancy. MATERIALS AND METHODS: Between January 2004 and June 2009, a prospective study was conducted in 20 consecutive patients with cervical pregnancy. The patients were treated with ...

Spontaneous tubal twin pregnancy is a rare condition with an incidence of 1 in every 125,000 pregnancies. We present the case of a unilateral tubal twin ectopic pregnancy treated with single-dose methotrexate. A 26-year-old nulliparous woman was admitted to our clinic with a complaint of vaginal bleeding and leftside pelvic ...

Our aim was to present our experience with the management of six women with uterine scar pregnancies in KK Women's and Children's Hospital, Singapore. The medical records of women with a pregnancy in previous uterine scar that had been diagnosed in our department during 2004-2008 were reviewed. Out of six ...

OBJECTIVE: To report the successful treatment of an advanced interstitial ectopic pregnancy via laparoscopic cornuotomy following treatment failure with methotrexate (MTX). CASE: A 28-year-old, gravida 3, para 0 woman with a history of successfully treated tubal pregnancy with medical therapy 2 years ago, presented with spotting bleeding and lower abdominal ...

Cornual pregnancy is a rare form of ectopic pregnancy. The incidence of hydatiform molar pregnancy is 1 in 1000 to 2000 pregnancies. Molar cornual ectopic pregnancy is extremely rare. A 41-year-old nulliparous woman was admitted via the emergency department because of vaginal bleeding for 2 weeks. Transvaginal sonography exhibited a ...

In this prospective study 294 patients diagnosed with ectopic pregnancy (EP) were treated with multiple-dose methotrexate (MTX) to determine the conversion rate to surgery. We concluded that multiple-dose MTX treatment had a low success rate, and the success rate was not related to initial b-hCG value; it was more related ...

We describe our experience with the treatment of 4 caesarean scar pregnancies and provide an overview of current literature. Four women diagnosed with a caesarean scar pregnancy in our hospital between 1996 and 2007 were treated with local or systemic methotrexate and had a steady decline of the serum beta-hCG ...

OBJECTIVE: To report three cases of interstitial pregnancies treated successfully by combining uterine artery embolization (UAE) and ultrasound-guided local administration of methotrexate (MTX); and to assess the effect of UAE on ovarian reserve by prospectively measuring serum antim?llerian hormone (AMH) levels. DESIGN: Case report. SETTING: Departments of obstetrics and gynecology ...

A 38-year-old woman, gravida 3, para 1 with a history of a left salpingectomy for an ectopic pregnancy was admitted for treatment of a presumed ectopic pregnancy. Transvaginal sonography revealed an ill-defined gestational sac and fetal heart beat within the fundal myometrium adjacent to the left cornua. Laparoscopy was performed ...

We performed laparoscopic myomectomy for treatment of a large, twisted, subserous myoma at 25 weeks of pregnancy in a woman with acute abdominal pain that did not respond to analgesic therapy. There are few reports in literature about laparoscopic management of uterine leiomyoma during the first half of pregnancy that ...

BACKGROUND AND OBJECTIVE: Persistent urachus rarely presents in the aging male or during pregnancy. The authors report their experience with the laparoscopic excision of urachal cysts in two elderly men with significant co-morbidities and following pregnancy in a 32-year-old female. MATERIAL AND METHOD: The two male patients (65 and 70 ...

The incidence of interstitial pregnancy is rising. Traditional treatment with laparotomy, hysterectomy, or cornual wedge resection is associated with high morbidity and detrimental effects on future fertility. A diverse array of alternate treatments has been introduced over the last 3 decades, with the common goal of achieving a minimally invasive, ...

The first laparoscopic surgery in pregnancy was a cholecystectomy in 1991. Since that time, a number of articles and case series have been published addressing laparoscopy in pregnancy. Current recommendations are on the basis of these findings, such as operating during any trimester in pregnancy can be safely performed, fetal ...

An interstitial pregnancy is a rare type of ectopic pregnancy located within the proximal portion of the fallopian tube in the muscular wall of the uterus. They are more likely to result in significant or fatal hemorrhage because of the increased vascularity. Diagnosis of interstitial pregnancy is challenging but critical ...

We present a case report of laparoscopic management of a spontaneous hemoperitoneum in the second trimester of pregnancy. The patient was a 40-year-old woman at 15 weeks of gestation. At laparoscopic surgery, the hemoperitoneum was evacuated, and the right-sided uterine vessels were closed with diathermocoagulation. Every pregnant woman with severe ...

Interstitial pregnancy is a rare but life-threatening condition. It is usually treated using cornual resection at operative laparoscopy or laparotomy; however, this may adversely affect future fertility and pregnancy. Transcervical suction using an 8F pediatric catheter placed through the cornua under laparoscopic and hysteroscopic guidance may be possible in some ...

Pregnancy following endometrial ablation carries significant risks, including spontaneous abortion, preterm delivery, and abnormal placental adherence. Surgical termination of pregnancy following endometrial ablation has an increased risk for failure and complications. A 29-year-old woman became pregnant following an endometrial ablation. The pregnancy resulted in a missed abortion; due to prior ...

INTRODUCTION: Ectopic pregnancy is an acute emergency in the first trimester where surgery is the mainstay of treatment. With the advent of improved diagnostic techniques like high-resolution transvaginal ultrasonography and expedient serum human chorionic gonadotrophin (HCG) assay, ectopic pregnancy is now diagnosed early. At this stage, the conceptus is often ...

OBJECTIVE: To report two cases of women who presented with amenorrhea, lower abdominal pain, and vaginal bleeding and who were diagnosed with advanced interstitial pregnancy after initial negative laparoscopies. DESIGN: Case report. SETTING: Early pregnancy unit of district general hospital. PATIENT(S): A 39-year-old woman with a history of right salpingectomy ...

Objective. To determine which treatment should be offered to women with a non-ruptured tubal pregnancy: a single dose of methotrexate (MTX) or laparoscopic surgery. Design. Prospective, randomized, open multicenter study. Setting. Seven Danish departments of obstetrics and gynecology. Sample. A total of 106 women diagnosed with ectopic pregnancy (EP). Methods. ...

Interstitial pregnancy is a rare form of ectopic pregnancy, but it results in significant maternal morbidity and mortality. In this paper, describe a case of interstitial pregnancy that was successfully managed by laparoscopic occlusion of the ipsilateral ascending branch of uterine artery and the communication of the ovarian artery. It ...

The laparoscopic approach for appendicectomy in pregnancy was not considered the preferred procedure until recently. The aim of this study was to examine our experience with laparoscopic appendicectomy in pregnancy and review the scientific evidence available in the medical literature. The clinical data of all patients who underwent laparoscopic appendicectomy ...

BACKGROUND: Cyclosporine is considered a safe and effective treatment of severe steroid-refractory ulcerative colitis (UC). However, few data are available concerning its safety profile in pregnant women. We report here the experience of 5 GETAID centers. METHODS: In a retrospective study data on patients with severe UC treated with cyclosporine ...

OBJECTIVE: To analyze the safety of methotrexate (MTX) in rheumatoid arthritis (RA) regarding the reproductive system (fertility, pregnancy, and breastfeeding). METHODS: Systematic review of studies retrieved by a sensitive search strategy in Medline (1961 - October 2007), Embase (1961 - October 2007), Cochrane Library (up to October 2007), and from ...

OBJECTIVE: The objective of the study was to compare the efficacy and safety of uterine artery embolization (UAE) vs systemic methotrexate (MTX) for pregnancy within a cesarean scar. STUDY DESIGN: Seventy-two women with pregnancy within cesarean scar were randomly allocated to a UAE group (37 cases) or an MTX group ...

OBJECTIVE: The objective of our study was to evaluate the technical and clinical outcomes of uterine artery embolization (UAE) along with the administration of methotrexate (MTX) for cervical ectopic pregnancy with vaginal bleeding as an alternative nonsurgical treatment to control bleeding and preserve fertility. MATERIALS AND METHODS: Eight patients (age ...

OBJECTIVE: To describe a conservative management by laparoscopy of an unusual interstitial twin pregnancy. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 27-year-old woman, pregnant at 6th week of amenorrhea with interstitial twin pregnancy. INTERVENTION(S): The woman was submitted to two- and three-dimensional transvaginal ultrasound and to diagnostic hysteroscopy. Subsequently, ...

PURPOSE: To present a case of an ectopic pregnancy in a previous caesarean scar in a woman who wishes to preserve her fertility, and its treatment with the local administration of potassium chloride (KCl) and methotrexate (MTX) via a transvaginal needle. CASE: A 35-year-old woman with a viable caesarean scar ...

OBJECTIVE: To present our experience with hysteroscopic removal of cesarean scar ectopic pregnancy (CSP) and review the literature on the current management. DESIGN: Retrospective cohort study. SETTING: A tertiary referral university hospital, Sydney, Australia. PATIENT(S): Six patients diagnosed with CSP. INTERVENTION(S): Four patients were successfully treated with primary hysteroscopic removal ...

OBJECTIVE: To describe the successful laparoscopic management of a primary omental pregnancy. DESIGN: Case report. SETTING: Department of Obstetrics and Gynecology, Dr. Sami Ulus Obstetrics, Gynecology and Children's Hospital, Ankara, Turkey. PATIENT(S): A 22-year-old patient with an omental pregnancy. INTERVENTION(S): Laparoscopic partial omentectomy. MAIN OUTCOME MEASURE(S): Successful laparoscopic management of ...

In this chapter an overview is given of the best available evidence on the conservative treatment for tubal ectopic pregnancy, i.e., expectant management and medical treatment with systemic methotrexate. From the two randomized controlled trials on expectant management, no conclusions can be drawn yet. It may be that women with ...

OBJECTIVE: To assess gynaecologists' management of ectopic pregnancies in adolescents. METHODS: A survey was sent to Canadian gynaecologists, including pediatric gynaecologists, by mail and email. Pediatric gynaecologists in the United States were surveyed by mail. Variations in preferences and practices in the management of ectopic pregnancy were identified, with specific ...

Ectopic pregnancy remains the leading cause of death in the first trimester of pregnancy. Today, serial serum hCG measurements and transvaginal ultrasound examination can provide early detection of most ectopic pregnancies allowing medical treatment with methotrexate. In those who require surgery, the type of procedure depends on the clinical situation ...

Rupture of intracranial aneurysm in pregnancy is rare and the presentation is easily confused with eclampsia. A high index of suspicion could lead to early diagnosis and prompt management. A multidisciplinary team approach is essential for best outcome.

Background. The upper anterior abdominal wall is a very unusual location for an ectopic pregnancy making optimal management uncertain. Case. We report the case of a 26-year-old gravida 4, para 1, aborta 2 with a rising quantitative human chorionic gonadotropin level following a negative diagnostic laparoscopic examination. She was subsequently ...

Cornual pregnancy often poses a diagnostic and therapeutic challenge, with a significant risk for morbidity and mortality. Traditional treatment for cornual pregnancy has been through laparotomy, wedge resection, or hysterectomy. Early diagnosis is now possible through transvaginal ultrasonography and highly-sensitive beta-human chorionic gonadotropin assays. Consequently, several less-invasive therapies and techniques ...

OBJECTIVE: To determine which treatment should be offered to women with a non-ruptured tubal pregnancy: a single dose of methotrexate (MTX) or laparoscopic surgery. DESIGN: Prospective, randomized, open multicenter study. SETTING: Seven Danish departments of obstetrics and gynecology. SAMPLE: A total of 106 women diagnosed with ectopic pregnancy (EP). METHODS: ...

Cornual heterotopic pregnancy is a very rare condition; its incidence remains unknown. We report a case of cornual heterotopic pregnancy managed by laparoscopy and guided methotrexate injection into the cornual sac. A cornual heterotopic pregnancy was diagnosed at 9 weeks of amenorrhoea in a 31-year-old healthy woman. Ultrasound examination showed ...

Three cases of cesarean scar pregnancy successfully treated with methotrexate are described. The diagnosis was confirmed by transvaginal sonographic examinations showing a well-formed gestational sac in the myometrium of the lower uterine segment. Initial treatment with a systemic injection of 50 mg of methotrexate was not sufficient, and multiple doses ...

INTRODUCTION: Interstitial pregnancy is a rare but dangerous form of ectopic pregnancy. Although various forms of minimally invasive management for this disorder have been previously reported, optimal treatment regimen has not been yet unknown due to its rarity. CASE REPORT: A 29-year-old married woman with no previous disease history was ...

The objective of this study was to determine whether a single or repeated injection of methotrexate (MTX) to treat ectopic pregnancy results in either teratogenicity or other bad obstetric outcome in the pregnancy that shortly follows treatment. Data were retrieved from the medical records of 314 women treated with MTX ...

PURPOSE: Medical treatment of viable unruptured ectopic pregnancies by systemic methotrexate (MTX) is controversial due to elevated failure rates. This study describes a combined local and systemic MTX administration and compares the outcomes between viable ectopics in different locations. METHODS: This retrospective study evaluated 31 patients treated with combined local ...