Angular-interstitial pregnancy is a rare and potentially dangerous occurrence of ectopic pregnancy for which appropriate treatment has not been established. A 41-year-old woman with a history of ectopic pregnancy was treated with a combined regimen of conservative treatment comprising medical therapy with methotrexate and a minimally invasive laparoscopic-assisted surgical approach. ...

Conventional wisdom teaches that chronic headaches typically improve and often abate during pregnancy, leading many clinicians to take a wait-and-see approach of delaying treatment in hopes of seeing spontaneous improvement. Although headaches do improve in later pregnancy for up to 50% of chronic headache sufferers, headaches persist and may even ...

BACKGROUND: The aim of this review was to compare the efficacy, safety, patient preference, and cost-effectiveness of once-daily budesonide aqueous nasal spray (BANS), fluticasone propionate nasal spray (FPNS), mometasone furoate nasal spray (MFNS), and triamcinolone aqueous nasal spray (TANS) for treatment of allergic rhinitis (AR) in adult patients. METHODS: A ...

OBJECTIVE: To evaluate the safety and acceptability of a novel dosing regimen of methotrexate to treat ectopic pregnancy. DESIGN: Prospective study. SETTING: Three academic medical centers. PATIENT(S): One hundred one patients with ectopic pregnancy who elected to have medical therapy. INTERVENTION(S): Intramuscular methotrexate 50 mg/m(2) was administered on days 0 ...

OBJECTIVE(S): To clarify the respective definitions of cornual and interstitial pregnancy and to explore the difficulties in diagnosing these entities, particularly in the context of Müllerian fusion defects. DESIGN: Case study. SETTING: Community and tertiary-care hospitals. PATIENT(S): Female with recurrent pregnancy loss initially diagnosed with an interstitial pregnancy but subsequently ...

We report a case of cervical ectopic pregnancy successfully treated with systemic methotrexate. Conservative management with single-dose methotrexate was undertaken, but owing to the failure of human chorionic gonadotropin (hCG) levels to fall by 15% by day 7 and the persistence of fetal cardiac activity, two further doses of methotrexate ...

We report a case of a fetus with shortened proximal long bones, ambiguous genitalia, intrauterine growth restriction and abnormal umbilical artery Doppler velocities observed on antenatal ultrasound exam. At 34 weeks the patient revealed methotrexate/misoprostol exposure at 6 weeks gestational age in attempted medical termination of pregnancy. On newborn exam, ...

BACKGROUND: Ectopic pregnancy is the most important cause of maternal mortality and morbidity in the first trimester. Over the past few decades, the management of ectopic pregnancy has been revolutionized; various modalities of treatment are currently in practice. The purpose of this study was to determine the frequency ofthese modes ...

CONTEXT AND OBJECTIVE: As there is little information about fertility outcomes among women following clinical treatment (methotrexate and expectant management) and surgery (salpingectomy) consequent to ectopic pregnancy, we evaluate the results from hysterosalpingography subsequent to treatment. The objective was to evaluate contralateral tubal patency using hysterosalpingography following surgery and clinical ...

A 34-year-old woman was diagnosed by ultrasound with a six-week ectopic pregnancy with implantation of the gestational sac in the bladder wall. She was initially treated with methotrexate 50 mg/m(2) i.m. Although a 22% reduction in the levels of beta-hCG was observed at first, there was a rupture of gestational ...

Cervical pregnancy (CP) is an uncommon ectopic pregnancy that accounts for approximately less than 1% of extrauterine gestations. This case report describes a case of a viable ectopic CP successfully treated with systemic methotrexate therapy combined with hysteroscopic local endocervical resection of the heterotopic gestational sac. This approach, if validated, ...

A brief review is provided on the role of experimental modulation of the visual system during its plastic period. The importance of several substances has been demonstrated. Potential clinical applications of available studies on the treatment of amblyopia are summarized. The role of the dopaminergic system and particularly of dopamine ...

BACKGROUND: Q-switched (QS) pigmented lasers and intense pulsed light (IPL) successfully treat pigment disorders. OBJECTIVE: We sought to compare efficacy and side effects of QS alexandrite laser (QSAL) and IPL for freckle and lentigo treatment in Asians. METHODS: In all, 15 patients with freckles and 17 patients with lentigines were ...

OBJECTIVE: To evaluate the role of conservative management in the treatment of cervical ectopic pregnancies. METHODS: This was a retrospective analysis of all cervical ectopic pregnancies diagnosed in women attending our early pregnancy unit between April 1997 and September 2004 inclusive. The diagnosis of cervical ectopic pregnancy was made using ...

BACKGROUND: Medical treatment of the rare interstitial ectopic pregnancy with methotrexate has been considered an alternative to surgical resection. AIM: To determine the treatment success rate with a single-dose intravenous methotrexate/folinic acid regimen and to identify predictors of treatment outcome. METHODS: A 5-year audit (April 2000-August 2005) was carried out, ...

STUDY OBJECTIVE: To assess pregnancy course and outcome after laparoscopic cryomyolysis. DESIGN: Open, one-arm, observational clinical pilot study. (Canadian Task Force classification II). SETTING: University-affiliated public hospital. PATIENTS: Nine women who underwent laparoscopic cryomyolysis, with nine pregnancies observed. INTERVENTION: Laparoscopic cryomyolysis was performed by penetrating along the long axis of ...

We report three cases of first-trimester Cesarean scar pregnancy (CSP) treated with evacuation therapy. In one patient with a gestational age of 7 weeks and with deep sac implantation, there was massive uterine bleeding and uterine perforation following evacuation. The other two patients, both with a pregnancy < 7 weeks ...

Interstitial pregnancy is a rare condition of tubal pregnancy with a mortality rate of 2-2.5% [4] that can easily be misdiagnosed. The prevalence of interstitial pregnancy is 0.8% in normal population and it increased during the past few decades due to reproduction techniques development even up to 11% in groups ...

BACKGROUND: Methotrexate (MTX) embryopathy was described nearly 50 years ago, when this agent began to be used as a cancer treatment and abortifacient. In this report we describe a case with typical features of MTX syndrome together with new features to expand the phenotype. CASE: A 29-year-old woman decided to ...

BACKGROUND: Medical therapy with methotrexate is a standard practice for the commonly encountered problem of ectopic pregnancy. Methotrexate is excreted predominantly by the kidney and should be used with extreme caution in renal insufficiency. All physicians who administer methotrexate must understand its mechanism of action, distribution, and elimination to minimize ...

BACKGROUND: Symptoms of gastroesophageal reflux disease (GERD) are experienced by up to 85% of pregnant women. Some young women on maintenance proton pump inhibitor (PPI) treatment are choosing surgery to stop their medical treatment and avoid severe symptoms during pregnancy. There are no reports describing the effect of pregnancy on ...

We report that a-63-year-old woman developed Pneumocystis jiroveci pneumonia (PCP) as a complication from treatment with infliximab for rheumatoid arthritis. Although there was neither symptoms of dyspnea nor typical observations on a chest X-ray examination, low levels of oxygen saturation and findings of high-resolution chest computed tomographic scanning suggested a ...

STUDY OBJECTIVE: To introduce a novel tubal-sparing regimen for the treatment of nonruptured cornual pregnancies. DESIGN: Case report and systematic review of the literature. SETTING: Tertiary Care University setting. PATIENTS: Two patients referred for care in our subspecialty clinic. INTERVENTIONS: Laparoscopic surgery, dilation and evacuation, and postoperative methotrexate injection. Systematic ...

OBJECTIVE: To determine the reproductive outcome of women who have received methotrexate or been treated by laparoscopic salpingotomy (LS) for ectopic tubal pregnancy. STUDY DESIGN: The study consisted of 123 participants, all women with tubal pregnancies, who had been treated either by methotrexate per os or by laparoscopic salpingotomy. The ...

OBJECTIVE: After the confirmation of an intact interstitial pregnancy through sonographic diagnosis and laparoscopy, systemic and local methotrexate therapy is a well established conservative treatment to preserve the uterus. The parameters of successful treatment are the course of serum hCG value and sonographic changes. In this case series we describe ...

Unruptured live tubal ectopic pregnancies are often managed surgically. Significantly elevated beta-hCG levels in these patients make treatment with methotrexate ineffective. However, achieving cardiac asystole via sonographically guided injection of potassium chloride (KCl) along with systemic methotrexate can improve treatment outcome. We describe the successful conservative management of 3 cases ...

BACKGROUND: An ectopic pregnancy developing in a Caesarean section scar is extremely rare. This type of ectopic pregnancy carries with it a high risk of morbidity related to uterine rupture and extensive hemorrhage. Conservative treatment in the form of local or systemic injection of methotrexate or local injection of potassium ...

BACKGROUND: A 25-year-old woman with a 3-year history of rheumatoid arthritis presented 6 months before her first planned pregnancy. At the time of presentation, she was being successfully treated with infliximab and methotrexate. During her pregnancy, the patient discontinued infliximab and methotrexate and her arthritis relapsed. She was treated with ...

BACKGROUND: Interstitial pregnancy is a rare and dangerous form of ectopic pregnancy which is treated by surgery, medical treatment, or both. Management options are not standardized. Currently, conservative nonsurgical treatment seems to be an alternative method in case of interstitial pregnancy. CASE: A right interstitial pregnancy was diagnosed in a ...

Appendectomy is the most common nongynecologic surgery performed during pregnancy. Although many surgeons offer laparoscopic appendectomy (LA) as an alternative to open appendectomy (OA) during early pregnancy, few studies have compared the effects of LA versus OA on the fetus and the outcome of the pregnancy. Twenty-eight consecutive females undergoing ...

INTRODUCTION: We describe a patient who developed an acute generalised pustular eruption associated with pyrexia at 33 weeks of gestation. CLINICAL PICTURE: Her condition was complicated by preterm labour, requiring an emergency caesarean section delivery. A diagnosis of impetigo herpetiformis was made on clinicopathological grounds. TREATMENT: Initial treatment with topical ...

OBJECTIVE: To identify demographic, morphological and biochemical characteristics of interstitial pregnancies that are associated with a successful outcome of conservative treatment (expectant management or medical treatment with methotrexate). METHODS: Over a period of 6 years all clinically stable women with a certain ultrasound diagnosis of interstitial ectopic pregnancy were managed ...

Cornual pregnancy is a rare condition. The morbidity and mortality are directly related to the length of time for diagnosis. The present paper reports a case of unruptured left cornual pregnancy which was diagnosed by the patient's symptom, physical examination and positive urine pregnancy test. Ultrasonography confirmed the diagnosis. Left ...

BACKGROUND AND OBJECTIVE: Subpurpuric treatments with the pulsed dye laser can be effective for treatment of vascular lesions, although less so than when purpuric fluences are used. Increased efficacy may be achieved by performing multiple passes at the time of treatment. We performed a split-face bilateral paired comparison of multiple ...

This report concerns a recurrent spontaneous cornual pregnancy 2 years after selective feticide of a heterotopic cornual pregnancy which occurred after IVF for tubal pathology. The recurrent cornual pregnancy was treated successfully with systemic methotrexate. Assisted reproductive techniques, especially in patients with tubal pathology, and non-invasive management of cornual pregnancies ...

Ectopic pregnancy developing in a previous Cesarean section scar is rare and is associated with catastrophic complications, such as uterine rupture and uncontrollable bleeding, which may lead to loss of the uterus. The operative treatments that have been reported for cesarean scar pregnancy are dilatation and curettage and excision of ...

BACKGROUND AND OBJECTIVE: Nonablative resurfacing has proven its efficacy in vascular and pigmented lesions, while its capacity of substantial wrinkle reduction is still discussed controversially. We present the treatment results of a 1,450 nm diode laser for facial rhytides. METHODS: Thirty facial regions were treated with a 1,450 nm diode ...

Current management of cesarean scar pregnancy is conservative and consists of medical treatment with methotrexate (MTX). We present a report on a woman with this type of pregnancy who had continuous vaginal bleeding and persistent serum levels of beta human chorionic gonadotropin after undergoing curettage and MTX. Eventually, the remaining ...

The market for skin rejuvenation has grown vastly during the last decade. Many new laser technologies are now available to the practitioner for the treatment of sundamage. Ablative laser techniques, while currently less popular because of associated protracted healing times and greater risk of scarring and pigmentary change, remain the ...

BACKGROUND: Pregnancy developing in a cesarean scar is a very rare but possibly life-threatening condition because of the risk of rupture and excessive hemorrhage. CASE: A 34-year-old woman presented with lower abdominal pain at 6 weeks of gestation. A cesarean delivery had been performed 3 years earlier. Transvaginal ultrasound examination ...

BACKGROUND: Cornual pregnancy is a rare type of ectopic pregnancy. Methotrexate (MTX) has been used successfully for the treatment of tubal pregnancies; however, its use for interstitial pregnancies is less common. CASES: Three cases of cornual pregnancy were successfully treated with a single MTX injection (50 mg/m2), without complications. CONCLUSION: ...

OBJECTIVE: To evaluate tubal patency using hysterosalpingography after clinical treatment of tubal pregnancy. METHOD: Of 80 patients who underwent hysterosalpingography after clinical treatment of tubal pregnancy from April 1994 to February 2002, 30 were treated with a single 50 mg/m(2) dose of methotrexate intramuscularly (n=30) and 50 were followed up ...

A case of an early cervical pregnancy diagnosed by transvaginal Doppler ultrasonography and successfully treated by systemic and local injection of methotrexate to avoid complications of the surgical procedures in use and to preserve future fertility is presented. This procedure may become a useful alternative to more radical or complex ...

PURPOSE: To review the problem of heartburn in gravid women, discuss the present treatment options, and examine the use of proton pump inhibitors (PPIs) as one of the treatment options for moderate to severe heartburn. DATA SOURCES: Extensive review of worldwide scientific literature on the use and safety of PPIs ...

We present a case of a 30-year-old pregnant woman with renal cell carcinoma who underwent successful laparoscopic radical nephrectomy at 11 weeks of gestational age. The remainder of the pregnancy was uncomplicated, and the patient gave birth to a healthy baby boy at term. Although previous cases of successful nephrectomy ...

To evaluate methotrexate (MTX) administration as a conservative treatment for ectopic pregnancy, we reviewed the medical records of 248 cases (210 patients) of MTX treatment for tubal pregnancies at our department between December 1985 and December 2003, and compared its pregnancy prognosis with that of laparoscopic salpigotomy (59 patients). With ...

BACKGROUND: Interstitial pregnancies too large to be treated with methotrexate are usually managed surgically, and that may adversely affect future fertility and pregnancies. Transcervical curettage under laparoscopic guidance may be possible in some cases if the pregnancy is accessible vaginally. CASE: Three women with interstitial pregnancy were treated by transcervical ...

OBJECTIVES: To evaluate the effectiveness of systemic methotrexate in the treatment of interstitial pregnancy. DESIGN: Prospective observational study. SETTING: An Early Pregnancy Assessment Unit in a London teaching hospital. SAMPLE: Twenty consecutive women diagnosed with an interstitial pregnancy. METHODS: Women were diagnosed with an interstitial pregnancy based on transvaginal ultrasound ...

A 30-year-old woman with a history of 6 spontaneous first trimester abortions and no living children, who had previously been treated for polycystic ovarian syndrome, was given methotrexate parenterally for a suspected ectopic pregnancy at 5 weeks of amenorrhea. Later, a surviving intrauterine pregnancy was noted, and the pregnancy continued. ...

OBJECTIVE: To determine the success rate of methotrexate treatment of ruptured ectopic pregnancy with hemodynamically stable and unruptured ectopic pregnancy patients. STUDY DESIGN: This prospective clinical study was carried out on 161 patients with suspected tubal ectopic pregnancy. Fourty-six patients have been accepted as ruptured ectopic pregnancy with hemodynamically stable ...