Tramadol produces analgesic effects through both non-opioid and weak opioid activity and is commonly used to treat mild to moderate pain. It has been in use for over 30years and has a well-established safety profile in the general population. Since tramadol is not licensed for use in pregnancy and lactation, ...

Gallstone pancreatitis is a rare problem in pregnant patients. A primigravida with persistent symptoms of abdomen pain, nausea, vomiting, and inability to tolerate oral diet presented at 5 weeks of pregnancy. A laparoscopic cystogastrostomy with cholecystectomy was performed at 13 weeks of pregnancy. There are only 10 case reports in ...

There is a common belief that the laxity of pelvic joints increases in pregnancy. The hormone relaxin is suggested to be one of the most influential factors implementing this effect. Furthermore, increased laxity is assumed to induce pelvic girdle pain (PGP). The objectives were to examine the serum relaxin levels ...

Vaginal bleeding, abdominopelvic pain, nausea, and vomiting are common presenting symptoms in early pregnancy. All women of reproductive age who present with abdominal or pelvic pain or with vaginal bleeding should be evaluated for possible pregnancy. There should be a high index of suspicion for ectopic pregnancy in women presenting ...

Perforated Peptic Ulcer (PPU) is extremely rare in pregnancy. We report a case of perforated peptic ulcer in pregnancy during Ramadan fasting. The patient is a 16 years old primigravida who presented with features of peritonitis at 28weeks of gestation while fasting during Ramadan. Ultrasound scan reported a singleton live ...

Several studies have reported that the fine-tuning of regulatory T cells (Tregs) is required for a successful pregnancy and for the control of autoimmune diseases. Here, we review the mechanisms that control the expansion of Tregs, based on insights obtained from the study of women suffering unsuccessful pregnancies and on ...

To evaluate volumetric changes of uterine myomas (fibroids) during pregnancy. This was an observational, longitudinal and prospective study of 38 consecutive Caucasian women with singleton pregnancies and a total of 42 uterine myomas, enrolled from a cohort of 1492 women who took part in our first-trimester Down syndrome screening program. ...

We present a study of 37 women who underwent uterine compression suture for postpartum hemorrhage, with 13 postoperative assessments by hysteroscopy. Synechia occurred in seven patients, of whom three had Asherman syndrome (23% of women who desired pregnancy and had hysteroscopic evaluation) that could not be corrected.

Patients with duplication anomalies have a higher incidence of infertility, repeated first trimester spontaneous abortions, fetal intrauterine growth restriction, fetal malposition, preterm labor, and retained placenta. The role of imaging is not only to detect and diagnose müllerian anomalies but also to help distinguish surgically correctable forms of müllerian duct ...

Ultrasonography (US) could be used in emergency out-of-hospital settings to diagnose abdominal hemorrhage. To report the diagnosis by US of a suspected case of ruptured ectopic pregnancy despite a supposedly in utero pregnancy. A mobile intensive care unit with an emergency physician on board was sent out to a 22-year-old ...

Uterine secretions are essential for the development of the conceptus during pregnancy. In pigs, various molecules, including transport proteins, growth factors, enzymes, and extracellular matrix proteins, are secreted into the uterine lumen. Our previous work identified salivary lipocalin (SAL1), a steroidal pheromone-binding protein, as present in the porcine uterus. To ...

To evaluate the outcome of pregnancy after uterine fibroid embolization (UFE). Retrospective study. Private hospital affiliated with a university. In a single center, UFE was performed in 74 patients who wanted to become pregnant. Polyvinyl alcohol particles (PVA) or embozene microspheres were used to embolize the uterine arteries. Enhanced pelvic ...

A successful pregnancy outcome relies on extensive maternal cardiovascular adaptation, including enhanced uteroplacental vasodilator mechanisms. The objective of the present study was to determine the contribution of the endothelium-derived hyperpolarizing factor (EDHF) signaling in pregnancy-enhanced uterine vasodilation, to define the role of Ca(2+)-activated K(+) channels in mediating EDHF effects, and ...

OBJECTIVE: The reproductive and gynecologic outcomes for women after the pregnancy complicated by open maternal-fetal surgery (OMFS) were evaluated. STUDY DESIGN: The retrospective review identified 93 women with OMFS from a single institution (1996-2007). Consent and questionnaires were sent to women. Institutional review board approval was obtained from the Committee ...

Rupture of an unscarred uterus is a rare and potentially catastrophic event. Common presenting signs and symptoms include abdominal pain, fetal heart rate abnormalities, and evidence of hypovolemia. A woman with a history of 2 prior uncomplicated first-trimester pregnancy terminations presented several years later at 32 weeks' gestation with abdominal ...

Retroverted uterine incarceration with sacculation of the anterior wall is reported to occur approximately in 1/3000 pregnancies. A literature search identified only one case report of incarceration of an anteflexed gravid uterus and six reported cases of recurrent incarceration and/or sacculation. We present a case of an incarceration of an ...

OBJECTIVE: To estimate the width of the normal uterine cavity at the fundus and evaluate its relationship to parity, gravidity, prior cesarean delivery, uterine volume, and patient age. METHODS: From September 1, 2009, to November 10, 2009, all premenopausal patients aged 50 years or younger who had a normal uterus ...

Uterine artery pseudoaneurysm is a rare complication mainly of abdominal or interventional delivery that can cause profuse postpartum hemorrhage if unrecognized or inadequately treated. There has been no report of this disorder accompanying uneventful second-trimester pregnancy termination. A primiparous Japanese woman underwent pregnancy termination at 24 weeks' gestation due to ...

Uterine arteries play a major role in regulating uteroplacental blood flow. Failure to maintain blood flow to the uteroplacental compartment during pregnancy often results in intrauterine growth retardation. Immunohistochemical staining of adrenomedullin (AM), an endogenous vasoactive peptide, in uterine artery was intense in pregnant compared to nonpregnant rats, but it ...

BACKGROUND: Short interpregnancy interval and uterine instrumentation are risk factors for uterine rupture in subsequent pregnancies. Misoprostol as a uterotonic agent is an additive risk factor for rupture of a scarred uterus. CASE: Misoprostol induction for a term stillbirth was complicated by uterine rupture. Risk factors for this uterine rupture ...

We reviewed the existing literature on medical termination of pregnancy in cases of congenital uterine malformation. Is medical termination of pregnancy safe in the presence of a uterine anomaly? Can termination of pregnancy still be performed when information concerning the presence of congenital uterine malformation is not available? The risk ...

Intrauterine growth restriction (IUGR) is observed in conditions with limitations in uterine space (e.g., uterine anomalies and multifetal gestations). IUGR is associated with reduced fetal weight, organ growth, and a spectrum of adult-onset diseases. To examine the interaction of uterine anomalies and multifetal gestations, we developed a surgical uterine space ...

Uterine leiomyomas (fibroids, myomas) are a common benign disease of the uterus with a prevalence of 8-18%. Prevalence rates vary with race, and fibroids are most common in African American women. Uterine leiomyomas can also be present during pregnancy, which may occur more frequently than previously suspected, with prevalence rates ...

The prevalence of uterine myomas during pregnancy is estimated to range from 0.3% to 2.6%. Although leiomyomas usually remain asymptomatic, in one often cases they may be complicated. The management of uterine fibroids during pregnancy is largely conservative and surgical removal is generally delayed until post partum. A 37-year-old pregnant ...

This study was conducted to determine uterine echogenicity by grey-scale analysis (GSA) and transcutaneous ultrasonography in pregnant sows (P-sows; n=16) and gilts (P-gilts; n=13) vs. cyclic gilts (C-gilts; n=9) between days 8 and 16 post ovulation (po) with the aims of testing for feasibility of uterine GSA and of gathering ...

Ruptured uterus is an obstetric catastrophe and results in significant maternal and perinatal morbidity and mortality in Nigeria. To review the incidence and management of ruptured uterus over the 8-year period (2000-2004 and 2007-2009) and analysis of records of cases of ruptured uterus during the period under review in a ...

Transgenic and knockout mouse models have proven useful in the study of genes necessary for parturition-including genes that affect the timing and/or progression of labor contractions. However, taking full advantage of these models will require a detailed characterization of the contractile patterns in the mouse uterus. Currently the best methodology ...

We performed a systematic review of the current literature on efficacy, complications and impact on future pregnancies of uterine compression sutures (UCS) applied in cases of severe postpartum haemorrhage (PPH) in women who wish to preserve fertility. Publications related to UCS from their initial description 03/1996-07/2009, were identified using PubMed ...

Vitamin A (VA) is required for normal fetal development and successful pregnancy. Excessive VA intake during pregnancy may lead to adverse maternal and fetal effects. Cytochrome P450 26A1 (cyp26a1), a retinoic acid (RA)-metabolizing enzyme, is involved in VA metabolism. It has been shown that cyp26a1 is expressed in female reproductive ...

OBJECTIVES: (a) To review the cases of ruptured uterus over the last 25 years and analyze the causative factors with a view to its prevention (b) To analyze subsequent pregnancy outcome with a view to its safety. METHOD: The case notes were reviewed for all patients with ruptured uterus over ...

The purpose of this study was to analyse hysteroscopic results in patients with recurrent miscarriages and to compare the frequency of uterine anomalies in women with a history of exactly two and with more than two consecutive miscarriages. A retrospective analysis of 206 patients undergoing hysteroscopy for repeated early pregnancy ...

Uterine fibroids are the most common benign tumor of the uterus in women of reproductive age. However, most of them are asymptomatic and do not require any treatment. Menorrhagia and pelvic pain are the most usual symptoms, and some women may present with infertility or pregnancy-related complications. In those with ...

We report a case of a rudimentary horn pregnancy with herniation of a fetal arm and umbilical cord into the main uterine cavity that presented as an incidental finding on a routine second-trimester ultrasound scan. We also review the literature that guides the diagnosis and management of these rare complicated ...

Uterine rupture is an important cause of obstetrical hemorrhage associated with morbidity for mother and fetus. Risk factors should be discussed in the counseling process. Intrapartum findings including maternal condition, fetal heart rate monitoring, and uterine activity may prove helpful in making the diagnosis of a dehiscence or rupture, but ...

Many signaling pathways that contribute to tumorigenesis are also functional in pregnancy, although they are dysregulated in the former and tightly regulated in the latter. Transformation-related protein 53 (Trp53), which encodes p53, is a tumor suppressor gene whose mutation is strongly associated with cancer. However, its role in normal physiological ...

BACKGROUND: Congenital uterine anomalies are associated with the highest incidence of reproductive failure and obstetric complications. This study aimed to summarize the clinical characteristics and prenatal outcome of pregnancy in women with congenital uterine malformations. METHODS: This retrospective study evaluated the fertility and obstetric outcome of 116 inpatients with uterine ...

BACKGROUND: Uterine rupture after endometrial ablation is rare and has not been reported previously in the English literature. CASE: A 33-year-old multigravida at 26 5/7 weeks of gestation had undergone two endometrial ablation procedures. The first attempt 2 years before pregnancy was complicated by uterine perforation. She presented with severe ...

We report a case of spontaneous uterine rupture caused by placenta percreta at 18 weeks' gestation after in vitro fertilization. Spontaneous uterine rupture is an extremely infrequent obstetric complication that may compromise the lives of the fetus and the mother. We describe the case of a pregnant woman at 18 ...

OBJECTIVE: To evaluate reproductive outcomes after hysteroscopic metroplasty of uterine septa using three-dimensional ultrasound. DESIGN: Prospective study. SETTING: University teaching hospital. PATIENT(S): One hundred fourteen women with uterine septa. INTERVENTION(S): Three-dimensional ultrasound followed by hysteroscopic resection of the uterine septum (metroplasty). MAIN OUTCOME MEASURE(S): Reproductive outcome after hysteroscopic metroplasty. RESULT(S): ...

Uterine rupture during pregnancy is a rare occurrence that frequently results in high incidence of maternal and fetal morbidity and mortality. To study the incidence, risk factors, maternal and fetal outcome of uterine rupture. A retrospective study. A retrospective study was carried out in the Department of Obstetrics and Gynecology ...

The adaptive growth of the uterus is a critical event that involves changes in cellular phenotypes throughout pregnancy. In early pregnancy, uterine growth is due to hyperplasia of uterine smooth muscle cells (SMCs) within the myometrium; however, the major component of myometrial growth occurs after mid-gestation. This study sought to ...

We report the case of a 30-year-old woman who presented with intrauterine fetal demise of a 17-2/7-week male fetus. The patient failed misoprostol induction and was taken for surgical evaluation. At the time of surgery an ectopic pregnancy in a noncommunicating rudimentary uterine horn was found. Histologic examination of the ...

OBJECTIVES: To determine and compare the fertility and pregnancy outcomes following embolisation with or without uterine-sparing surgery for postpartum haemorrhage, and to attempt to identify specific risk factors associated with an increased likelihood of intrauterine synechia. DESIGN: Retrospective study. SETTING: University-affiliated tertiary referral centre. POPULATION: All consecutive women who had ...

BACKGROUND: Uterine prolapse in pregnancy is rare and can either occur during pregnancy or be present before the pregnancy. We present a case of a successful pregnancy in a patient with preexisting uterine procidentia. CASE: A 44-year-old woman with a history of complete uterine prolapse presented with an unplanned pregnancy. ...

In 1% of Rhesus negative women sensitisation occurs without any overt sensitising event during pregnancy. This accounts for late immunisation during a first pregnancy and is responsible for 18-27% of cases of alloimmunisation. The incidence of congenital uterine anomalies in a fertile population is 3.2% of which 5% are bicornuate ...

Congenital uterine anomalies (CUA) are a known cause of recurrent miscarriage (RM), but the pattern of pregnancy loss that different CUA produce remains unknown. This study included 665 women with RM who were screened for CUA using a combined two-dimensional ultrasound (2D-US) and hysterosalpingography (HSG) approach. All suspected CUA were ...

In cattle, limited data are available regarding the sex ratio of the offspring in relation to the horn of gestation. Therefore, the objective of this study was to evaluate the sex ratio of fetuses gestated in the left and right uterine horns of cattle (Bos taurus, Bos indicus and crosses). ...

Uterine rupture is one of the most feared obstetric complications, carrying an increased risk of maternal and perinatal morbidity and mortality. Here, we present a case of spontaneous uterine rupture during the first half of pregnancy. The patient did not report any recent trauma, however she had a history of ...

Colour-Doppler ultrasonography was used to study the spatial relationship between vascular perfusion in the middle of each uterine horn and the reported location of the embryo proper and expanding conceptus using endometrial vascularity scores 1-4 (nil-maximal). Vascularity increased in both uterine horns between days 14 and 18 (day 0=ovulation) in ...

PURPOSE: Information about fetal and maternal outcome in pregnant women with mixed connective tissue disease (MCTD) is rare and in part contradictory. The purpose of this study is to review published literature about MCTD in pregnancy in the context of a rare case of peripartum bilateral uterine rupture in a ...