OBJECTIVE: To validate the efficacy and safety of our clinical protocol for expectant management of selected women diagnosed with tubal ectopic pregnancy. METHODS: This was a prospective observational study carried out in the Early Pregnancy Unit (EPU) of a London inner city university teaching hospital from the 1(st) of January ...

ABSTRACT Background. In the light of several recent recommendations to use total thyroxine (T4) measurements in the diagnosis of thyroid function in pregnancy, [in particular "Clinical Practice Guidelines for Hypothyroidism in Adults", cosponsored by the American Thyroid Association and the American Association of Clinical Endocrinologists, which promote the use of ...

Observational studies suggest higher pregnancy rates after the hysteroscopic removal of endometrial polyps, submucous fibroids, uterine septum or intrauterine adhesions, which are detectable in 10% to 15% of women seeking treatment for subfertility. To assess the effects of the hysteroscopic removal of endometrial polyps, submucous fibroids, uterine septum or intrauterine ...

Ectopic pregnancy after hysterectomy is an unusual diagnosis that may lead to significant morbidity, especially when diagnosis is not timely. A 41-year-old woman presenting with abdominal pain and vaginal bleeding 5 years after a vaginal hysterectomy was found to have a tubal ectopic pregnancy, which required emergent surgical intervention. Ectopic ...

The aim of this study is to assess the rate of prenatal detection of multiple congenital contractures, to identify reasons for the failure of prenatal diagnosis and to propose the first guidelines to improve prenatal diagnosis. We evaluated records on 107 individuals recognized at birth to have Amyoplasia. We reviewed ...

Despite its recognized limitations, fetal heart rate monitoring is a mainstay of intrapartum care. Although the basic technology in standard electronic fetal monitors has changed little in recent decades, clinical behavior in response to heart rate monitoring has changed considerably. In addition to clearly defined nomenclature and clinical guidelines, there ...

An interstitial ectopic pregnancy is a rare and a dangerous form of an ectopic pregnancy. It presents late clinically and it is difficult to be imaged radiographically. We are presenting a case of an interstitial pregnancy which was a surprise intra operative finding.As Assisted Reproductive Technology (ART) procedures are becoming ...

Given the present lack of clinically useful tests for the accurate diagnosis of ectopic pregnancy (EP), there is a need to select out those immunological factors measured in the maternal serum, as potential biomarkers. Our assumption was that C1q/anti-C1q antibody complexes and serum levels of interleukin-15 (IL-15) may play a ...

In fetal/neonatal alloimmune thrombocytopenia (FNAIT), antibodies against paternal antigens present on fetal platelets are produced by the mother. These antibodies will cross the placenta and can cause thrombocytopenia of the unborn. One severe consequence of thrombocytopenia is intracranial bleeding which may lead to death or severe sequelae. FNAIT index cases ...

The assessment of the embryo quality is crucial to maintain an high pregnancy rate and to reduce the risk of multiple pregnancy. The evaluation of the pronuclear and nucleolar characteristics of human zygote have been proposed as an indicator of embryo development and chromosomal complement. The aim of the ...

To examine the extent of primary care follow-up and mental health outcomes among women referred for ultrasound assessment of pain and/or bleeding in early pregnancy, including those whose pregnancy is found to be viable on ultrasound assessment. Questionnaire study with prospective follow-up. Urgent gynaecology clinic in secondary care, England. 57 ...

The clinical presentation of eosinophilic myocarditis may vary from asymptomatic to the manifestation of severe symptoms, including cardiac tamponade and arrhythmias. In pregnant patients with this condition, drugs must be used cautiously up to approximately the 4th month of pregnancy because drug use should be limited during the period of ...

Autoantibodies to thyroglobulin and thyroid peroxidase are common in the euthyroid population and are considered secondary responses and indicative of thyroid inflammation. By contrast, autoantibodies to the TSH receptor are unique to patients with Graves' disease and to some patients with Hashimoto's thyroiditis. Both types of thyroid antibodies are useful ...

Unicornuate uterus occurs due to a complete or partial nondevelopment of one Mullerian duct; sometimes it is associated with a rudimentary horn, which can communicate or not with uterine cavity or contain functional endometrium. Pregnancy in a rudimentary horn is rare and the outcome almost always unfavorable, usually ending in ...

Presented is a case of an acute, right flank, loin to groin pain in the third trimester of an otherwise uncomplicated pregnancy. Renal calculi was suspected clinically and supported by radiological evidence. Temporising treatment was undertaken successfully by retrograde ureteric stenting, which became blocked, secondarily resulting in a percutaneous nephrostomy. ...

Placental chorioangiomas are relatively common benign placental tumors occurring with an incidence of approximately 1% of histologically studied placentas. However, they show clinical manifestations in very rare pregnancies usually at a median gestational age of 28 weeks. Our report presents an interesting and rare case of severe hydramnios with consequent ...

In this paper, we present the very rare case of a 21 weeks pregnant woman, examined clinically and by ultrasound. We could observe the present of two heads and a common trunk and therefore we proceeded to the small caesarian of necessity. We examined the fetus from the clinical and ...

Synchronization between embryonic stage and endometrium is vital to achieve a successful pregnancy. The objective of this study was to assess the implantation, clinical pregnancy and live birth rates of cryopreserved embryo transfer cycles using embryos after extended culture for 16h. A prospective randomized controlled pilot study was performed on ...

We report the case of a 20-year-old female who presented to the ER with a 1-week history of worsening abdominal pain and intermittent vaginal bleeding for the previous 5 days. Physical exam was notable for bilateral adnexal tenderness and a closed cervix without motion tenderness or discharge. Laboratory data demonstrated a ...

BACKGROUND: There are over 30 cases of prenatally diagnosed sacral extensions or human 'tails' in the literature, including isolated and syndromic etiologies. Most cases were reported to resolve by the second trimester and postnatal course was benign. Our objective was to describe the prenatal findings, associated anomalies, and clinical outcome ...

The sperm chromatin structure assay (SCSA) parameter DNA fragmentation Index (DFI) is a valuable tool for prediction of fertility in vivo. Clinical data show that a DFI above 30% is associated with very low chance for achieving pregnancy by natural conception or by insemination. Already when DFI is above 20% ...

This single-centre retrospective observational study was performed at a university IVF centre. The aim was to examine the predictive power of AMH concentrations for clinical pregnancy rate (CPR) and establish a cut-off concentration of AMH below which no pregnancies were achieved. Data from 820 women with one treatment cycle each ...

The peripartum period entails the next prenatal interval when novel neuroprotective strategies will be designed and tested. Research development will lead to novel evaluations for maternal-fetal pairs who require inpatient treatment and possible delivery for worsening or acute neurologic problems. Future studies should critically compare serial fetal surveillance assessments with ...

It has long been hoped that cesarean hysterotomy scar imaging data could predict obstetric complications in subsequent pregnancies with sufficient precision to be used for clinical decision-making. Although large visualized defects in nonpregnant uteri, and thinning of the lower uterine segment late in subsequent pregnancies, may be associated with increased ...

A new diagnosis of primary adrenal insufficiency (PAI) during pregnancy is extremely rare and difficult to recognise as signs and symptoms such as nausea, fatigue and hypotension may resemble features of normal pregnancy. However, if the diagnosis is overlooked and steroid replacement delayed, subsequent adrenal crisis triggered by hyperemesis gravidarum, ...

OBJECTIVE: To compare the clinical outcomes between fresh and vitrified-thawed day 5 blastocyst transfers. DESIGN: Retrospective case control study. SETTING: Tertiary referral center. PATIENT(S): Patients 38 years of age or less who underwent IVF/ICSI cycles with fresh or frozen-thawed blastocysts transferred from June 1, 2009 to November 30, 2011 INTERVENTION(S): Vitrification ...

A mild thrombocytopenia is relatively frequent during pregnancy and has generally no consequences for either the mother or the fetus. Although representing no threat in the majority of patients, thrombocytopenia may result from a range of pathologic conditions requiring closer monitoring and possible therapy. Two clinical scenarios are particularly relevant ...

Ischemic heart disease is uncommon during pregnancy, occurring in approximately 1/10,000 pregnancies resulting in live births. However, the increased age and fertility of mothers has suggested that the coexistence of pregnancy and coronary artery disease is likely to increase. A subject of debate is the management of dual antiplatelet therapy ...

INTRODUCTION: Prenatal counselling in case of fetal obstructive uropathies still represents a clinical dilemma, despite ultrasound detection of lower urinary tract obstruction has greatly advanced during recent years as well as fetal intervention techniques. MATERIALS AND METHODS: A systematic review of the relevant literature on the topic was performed, with ...

The present study investigated if acetyl salicylic acid (ASA) and terbutaline in combination increased the clinical pregnancy rate in patients undergoing in vitro fertilisation (IVF)/intra-cytoplasmic sperm injection (ICSI). A randomised controlled trial was designed, in which 167 patients were randomised to taking ASA for 9 weeks after embryo transfer and ...

Nowadays ectopic pregnancy often can be diagnosed before the woman's condition has deteriorated, which has altered the former clinical picture of a life-threatening disease into a more benign condition. This review describes the historical developments in the diagnostic and therapeutic management of ectopic pregnancy leading up to current clinical practice. ...

Pregnancy of unknown location (PUL) is a common diagnostic challenge. The primary diagnostic goal is to ensure that the PUL is nonviable prior to proceeding with any invasive procedures. In nonviable PUL, there are several diagnostic and treatment strategies, which are generally quite safe. However, the management option that provides ...

Abstract The collection of fetal genetic materials is required for the prenatal diagnosis of fetal genetic diseases. The conventional methods for sampling fetal genetic materials, such as amniocentesis and chorionic villus sampling, are invasive in nature and are associated with a risk of fetal miscarriage. For decades, scientists had been ...

In this article, we critically examine the clinical guidelines for obesity in pregnancy put forth by the Society of Obstetricians and Gynaecologists of Canada (SOGC) that are underpinned by the rules of Evidence-Based Medicine (EBM), a system of ranking knowledge that promises to provide unbiased evidence about the effectiveness of ...

BACKGROUND: Complete automation of high-performance liquid chromatography (HPLC) for determination of hemoglobin F (%Hb F) and hemoglobin A1c (%Hb A1c) levels has made this procedure available in many clinical laboratories. However, the physiological changes in %Hb F during pregnancy and the effects of physiological and supraphysiological levels of %Hb A1c ...

Molar pregnancies in most instances develop within the uterine cavity, but may occur at any site. Ectopic molar pregnancy is a rare event. The objective of this study was to present a case of ruptured tubal molar gestation, discuss its clinical features and ways to improve diagnostic accuracy. A 35-year-old ...

The serial measurement of serum hCG concentrations is an important clinical tool used to differentiate normal from abnormal pregnancies. At hCG values below which ultrasonography can be diagnostic, the comparison of a patient's hCG dynamics to those of established expected curves of rise or fall can aid the clinician in ...

Gestational hypertension and preeclampsia are major contributors to perinatal morbidity and mortality. The diagnosis of gestational hypertension still relies on conventional clinic blood pressure (BP) measurements and thresholds of ≥140/90 mm Hg for systolic (SBP)/diastolic (DBP) BP. However, the correlation between BP level and target organ damage, cardiovascular disease risk, and ...

The aim of this study is to compare the cumulative clinical pregnancy and live birth rates (fresh embryo transfers followed by frozen-thawed embryo transfers from the same stimulated cycle) between single-embryo transfer (SET) and double-embryo transfer (DET) in an oocyte donation programme. A retrospective analysis of the outcome in 1139 ...

In some IVF cycles, no fresh embryo transfer in the stimulated cycle is advisable. The cryopreservation of zygotes and the transfer of blastocysts in a cryo-embryo transfer is an option to circumvent an inadequate uterine environment due to risk of ovarian hyperstimulation syndrome, inappropriate endometrium build up, endometrial polyps or ...

A primary ovarian pregnancy is one of the rarest varieties of ectopic pregnancies. The conditions which are most commonly confused with an ovarian pregnancy are, a ruptured corpus luteal cyst, a haemorrhagic corpus luteum and a ruptured endometriotic cyst. This case presents the clinical and the histological findings of a ...

BACKGROUNDThe term 'pregnancy of unknown location' (PUL) refers to cases where a pregnancy test is positive but the pregnancy cannot be visualized by transvaginal sonography (TVS). Various strategies integrating TVS and serum hCG measures are used to follow-up until the location and/or viability of the pregnancy becomes clear; however, the ...

During pregnancy, hormonal fluctuations, fluid shifts, and musculoskeletal changes predispose women to carpal tunnel syndrome. While the clinical presentation is similar to other patients, the history obtained must include information regarding the pregnancy itself. Currently, the indication for electrodiagnostic testing is not clearly defined. Given that symptoms often improve with ...

Abstract Background: Termination of pregnancy (ToP) is currently illegal in Ireland. In 2010, more than 4000 women travelled from Ireland to the UK for a ToP. Objectives: The aims of this study were to assess the attitudes and clinical experiences of Irish General Practitioners (GPs) and GPs-in-training (GPRs) towards ToP. ...

Premature rupture of membranes (PROM) is one of the most common complications of pregnancy that has a major impact on pregnancy outcomes. A diagnostic tool that is non-invasive, specific and quick is needed to predict PROM. The purpose of this study was to evaluate the diagnostic power of the vaginal ...

For women with multiple sclerosis (MS) who become pregnant, the risks and benefits of ongoing therapy for the health of both the mother and the fetus must be carefully considered. Based on a literature review and our MS center's standard practices, we provide guidance to aid clinical decision making in ...

OBJECTIVE: To establish the current practice of obstetricians with regard to assessment of women in labour before instrumental delivery. STUDY DESIGN: A national postal survey of obstetricians in consultant-led obstetric units in the United Kingdom and Ireland. Clinical assessment before instrumental delivery, factors associated with difficulty in determining the fetal ...

Abstract Objective: The objective of the study is to evaluate whether there is a difference in serum soluble free acid synthesis (sFas)/sFasL levels between patients with preeclampsia, severe preeclampsia and normal healthy pregnancy. Methods: This is a case control study comparing serum sFas and sFasL concentrations in patients with mild ...

Preeclampsia is a pregnancy-specific disorder characterized by hypertension and systemic endothelial dysfunction. Interleukin (IL)-1β is a possible mediator of maternal endothelial dysfunction in preeclampsia. Serum IL-1β as well as its natural inhibitor IL-1 receptor antagonist (IL-1Ra) were reported to be increased in women with preeclampsia. In the current study, we ...

Abstract Objective: To examine the potential value of maternal serum level of C-reactive protein (CRP) in the first trimester of pregnancy in the prediction of spontaneous early preterm delivery. Methods: Maternal serum concentration of high-sensitivity CRP at 11-13 weeks' gestation was measured in a case-control study of singleton pregnancies delivering ...