| Differential diagnosis of suspected cervical pregnancy and conservative treatment with the combination of laparoscopy-assisted uterine artery ligation and hysteroscopic endocervical resection. | |
| | |
MedLine Citation:
|
PMID: 15193489 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To determine the accuracy of differential diagnosis by team consultation of abortion in progression, low-lying implantation/cervicoisthmic pregnancy, and cervical pregnancy (CP) in patients referred for suspicion of abnormal implantation on the lower segment and cervix of the uterus and to determine the efficacy of endoscopic surgery with uterine artery blockade followed by cervical evacuation in the treatment of confirmed CP. DESIGN: Prospective observational study under multiple-clinic and multiple-hospital cooperation. SETTING: Tertiary clinical and academic medical center. PATIENT(S): Twenty-seven women with a tentative diagnosis of CP made at their primary gynecologists' offices from July 1999 to June 2003. INTERVENTION(S): Second-opinion ultrasound scanning with transabdominal and transvaginal approach and optional color Doppler use. For patients with confirmed CP, a new treatment modality with laparoscopy-assisted uterine artery ligation followed by hysteroscopic local endocervical resection to remove the ectopic pregnancy was employed. For patients with abortion in progression or low-lying implantation/cervicoisthmic pregnancy (non-CP) requiring termination, dilatation and curettage (D&C) was performed under transabdominal ultrasound guidance. MAIN OUTCOME MEASURE(S): Fulfillment of ultrasound-based diagnostic criteria and operative course, convalescence, and commencement of menstruation in those patients with confirmed CP. RESULT(S): Cervical pregnancy was diagnosed in six (22.2%) patients at <or=9-weeks' gestation, and they were all successfully treated without the need for adjuvant therapy. The mean operating time was 119 minutes, and the mean blood loss was 125 mL. Menstruation began a mean of 63 days after the treatment. Termination of non-CPs was achieved by a simple D&C. CONCLUSION(S): Team consultation minimizes false-positive ultrasound-based diagnosis of CP. A single-step combination endoscopic operation is an effective uterus-preserving alternative in the management of CP. |
| | |
Authors:
|
Fu-Tsai Kung; Hao Lin; Te-Yao Hsu; Chih-Yang Chang; Hsuan-Wei Huang; Li-Ying Huang; Yin-Jou Chou; Kuan-Hui Huang |
Related Documents
:
|
9819869 - Cervical length at 23 weeks of gestation: the value of shirodkar suture for the short c... 15274649 - Relationship between cervical mucus interleukin-8 concentrations and vaginal bacteria i... 4015189 - The outcome of pregnancy and preterm delivery after conization of the cervix. 12053099 - Detection of the cervical gland area in threatened preterm labor using transvaginal son... 9046999 - Hormonal regulation of matrix metalloproteinase 9/gelatinase b gene expression in rabbi... 19878979 - Radical abdominal trachelectomy for stage ib1 cervical cancer at 15-week gestation. 21477099 - Intermittent preventive treatment of malaria in pregnancy: at the crossroads of public ... 16326099 - Cancer and pregnancy: poena magna, not anymore. 8423949 - An obstetric scoring system: its development and application in obstetric management. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Fertility and sterility Volume: 81 ISSN: 0015-0282 ISO Abbreviation: Fertil. Steril. Publication Date: 2004 Jun |
Date Detail:
|
Created Date: 2004-06-14 Completed Date: 2004-07-14 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0372772 Medline TA: Fertil Steril Country: United States |
Other Details:
|
Languages: eng Pagination: 1642-9 Citation Subset: IM |
Affiliation:
|
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan. ftkung@ksts.seed.net.tw |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Abortion, Spontaneous
/
ultrasonography Adult Arteries Blood Loss, Surgical Cervix Uteri / surgery* Diagnosis, Differential Female Humans Hysteroscopy* Laparoscopy* Ligation Menstruation Postoperative Period Pregnancy Pregnancy, Ectopic / surgery*, ultrasonography* Prospective Studies Time Factors Ultrasonography, Doppler, Color Uterus / blood supply* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: A common interleukin-6 gene promoter polymorphism influences the clinical characteristics of women w...
Next Document: Polymorphisms in the estrogen receptor beta gene but not estrogen receptor alpha gene affect the ris...