| Proximal ectopic pregnancy: a descriptive general population-based study and results of different management options in 86 cases. | |
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MedLine Citation:
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PMID: 21047630 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: To describe different approaches for diagnosis and management of proximal ectopic pregnancies (PP) in general population. DESIGN: Observational population based-study. SETTING: Regional ectopic pregnancy registry. PATIENT(S): Eighty-six PP registered from 1992 to 2008. INTERVENTION(S): Surgical (radical or conservative), medical, or combined therapies. MAIN OUTCOME MEASURE(S): Epidemiologic characteristics, clinical presentation, hCG level, treatments performed, failure rate, and recurrence. RESULT(S): Mean gestational age was 48.2 days. Estimated incidence of PP was 2.7%. Abdominal pain and vaginal bleeding were the commonest symptoms. Two patients were admitted in hypovolemic shock. Diagnostic modalities included transvaginal ultrasound, abdominal ultrasonography, and laparoscopy in 38 (44%), 7 (8%), and 39 (45%) cases, respectively. Mean hCG level was 10,759 IU/L. Thirty-four patients underwent primary cornual resection (39.5%) by laparoscopy (n = 32) or laparotomy (n = 2). Twenty-seven patients (31.4%) underwent primary conservative surgery by laparoscopy: cornuostomy (n = 18) or extended salpigostomy (n = 9). Primary medical treatment with methotrexate was attempted in 14 patients (16.3%). Expectant management was attempted in one case (1.2%). Eleven cases received combined therapies (11.6%). Failure rates for medical and surgical treatments were 35.7% and 28%, respectively. No failures were noted among patients who received combined therapies. CONCLUSION(S): Proximal ectopic pregnancy remains a life-threatening condition. Diagnosis is challenging and requires a high index of suspicion. Despite available conservative strategies, management of PP remains heterogeneous. |
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Authors:
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Demetrio Larraín; Francesca Marengo; Nicolas Bourdel; Patricia Jaffeux; Bruno Aublet-Cuvelier; Jean-Luc Pouly; Gerard Mage; Benoit Rabischong |
Publication Detail:
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Type: Journal Article Date: 2010-11-03 |
Journal Detail:
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Title: Fertility and sterility Volume: 95 ISSN: 1556-5653 ISO Abbreviation: Fertil. Steril. Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-02-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372772 Medline TA: Fertil Steril Country: United States |
Other Details:
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Languages: eng Pagination: 867-71 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire, Estaing, Clermont-Ferrand, France. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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