| A rare gynecologic contraindication to the use of prostaglandins and oxytocin to induce abortion. A case report. | |
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MedLine Citation:
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PMID: 2795568 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Premature rupture of the membranes was diagnosed in a 27-year-old nullipara at 24 weeks' gestation. Medical induction of abortion (because of sepsis) was attempted and failed. The products of conception were removed surgically per vagina; that procedure was followed by an intractable hemorrhage. Subtotal hysterectomy and repair of the left common iliac artery and vein were performed to stop the bleeding. In retrospect the case was diagnosed as a left ligamentary ectopic pregnancy with uterine rupture and erosion of the left common iliac vessels. A case report of a ligamentary ectopic pregnancy that failed to respond to prostaglandin E2 for induced abortion for sepsis at 24 weeks is presented. The 27-year-old nullipara had normal ultrasound findings for gestational age up to 21 weeks gestation. She had consulted at 5 weeks for abdominal pain and bleeding, at 14 weeks again for abdominal pain, shoulder pain and vaginal bleeding, although both times the pain and bleeding resolved spontaneously. She was seen again at 16 and 21 weeks gestation, when ultrasound scans were normal for dates. At 24 weeks, she experienced vaginal discharge of blood and tissue, and was managed as premature rupture of membranes. She became septic 12 days later. She was treated with transcervical PGE2 and iv oxytocin without response for 3 days. Surgical evacuation was successful, but bleeding persisted. During laparotomy she had a large left broad ligament hematoma, a left ruptured uterus, and open left internal iliac artery and vein. These were repaired, and she received 40 units of blood, 8 platelets and 14 of plasma. Only after histology was the diagnosis of ligamentary pregnancy made. The lack of response to PG for abortion should raise suspicion of ectopic pregnancy, although preoperative diagnosis of ligamentary pregnancy is extremely rare. |
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Authors:
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A R Markos |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of reproductive medicine Volume: 34 ISSN: 0024-7758 ISO Abbreviation: J Reprod Med Publication Date: 1989 Oct |
Date Detail:
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Created Date: 1989-11-20 Completed Date: 1989-11-20 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0173343 Medline TA: J Reprod Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 839-41 Citation Subset: IM; J |
Affiliation:
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Department of Obstetrics and Gynaecology, Walsgrave Hospital, Coventry, England. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Abortion, Therapeutic* Adult Female Fetal Membranes, Premature Rupture / complications*, diagnosis Humans Oxytocin / therapeutic use Pregnancy Pregnancy, Ectopic / complications*, diagnosis Prostaglandins E / therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Prostaglandins E; 50-56-6/Oxytocin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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