1,656 results match your criteria Surgical Management of Ectopic Pregnancy


Predictive value of a modified classification of fallopian tube status on prognosis of tubal factor infertility after laparoscopic surgery.

Medicine (Baltimore) 2019 Mar;98(13):e14952

Department of Obstetrics and Gynecology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian.

Built on 2 existing classification systems, this study was to develop a new classification system to better predict the pregnancy prognosis after laparoscopic surgery in patients with tubal factor infertility and accordingly propose a management strategy.We followed up 423 patients suffering from tubal factor infertility who had undergone hysteroscopic-laparoscopic surgery for 2 years without in vitro fertilization and embryo transfer (IVF/ET). Based on the operative reports, a new, modified classification of fallopian tube status (hereafter referred to as the modified classification) was developed with reference to the 2 existing classification systems (the r-AFS classification of pelvic adhesions and the scoring system of distal tubal obstruction). Read More

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http://dx.doi.org/10.1097/MD.0000000000014952DOI Listing
March 2019
4 Reads

Severe morbidity with ectopic pregnancy is associated with late presentation.

J Obstet Gynaecol 2019 Mar 27:1-5. Epub 2019 Mar 27.

a Bart's Health Trust , Whipps Cross Hospital , London , UK.

This article investigates if severe morbidity associated with ectopic pregnancy (EP) is related to patient characteristics or the quality of patient care after presentation. This is a retrospective study of women who had surgical management of tubal EP between 2008 and 2012. Severe maternal morbidity was defined as a blood loss ≥800 mL. Read More

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http://dx.doi.org/10.1080/01443615.2018.1557610DOI Listing
March 2019
1 Read

Delayed diagnosis of a cesarean scar pregnancy: a case report.

J Med Case Rep 2019 Mar 7;13(1):53. Epub 2019 Mar 7.

Department of Obstetrics and Gynecology, Kyungpook National University Hospital, School of Medicine, 807 Hogukro, Buk-gu, Daegu, 41404, Republic of Korea.

Background: Cesarean scar pregnancy is rare but may be related to early uterine rupture and may result in massive hemorrhage. Nowadays, most cesarean scar pregnancies are diagnosed early and can be managed properly. However, diagnoses of cesarean scar pregnancies that develop in the obstetrical area are sometimes delayed. Read More

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http://dx.doi.org/10.1186/s13256-019-1983-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6404313PMC
March 2019
3 Reads

Can early βhCG change and baseline progesterone level predict treatment outcome in patients receiving single dose Methotrexate protocol for tubal ectopic pregnancy?

Arch Gynecol Obstet 2019 Mar 8;299(3):741-745. Epub 2019 Feb 8.

CHU Toulouse, Pôle de Gynécologie Obstétrique, Department of Obstetrics and Gynecology, Hôpital Paule de Viguier, 31059, Toulouse, France.

Introduction: We aimed to assess the prognostic significance of early βhCG change and baseline progesterone level on treatment outcome among women receiving single dose Methotrexate protocol for tubal ectopic pregnancy (EP).

Material And Methods: Retrospective study involving all consecutive patients diagnosed with EP and receiving Methotrexate therapy form January 2015 to December 2016. Patients were stratified into 2 groups according to treatment outcome: success group (n = 66) involved women who displayed complete resolution of serum βhCG levels following a single course of Methotrexate; failure group (n = 55) included patients who required repeated Methotrexate administration and/or surgical management. Read More

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http://dx.doi.org/10.1007/s00404-019-05068-1DOI Listing
March 2019
2 Reads

Persistent omental trophoblastic implantation following salpingostomy, salpingectomy and methotrexate for ectopic pregnancy: A case report.

Case Rep Womens Health 2019 Jan 14;21:e00095. Epub 2019 Jan 14.

Royal Prince Alfred Hospital, Research Institute, Missenden Road, Camperdown, NSW, Australia.

2% of all pregnancies are ectopic. Optimal surgical management is currently salpingectomy over salpingostomy, secondary to the risks of persistent trophoblastic tissue or omental implants (15%). However, rare cases of omental trophoblastic implants following laparoscopic salpingectomy have been noted in the literature. Read More

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http://dx.doi.org/10.1016/j.crwh.2019.e00095DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350100PMC
January 2019
2 Reads

First Trimester Bleeding: Evaluation and Management.

Am Fam Physician 2019 Feb;99(3):166-174

University of Michigan Medical School, Ann Arbor, MI, USA.

Approximately one-fourth of pregnant women will experience bleeding in the first trimester. The differential diagnosis includes threatened abortion, early pregnancy loss, and ectopic pregnancy. Pain and heavy bleeding are associated with an increased risk of early pregnancy loss. Read More

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February 2019
11 Reads

Laparoscopic Removal of an Abdominal Pregnancy in the Pelvic Sidewall.

J Minim Invasive Gynecol 2019 Jan 9. Epub 2019 Jan 9.

Department of Obstetrics and Gynecology, Assuta Ashdod University Hospital, Ashdod, Israel (all authors), and the Faculty of Health Sciences, Ben-Gurion University, Beersheba, Israel (Dr. Barel).

Study Objective: To describe the presentation, diagnosis, and management of a patient with abdominal pregnancy and to illustrate the laparoscopic technique used to manage this patient.

Design: A descriptive study approved by our local Institutional Review Board. Consent was given from the patient. Read More

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http://dx.doi.org/10.1016/j.jmig.2018.12.020DOI Listing
January 2019
5 Reads

A Case of Pregnancy Complicated by Primary Hyperparathyroidism Due to a Parathyroid Adenoma.

Am J Case Rep 2019 Jan 14;20:53-59. Epub 2019 Jan 14.

Laboratory of Age-Related Metabolic and Endocrine Disorders, The Russian Gerontology Clinical Research Center, Moscow, Russian Federation.

BACKGROUND Primary hyperparathyroidism is most common in women during the menopause and its occurrence in pregnant women is rare. However, because neonatal mortality is associated with maternal hyperparathyroidism, early diagnosis is essential. This report describes the case of a late diagnosis of primary hyperparathyroidism in a 28-year-old pregnant woman and describes the effects on the mother and neonate. Read More

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http://dx.doi.org/10.12659/AJCR.912436DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340266PMC
January 2019
5 Reads

Ovarian Ectopic Pregnancy: Laparoscopic Excision and Ovarian Conservation.

J Minim Invasive Gynecol 2019 Jan 4. Epub 2019 Jan 4.

Department of Gynaecology, St Mary's Hospital, Manchester University Foundation Trust, Manchester, UK (all authors).. Electronic address:

Study Objective: To show a case of laparoscopic excision of an ovarian ectopic pregnancy and the technique used.

Setting: A university hospital (Manchester University Foundation Trust).

Patient: A 23-year-old primigravida presentation at 6 weeks of gestation with an ectopic pregnancy. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S15534650193000
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http://dx.doi.org/10.1016/j.jmig.2018.12.017DOI Listing
January 2019
7 Reads

Diagnosis and laparoscopic management of a 5-week ectopic pregnancy in a rudimentary uterine horn: A case report.

Case Rep Womens Health 2019 Jan 15;21:e00088. Epub 2018 Nov 15.

Department of Clinical and Experimental Medicine, Division of Gynecology and Obstetrics, University of Pisa, Italy.

Uterine anomalies result from the failure of complete fusion of the Müllerian ducts during embryogenesis. A unicornuate uterus with a rudimentary horn is the rarest anomaly and results from the failure of one of the Müllerian ducts to develop completely and an incomplete fusion with the contralateral side. Diagnosis and surgical management of a 5-week ectopic pregnancy in a non-communicating rudimentary horn in an 18-year-old nulliparous woman in whom this congenital uterine anomaly was previously unknown are described. Read More

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http://dx.doi.org/10.1016/j.crwh.2018.e00088DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6305893PMC
January 2019
3 Reads

A multi-centre, double-blind, placebo-controlled, randomised trial of combination methotrexate and gefitinib versus methotrexate alone to treat tubal ectopic pregnancies (GEM3): trial protocol.

Trials 2018 Nov 20;19(1):643. Epub 2018 Nov 20.

MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4SA, UK.

Background: Tubal ectopic pregnancy (tEP) is the most common life-threatening condition in gynaecology. Treatment options include surgery and medical management. Stable women with tEPs with pre-treatment serum human chorionic gonadotrophin (hCG) levels < 1000 IU/L respond well to outpatient medical treatment with intramuscular methotrexate. Read More

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http://dx.doi.org/10.1186/s13063-018-3008-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6247635PMC
November 2018
17 Reads

[Management and pregnancy outcomes of heterotopic pregnancy].

Zhonghua Fu Chan Ke Za Zhi 2018 Nov;53(11):768-775

Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China.

To investigate the clinical features, diagnosis and treatments of heterotopic pregnancy (HP) and demonstrate the outcomes of HP after the surgical treatment of ectopic pregnancies. A retrospective analysis was performed on 144 cases of HP in Womens Hospital, School of Medicine, Zhejiang University from January 2003 to December 2016. (1) Clinical features of HP:the average age of patients was (30. Read More

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http://dx.doi.org/10.3760/cma.j.issn.0529-567x.2018.11.007DOI Listing
November 2018
15 Reads

The role of ultrasonography in methotrexate therapy for ectopic pregnancy.

Authors:
Piotr Czuczwar

J Ultrason 2018 ;18(73):158-161

3rd Department of Gynecology, Medical University of Lublin, Lublin, Poland.

Medical management of ectopic pregnancy with methotrexate, an antimetabolite of folic acid, is an important alternative to surgical treatment, as it ensures a similar outcome whilst being far less invasive. Ultrasound evaluation does not only facilitate an accurate diagnosis, but also helps to select patients most likely to benefit from methotrexate treatment, as opposed to those with a high likelihood of failure of medical management, who are thus eligible for primary surgical treatment. Ultrasound also allows to monitor the outcome of methotrexate therapy. Read More

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http://jultrason.pl/index.php/issues/volume-18-no-73/the-rol
Publisher Site
http://dx.doi.org/10.15557/JoU.2018.0023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440515PMC
January 2018
15 Reads

Late morbidity in cesarean section scar syndrome.

Ceska Gynekol Fall 2018;83(4):300-306

Objective: To summarize recent knowledge on ethiology, diagnostic management and treatment possibilities of cesarean section scar syndrome (isthmocoele).

Design: Review article.

Setting: Department of Gynaecology and Obstetrics, Faculty Hospital and Palacky University, Olomouc; Department of Gynaecology and Obstetrics, Vítkovická nemocnice, Ostrava-Vítkovice. Read More

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January 2019
12 Reads

A rare case of ectopic pregnancy - retroperitoneal ectopic pregnancy.

Neuro Endocrinol Lett 2018 Sep;39(3):156-159

Department of Pathology, Hospital Ceske Budejovice , Czech Republic.

Ectopic pregnancy is a condition when fertilized egg implants outside the uterine cavity. The reported incidence is about 0.5-1% of all pregnancies. Read More

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September 2018
6 Reads

Selective Reduction of a Heterotopic Cesarean Scar Pregnancy Complicated by Septic Abortion.

Case Rep Obstet Gynecol 2018 21;2018:6478589. Epub 2018 Oct 21.

Montefiore Medical Center, Department of Obstetrics & Gynecology and Women's Health, Bronx, NY, USA.

Background: Heterotopic pregnancy involving the implantation of an ectopic pregnancy into a prior cesarean scar with a concurrent intrauterine pregnancy is a rare and potentially life-threatening condition with minimal information in the literature to guide treatment and management options.

Case: A 40-year-old G5P3103 at 12 weeks and 3 days with a history of two cesarean deliveries was diagnosed with a live heterotopic pregnancy containing a cesarean scar ectopic and an intrauterine pregnancy. After selective reduction of the cesarean scar gestation with potassium chloride (KCl), the patient presented ten days later to the emergency department with septic abortion and sepsis. Read More

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https://www.hindawi.com/journals/criog/2018/6478589/
Publisher Site
http://dx.doi.org/10.1155/2018/6478589DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6215580PMC
October 2018
13 Reads

Interstitial and Cornual Ectopic Pregnancy: Conservative Surgical and Medical Management.

J Obstet Gynaecol India 2018 Dec 28;68(6):471-476. Epub 2017 Nov 28.

Sir Ganga Ram Hospital Marg, Rajinder Nagar, New Delhi, 110060 India.

Background: Interstitial and cornual ectopic pregnancy is rare, accounting for 2-4% of ectopic pregnancies and remains the most difficult type of ectopic pregnancy to diagnose due to low sensitivity and specificity of symptoms and imaging. The classic triad of ectopic pregnancy-abdominal pain, amenorrhea and vaginal bleeding-occurs in less than 40% of patients. The site of implantation in the intrauterine portion of fallopian tube and invasion through the uterine wall make this pregnancy difficult to differentiate from an intrauterine pregnancy on ultrasound. Read More

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http://link.springer.com/10.1007/s13224-017-1078-0
Publisher Site
http://dx.doi.org/10.1007/s13224-017-1078-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6207538PMC
December 2018
17 Reads

Hemoperitoneum in a Peritoneal Dialysis Patient: Ruptured Ectopic Pregnancy.

Perit Dial Int 2018 Nov-Dec;38(6):455-456

Surgery, University of Chicago Medical Center, Chicago, IL, USA.

Hemoperitoneum is a well-recognized complication in female peritoneal dialysis (PD) patients of childbearing age. Bloody effluent is commonly of minor nature, presenting during menstruation or midcycle, resolving after a few rapid exchanges without a need for further intervention. One must remain vigilant, however, and consider a broader differential diagnosis when hemoperitoneum is persistent or severe, as it indicates a serious and potentially life-threatening etiology. Read More

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http://www.pdiconnect.com/lookup/doi/10.3747/pdi.2018.00066
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http://dx.doi.org/10.3747/pdi.2018.00066DOI Listing
March 2019
16 Reads

Interstitial Pregnancy: From Medical to Surgical Approach-Report of Three Cases.

Case Rep Obstet Gynecol 2018 15;2018:2815871. Epub 2018 Oct 15.

Department of Obstetrics and Gynecology, SS Annunziata Hospital, Chieti, Italy.

Background: Interstitial pregnancy is a rare form of ectopic pregnancy that usually leads to uterine rupture resulting in sudden life-threatening haemorrhage, need for blood transfusion, and admission to intensive care unit. Mortality rate is 6-7 times higher than that in classical ectopic pregnancy. Uterine rupture has been typically reported to occur at more advanced gestational ages compared to tubal pregnancy although several recent reports have shown a high risk of rupture before 12 weeks of gestation. Read More

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https://www.hindawi.com/journals/criog/2018/2815871/
Publisher Site
http://dx.doi.org/10.1155/2018/2815871DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6205099PMC
October 2018
27 Reads

Ectopic pregnancy hospitalisations: A national population-based study of rates, management and outcomes.

Eur J Obstet Gynecol Reprod Biol 2018 Dec 30;231:174-179. Epub 2018 Oct 30.

National Perinatal Epidemiology Centre (NPEC), Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland; School of Public Health, University College Cork, Cork, Ireland.

Objective: To determine whether there were changes in the incidence, management and outcomes of ectopic pregnancy hospitalisations in Ireland during 2005-2016.

Study Design: Population-based study was carried out from January 2005 to December 2016. A total of 12,098 women hospitalised due to ectopic pregnancy. Read More

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http://dx.doi.org/10.1016/j.ejogrb.2018.10.054DOI Listing
December 2018
11 Reads

A single centre's experience of caesarean scar pregnancy and proposal of a management algorithm.

J Obstet Gynaecol 2019 Feb 29;39(2):259-264. Epub 2018 Oct 29.

a Department of Obstetrics and Gynecology , University of Health Sciences Gazi Yasargil Research and Training Hospital , Diyarbakir , Turkey.

The management of a caesarean scar pregnancy ranges from conservative medical therapy to surgical treatment. The aim of this study is to present our experience of caesarean scar ectopic pregnancies treated with different modalities and to develop a management algorithm. This retrospective clinical analysis included 21 caesarean scar pregnancies. Read More

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http://dx.doi.org/10.1080/01443615.2018.1499714DOI Listing
February 2019
22 Reads

Cesarean scar pregnancy; Diagnosis and management between 2003 and 2015 in a single center.

Taiwan J Obstet Gynecol 2018 Oct;57(5):688-691

Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Cheil General Hospital and Women's Healthcare Center, College of Medicine, Dankook University, Seoul, South Korea; Department of Obstetrics and Gynecology, Mount Sinai Medical Center, Miami Beach, FL, USA. Electronic address:

Objectives: We aimed to evaluate diagnosis and management of an ectopic pregnancy developing in a previous cesarean scar.

Materials And Methods: Between March 2003 and October 2015, total 64 cases of cesarean scar pregnancy (CSP) were retrospectively reviewed. The cliniscal characteristics, diagnosis, various methods of treatment and clinical outcomes were analyzed. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10284559183018
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http://dx.doi.org/10.1016/j.tjog.2018.08.013DOI Listing
October 2018
24 Reads

Successful Procedure in Conservative Management of Interstitial (Cornual) Ectopic Pregnancy.

Gynecol Minim Invasive Ther 2018 Oct-Dec;7(4):172-174. Epub 2018 Sep 26.

Department of Obstetrics and Gynecology, Division of Reproductive Health, Faculty of Medicine, Dr. Cipto Mangunkusumo National General Hospital, University of Indonesia, Jakarta, Indonesia.

A 35-year-old woman presented with spotting and lower abdominal pain. Follow-up sonography was suggestive of interstitial ectopic pregnancy. Laparoscopic cornuostomy was carried out. Read More

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http://www.e-gmit.com/text.asp?2018/7/4/172/242305
Publisher Site
http://dx.doi.org/10.4103/GMIT.GMIT_9_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6172874PMC
September 2018
9 Reads

Methotrexate for the treatment of unruptured tubal ectopic pregnancy.

CJEM 2018 Oct 8:1-4. Epub 2018 Oct 8.

*Schwartz/Reisman Emergency Medicine Institute,Toronto,ON.

Objective: The objective of this study was to determine the outcomes of women who presented to the emergency department (ED) with suspected ectopic pregnancy and received methotrexate as first-line treatment.

Methods: This was a retrospective chart review of pregnant (< 12 week' gestational age) women from an academic tertiary care ED with a diagnosis of ectopic pregnancy, rule-out ectopic pregnancy, or pregnancy of unknown location over a 7-year period.

Results: Of 612 patients with a suspected ectopic pregnancy at initial ED presentation, 326 (53. Read More

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https://www.cambridge.org/core/product/identifier/S148180351
Publisher Site
http://dx.doi.org/10.1017/cem.2018.440DOI Listing
October 2018
8 Reads

Partial tubal devascularisation: a novel procedure for tubal conservation in ectopic pregnancy.

J Obstet Gynaecol 2019 Feb 4;39(2):202-205. Epub 2018 Oct 4.

b Women's Health Hospital , Assiut University , Assiut , Egypt.

Ectopic pregnancy is a serious condition that complicates 1-2% of pregnancies. Using surgical management is efficient, but may have an impact on future fertility. Although conservative tubal surgery has not been shown to have a significant advantage over a salpingectomy in terms of the future fertility potential, the conservative surgical techniques remain widely-utilised, particularly in the context of a contralateral diseased or absent tube. Read More

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https://www.tandfonline.com/doi/full/10.1080/01443615.2018.1
Publisher Site
http://dx.doi.org/10.1080/01443615.2018.1476472DOI Listing
February 2019
6 Reads

Successful Treatment of Cesarean Scar Pregnancy With Suction Curettage: Our Experiences in Early Pregnancy.

Ochsner J 2018 ;18(3):222-225

Department of Obstetrics and Gynecology, Süleymaniye Maternity Hospital, Istanbul, Turkey.

Background: Cesarean scar pregnancy is an ectopic pregnancy embedded in the myometrium of a cesarean scar. Several types of conservative treatment have been used to treat cesarean scar pregnancy, but no management protocol has been established for this rare, life-threatening condition. The purpose of this study was to evaluate the feasibility of suction curettage as a first-line treatment in early cesarean scar pregnancy. Read More

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http://dx.doi.org/10.31486/toj.17.0118DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6162122PMC
January 2018
5 Reads

Optimal treatment for women with a persisting pregnancy of unknown location, a randomized controlled trial: The ACT-or-NOT trial.

Contemp Clin Trials 2018 Oct 20;73:145-151. Epub 2018 Sep 20.

Department of Biostatistics, Yale University School of Public Health, New Haven, CT, United States.

Objective: Pregnancy of unknown location (PUL) is not a diagnosis but a transient state used to classify a woman when she has a positive pregnancy test without definitive evidence of an intra-uterine or extra-uterine pregnancy on transvaginal ultrasonography. Management of a persisting PUL varies substantially, including expectant or active management. Active management can include uterine cavity evacuation or systemic administration of methotrexate. Read More

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http://dx.doi.org/10.1016/j.cct.2018.09.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231403PMC
October 2018
5 Reads

A spontaneous bilateral tubal pregnancy: A case report.

Authors:
Hong Xu

Medicine (Baltimore) 2018 Sep;97(38):e12365

Rationale: Ectopic pregnancy (EP) is a condition in which a fertilized oocyte implants outside the uterine. Spontaneous bilateral tubal pregnancies are the rarest form of ectopic and are considered spontaneous when no fertility treatments are involved. There are few prior cases. Read More

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http://dx.doi.org/10.1097/MD.0000000000012365DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6160232PMC
September 2018
3 Reads

Second Trimester Cervical Ectopic Pregnancy and Hemorrhage: A Case Report and Review of the Literature.

Case Rep Obstet Gynecol 2018 26;2018:3860274. Epub 2018 Aug 26.

OB/GYN and Women's Health Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA.

Cervical ectopic pregnancies are a rare occurrence in the United States. Here we present the interdisciplinary and conservative management approach to a cervical ectopic at an advanced gestational age. In addition, we review the surgical management of hemorrhage from cervical ectopic pregnancies, which is often catastrophic and life-threatening. Read More

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http://dx.doi.org/10.1155/2018/3860274DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6129320PMC
August 2018
3 Reads

Successful management of a spontaneous viable monochorionic diamniotic twin pregnancy on cesarean scar with systemic methotrexate: A case report.

Medicine (Baltimore) 2018 Sep;97(37):e12343

Reproductive Endocrine and Infertility Medicine Department, King Fahad Medical City, Riyadh, Saudi Arabia.

Rationale: Cesarean scar twin pregnancy is exceedingly rare and it remains to be a life-threatening condition even in the early weeks of gestation. Because of its rare occurrence, there is no consensus on the treatment modality of cesarean ectopic pregnancy.

Patient Concerns: A 41-year-old, woman, gravida 7, para 6, with a history of low transverse cesarean section 2 years back presented with an estimated 6 weeks gestational age and viable spontaneous twin, monochorionic diamniotic gestation. Read More

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http://dx.doi.org/10.1097/MD.0000000000012343DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6155970PMC
September 2018
4 Reads

Pregnancy in idiopathic non-cirrhotic portal hypertension: A multicentric study on maternal and fetal management and outcome.

J Hepatol 2018 Dec 21;69(6):1242-1249. Epub 2018 Aug 21.

Service d'Hépatologie, DHU Unity, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, Clichy, France; INSERM, U970, Paris Cardiovascular Research Center - PARCC, Paris, France; Université Denis Diderot-Paris 7, Sorbonne Paris Cité, 75018, Paris, France. Electronic address:

Background & Aims: A total of 15% of patients with idiopathic non-cirrhotic portal hypertension (INCPH) are women of childbearing age. We aimed to determine maternal and fetal outcome of pregnancies occurring in women with INCPH.

Methods: We retrospectively analyzed the charts of women with INCPH followed in the centers of the VALDIG network, having had ≥1 pregnancy during the follow-up of their liver disease. Read More

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http://dx.doi.org/10.1016/j.jhep.2018.08.007DOI Listing
December 2018
14 Reads

The value of 3-dimensional color Doppler in predicting intraoperative hemorrhage for cesarean scar pregnancy.

Medicine (Baltimore) 2018 Aug;97(33):e11969

The aim of this study is to evaluate the efficacy of 3-dimensional (3D) ultrasonography and 3D color power Doppler ultrasound in the management of cesarean scar pregnancy (CSP).A case-control study enrolled 190 CSP patients who underwent uterine artery embolization (UAE) in combination with dilatation and curettage (D&C). The maximum diameter of gestational sac or CSP mass, uterine scar thickness, and resistance index (RI) were measured by 2D ultrasound. Read More

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http://dx.doi.org/10.1097/MD.0000000000011969DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6113015PMC
August 2018
3 Reads

A Novel Approach to Management of Angular Pregnancies: A Case Series.

J Minim Invasive Gynecol 2019 Jan 11;26(1):178-181. Epub 2018 Aug 11.

Department of Obstetrics and Gynecology, University of Chicago Medical Center, Chicago, Illinois.

Cornual, interstitial, and angular pregnancies are terms that are often used interchangeably in both the literature and clinical setting to describe various ectopic pregnancies. The diagnosis of these pregnancies can be difficult, and fear of disrupting an intrauterine pregnancy can cause hesitation during evaluation and management. In our 2 cases, a combination of transvaginal and 3-dimensional ultrasound images provided assistance in the accurate diagnosis of angular ectopic pregnancies. Read More

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http://dx.doi.org/10.1016/j.jmig.2018.08.002DOI Listing
January 2019
5 Reads

Combined laparoscopic and hysteroscopic management of cesarean scar pregnancy with temporary occlusion of bilateral internal iliac arteries: A case report and literature review.

Medicine (Baltimore) 2018 Aug;97(32):e11811

Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine.

Rationale: Cesarean scar pregnancy is a rare event that carries a risk of heavy hemorrhage and emergency hysterectomy. Many treatment modalities have been reported, but with no consensus. Here we report a case of combined laparoscopic and hysteroscopic treatment with temporary occlusion of the bilateral internal iliac arteries. Read More

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http://dx.doi.org/10.1097/MD.0000000000011811DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6133634PMC
August 2018
8 Reads

Angular vs. interstitial pregnancy: A case report highlighting diagnostic nuances with stark management differences.

Case Rep Womens Health 2018 Jul 20;19:e00068. Epub 2018 Jun 20.

Department of Obstetrics & Gynecology, The George Washington University, 2150 Pennsylvania Ave NW, Suite 6A, Washington, DC 20037, United States.

Background: In the literature, the terms "angular", "interstitial" and "cornual" have often been inappropriately interchanged. The consequence is under-recognition of their differences as well as inaccurate imaging guidelines which do not reliably distinguish them as distinct entities. Angular pregnancies should be considered viable and may be managed to term. Read More

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http://dx.doi.org/10.1016/j.crwh.2018.e00068DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6071364PMC
July 2018
9 Reads

New ultrasound grading system for cesarean scar pregnancy and its implications for management strategies: An observational cohort study.

PLoS One 2018 9;13(8):e0202020. Epub 2018 Aug 9.

Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

A cesarean section pregnancy (CSP) indicated the gestational sac (GS) implanted in the previous cesarean scar. The clinical manifestations of CSP present a wide range of variations, and the optimal management is yet to be defined. We retrospectively enrolled 109 patients with the diagnosis of CSP from our department and categorized them into four grades based on the ultrasound presentation. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0202020PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6084953PMC
February 2019
2 Reads

Management of Bilateral Ectopic Pregnancies after Ovulation Induction Using Unilateral Salpingectomy and Methotrexate for the Remaining Ectopic with Subsequent Intrauterine Pregnancy.

Case Rep Obstet Gynecol 2018 5;2018:7539713. Epub 2018 Jul 5.

Department of Obstetrics and Gynecology, The George Washington University Hospital, Washington, DC, USA.

Bilateral ectopic pregnancy is a rare phenomenon which is found with increased frequency when using assisted reproductive technology (ART). This diagnosis is most often made incidentally and intraoperatively, as ultrasound and serial -hCG trends have shown poor efficacy for accurate diagnosis. Management of bilateral ectopic pregnancies is most commonly reported using bilateral surgical removal of the ectopic pregnancy (salpingostomy and/or salpingectomy). Read More

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http://dx.doi.org/10.1155/2018/7539713DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6057319PMC
July 2018
5 Reads

Laparoendoscopic Single-Site Surgery for Management of Heterotopic Pregnancy: A Case Report and Review of Literature.

Case Rep Obstet Gynecol 2018 4;2018:7232637. Epub 2018 Jul 4.

Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Baylor College of Medicine, 6651 Main Street, 10 Floor, Houston, TX 77030, USA.

Background: Heterotopic pregnancy occurs when two pregnancies occur simultaneously in the uterus and an ectopic location. Treatment includes removal of the ectopic pregnancy with preservation of the intrauterine pregnancy. Treatment is done laparoscopically with either a Laparoendoscopic Single-Site Surgery (LESS) or a multiport laparoscopic surgery. Read More

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http://dx.doi.org/10.1155/2018/7232637DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6057289PMC
July 2018
16 Reads

Multidosing Intramuscular Administration of Methotrexate in Interstitial Pregnancy With Very High Levels of β-hCG: A Case Report and Review of the Literature.

Front Endocrinol (Lausanne) 2018 10;9:363. Epub 2018 Jul 10.

Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Fisciano, Italy.

Ectopic pregnancy (EP) is the implantation of an embryo outside the endometrial cavity of the uterus. Signs and symptoms of EP may arise between the 6th and the 8th week of gestation and include vaginal bleeding, lower abdominal and pelvic pain. Frequently EPs implant in the fallopian tubes. Read More

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https://www.frontiersin.org/article/10.3389/fendo.2018.00363
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http://dx.doi.org/10.3389/fendo.2018.00363DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6048239PMC
July 2018
13 Reads

Left-Right Asymmetry of Tubal Pregnancy: A 12-Year Retrospective Hospital-Based Study.

J Minim Invasive Gynecol 2018 Jul 19. Epub 2018 Jul 19.

Department of Gynecology Minimally Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China (Dr. Duan).. Electronic address:

Study Objective: To investigate whether there are left-right asymmetries, factors affecting lateral dominance, and clinical feature differences in the left and right sides of tubal pregnancy (TP).

Design: Retrospective study (Canadian Task Force classification II-2).

Setting: International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University. Read More

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http://dx.doi.org/10.1016/j.jmig.2018.07.010DOI Listing
July 2018
29 Reads
1.575 Impact Factor

Cesarean scar pregnancy with deep serosal invasion at 16 weeks: Uterus-sparing surgery with posterior hysterotomy after transcatheter arterial embolization.

J Obstet Gynaecol Res 2018 Sep 5;44(9):1824-1827. Epub 2018 Jul 5.

Department of Obstetrics and Gynecology, Hôpital Lariboisière, Assistance Publique - Hôpitaux de Paris, Paris, France.

We report a case of cesarean scar pregnancy at 16 weeks. Magnetic resonance imaging confirmed the isthmic ectopic location with an empty fundus and a high suspicion of placental invasion to the anterior myometrium. Because of pelvic pain, bleeding and the major risks of hysterectomy, a decision was made to terminate the pregnancy. Read More

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http://dx.doi.org/10.1111/jog.13707DOI Listing
September 2018
12 Reads

Hysteroscopic and laparoscopic management of caesarean scar (niche) defects in symptomatic patients.

J Obstet Gynaecol 2018 Jul;38(5):730

a Department of Obstetrics and Gynaecology , NHS Tayside , Dundee , Scotland.

Introduction: Worldwide, rates of caesarean section are rising. The term 'niche' describes the presence of an hypoechoic area within the myometrium of the lower uterine segment, reflecting a discontinuation of the myometrium at the site of a previous caesarean section. A defect in caesarean section scar is associated with symptoms like abnormal uterine bleeding, infertility and complications in subsequent pregnancy including: risk of rupture and morbidly adherent placenta. Read More

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http://dx.doi.org/10.1080/01443615.2018.1444394DOI Listing
July 2018
13 Reads

[Cornual pregnancy in 2 cases].

Beijing Da Xue Xue Bao Yi Xue Ban 2018 Jun;50(3):576-579

Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China.

Cornual pregnancy is one of the diseases caused by embryo embedment at abnormal site. Since few women with cornual pregnancy continue to a middle or late gestation are at a relatively increased risk of uterus rupture,placenta accrete,postpartum hemorrhage and some other severe obstetric complications. We reported two cases of cornual pregnancy at the third trimester, including their clinical symptoms, diagnoses, treatments and obstetric outcomes. Read More

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June 2018
22 Reads

Normal vaginal delivery at term after expectant management of heterotopic caesarean scar pregnancy: a case report.

J Med Case Rep 2018 Jun 21;12(1):179. Epub 2018 Jun 21.

Department of Obstetrics and Gynaecology, Skåne University Hospital Malmö, Lund University, Box 117, 221 00, Lund, Sweden.

Background: Heterotopic pregnancy with a combination of a caesarean scar pregnancy and an intrauterine pregnancy is rare and has potentially life-threatening complications.

Case Presentation: We describe the case of a 27-year-old white woman who had experienced an emergency caesarean delivery at 39 weeks for fetal distress with no postpartum complications. This is a report of the successful expectant management of a heterotopic scar pregnancy. Read More

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http://dx.doi.org/10.1186/s13256-018-1713-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6011475PMC
June 2018
2 Reads

Laparoscopic Resection of Cesarean Scar Ectopic Pregnancy after Unsuccessful Systemic Methotrexate Treatment.

J Minim Invasive Gynecol 2019 Mar - Apr;26(3):399-400. Epub 2018 Jun 8.

University of Medicine and Pharmacy Timișoara, Timișoara, Romania.

Study Objective: To present a case of a cesarean scar ectopic pregnancy treated by laparoscopic resection followed by isthmocele repair.

Design: A case report.

Settings: The University Gynecology Clinic of the Emergency Clinical City Hospital Timișoara, Timișoara, România. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S15534650183030
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http://dx.doi.org/10.1016/j.jmig.2018.06.003DOI Listing
June 2018
9 Reads

Non-surgical management of caesarean scar ectopic pregnancy - a five-year experience.

J Obstet Gynaecol 2018 Nov 8;38(8):1121-1127. Epub 2018 Jun 8.

a The Obstetrics and Gynaecology Department , The Wigan and Leigh NHS Foundation Trust , Wigan , UK.

The aim of this paper is to review the diagnosis and treatment of patients with a caesarean scar pregnancy (CSP), who have been managed at our unit, as well as to evaluate the effectiveness of the non-surgical treatment options. Twenty-six cases were identified over a period of 5 years and 4 months (January 2012 until April 2017). The main outcome measures were a number of previous caesarean births, a method of diagnosis of CSP, the mode of treatment and the outcome. Read More

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http://dx.doi.org/10.1080/01443615.2018.1451986DOI Listing
November 2018
11 Reads

Trends in the Management of Nonviable Pregnancies of Unknown Location in the United States.

Gynecol Obstet Invest 2018 6;83(6):552-557. Epub 2018 Jun 6.

Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia, USA.

Background: When managing a nonviable pregnancy of unknown location (PUL), a debate has emerged in the literature whether to perform uterine curettage for definitive diagnosis of pregnancy location or administer methotrexate for a presumed ectopic pregnancy. The purpose of this study is to describe the treatment patterns when managing a PUL.

Methods: A prospective, anonymous Internet based-electronic survey of PUL case scenarios was administered to a random sample of physicians across the United States. Read More

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http://dx.doi.org/10.1159/000488760DOI Listing
January 2019
1 Read

Cesarean Scar Ectopic Pregnancy: Current Management Strategies.

Obstet Gynecol Surv 2018 May;73(5):293-302

Professor of Obstetrics and Gynecology, and Director of the Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Boonshoft School of Medicine, Wright State University, Dayton, OH.

Importance: Cesarean scar ectopic pregnancy (CSEP) has a high rate of morbidity with nonspecific signs and symptoms making identification difficult. The criterion-standard treatment of CSEP has been subject to debate.

Objective: This review defines CSEP, discusses pathogenesis and diagnosis, and compares treatment options and outcomes. Read More

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http://dx.doi.org/10.1097/OGX.0000000000000561DOI Listing
May 2018
11 Reads

Cesarean scar pregnancy - a new challenge for obstetricians.

J Ultrason 2018 Mar 30;18(72):56-62. Epub 2018 Mar 30.

First Department of Gynecology and Obstetrics of the Medical University of Łódź, Teaching Clinic of Operative Gynecology and Gynecologic Oncology, Łódź, Poland.

Diagnosis and treatment of ectopic cesarean scar pregnancy has become a challenge for contemporary obstetrics. With an increase in the number of pregnancies concluded with a cesarean section and with the development of transvaginal ultrasonography, the frequency of cesarean scar pregnancy diagnoses has increased as well. The aim of the study is to evaluate various diagnostic methods (ultrasonography in particular) and analyze effective treatment methods for cesarean scar pregnancy. Read More

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http://dx.doi.org/10.15557/JoU.2018.0009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5911720PMC
March 2018
5 Reads

Irish women's experience of Ectopic pregnancy.

Sex Reprod Healthc 2018 Jun 5;16:154-159. Epub 2018 Apr 5.

Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Ireland.

Objective: Ectopic pregnancy can become a life threatening condition. Due to the specific nature of Ectopic pregnancy the grief experienced may well be overlooked compared to other pregnancy losses. Fertility concerns for the future and recovery from surgical or medical treatment may instead become the focus of care. Read More

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http://dx.doi.org/10.1016/j.srhc.2018.04.002DOI Listing
June 2018
5 Reads