1,750 results match your criteria Surgical Management of Ectopic Pregnancy


Ectopic Pregnancy: Diagnosis and Management.

Am Fam Physician 2020 May;101(10):599-606

Mount Sinai School of Medicine, New York, NY, USA.

Ectopic pregnancy occurs when a fertilized ovum implants outside of the uterine cavity. In the United States, the estimated prevalence of ectopic pregnancy is 1% to 2%, and ruptured ectopic pregnancy accounts for 2.7% of pregnancy-related deaths. Read More

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Evaluation of maternal serum biomarkers in predicting outcome of successful expectant management of tubal ectopic pregnancies.

Eur J Obstet Gynecol Reprod Biol 2020 Apr 30;250:61-65. Epub 2020 Apr 30.

Institute for Women's Health, Faculty of Population Health Sciences, University College London (UCL), London, UK.

Objective: To assess the value of multiple serum biomarkers for the prediction of successful outcome of expectant management in women with tubal ectopic pregnancy (TEP).

Study Design: Women with a conclusive ultrasound diagnosis of TEP had a blood test to measure β-human chorionic gonadotropin (β-hCG), progesterone, inhibin A, activin A and high sensitivity C-reactive protein (hsCRP) at the initial visit. Women presenting with pain, serum β-hCG ≥ 1500 IU, evidence of a live ectopic pregnancy or a significant haemoperitoneum were advised to have emergency surgery. Read More

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http://dx.doi.org/10.1016/j.ejogrb.2020.04.009DOI Listing

Spontaneous Intraoperative Rupture of a Large Interstitial Pregnancy: Laparoscopic Management.

Case Rep Obstet Gynecol 2020 14;2020:5626783. Epub 2020 Apr 14.

Tertiary Referral Center of Gynecological Laparoscopy, Lefkos Stavros Hospital, Athens, Greece.

We present a case of a large interstitial pregnancy which was intraoperatively ruptured, but was eventually laparoscopically treated. The patient experienced 9 weeks of amenorrhea, and a right cornual pregnancy measuring 6 cm was diagnosed. The patient consented on having a minimal surgical treatment, and a laparoscopic right cornuotomy was decided. Read More

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http://dx.doi.org/10.1155/2020/5626783DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7178462PMC

Effectiveness of conservative medical treatment for non-tubal ectopic pregnancies: a multicenter study.

J Gynecol Obstet Hum Reprod 2020 Apr 20:101762. Epub 2020 Apr 20.

Department of Obstetrics and Gynecology, CHU Rennes Hospital, 35000 Rennes, France; Université de Rennes 1 : 2 avenue de Professeur Léon Bernard, 35000, Rennes, France; SAFE CIC 1414 Thematic Team, University Hospital Rennes, Rennes, France; INSERM, UMR 1099, Rennes, F-35000, France; Université de Rennes 1, LTSI, Rennes, F-35000, France.

Objective: To assess the effectiveness of conservative treatment for the management of non-tubal ectopic pregnancies (NTEP) METHODS: Retrospective cohort study in three centers (two referral centers) of patients managed for NTEP diagnosed by 2D or 3D ultrasonograhy. Patients underwent one of the following: expectant management, systemic methotrexate (MTX) injection, local MTX injection, combined MTX injection (local and systemic), local injection of hyperosmolar glucose, or misoprostol administration. The primary endpoint was final success defined by resolution of hCG level without need for emergency surgical treatment. Read More

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http://dx.doi.org/10.1016/j.jogoh.2020.101762DOI Listing

Cornuostomy and Cornuectomy: Laparoscopic Management of Interstitial Ectopic Pregnancies.

J Minim Invasive Gynecol 2020 Apr 11. Epub 2020 Apr 11.

Department of Gynaecology, St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom (all authors).

Objective: To demonstrate and contrast 2 techniques of laparoscopic management of interstitial ectopic pregnancies.

Design: Stepwise demonstration of the technique with narrated video footage.

Setting: Tertiary referral center in Manchester, United Kingdom. Read More

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http://dx.doi.org/10.1016/j.jmig.2020.04.008DOI Listing

Combination of conservative treatment and temporary bilateral laparoscopic uterine artery clipping with hysteroscopic transcervical resection for cervical pregnancy: A retrospective study.

J Gynecol Obstet Hum Reprod 2020 Apr 3:101735. Epub 2020 Apr 3.

Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, 1-12-1-40, Maeda, Teine-ku, Sapporo 006-8555, Japan. Electronic address:

Introduction: We investigated whether temporary bilateral laparoscopic uterine artery clipping with hysteroscopic transcervical resection (LUA clipping-TCR) is an effective minimally invasive treatment for the management of cervical pregnancy.

Materials And Methods: This study is a retrospective clinical case series conducted at Teine Keijinkai Hospital from January 2014 to June 2019. Nine cervical pregnancies among 164 ectopic pregnancies were retrospectively examined. Read More

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http://dx.doi.org/10.1016/j.jogoh.2020.101735DOI Listing

Serum β-human chorionic gonadotropin profile and its correlations with ultrasound parameters in low-lying-implantation ectopic pregnancy in the first trimester.

J Obstet Gynaecol Res 2020 Mar 17. Epub 2020 Mar 17.

Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Aim: Cervical pregnancy (CP) and cesarean scar pregnancy (CSP), defined as low-lying-implantation ectopic pregnancy (LLIEP), are rare conditions of aberrant implantation around the lowest portion of the uterus. This study aimed to illustrate the serum β-human chorionic gonadotropin (β-hCG) profile of LLIEP and to explore its implications with the clinical characteristics.

Methods: Women with LLIEP during the first trimester were retrospectively evaluated at a tertiary referral center from August 1999 to July 2016. Read More

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http://dx.doi.org/10.1111/jog.14248DOI Listing

[CONSERVATIVE MANAGEMENT IN A PATIENT WITH CERVICAL ECTOPIC PREGNANCY IN NARIÑO, COLOMBIA: CASE REPORT AND REVIEW OF THE LITERATURE].

Rev Colomb Obstet Ginecol 2019 12;70(4):277-292

Hospital Universitario Departamental de Nariño, Fundación Universitaria San Martín, San Juan de Pasto (Colombia).

Objective: To report a case of cervical pregnancy (CP) treated successfully with a conservative approach, and to conduct a review of the literature regarding conservative medical and surgical treatment.

Methods: Patient with cervical pregnancy treated pharmacologically with methotrexate (MTX) followed by dilation and curettage, with a satisfactory clinical course. A search of articles was conducted in Medline via PubMed, LILACS, SciElo and Google Scholar using the terms "cervical ectopic pregnancy," "conservative treatment," "curettage,» "methotrexate," "uterine artery embolization," "hysteroscopy. Read More

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http://dx.doi.org/10.18597/rcog.3357DOI Listing
December 2019

Setting priorities in the conventional approaches in managing ectopic pregnancy; is it time to reform? A teaching hospital experience.

Prz Menopauzalny 2019 Dec 15;18(4):222-226. Epub 2020 Jan 15.

Department of Obstetrics and Gynecology, Jordan University Hospital, Amman, Jordan.

The Aim Of The Study: To review the management approaches of ectopic pregnancy (EP) at the Department of Obstetrics and Gynecology at Jordan University Hospital (JUH).

Material And Methods: All patients admitted to our department with the diagnosis of EP treated during the study period extending from January 2017 to June 2019. Data were collected retrospectively using the patients' files anonymously. Read More

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http://dx.doi.org/10.5114/pm.2019.93115DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045355PMC
December 2019

Ectopic pregnancy and its long-term results.

Wiad Lek 2020 ;73(1):139-144

I.Horbachevsky Ternopil National Medical University, Ternopil, Ukraine.

Objective: The aim: The purpose of this study was to assess the long-term outcomes of restoration of reproductive function after surgical and medical treatment of ectopic pregnancy, taking into consideration the patency of the fallopian tubes and the incidence of uterine pregnancy.

Patients And Methods: Materials and methods: A two-stage experimental approach was used to address research objectives. In the first stage, a retrospective analysis of 615 histories of patients with ectopic pregnancy has been performed. Read More

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Conservative management of 11 weeks old cervical ectopic pregnancy with transvaginal ultrasound-guided combined methotrexate injection: Case Report and Literature Review.

Int J Surg Case Rep 2020 27;67:215-218. Epub 2020 Jan 27.

Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty, Istanbul University Cerrahpasa, Istanbul, Turkey.

Introduction: The ultimate treatment approach for cervical ectopic pregnancy remains controversial. Gestational age, serum β-hCG levels, fetal cardiac activity presence and the patient's claim for fertility preservation are the major challenges for method of choice in each individual case. Medical treatment may be a favorable option for the treatment of late diagnosed cases, as well as the early ones. Read More

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http://dx.doi.org/10.1016/j.ijscr.2020.01.020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7025962PMC
January 2020

Intramyometrial pregnancy after cryopreserved embryo transfer: a case report.

Authors:
Yuan Liu Yu Wu

BMC Pregnancy Childbirth 2020 Feb 10;20(1):90. Epub 2020 Feb 10.

Reproductive Medicine Center, Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiaotong University School of Meidicine, Shanghai, China.

Background: Intramyometrial pregnancy is a rare subtype of ectopic pregnancy. The cases following IVF-ET were few reported in recent years. The etiological factors include previous uterine trauma like myomectomy, salpingectomy, dilatation and curettage, assisted reproductive technologies and adenomyosis. Read More

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http://dx.doi.org/10.1186/s12884-020-2784-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011315PMC
February 2020

Management strategies of heterotopic pregnancy following in vitro fertilization-embryo transfer.

Taiwan J Obstet Gynecol 2020 Jan;59(1):67-72

School of Medicine, Shandong University, Ji'nan, Shandong, 250012, China; Center for Reproductive Medicine, Reproductive Hospital Affiliated to Shandong University, Ji'nan, Shandong, China. Electronic address:

Objective: The purpose of this study was to evaluate the efficiency and safety of different treatment modalities for heterotopic pregnancy (HP) in vitro fertilization-embryo transfer (IVF-ET) cycles to avoid influence on intrauterine pregnancy (IUP).

Materials And Methods: Cases of HP (n = 90) were from the IVF/ICSI registry database at the Reproductive Hospital Affiliated to Shandong University. An additional 360 women were randomly selected as controls. Read More

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http://dx.doi.org/10.1016/j.tjog.2019.11.010DOI Listing
January 2020

Society for Maternal-Fetal Medicine (SMFM) Consult Series #49: Cesarean scar pregnancy.

Am J Obstet Gynecol 2020 May 21;222(5):B2-B14. Epub 2020 Jan 21.

The American College of Obstetricians and Gynecologists (ACOG), the American Institute of Ultrasound in Medicine (AIUM), and the Society of Family Planning (SFP) endorse this document.

Cesarean scar pregnancy is a complication in which an early pregnancy implants in the scar from a prior cesarean delivery. This condition presents a substantial risk for severe maternal morbidity because of challenges in securing a prompt diagnosis, as well as uncertainty regarding optimal treatment once identified. Ultrasound is the primary imaging modality for cesarean scar pregnancy diagnosis, although a correct and timely determination can be difficult. Read More

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http://dx.doi.org/10.1016/j.ajog.2020.01.030DOI Listing

Use of Laparoscopic Slip Knot with Purse-String Suture in Surgical Management of Unruptured Heterotopic Interstitial Pregnancies.

Med Sci Monit 2020 Jan 1;26:e921185. Epub 2020 Jan 1.

Department of Gynecologic Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China (mainland).

BACKGROUND The aim of this study was to investigate the advantages and disadvantages of using laparoscopic slip knot with purse-string suture technique in the surgical management of unruptured heterotopic interstitial pregnancies compared with other surgical strategies. MATERIAL AND METHODS We retrospectively analyzed data on 13 patients with unruptured heterotopic interstitial pregnancies who underwent laparoscopy in our hospital between May 2012 and August 2018. The control group consisted of 10 patients who underwent cornual resection or cornuostomy with conventional sutures and knots. Read More

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http://dx.doi.org/10.12659/MSM.921185DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6977598PMC
January 2020

Unexpected rupture of an expectantly managed tubal ectopic pregnancy: a reminder for enhanced diligence.

BMJ Case Rep 2019 Dec 29;12(12). Epub 2019 Dec 29.

Obstetrics and Gynaecology, Paras Hospitals, Gurgaon, Haryana, India.

Expectant management of tubal ectopic pregnancies is a feasible and possibly preferable method of management in asymptomatic women with low serum β-human chorionic gonadotropin (hCG). This involves serial monitoring of β-hCG until negative, after which it is deemed as spontaneously resolved ectopic pregnancy. We describe a case of tubal ectopic pregnancy which was expectantly managed with an initial β-hCG of 585 mIU/mL until undetectable. Read More

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http://dx.doi.org/10.1136/bcr-2019-230876DOI Listing
December 2019

Resident Trainees Increase Surgical Time: A Comparison of Obstetric and Gynaecologic Procedures in Academic Versus Community Hospitals.

J Obstet Gynaecol Can 2020 Apr 18;42(4):430-438.e2. Epub 2019 Dec 18.

Department of Obstetrics and Gynecology, Schulich Medicine and Dentistry, Western University, London, ON.

Objective: The impact of resident involvement in the operating room for common procedures in obstetrics and gynaecology can shed light on the resource demands of teaching. The objective of this study was to quantify the increased surgical time associated with teaching obstetrics and gynaecology resident trainees across a range of procedures known to require surgical assistance.

Methods: This population-based retrospective cohort study compared surgical duration between academic (teaching) hospitals and community (non-teaching) hospitals. Read More

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http://dx.doi.org/10.1016/j.jogc.2019.08.042DOI Listing

Role of collateral embolization in addition to uterine artery embolization followed by hysteroscopic curettage for the management of cesarean scar pregnancy.

BMC Pregnancy Childbirth 2019 Dec 16;19(1):502. Epub 2019 Dec 16.

Department of Interventional Radiology, Shandong Medical Imaging Research Institute Affiliated to Shandong University, Jinan, 250021, People's Republic of China.

Background: The aim of this study was to assess the feasibility, safety and outcome of the embolization of non-gonadal collateral supplying gestational sac (GS) in addition to uterine artery embolization (UAE), followed by hysteroscopic curettage for the management of cesarean scar pregnancy (CSP).

Methods: A retrospective study was undertaken from January 2012 to September 2018 in 24 CSP patients in whom non-gonadal collaterals supplying GS were identified by arterial angiography performed immediately after UAE. These patients underwent attempt collateral embolization in addition to UAE, followed by hysteroscopic curettage for the management of CSP. Read More

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http://dx.doi.org/10.1186/s12884-019-2590-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6915915PMC
December 2019
2.190 Impact Factor

Refining Angular Pregnancy Diagnosis in the First Trimester: A Case Series of Expectant Management.

Obstet Gynecol 2020 01;135(1):175-184

Department of Obstetrics, Gynecology and Women's Health, University of Missouri, Columbia, Missouri.

Objective: To describe the natural history and outcomes of a large cohort of expectantly managed angular pregnancies diagnosed in the first trimester by specific ultrasound criteria.

Methods: We conducted a prospective case series of women with prenatally diagnosed angular pregnancy at a single academic tertiary care center from March 2017 to February 2019. Participants were identified at first-trimester ultrasound scan using specifically proposed diagnostic criteria for angular pregnancy and followed prospectively. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003595DOI Listing
January 2020

Maternal characteristics and outcomes affected by hypothyroidism during pregnancy (maternal hypothyroidism on pregnancy outcomes, MHPO-1).

BMC Pregnancy Childbirth 2019 Dec 5;19(1):476. Epub 2019 Dec 5.

Section of Endocrinology, Department of Medicine, Aga Khan University Hospital, Stadium Road, P.O. Box 3500, Karachi, Pakistan.

Background: Hypothyroidism in pregnancy is an arena of ongoing research, with international conflicts regarding screening, management, and outcomes. Various studies have described the outcomes depending on geographical and international diagnostic criteria. No study has been conducted in this regard from the region of Pakistan. Read More

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http://dx.doi.org/10.1186/s12884-019-2596-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6896307PMC
December 2019

Successful management of a rudimentary uterine horn ectopic pregnancy by combining methotrexate and surgery: A case report.

Case Rep Womens Health 2019 Oct 31;24:e00158. Epub 2019 Oct 31.

Department of Gynaecology, Coimbra Hospital and University Centre, Coimbra, Portugal.

Pregnancy in a non-communicating rudimentary uterine horn is rare but presents a significantly increased risk of maternal and foetal morbidity due to uterine rupture. We describe a case of rudimentary horn pregnancy diagnosed in the first trimester in an asymptomatic and haemodynamically stable woman. Medical termination of the pregnancy was performed with systemic and intrasacular methotrexate. Read More

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http://dx.doi.org/10.1016/j.crwh.2019.e00158DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6881690PMC
October 2019

Management and reproductive counseling in cervical, caesarean scar and interstitial ectopic pregnancies over 11 years: identifying the need for a modern management algorithm.

Hum Reprod Open 2019 4;2019(4):hoz028. Epub 2019 Nov 4.

Department of Obstetrics & Gynecology, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA.

Study Question: Do management strategies (treatment type and order), including provision of reproductive counseling, differ in patients with non-tubal pregnancies?

Summary Answer: Medical and surgical treatment strategies varied widely for each type of non-tubal pregnancy and reproductive counseling in this patient population is lacking.

What Is Known Already: Owing to the rarity of non-tubal pregnancies, there is no consensus regarding treatment strategies or protocol. Furthermore, there is limited data on how patients with a non-tubal pregnancy are counseled about future fertility. Read More

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http://dx.doi.org/10.1093/hropen/hoz028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6870555PMC
November 2019

Abdominal pregnancy with a healthy newborn: a new case.

Pan Afr Med J 2019 16;34:35. Epub 2019 Sep 16.

Department of Gynecology and Obstetrics, Souissi Maternity, Ibn Sina University Teaching Hospital, Mohamed V University, Rabat, Morocco.

Abdominal pregnancy is a rare form of ectopic pregnancy with very high morbidity and mortality for both the mother and the fetus. Diagnosis and management can pose some difficulties especially in low-resource centers. We report a case of abdominal pregnancy with a healthy newborn. Read More

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http://dx.doi.org/10.11604/pamj.2019.34.35.20169DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6859041PMC
December 2019

The indicator of clinical outcomes for patients with heterotopic pregnancy following in-vitro fertilization with embryo transfer.

Taiwan J Obstet Gynecol 2019 Nov;58(6):827-832

Department of Ultrasonic Medicine, Fetal Medical Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

Objective: To explore the early predictors for pregnancy outcomes in patients with heterotopic pregnancy (HP) following in-vitro fertilization with embryo transfer (IVF-ET).

Material And Methods: This retrospective study reviewed 81 patients with HP following IVF-ET in our institution between January 2003 and September 2017. The relationships between clinical outcomes and general characteristics, sonographic features and different management options were analyzed by logistic regression analysis. Read More

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http://dx.doi.org/10.1016/j.tjog.2019.09.018DOI Listing
November 2019

Cesarean scar pregnancy: A case report with surgical management after initially effective conservative treatment.

Int J Surg Case Rep 2019 6;65:238-241. Epub 2019 Nov 6.

Third Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece.

Introduction: The incidence of cesarean scar pregnancies (CSPs) is increasing, possibly due to higher rates of cesarean sections. We report a case of a CSP with severe bleeding following initial conservative management, that was eventually treated surgically.

Presentation Of The Case: A 33-year old woman with history of one cesarean section presented with abdominal pain and amenorrhea and was diagnosed with CSP. Read More

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http://dx.doi.org/10.1016/j.ijscr.2019.11.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6864124PMC
November 2019

Cesarean Scar Pregnancy: Patient Counseling and Management.

Obstet Gynecol Clin North Am 2019 Dec;46(4):813-828

Nottingham University Hospitals NHS, Queens Medical Centre, Derby Road, Nottingham, NG7 2UH, UK.

There is no universally agreed upon and adopted management protocol supported by professional societies in the United States or around the world for the treatment of cesarean scar pregnancy. There is a wide range of management options in the literature, and many of them can to lead to severe bleeding complications, which can result in loss of fertility or even maternal death. If inadequately managed, it can lead to untoward complications throughout all 3 trimesters of the pregnancy. Read More

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http://dx.doi.org/10.1016/j.ogc.2019.07.010DOI Listing
December 2019

A Case of Ectopic Tubal Pregnancy Eight Years After a Hysterectomy Presenting as a Diagnostic Challenge.

Am J Case Rep 2019 Oct 31;20:1596-1600. Epub 2019 Oct 31.

Department of Obstetrics and Gynecology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania.

BACKGROUND Ectopic pregnancy after hysterectomy is extremely rare, and the diagnosis can be challenging, even with modern imaging methods. A rare case is presented of ectopic tubal pregnancy in a 28-year-old woman that presented eight years following a hysterectomy. CASE REPORT A 28-year-old woman was admitted in our hospital with moderate hypogastric pain, mild vaginal bleeding, and bilateral mastalgia. Read More

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http://dx.doi.org/10.12659/AJCR.918894DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849500PMC
October 2019

Comments on Manuscript: Interstitial and Cornual Ectopic Pregnancy: Conservative Surgical and Medical Management.

J Obstet Gynaecol India 2019 Oct 9;69(5):476-477. Epub 2019 Mar 9.

Post-graduate Diploma (PGD), Department of Obstetrics and Gynecology №1, Marat Ospanov, West Kazakhstan State Medical University (WKSMU), Aktobe, Kazakhstan.

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http://dx.doi.org/10.1007/s13224-019-01210-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6765055PMC
October 2019
3 Reads

Unilateral live twin tubal ectopic pregnancy presenting at 12 weeks of gestation: A case report.

Medicine (Baltimore) 2019 Sep;98(38):e17229

Sarawak General Hospital, Kuching, Sarawak, Malaysia.

Rationale: Abdominal pain in pregnancy represents a demanding diagnostic challenge in the emergency department (ED) due to the extensive list of differential diagnoses to be considered, coupled with the possibility of each disease having nonclassical, atypical signs and symptoms, resultant from the patient's pregnant state. Additionally, emergency physicians (EPs) face limitations on investigative imaging modalities because of the need to minimize fetal radiation exposure. EPs have to tackle this diagnostic challenge while performing a balancing act to maximize both maternal and fetal outcomes in a time-sensitive manner, becauser any delays in decision-making at the ED may threaten the safety of mother and child. Read More

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http://dx.doi.org/10.1097/MD.0000000000017229DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6756681PMC
September 2019
7 Reads

Conservative management of Caesarean scar pregnancies with systemic multidose methotrexate: predictors of treatment failure and reproductive outcomes.

Reprod Biomed Online 2019 Nov 24;39(5):827-834. Epub 2019 May 24.

Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

Research Question: Caesarean scar pregnancy (CSP) is an increasing concern in modern obstetrics. Early diagnosis and management are of utmost importance. The optimal management approach for CSP is not well established, with various treatment modalities reported. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S14726483193055
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http://dx.doi.org/10.1016/j.rbmo.2019.05.015DOI Listing
November 2019
3 Reads

Utilisation of emergency blood in a cohort of South African emergency centres with no direct access to a blood bank.

Afr J Emerg Med 2019 Sep 10;9(3):114-118. Epub 2019 Feb 10.

Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa.

Introduction: The transfusion of emergency blood is an essential part of haemostatic resuscitation. Locally, where direct access to a blood bank is limited, emergency blood is stored within emergency centres. It was previously suggested that stored blood provides inadequate volumes compared to what is needed. Read More

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http://dx.doi.org/10.1016/j.afjem.2019.01.017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6742592PMC
September 2019
1 Read

Pelvic Inflammatory Disease: Diagnosis, Management, and Prevention.

Am Fam Physician 2019 09;100(6):357-364

Via Christi Health, University of Kansas, Wichita, KS, USA.

Pelvic inflammatory disease (PID) is an infection of the upper genital tract occurring predominantly in sexually active young women. Chlamydia trachomatis and Neisseria gonorrhoeae are common causes; however, other cervical, enteric, bacterial vaginosis-associated, and respiratory pathogens, including Mycobacterium tuberculosis, may be involved. PID can be acute, chronic, or subclinical and is often underdiagnosed. Read More

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September 2019
3 Reads

Simulation-based Training in Ectopic Pregnancy and Salpingostomy.

Cureus 2019 Jul 10;11(7):e5116. Epub 2019 Jul 10.

Obstetrics and Gynecology, Summa Health System, Akron, USA.

Objective Ectopic pregnancy leads to approximately 3% of deaths in pregnancy. Surgical management is indicated when patients are hemodynamically unstable or have signs of a ruptured ectopic pregnancy. Salpingectomy is more commonly performed, but salpingostomy is preferred in a patient with prior salpingectomy with a desire for future pregnancy. Read More

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https://www.cureus.com/articles/19231-simulation-based-train
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http://dx.doi.org/10.7759/cureus.5116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6741363PMC
July 2019
2 Reads

Pre-curettage cerclage in a viable triplet cervical pregnancy: A case report and review of literature.

Int J Reprod Biomed (Yazd) 2019 Jul 31;17(7):521-524. Epub 2019 Jul 31.

Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Background: Cervical ectopic pregnancy (CEP) is a rare and dangerous form of ectopic pregnancy in which the blastocyst is installed within the endo-cervical canal. CEP diagnosis requires special awareness to evaluate patient precisely. Individualizing controversial medical and surgical management strategies is of importance in medical practice. Read More

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http://mr.crossref.org/iPage?doi=10.18502%2Fijrm.v17i7.4864
Publisher Site
http://dx.doi.org/10.18502/ijrm.v17i7.4864DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6718882PMC
July 2019
8 Reads

Analyzing the clinical significance of postoperative methotrexate in the management of early abdominal pregnancy: analysis of 10 cases.

Ginekol Pol 2019 ;90(8):438-443

The First Affiliated Hospital of Wenzhou Medical University, China.

Objectives: To assess the clinical value and treatment outcomes of postoperative methotrexate (MTX) therapy in themanagement of early abdominal pregnancy.

Material And Methods: We retrospectively analyzed ten (10) cases of early abdominal pregnancy at our hospital between7th August, 2006 and 20th April, 2017.

Results: Out of the ten (10) cases identified, six (6) patients and four (4) patients underwent surgery (laparotomy or laparoscopy)only and surgery (laparotomy or laparoscopy) plus IM 50 mg/m2 methotrexate (MTX) within 24 hours of surgeryrespectively. Read More

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https://journals.viamedica.pl/ginekologia_polska/article/vie
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http://dx.doi.org/10.5603/GP.2019.0078DOI Listing
April 2020
4 Reads

Non-Fluoroscopic Radiofrequency Ablation of Left Atrial Appendage Tachycardia During Early Pregnancy.

Braz J Cardiovasc Surg 2019 08 27;34(4):495-498. Epub 2019 Aug 27.

Bethune International Peace Hospital Department of Cardiology Shijiazhuang Hebei China Department of Cardiology, Bethune International Peace Hospital, Shijiazhuang, Hebei, China.

Management of symptomatic atrial tachycardia (AT) during pregnancy seems challenging, especially those originating from left atrial appendage (LAA), which easily tend to be incessant and mediate cardiomyopathy. It's contradictory between therapy and pregnancy. In this study, we report a case of a woman who presented with persistent AT, which lead to heart failure, during early pregnancy. Read More

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http://dx.doi.org/10.21470/1678-9741-2018-0370DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6713366PMC

Using short tandem repeat analysis for choriocarcinoma diagnosis: a case series.

Diagn Pathol 2019 Aug 17;14(1):93. Epub 2019 Aug 17.

Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, Zhejiang, 310006, People's Republic of China.

Background: Choriocarcinoma is a highly aggressive, malignant trophoblastic neoplasm that can be gestational or non-gestational in origin. Accurate discrimination between these two subtypes, the causative pregnancy type, and the pregnancy-to-treatment interval for gestational choriocarcinoma are vital for clinical management.

Methods: Fifteen choriocarcinomas were genotyped using multiplex fluorescent polymerase chain reaction amplification of 15 short tandem repeat (STR) loci and the amelogenin locus (XY determination). Read More

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http://dx.doi.org/10.1186/s13000-019-0866-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698345PMC
August 2019
3 Reads

First trimester termination of pregnancy.

Best Pract Res Clin Obstet Gynaecol 2020 Feb 12;63:13-23. Epub 2019 Jul 12.

Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, 6/F, Professorial Block, 102 Pokfulam Road, Hong Kong.

First trimester termination of pregnancy (TOP) is a safe and effective procedure. The complete abortion rates of surgical and medical abortion are approximately 97% and 95%, respectively. Vacuum aspiration (VA) either by electrical suction or manual aspiration is the method of choice for surgical TOP. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S15216934193008
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http://dx.doi.org/10.1016/j.bpobgyn.2019.06.004DOI Listing
February 2020
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Efficacy and safety of laparoscopy versus local injection with absolute ethanol in the management of tubal ectopic pregnancy.

Eur J Obstet Gynecol Reprod Biol X 2019 Jul 30;3:100032. Epub 2019 Apr 30.

Center of Reproductive Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China.

Objective: To compare the efficacy and safety between laparoscopy and local injection with absolute ethanol (AE) for treating tubal ectopic pregnancy (EP).

Study Design: Retrospective cohort study of ectopic pregnancies in the fallopian tube from two tertiary hospitals between January 2015 and December 2017. Clinical information such as presenting symptoms, reproductive history, possible risk factors, initial diagnosis, serum beta-human chor-ionic gonadotropin (β-HCG) level, transvaginal ultrasonography findings, methods of treatment and outcomes were reviewed and analyzed. Read More

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http://dx.doi.org/10.1016/j.eurox.2019.100032DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6687442PMC
July 2019
2 Reads

Laparoscopy-assisted suprapubic salpingectomy 'Kaya technic' - a low-cost treatment of ectopic pregnancy.

J Obstet Gynaecol 2019 Nov 23;39(8):1164-1168. Epub 2019 Jul 23.

Department of Dermatology, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital , Istanbul , Turkey.

We aimed to demonstrate the feasibility and total cost of laparoscopy-assisted suprapubic salpingectomy (LASS), which utilises conventional open surgery equipment without any sealing or coagulation devices and reduces port sites compared to conventional laparoscopy (CL). Fifty-seven consecutive, age-matched patients presenting with a tubal pregnancy were enrolled. In the LASS group, a 10 mm reusable umbilical optical trocar and a 10 mm suprapubic trocar was used. Read More

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http://dx.doi.org/10.1080/01443615.2019.1604641DOI Listing
November 2019
5 Reads

From β-hCG values to counseling in tubal pregnancy: what do women want?

Gynecol Endocrinol 2019 Dec 19;35(12):1021-1026. Epub 2019 Jul 19.

Division of Obstetrics and Gynecology, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.

Tubal pregnancy represents an entity that every gynecologist will encounter during professional life. Because of the high prevalence among the pregnant population, standardized protocols are needed in order to choose the optimal strategy for each case. Accurate ultrasound pictures are supporting a more precise diagnosis of ectopic tubal pregnancy, the evolution of which should be closely monitored in follow-up with serial β-hCG values. Read More

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http://dx.doi.org/10.1080/09513590.2019.1640201DOI Listing
December 2019
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Reproductive, obstetric, and perinatal outcomes of women with adenomyosis and endometriosis: a systematic review and meta-analysis.

Hum Reprod Update 2019 09;25(5):592-632

University of Southampton, Human Development and Health, Southampton, UK.

Background: The reproductive impact of adenomyosis and endometriosis is widely researched but the extent of these impacts remains elusive. It has been demonstrated that endometriosis, in particular, is known to result in subfertility but endometriosis and adenomyosis are increasingly linked to late pregnancy complications such as those caused by placental insufficiency. At the molecular level, the presence of ectopic endometrium perturbs the endometrial hormonal, cellular, and immunological milieu, negatively influencing decidualization, placentation, and developmental programming of the embryo. Read More

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http://dx.doi.org/10.1093/humupd/dmz012DOI Listing
September 2019
2 Reads

Laparoscopic approach to cornual ectopic: a step-by-step demonstration.

Fertil Steril 2019 08 4;112(2):397-398. Epub 2019 Jul 4.

University of South Florida, Tampa, Florida.

Objective: To concisely review what is known about cornual ectopic pregnancies and to provide a step-by-step demonstration of the resection of a large cornual ectopic pregnancy, highlighting various laparoscopic techniques.

Design: A video review of cornual ectopic pregnancy and a laparoscopic approach for treatment featuring a patient case at 9 weeks gestation.

Setting: Tertiary care facility. Read More

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http://dx.doi.org/10.1016/j.fertnstert.2019.04.030DOI Listing
August 2019
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Reply letter to: "Comments on manuscript: Laparoscopic treatment of cornual heterotopic pregnancy: A retrospective cohort study".

Int J Surg 2019 08 2;68:168-169. Epub 2019 Jul 2.

Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, No.3 East Qing Chun Road, Hangzhou, 310016, PR China. Electronic address:

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https://linkinghub.elsevier.com/retrieve/pii/S17439191193014
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http://dx.doi.org/10.1016/j.ijsu.2019.06.019DOI Listing
August 2019
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Indwelling Intrauterine Foley Balloon Catheter for Intraoperative and Postoperative Bleeding in Cesarean Scar Pregnancy.

J Minim Invasive Gynecol 2020 Jan 15;27(1):94-99. Epub 2019 Jun 15.

Department of Gynecology and Obstetrics, The Affiliated Shengjing Hospital, China Medical University, Shenyang, China (all authors).

Study Objective: Cesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy, and a significant concern in the management of this condition is the control and prevention of bleeding. We aimed to determine the efficacy and value of an indwelling, intrauterine Foley balloon catheter in controlling and preventing intraoperative and postoperative bleeding in patients with CSP.

Design: Retrospective case series. Read More

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http://dx.doi.org/10.1016/j.jmig.2019.02.024DOI Listing
January 2020
13 Reads

Rupture of a caesarean scar ectopic pregnancy: A case report.

Case Rep Womens Health 2019 Apr 29;22:e00120. Epub 2019 Apr 29.

Royal Prince Alfred Hospital, Sydney, NSW, Australia.

Background: Caesarean scar pregnancy is an uncommon form of ectopic pregnancy characterized by implantation into the site of a caesarean scar. Common clinical features include vaginal bleeding and abdominal pain; however, a significant proportion of cases are asymptomatic. The primary diagnostic modality is transvaginal ultrasound. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S22149112193006
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http://dx.doi.org/10.1016/j.crwh.2019.e00120DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6510699PMC
April 2019
6 Reads

MANAGEMENT OF RUPTURED CORPUS LUTEUM WITH HEMOPERITONEUM IN EARLY PREGNANCY - A CASE REPORT.

Acta Clin Croat 2018 Dec;57(4):785-788

1Rotunda IVF, Parnell Square, Dublin, Ireland; 2Department of Gynecology and Obstetrics, Sveti Duh University Hospital, Zagreb, Croatia.

- Rupture of the corpus luteum is a frequent condition in women of reproductive age. Because of abdominal pain accompanied by hemoperitoneum, ruptured corpus luteum can easily be confused with ectopic pregnancy. The management of ruptured corpus luteum depends on the symptoms and laboratory findings, and can be just observation but laparoscopy or urgent laparotomy may also be needed. Read More

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http://dx.doi.org/10.20471/acc.2018.57.04.24DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6544092PMC
December 2018
25 Reads

Isthmocele: an overview of diagnosis and treatment.

Rev Assoc Med Bras (1992) 2019 Jun 3;65(5):714-721. Epub 2019 Jun 3.

Department of Gynecology and Obstetrics at the Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil.

An isthmocele, a cesarean scar defect or uterine niche, is any indentation representing myometrial discontinuity or a triangular anechoic defect in the anterior uterine wall, with the base communicating to the uterine cavity, at the site of a previous cesarean section scar. It can be classified as a small or large defect, depending on the wall thickness of the myometrial deficiency. Although usually asymptomatic, its primary symptom is abnormal or postmenstrual bleeding, and chronic pelvic pain may also occur. Read More

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http://dx.doi.org/10.1590/1806-9282.65.5.714DOI Listing
June 2019
8 Reads