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abdominal pregnancy

Francisco Eliomar Gomes de Oliveira, Sandra Regina Alves Dos Santos, Bruno Gomes Duarte, Alexandre Sabino Sisnando
Ectopic pregnancy is the leading cause of pregnancy-related death during the first trimester, and it occurs in 1 to 2% of pregnancies. Over 90% of ectopic pregnancies are located in the fallopian tube. Abdominal pregnancy refers to an ectopic pregnancy that has implanted in the peritoneal cavity, external to the uterine cavity and fallopian tubes. The estimated incidence is 1 per 10,000 births and 1.4% of ectopic pregnancies. Lithopedion is a rare type of ectopic pregnancy, and it occurs when the fetus from an unrecognized abdominal pregnancy may die and calcify...
February 2019: Revista Brasileira de Ginecologia e Obstetrícia
F Marek, L Kunovsky, T Grolich, B Hemmelová, K Poredská, D Bartušek, Z Kala
INTRODUCTION: Crohns disease (CD) as a chronic inflammatory disease can affect the entire digestive tract and therefore involves a wide range of symptoms and health problems. It often mimics other diseases of the digestive tract. In the case of acute abdomen in a patient with CD, it is necessary to approach it individually in cooperation with a gastroenterologist in order to reduce the extent of resection and to ensure fewer resections. CASE REPORTS: In our two case reports, we present patients with bowel obstruction and inflammatory acute abdomen...
2019: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Eryn H Dutta, Ralph N Burns, Luis D Pacheco, Caroline C Marrs, Aristides Koutrouvelis, Gayle L Olson Koutrouvelis
BACKGROUND:  Obesity and pregnancy are risk factors for venous thromboembolism (VTE). In nonpregnant individuals, abdominal obesity is associated with venous insufficiency. OBJECTIVE:  To compare venous Doppler volume flow and velocity in the lower extremities of obese versus nonobese women. STUDY DESIGN:  A prospective cohort study was performed. Duplex ultrasound examined bilateral lower extremity venous flow and velocity (time-averaged mean velocity, TAMV)...
February 19, 2019: American Journal of Perinatology
Katie M Groom, Lesley M Mccowan, Laura K Mackay, Arier C Lee, Glenn Gardener, Julia Unterscheider, Renuka Sekar, Jan E Dickinson, Peter Muller, Rosemary A Reid, David Watson, Alec Welsh, Jay Marlow, Susan P Walker, Jon Hyett, Jonathan Morris, Peter R Stone, Philip N Baker
OBJECTIVE: To assess the effect of maternal sildenafil therapy on fetal growth in pregnancies with early-onset fetal growth restriction. DESIGN: A randomised placebo-controlled trial. SETTING: Thirteen maternal-fetal medicine units across New Zealand and Australia. POPULATION: Women with singleton pregnancies affected by fetal growth restriction at 22+0 to 29+6 weeks. METHODS: Women were randomised to oral 25mg sildenafil citrate or visually matching placebo three times daily until 32+0 weeks, birth or fetal death (whichever occurred first)...
February 19, 2019: BJOG: An International Journal of Obstetrics and Gynaecology
Anca Ciobanu, Clara Formuso, Argyro Syngelaki, Ranjit Akolekar, Kypros H Nicolaides
OBJECTIVE: To evaluate the performance of ultrasonographic estimated fetal weight (EFW) at 35+0 - 36+6 weeks' gestation in the prediction of small for gestational age (SGA) neonates and assess the additive value of first, maternal risk factors and second, fetal growth velocity between 20 and 36 weeks' gestation in improving such prediction. METHODS: This was a prospective study of 44,043 singleton pregnancies that had undergone routine ultrasound examination at 19+0 - 23+6 and at 35+0 - 36+6 weeks' gestation...
February 19, 2019: Ultrasound in Obstetrics & Gynecology
Mohamed Balaha, Torki Al-Otaibi, Osama A Gheith, Medhat A Halim, Mohamed Shaker, Zohair Fayyad, Prasad Nair, Zakaria Zakaria, Hasaneen Abo-Atya, Yahya Makkeyia
To avoid graft rejection during pregnancy, frequent monitoring of serum drug levels is recommended. Pregnancy induces hyperfiltration in transplanted kidneys, as in native kidneys; therefore, detection of rejection can be difficult when monitoring by serum creatinine. If rejection is suspected, ultrasonographguided graft biopsy can be done; once proven, it can be treated with pulse steroids, but data are scarce regarding other agents. Here, we present a 28-year-old pregnant female patient with resistant acute rejection but with successful pregnancy outcome...
January 2019: Experimental and Clinical Transplantation
Justine K Stremick, Kyle Couperus, Simeon W Ashworth
Tubal ectopic pregnancies are commonly diagnosed during the first trimester. Here we present a second-trimester tubal ectopic pregnancy that was previously misdiagnosed as an intrauterine pregnancy on a first-trimester ultrasound. A 39-year-old gravida 1 para 0 woman at 15 weeks gestation presented with 10 days of progressive, severe abdominal pain, along with vaginal bleeding and intermittent vomiting for two months. She was ultimately found to have a ruptured left tubal ectopic pregnancy. Second-trimester ectopic pregnancies carry a significant maternal mortality risk...
February 2019: Clinical practice and cases in emergency medicine
Matthew R Neth, Maxwell A Thompson, Courtney Blayke Gibson, John P Gullett, David C Pigott
Ruptured ectopic pregnancy is the leading cause of first trimester maternal mortality. The diagnosis of ectopic pregnancy should always be suspected in patients with abdominal pain, vaginal bleeding or syncope. While the use of an intrauterine device (IUD) markedly reduces the incidence of intrauterine pregnancy, it does not confer equal protection from the risk of ectopic pregnancy. In this report we discuss the case of a female patient who presented with a ruptured ectopic pregnancy and hemoperitoneum despite a correctly positioned IUD...
February 2019: Clinical practice and cases in emergency medicine
Tallat Ejaz, Eltaib Saad, Andik Nabil, James Slattery
A 46-year-old female presented to our emergency department (ED) with a 2-day history of right lower abdominal pain which was associated with nausea and anorexia. Abdominal examination revealed tenderness in the right iliac fossa (RIF) with rebound tenderness and a localized guarding. Urine dipstick was normal, and the pregnancy test was negative. Her laboratory investigations were significant only for a CRP of 16.6. A presumptive clinical diagnosis of acute appendicitis was suggested based on the given history and relevant physical signs...
2019: Case Reports in Surgery
Farideh Mohsenzadeh-Ledari, Ziba Taghizadeh, Zahra Motaghi, Afsaneh Keramat, Mahmood Moosazadeh, Ali Najafi
Metabolic syndrome (MetS), a series of symptoms, including abdominal obesity, impaired glucose tolerance and insulin metabolism, hypertension, and dyslipidemia, is considered as the risk of developing cardiovascular disease and diabetes that can predispose a pregnant women to serious health problem, women in the developed as well as the developing countries. This study was aimed to investigate the effects of appropriate interventions on pregnant women with indicators of MetS to further improve the outcome of pregnancy...
2019: International Journal of Preventive Medicine
S Devroe, T Bleeser, M Van de Velde, L Verbrugge, F De Buck, J Deprest, R Devlieger, S Rex
INTRODUCTION: This retrospective, matched case-control cohort study describes the incidence, indications, anesthesia techniques and outcomes of pregnancies complicated by surgery in a single tertiary-referral hospital. METHODS: Retrospective review of the hospital records of 171 patients who had non-obstetric surgery in the current pregnancy, between 2001 and 2016. Pregnancy outcomes of these women were firstly compared with all contemporary non-exposed patients (n=35 411), and secondly with 684 non-exposed control patients, matched for age, time of delivery and parity...
January 12, 2019: International Journal of Obstetric Anesthesia
Ferras Alwan, Chiara Vendramin, Ri Liesner, Amanda Clark, William Lester, Tina Dutt, William Thomas, Richard Gooding, Tina Biss, H G Watson, Nichola Cooper, Rachel Rayment, Tanya Cranfield, Joost J van Veen, Quentin A Hill, Sarah Davis, Jayashree Motwani, Neha Bhatnagar, Nicole Priddee, Marianna David, Maeve P Crowley, Jayanthi Alamelu, Hamish Lyall, John-Paul Westwood, Mari Thomas, Marie Scully
Congenital Thrombotic Thrombocytopenic Purpura (cTTP) is an ultra rare thrombomicroangiopathy caused by an inherited deficiency of ADAMTS13. There is limited data on the genotype-phenotype correlation and no consensus on treatment. We reviewed the largest cohort of cTTP cases, diagnosed in the UK, over the past 15 years. 73 cases of cTTP were diagnosed, confirmed by genetic analysis. 93% were alive at the time of review. 36% had homozygous mutations and 64% compound heterozygous mutations. Two presentation peaks were seen, childhood (median diagnosis age 3...
February 15, 2019: Blood
Francesca Parisi, Melek Rousian, Anton H J Koning, Sten P Willemsen, Eric A P Steegers, Régine P M Steegers-Theunissen
RESEARCH QUESTION: Is embryonic morphological development according to the Carnegie stages associated with pregnancy outcome? DESIGN: In a tertiary hospital-based cohort, 182 singleton non-malformed pregnancies were selected. Serial transvaginal three-dimensional ultrasound (3D-US) scans were carried out between 6+0 and 10+2 gestational weeks. Embryonic development was annotated according to the morphological criteria of the Carnegie classification using a virtual reality system...
December 21, 2018: Reproductive Biomedicine Online
Ashley Lane McCormack, Nader Rabie, Brianna Whittemore, Trevor Murphy, Collin Sitler, Everett Magann
Importance: Herpes simplex virus (HSV) hepatitis is a rare condition with a high mortality rate. Immunocompromised individuals, including pregnant women, are the most susceptible. When primary infection occurs during pregnancy, risk for disseminated HSV is greatly increased. Disseminated HSV can manifest in the form of HSV hepatitis. Objective: We aim to review the literature and summarize what is known about HSV hepatitis in pregnancy to aid in the diagnosis and treatment of this condition...
February 2019: Obstetrical & Gynecological Survey
Wolfgang Reinpold, Ferdinand Köckerling, Reinhard Bittner, Joachim Conze, René Fortelny, Andreas Koch, Jan Kukleta, Andreas Kuthe, Ralph Lorenz, Bernd Stechemesser
Introduction: Recently, the promising results of new procedures for the treatment of rectus diastasis with concomitant hernias using extraperitoneal mesh placement and anatomical restoration of the linea alba were published. To date, there is no recognized classification of rectus diastasis (RD) with concomitant hernias. This is urgently needed for comparative assessment of new surgical techniques. A working group of the German Hernia Society (DHG) and the International Endohernia Society (IEHS) set itself the task of devising such a classification...
2019: Frontiers in Surgery
P T Lim, Rohit, V Viardot-Foucault
INTRODUCTION: Hysterosalpingography (HSG) is routinely performed in the mid-follicular phase of a woman's menstrual cycle for cavity and tubal patency assessment as a part of the infertility screening. A pre-procedural pregnancy test is not routinely required unless the patient reports abnormal menstrual bleeding or irregular menstrual pattern. PRESENTATION OF CASE: We present the case of a 29 year-old sub fertile woman who had a HSG performed on day 12 of her menstrual cycle...
January 29, 2019: International Journal of Surgery Case Reports
Aline Silva Santos Sena, Alex Sandro Rolland de Souza, Vivianne de Oliveira Barros, Maria do Carmo Pinto Lima, Adriana Suely Oliveira Melo, Melania Maria Ramos de Amorim
OBJECTIVE: To assess fetal visceral adiposity and associated factors during pregnancy. METHODS: Secondary analysis of prospective cohort data with 172 pairs (pregnant woman/fetus) treated at public health units. Anthropometric data, metabolic (glucose, glycated hemoglobin, insulin, insulin resistance, total cholesterol and fractions, triglycerides) measures, fetal biometry, and visceral and subcutaneous adiposity in the binomial (pregnant woman/fetus) were evaluated at the 16th, 28th and 36th gestational weeks by ultrasonography...
February 8, 2019: Jornal de Pediatria
Matthieu St-Jean, Jessica MacKenzie-Feder, Isabelle Bourdeau, André Lacroix
A 29-year-old G4A3 woman presented at 25 weeks of pregnancy with progressive signs of Cushing's syndrome (CS), gestational diabetes requiring insulin and hypertension. A 3.4 × 3.3 cm right adrenal adenoma was identified during abdominal ultrasound imaging for nephrolithiasis. Investigation revealed elevated levels of plasma cortisol, 24 h urinary free cortisol (UFC) and late-night salivary cortisol (LNSC). Serum ACTH levels were not fully suppressed (4 and 5 pmol/L (N: 2-11)). One month post-partum, CS regressed, 24-h UFC had normalised while ACTH levels were now less than 2 pmol/L; however, dexamethasone failed to suppress cortisol levels...
February 7, 2019: Endocrinology, Diabetes & Metabolism Case Reports
Sofie Graner, Julia Mctaggart, Fanny Nordström, Emma Melander, Johan Widenberg, Helena Kopp Kallner
INTRODUCTION: The objective was to investigate the Pearl index for ectopic pregnancy in women using levonorgestrel intrauterine system (LNG-IUS) at time of conception. MATERIAL AND METHODS: This was a sub-study of a hospital based historical cohort including women with an ectopic pregnancy diagnosed in four referral hospitals in Stockholm Sweden between December 2013 and April 2017. Study participants and type of contraception at time of conception were identified through the electronic medical chart system...
February 8, 2019: Acta Obstetricia et Gynecologica Scandinavica
Theodore J Dubinsky, Jeremiah OʼRegan, Rachelle Sonneborn, Dan S Hippe, Manjiri Dighe, Mariam Moshiri
OBJECTIVES: The objective of this study is to establish a nomogram of fetal abdominal wall fat thickness in fetuses with known normal neonatal outcomes. METHODS: After IRB approval (HSD-49496), 157 ultrasound examinations in 100 patients, 41 of whom had multiple examinations during the same pregnancy were reviewed. The thickness of the fetal lateral abdominal wall fat Interreader agreement was summarized using the intraclass correlation coefficient (ICC). Fat thickness growth curve equations were estimated to quantify the relationship between fat thickness and gestational age...
February 4, 2019: Ultrasound Quarterly
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