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At least 1,531 records · Page 85Linked to original sources
PubMed2002

[Observation on treatment of ectopic pregnancy by combination therapy of Chinese herbal medicine with mifepristone or methotrexate].

OBJECTIVE: To find a simpler, effectiver with less side-effect method for treatment of ectopic pregnancy. METHODS: One hundred and fourteen patients of ectopic pregnancy were divided into two groups, the 56 patients in Group A were treated with Mifepristone and Chinese herbal medicine (CHM), and 58 patients in Group B were treated with Methotrexate and CHM. The therapeutic effect in both groups was observed and compared. RESULTS: The rate of success in Group A was 82.14% and in Group B 70.69%, comparison between them showed no significance (P > 0.05). Time for successful treatment was 14.54 +/- 5.87 days in Group A and 9.00 +/- 5.09 days in Group B, comparison of them showed significant difference (P < 0.01). Insignificance revealed in comparison between the occurrence of side-effects for the groups, such as nausea, vomiting, diarrhea, liver dysfunction and lowering of white blood cells, but significance was shown in re-menstruation time (43.43 +/- 1.77 days vs 38.38 +/- 1.13 days, P < 0.05). CONCLUSION: Treatments of combined CHM with Mifepristone or Methotrexate showed similar therapeutic effect in treating ectopic pregnancy, but the latter showed a quicker initiation and less side-effects in delaying the re-menstruation time.

Abortifacient Agents↗
PubMedDate not supplied

Intraoperative autologous blood transfusion for hemoperitoneum resulting from ectopic pregnancy or ovarian bleeding during laparoscopic surgery.

OBJECTIVE: Our purpose was to evaluate the efficacy and safety of intraoperative autologous blood transfusion during laparoscopic surgery for hemoperitoneum in benign gynecologic disease. METHODS: The Cell Saver, Haemo Lite 2, an intraoperative autologous blood salvage device, was used in laparoscopic surgery on 18 patients with ectopic pregnancies or ovarian bleeding who had a large hemoperitoneum with/without severe anemia and hypovolemic shock. RESULTS: The blood loss was 1186 +/- 789 mL, and the volume of reinfused processed blood was 661 +/- 405 mL in ectopic pregnancy cases. The blood loss was 716 +/- 219 mL, and the volume of reinfused processed blood was 496 +/- 138 mL in ovarian bleeding. Laparoscopic surgery was performed and homologous blood transfusion was not required in any patient. No adverse reactions or procedural difficulties associated with the autologous blood transfusions occurred. CONCLUSIONS: Intraoperative autologous blood transfusion enabled the performance of laparoscopic surgery for large hemoperitoneum caused by ectopic pregnancies or ovarian bleeding without a homologous blood transfusion.

Adult↗
PubMed1992

Transvaginal sonographic features in ectopic pregnancy.

A retrospective review of the transvaginal sonograms of 37 women with confirmed ectopic pregnancy was performed to characterize the findings from transvaginal sonography and correlate operative findings with sonographic features. Thirty-six of the 37 ectopic pregnancies were tubal pregnancies. Intrauterine findings showed an absence of gestational sac in all cases and a pseudosac in 1 case (7.14%). An ectopic gestational sac with a live embryo was documented in 2 cases (5.41%) and with embryo or yolk sac in 6 cases (16.22%) and nonspecific adnexal mass in 30 cases (81.08%). Fluid in the cul-de-sac was found in 22 cases (59.46%). Transvaginal sonography provides better access to the pelvic organ and allows a clear view of the uterus and adnexa, with no need to fill the bladder. Excellent visualization of the endometrial cavity permits the detection of even a very early intrauterine pregnancy and clearly shows the gestational sac where it is outside the uterine cavity. Blood and other fluids in the cul-de-sac can also be seen easily. This technic has reduced patients' risk by minimizing delay in diagnosis and treatment.

Female↗
PubMed2003

[Diagnosis of ectopic pregnancy: endometrial biopsy or diagnostic hysteroscopy].

OBJECTIVES: Define indications for endometrial biopsy and diagnostic hysteroscopy in ectopic pregnancy diagnosis. Define the indication of endometrial biopsy and diagnostic hysteroscopy in ectopic pregnancy diagnosis. MATERIALS AND METHODS: This prospective study included 15 women with a poorly localized pregnancy (ectopic or intrauterine localization not identified at ultrasound) who had an abnormal HCG curve and low progesteronemia. RESULTS: In 8 patients, an empty cavity was identified at diagnostic hysteroscopy and the endometrial biopsy was negative. In 2 patients hysteroscopy was non-contributive (pregnancy and intra uterine device with blood in the cavity) and the endometrial biopsy was negative. In 3 patients who had an early abortion hysteroscopy and endometrial biopsy demonstrated villosities. Finally, in 2 patients who had an early abortion hysteroscopy identified villosities and endometrial biopsy was non-contributive. The sensitivity and specificity of hysteroscopy for the diagnosis of EP was 100% but the sensitivity of endometrial biopsy was 50% with a specificity of 100%. CONCLUSION: If pregnancy cannot be correctly localized at ultrasonography, hysteroscopy appears to be better than endometrioal biopsy to discriminate between EP and early abortion.

Biopsy↗
PubMed1992

[Ectopic pregnancy--an analysis of the cases treated at the N. I. Pirogov Research Institute of Emergency Medicine].

Rate of ectopic pregnancy, a life-threatening pathology with great psycho-social significance, had reached from 4.5 per miles in 1970 up to 16.8 per miles in 1987. During a nine-year period (1980-1988) 466 women with diagnosis ectopic pregnancy were hospitalized in the Department of Urgent Gynaecology-Emergent Medical Institute "Pirogov". Married were 285 (61.16%) of them, not married--116 (24.89%) and divorced--65 (13.95%). Dull, not localized pain was observed in 300 (64.38%) of them. In 160 (34.33%) only colics were observed, dated from 15 days to 1 month before hospitalization. The classic triad of amenorrhea, colicky pains in the lower abdomen and bloody liquids, running out of genitalia. When hospitalized, 194 women (41.63%) were in very severe general condition, from these 92 in severe hemorrhagic shock. The blood loss, evaluated in the beginning of the operation was found to be: 0 ml--8 patients (1.72%); up to 300 ml--143 (30.69%); up to 600 ml--121 women (25.97%); up to 1000 ml--102 (21.88%); up to 1500 ml--36 (7.73%); up to 2000 ml--36 patients (7.73%); up to 3000 ml--17 (3.65%); more than 3000 ml--3 (0.64%). A conclusion was made that it is necessary to improve the prophylaxis, the diagnostic methods and the treatment of ectopic pregnancy, so as to save reproductive abilities of the women.

Adolescent↗
PubMedDate not supplied

Ovarian heterotopic pregnancy after IVF and contralateral tubal ectopic pregnancy after GIFT.

One case of ovarian ectopic associated with twin intrauterine viable pregnancy after in vitro fertilization, and one case of contralateral tubal ectopic pregnancy after gamete intra fallopian transfer performed with normal fallopian tubes, are reported. The possible pathogenesis and the management are discussed. The risk of ectopic pregnancy after assisted conception can be present even when the fallopian tubes are apparently normal.

Adult↗
PubMedDate not supplied

Ectopic pregnancy, the new gynecological epidemic disease: review of the modern work-up and the nonsurgical treatment option.

Over the past few decades, the incidence of ectopic pregnancy has increased almost to the extent of an "epidemic disease." Early diagnosis of tubal pregnancy, with the aid of serum human chorionic gonadotropin, high-resolution ultrasound, and the more liberal use of laparoscopy, has dramatically reduced both maternal mortality and the need for radical surgery. Despite this, women with previous ectopic pregnancies still have reduced fertility potential. We report on some current aspects of the epidemiology, etiology, and work-up of ectopic pregnancy. In a review of 328 patients, gleaned from the literature, who were treated with various nonsurgical options, 283 (86%) were able to avoid surgery. The benefits, safety, and efficacy of the various treatment options are discussed, with appropriate recommendations for their use.

Female↗
PubMed2003

[Fertility after ectopic pregnancy and indications of ART].

There is no simple answer to the problem of fertility after one ectopic pregnancy. Results reported in the literature have been satisfactory with rate of subsequent pregnancy about 60% and the risk of new ectopic pregnancy (EP) around 28%. We have deliberately excluded studies before 1990 except when the methodology was particularly good or the treatment particularly interesting. Strict and exhaustive criteria were lacking in most of these studies due to widely varying aims, the prospective or retrospective nature of the data, the number of patients included, and varying therapeutic decision-making schemes. Many patients were lost to and no mention is given concerning the proportion of patients who desired a subsequent pregnancy. Infertility factors were not considered in most cases. We were looking for fertility results according to treatment used. Among the 50 studies we retained, pregnancy rates after ectopic pregnancy were satisfactory whatever treatment was used, with laparoscopy being the gold standard. Medical treatment was at least as effective as surgical treatment. Associated infertility factors appeared to be the most important for fertility outcome. It is unfortunate that so few study have analyzed outcome in these patients without considering risks factors of EP, infertility factors and the proportion of women who attempted to conceive again.

Abortifacient Agents, Nonsteroidal↗
PubMed1992

[Appendectomy, a risk factor for ectopic pregnancy].

As part of a case-control study of ectopic pregnancy, we evaluated the potential etiological role of appendectomy. Previous appendectomy was associated with an increased risk of ectopic pregnancy (adjusted Odds-ratio: 2.2; 95 percent CI: 1.5-3.2). Ruptured appendix did not appear to be more strongly associated with an increased risk of ectopic pregnancy than unruptured appendix. Such confounding factors as absence of pathological diagnosis of appendicitis and relationship between age of appendectomy and age of first sexual intercourse are discussed. This study provides an additional argument in favor of laparoscopy in childbearing age to diagnose appendicitis and salpingitis.

Adolescent↗
PubMed2004

[A case of MEN IIA variant associated with ectopic ACTH production and mammary carcinoma].

A 69-year-old house wife admitted to our hospital with complaints of fever, drowsiness, watery diarrhea and uncontrolled blood sugar level. She had been operated for the right mammary carcinoma 11 years ago. Left adrenal mass and nodules in the thyroid gland were discovered by CT and hypersecretion of adrenocortical hormone, catecholamine and PTH as well as ectopic ACTH production were indicated endocrinologically. Autopsy and histopathological examination revealed left adrenal pheochromecytoma associated with bilateral adrenocortical hypertrophy, adenomas in 2 of 5 parathyroid glands and papillary thyroid carcinoma with adenomatous goiter. Ectopic ACTH production was identified immunohistochemically in the pheochromecytoma. This case is a rare variant of non-familial MEN (multiple endocrine neoplasm) type IIA with ectopic ACTH production and metachronous mammary carcinoma.

ACTH Syndrome, Ectopic↗
PubMed2004

[Ectopic hormone-producing tumors--research and clinics].

Recent progress in endocrinology, cytokine research, and oncology has provided new information for further understanding of ectopic hormone-producing tumors. The mechanisms responsible for this morbidity need further investigations to clarify the neuroendocrine nature of tumor cells. Meanwhile, a common hormonal substance produced by a specific tumor could serve as a specific tumor marker for the tumor, as is the case of ProGRP for small cell lung cancer. The development of drugs for ectopic hormonal syndrome might be a good lesson of the molecular targeting for hormone signaling pathways. It is reasonable to postulate that the clinical entities covered by the term 'ectopic humoral syndrome' will be increasing.

Biomarkers, Tumor↗
PubMed1992

Oral methotrexate for persistent ectopic pregnancy. A case report.

Persistent ectopic pregnancy complicates a significant percentage of conservative tubal pregnancy procedures. The optimal treatment of persistent trophoblast has yet to be determined. Most reported cases have been treated by reoperation and removal of the affected tube. Use of methotrexate may avoid the need for reoperation and permit tubal salvage. We report on a case of persistent ectopic pregnancy treated successfully using an oral methotrexate regimen originally described for treating nonmetastatic gestational trophoblastic neoplasia. Oral methotrexate provides a simple, convenient, outpatient treatment option for cases of persistent ectopic pregnancy diagnosed by a rise or plateau in human chorionic gonadotropin levels following conservative surgery.

Administration, Oral↗
PubMedDate not supplied

New options for diagnosis and treatment of ectopic pregnancy.

The incidence of ectopic pregnancy has increased 4.5-fold in the United States since 1970. Several risk factors have contributed to this rate of increase, but the primary underlying cause remains undefined. Significant advances in the diagnosis of ectopic pregnancy have occurred during this same interval as a consequence of an enhanced understanding of the natural course of the disease. Characteristic changes in human chorionic gonadotropin levels, ultrasound findings, and more frequent use of laparoscopy have contributed to earlier, more consistent diagnosis. Advances in treatment, including tubal-conserving operations, laparoscopic approaches, and medical treatment with methotrexate, have all proved to be safe and effective. The remaining principal challenge is to improve future fertility, which is often adversely affected by recurrence of an ectopic pregnancy.

Chorionic Gonadotropin↗
PubMed1992

Ectopic pregnancy.

During the last two decades, the incidence of ectopic pregnancy was shown to be rising. At the same time, ectopic pregnancy became less lethal due to improvements in diagnostic procedures, which are now able to confirm the ectopic implantation before the occurrence of life-threatening hemorrhagic complications. Earlier diagnosis has also offered the possibility of conservative surgical and medical treatments.

Causality↗
PubMed1992

Ectopic pregnancy: a case study.

Ectopic pregnancy occurs when a fertilized egg implants on tissue other than the lining of the uterus. As the number of ectopic pregnancies increase, it is important that PACU nurses understand postoperative assessment and interventions for these women. Hypovolemic shock from preoperative and intraoperative bleeding is one potential problem for these patients that requires close postoperative monitoring. The case study of the ectopic pregnancy patient included with this article demonstrates important postanesthesia assessment parameters.

Adult↗
PubMed2004

Medical management of ectopic pregnancy with extremely high beta-HCG levels: a case report.

We report the successful treatment of an unruptured ectopic pregnancy in a patient with extremely high beta-human chorionic gonadotropin concentrations. A 33-year-old woman, gravida 2, para 0, abortus 1, presented to our department due to menstrual delay. On transvaginal ultrasonography, she had an unruptured ectopic pregnancy (3.5 x 4.5 cm). Her initial beta-HCG concentration was 38,270 mIU/ml. The administration of methotrexate (50 mg/m2) was performed intramuscularly. Serum beta-HCG levels decreased > 15% between post-therapy days 4 (31,324 mIU/ml) and 7 (13,108 mIU/ml), and did not rise during the subsequent weekly controls. In selected cases with unruptured ectopic pregnancy and extremely high initial beta-HCG levels, medical management with a single-dose methotrexate regimen may be successful.

Abortifacient Agents, Nonsteroidal↗
PubMed1992

Gamete intrafallopian transfer in women who had ectopic pregnancy previously.

Eighty-seven women who had previously had ectopic pregnancy underwent 111 gamete intrafallopian transfers (GIFT). Forty-one women had moderate or severe pelvic adhesions, eight had mild pelvic adhesions, and 18 had had the fallopian tubes surgically repaired. The remaining 20 women had no obvious pelvic abnormality except for the absence of one fallopian tube. After stimulation of superovulation, between two and 22 oocytes were retrieved and two to four were transferred into the fallopian tubes after careful assessment of their condition. Twenty-eight pregnancies were achieved (25.2% per cycle), with 23 live births (20.7% per cycle), four abortions (14.3% of all pregnancies), and one ectopic pregnancy (3.6% of all pregnancies, 0.9% per cycle). This experience shows that GIFT can safely produce a reasonable pregnancy rate in carefully selected women who have had ectopic pregnancy.

Adult↗
PubMed2004

Preservation of tubal function following methotrexate treatment for ectopic pregnancy.

To evaluate methotrexate (MTX) administration as a conservative treatment for ectopic pregnancy, we reviewed the medical records of 248 cases (210 patients) of MTX treatment for tubal pregnancies at our department between December 1985 and December 2003, and compared its pregnancy prognosis with that of laparoscopic salpigotomy (59 patients). With the MTX treatment, 185 patients were successfully treated, and the subsequent pregnancy rate and ectopic pregnancy rate were 48.4 % and 18.4 %, respectively, while those rates were 49.2 % and 18.6 %, respectively, after the salpigotomy. These results suggest that MTX treatment is comparable to the more conservative operation. To clarify the (dys/) function of the ectopic implantation tubes and MTX-treated tube (s), we excluded patients who had a contra-lateral healthy tube, and extracted 40 patients as "the affected tube group", where the pregnancy-related parameters were not adversely affected. The findings suggest that MTX is not necessary to preserve tubal function.

Adult↗