Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ectopic”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,549 records · Page 86Linked to original sources
PubMed2005

Multiple parameters in the diagnosis of ectopic pregnancy.

OBJECTIVE: To determine the role of emergency ultrasound examination in the diagnosis and management of ectopic pregnancy. METHODS: A descriptive study done at the Radiology Department, Aga Khan University Hospital, Karachi from January 1999 to December 2000 using observational facts by non-probability convenient sampling method. Seventy one patients who presented with acute symptoms in early pregnancy, were subjected to emergency pelvic ultrasound. Both transabdominal and transvaginal ultrasound were done in 52 patients while in 19 patients only transabdominal ultrasound was performed. Serum Beta hCG levels, of all patients were greater than 1500 iu/ml. RESULTS: Ultrasound correctly identified ectopic pregnancy in 71 patients. Ultrasound diagnosis included live embryo in six patients, adnexal mass with pelvic fluid in 54 patients, extrauterine gestational sac in 4 patients and pelvic fluid without adnexal mass in 7 patients. There was no indeterminate ultrasound scan, resulting in 100% specificity and sensitivity. CONCLUSION: The use of multiple parameters in the diagnosis of ectopic pregnancy resulted in 100% sensitivity and specificity.

Adult↗
PubMed2005

[Gynecological laparoscopy and treatment of ectopic pregnancy].

The aim of the present study is to show the advantages of the gynecologic laparoscopy for the diagnosis and treatment of the intact tubal pregnancy. For the fulfillment of this aim was made a prospective study for 5 years' period of the patients with diagnosis "Ectopic pregnancy", treated in Gynecological clinic of UMBAL-Pleven. The objects of observation were 33 women with diagnosis: "Intact ectopic pregnancy". Methotrexate was used by plan for 6 patients, in 7 patients was made laparotomy, and in 20 patients--gynecological laparoscopy. From the performed 20 gynecological laparoscopy, 16 women were recovered laparoscopically, in 14 of which was made partial salpingectomy, and in 2--milking. In one of the last two patients was injected Methotrexate in the bed of the gestational bag. In 4 women was necessary laparotomy, because of impossibility of performing of laparoscopic surgery. The authors emphasized the advantages of the gynecological laparoscopy for precise diagnosis and contemporary treatment of the intact ectopic pregnancy.

Antimetabolites, Antineoplastic↗
PubMed2005

A case of Cushing syndrome secondary to ectopic adrenocorticotropic hormone producing carcinoid of the duodenum.

Cushing syndrome caused by adrenocorticotropic hormone (ACTH) production from solid tumors can result in life-threatening hypercortisolemia. Ectopic ACTH production is most commonly associated with bronchial carcinoids and squamous cell carcinoma of the lung. We report a case of Cushing syndrome caused by ectopic ACTH production from a carcinoid of the duodenum. The patient presented to an outside hospital in hypertensive crisis and diabetic ketoacidosis. After stabilization, diagnostic studies including a serum cortisol level, and computed tomography (CT) scans of the head, chest, abdomen, and pelvis revealed hypercortisolemia and a large mass in the head of the pancreas. Pancreaticoduodenectomy was performed. Pathologic investigation revealed a 1-cm carcinoid of the duodenum with two large metastatic lymph nodes near the head of the pancreas. This is the first reported case in the English literature of Cushing syndrome caused by ectopic ACTH production from a carcinoid of the duodenum.

ACTH Syndrome, Ectopic↗
PubMed2005

Ectopic pregnancy is not more likely following fresh vs frozen embryo transfer.

PURPOSE: To determine if the risk of ectopic pregnancy is greater following frozen vs fresh embryo transfer (ET). METHODS: Retrospective review of pregnancy outcome from January 1, 1997 to November 30, 2003. Cryopreservation was used as a simple freezing method and one-step removal of cryoprotectant. The cycles consisted mostly of graduated estradiol and progesterone supplementation. RESULTS: The ectopic pregnancy rate in 1,445 clinical pregnancies from fresh ET was 2.6% vs 2.0% of 975 clinical pregnancies resulting from frozen ET. CONCLUSION: In contrast to the conclusions of two previous studies, the present study evaluating twice as many clinical pregnancies than the two aforementioned studies combined failed to show any greater risk of ectopic pregnancy when transfers were performed on day 3.

Adult↗
PubMed1992

Ectopic pregnancy--United States, 1988-1989.

Although the number and rate of ectopic pregnancies in the United States increased from 1970 through 1987, they stabilized from 1987 through 1989 (1). This report presents data regarding the number and rate of ectopic pregnancies and ectopic pregnancy-related deaths in the United States from 1988 through 1989 and compares those data with information reported since 1970.

Adolescent↗
PubMed2006

Predictors of methotrexate treatment failure in ectopic pregnancy.

OBJECTIVE: To determine the possible predictors of methotrexate treatment failure in ectopic pregnancy. STUDY DESIGN: Fifty-eight patients diagnosed with ectopic pregnancy were treated with methotrexate (50 mg/m2). Selected variables in the history of the patients, the signs and symptoms at the time of admission, transvaginal ultrasound findings and serum beta-human chorionic gonadotropin (beta-hCG) levels on day 1 and 3 were evaluated in a logistic regression model to predict treatmentfailure, defined as tubal rupture. RESULTS: Methotrexate treatment failed in 9 cases (15.5 %). Another 9 cases (15.5%) required a second dose of methotrexate, and no treatment failures were observed in these cases. The presence of subchorionic tubal hematoma in the ectopic gestation (OR = 22.9, CI = 2.7-194.7, p = 0.004), the presence of an embryo (OR = 24, CI = 2.1-269, p = 0.01) and day 1 serum beta-hCG level > or = 3,000 mIU/mL (OR = 27.1, CI = 2.1-342.5, p = 0.01) were the main predictors of treatment failure. Follow-up serum beta-hCG levels > or =3,500 mIU/mL (OR = 42.9, CI = 4.3-421) on day 3 were significant predictors of treatment failure. Follow-up risk score was calculated as > 4 on day 3 by adding day 3 serum beta-hCG level to the admission score. Only 1 treatment failure (2.4%) occurred in 42 patients with an admission score of nil. No treatment failure occurred in 39 patients whose follow-up score was nil. The increase in admission risk (OR = 32.1, CI = 3.8-270, p = 0.001) and follow-up risk (OR = 9.2, CI = 2.4-35.2) were significant predictors of treatment failure. CONCLUSION: Transvaginal ultrasound findings are as important as serum beta-hCG level on the first day of methotrexate treatment. In unruptured cases, day 3 serum beta-hCG level is important to reevaluate the decision to continuefollow-up or perform early surgery for increased risk of treatment failure.

Abortifacient Agents, Nonsteroidal↗
PubMed2006

[Management of ectopic pregnancy. about 77 cases].

We report a retrospective study of 77 ectopic pregnancies, collected over a period of 5 years and 4 months. The aim of this study was to analyse the epidemiology, the clinical and special investigation findings of this pathology, and to report our result as regards management of ectopic pregnancy, eectopic pregnancy affects young women (mean age : 31.8 years), whether multiparous or pauciparous (81.1%). The most important risk factors were endouterine maneuvres (42.8 %) and IUD (36.3%). Suspicion of the diagnosis was based on clinics findings, US examination and beta HCG dosage. Diagnostic coelioscopy was performed in 90 % of cases to confirm the diagnosis. 7 patient underwent immediate laparotomie. Ectopic pregnancy was ampullar in 80% of cases. Treatment was given through a coelioscopy in 44 cases (57%). A laparo-conversion was required in 26 patient (33.7%). Treatment was radical in 52% of cases. We didn't note any serious per-operative or post-operative complication. About eighteen percent (18.1%) of out patient who subsequently wanted to get pregnatn, got an intra-uterine pregnancy. Only one case of recurrence was noted in our series.

Adult↗
PubMed2006

[Non surgical management of ectopic pregnancy].

During the past 25 years, the incidence of ectopic pregnancy has progressively increased while the morbidity and mortality have substantialy decreased, and the treatment has progressed from salpingectomy by laparotomy to conservative surgery by laparoscopy and more recently to medical therapy with Methotrexate or expectant management. This therapeutic transition from surgical emergency to non surgical managment has been attributed to early diagnosis through the use of sensitive assays for hCG and the high definition of vaginal ultrasound. By using these sensitive diagnostic tools, we are now able to select those patients who are most likely to respond to expectant or medical managment versus those who are at high risk of rupture and require surgery. We have reviewed the scientific literature on ectopic pregnancy published over the past 20 years, with the aim to assess the value of non surgical managment of etopic pregnancy. Predictor factors of expectant managment are discussed. Medical therapy with methotrexate: results, indications, Unpleasant side effects and complications are detailed. Several protocols are defined and therapeutic supervision is etablished. The authors offred several recommandations for OB/GY wich will optimize the effectivness of non invasive methods for treatment of ectopic pregnancy.

Adult↗
PubMed2006

Medical treatment of ectopic pregnancy: a ten-year review of 106 cases at Maharaj Nakorn Chiang Mai Hospital.

OBJECTIVE: To evaluate the effectiveness of single-dose intramuscular methotrexate in the treatment of ectopic pregnancy at Maharaj Nakorn Chiang Mai Hospital MATERIAL AND METHOD: A retrospective review of the patient records was performed on the patients with diagnosis of ectopic pregnancy and treatment with single-dose methotrexate according to the protocol of Stovall et al between 1996 and 2005. The successful treatment was defined as no need for surgical intervention. RESULTS: As many as 96 out of 106 (90.6%) were successfully treated with methotrexate, though four required a second dose. Pretreatment /f-human chorionic gonadotropin (beta-hCG) levels were significantly lower in women who responded to single-dose therapy than either in those who required two doses or who had a failure of medical management (p < 0. 01). The mean pretreatment level of beta-hCG was 873 mlU/ml. The median time to resolution of beta-hCG was 21 days. In addition, all cases with failed medical treatment had adnexal masses larger than 3.5 centimeters in diameter CONCLUSION: In the present series, treatment of ectopic pregnancy with single-dose methotrexate was as high as 90% successful. Women with a high pretreatment beta-hCG level and large sonographic adnexal masses had a greater probability of requiring either surgical intervention or multiple doses of methotrexate.

Abortifacient Agents, Nonsteroidal↗
PubMed2006

Repeat ipsilateral ectopic gestation: a series of 3 cases.

Ectopic pregnancy remains an important cause of maternal mortality and morbidity as well as early foetal wastage in Nigeria and in other developing countries. We report 3 different cases of repeat ipsilateral ectopic pregnancy seen in the gynaecological emergency unit of the University College Hospital, Ibadan. Cases of repeat ectopic pregnancy often gives rise to diagnostic dilemma, and this becomes more difficult when it occurs at an ipsilateral location.

Adult↗
PubMed1992

Transvaginal color Doppler study of blood flow in ectopic pregnancies.

OBJECTIVE: To compare Doppler indices of blood flow in the uterine and spiral arteries and the corpus luteum (CL), in ectopic and intrauterine pregnancies (IUPs). DESIGN: A prospective study of women with an ectopic or singleton IUP at the corresponding stage of gestation. SETTING: The Gynaecological Ultrasound Clinic, King's College Hospital. PATIENTS: Fifty-two women, 19 with an ectopic pregnancy (EP) and 33 with an IUP. INTERVENTIONS: All women were examined by transvaginal ultrasonography with color Doppler immediately before surgery. MAIN OUTCOME MEASURES: The resistance index from the left and right uterine arteries, the spiral arteries, and the CL. The peak blood velocity (cm/sec) from the uterine arteries. The length of gestation. RESULTS: Fetal heart activity was observed in all cases of IUP at 5 weeks' gestation. Three women had an EP with a live embryo, 5 had an embryo with no heart activity, 5 contained only a yolk sac, and 2 had an empty sac. A hematocele was seen in 3 women, and 1 had tubal thickening. The mean uterine and spiral arterial resistance index decreased with the gestational age of IUPs but remained constant during EPs. Peak blood velocity in the uterine arteries increased with the gestational age of IUPs, and the values were significantly higher than in EPs. A CL was seen in 88% of women with an IUP and in 100% of women with an EP. The resistance index was similar in CL associated with both types of pregnancy, and the values did not change with gestational age. CONCLUSION: These data show that: (1) blood flow impedance in the uterine and spiral arteries, and CL, is similar in IUPs and EPs and (2) peak flow velocity in the uterine arteries reflects a decreased blood supply to EPs.

Female↗
PubMedDate not supplied

[Pharmacokinetics of methotrexate and clinical response associated in the medical treatment of ectopic pregnancies].

Methotrexate (MTX) is used in the medical treatment of unruptured ectopic pregnancy. This drug is administered by intramuscular (IM) or intrasaccular (IS) injection under sonographic control. No data are available concerning the pharmacokinetics of MTX in this new indication. This study compares the two administration routes in 12 patients (21 to 37 years) taken as their own control and presenting with ectopic pregnancy (51 +/- 12 days of amenorrhea). Our aim was to compare the pharmacokinetic profile of MTX for each route to facilitate its use in the future. The initial level of hCG was 4.474 +/- 4.184 mIU/ml. Each patient firstly received 1 mg/kg of MTX intrasaccularly under vaginal sonography. The same dose was injected intramuscularly 48 hours later. The pharmacokinetic profiles of MTX after IS and IM administrations were determined after both injections during 48 hours. MTX serum levels were measured by Fluorescence Polarization Immuno Assay. Data were analyzed by model independent methods and compared by a Wilcoxon T test (p 0.01 was considered as significant). All the unruptured ectopic pregnancy were cured and the hCG serum levels were normalized (10 mIU/ml) in 37 +/- 18 days. After IM administration, AUC0-infinity is significantly (p 0.01) increased i.e., 15.1 +/- 4.1 mumol.h/l versus 11.2 +/- 4.8 after IS injection. T1/2 lambda z and MRT remained unchanged whatever the route is i.e., 11.3 +/- 4.9 h and 8.6 +/- 3.9 h (IS) versus 12.1 +/- 5.9 h and 7.3 +/- 1.8 h (IM). The decrement of AUC0-infinity 8 determined after IS injection might be the consequence of the capture of the MTX by the trophoblastic cells (target cells).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Chlamydial infection in women with ectopic pregnancy].

A study was carried out on the presence of antibodies to C. trachomatis in women with ectopic pregnancy, established during laparotomy. Pathohistological examination discovered that ectopic pregnancy occurred due to chronic salpingitis in a larger part of the women. The presence of antibodies to C. trachomatis was found in women with more sexual partners more frequently. Serum data for infection to C. trachomatis did not correlate with inflammatory gynecological diseases, undergone in the past. From the obtained results the authors could conclude that the endured subclinical chlamydial infection has caused damage of the Fallopian tubes, which is the cause for occurrence of ectopic pregnancy.

Antibodies, Bacterial↗
PubMed1991

Clinical use of immunoperoxidase markers in excluding ectopic gestation.

Ectopic pregnancy is suspected when a pregnancy test is positive and an Arias-Stella phenomenon with decidua is seen on endometrial curettings in the absence of chorionic villi and trophoblast. We performed immunoperoxidase stains for beta-hCG, hPL, placental alkaline phosphatase, and keratin (AE1/AE3) on endometrial curettings of 72 patients with first-trimester bleeding in whom ectopic pregnancy was suspected based on routine hematoxylin and eosin (H&E) stain. Negative immunoperoxidase stains correlated with a retrospective patient chart review identified only ten patients with extrauterine pregnancy, a prevalence of 14%. The sensitivity of hCG, hPL, placental alkaline phosphatase, and keratin markers in detecting trophoblastic cells in the curettings was 42, 48, 24, and 69%, respectively. Each marker had a specificity of 100%. When both keratin and hPL were used, the sensitivity improved to 73%; however, there was no advantage in using three or more markers. We conclude that 73% of patients suspected to have ectopic pregnancy would be spared additional diagnostic techniques when immunoperoxidase markers for keratin and hPL are used on endometrial curettings without trophoblast on routine H&E stain. The procedure requires only 3 hours of laboratory time.

Decidua↗
PubMed1991

[Incidence of ectopic pregnancy at the 1st Clinic of Obstetrics and Gynecology of Bari during the past 10 years. Clinico-statistical considerations].

The Authors, in the period 1979-1988, discovered 175 ectopic pregnancies out of a total of 16.641 pregnancies: a rate of incidence of 1 in 95 (1.05%); 28 patients were fitted with an IUD. In accordance with published data, they recognize an increase in the incidence of ectopic pregnancies and emphasize the importance of a precocious clinical diagnostic, to reconcile timeliness of operation with the need of conservative surgery, the indication for which should take into account many factors (the age, the general condition, the parity, the wish for a pregnancy, the state and condition of the tube on each side) since it seems to predispose to recurrent ectopic pregnancies. They indicate the negative effects on the tube for patients fitted with an IUD.

Female↗
PubMed1991

[Ectopic pregnancy. A ten-year case load of the Obstetric and Gynecologic Department of the Ospedale Civile of Taranto].

The Authors report the ectopic pregnancies incidence in the period from 1-1-79 to 31-12-88 at Department of Obstetric and Gynecology of the Hospital in Taranto. The ectopic pregnancies discovered were 130 with a rate of 0.49% versus the deliveries (26,515) and of 0.18% versus all the women recovered (70,024). The Authors observed no increase in the incidence of ectopic pregnancy and stress the value of early clinical diagnosis to preserve reproductive functions in these patients.

Female↗
PubMed1991

Epidemiology and etiology of ectopic pregnancy.

Although advances in earlier diagnosis have led to decreased case-fatality rates and conservative laparoscopic treatments have enabled improved outcomes, ectopic pregnancy remains a leading cause of maternal mortality and accounts for a sizable proportion of infertility and ectopic recurrence. The incidence of ectopic pregnancy, the trends observed in the last decade, reason for occurrence, and other questions regarding risk factors for this condition are discussed.

Adolescent↗
PubMed1991

Persistent ectopic pregnancy.

The potential hazards of persistent ectopic pregnancy are becoming more relevant as the incidence of ectopics increases and surgical treatment continues to evolve from a radical to a conservative approach. As a complication following conservative surgery, the incidence and possible management strategies of early detection and treatment of persistent ectopic pregnancy are discussed.

Female↗