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At least 1,621 records · Page 90Linked to original sources
PubMed1994

[Clinico-pathologic study of 285 cases of ectopic pregnancy in intrauterine devices-users and non-intrauterine devices-users].

Two hundred eighty five cases of ectopic pregnancy in Beijing area from Jan. 1 to Dec. 31 1990 including 150 cases of intrauterine devices (IUD) and 135 cases of non-IUD users were studied. Clinico-pathological observation included the history of pelvic inflammatory disease, the site of ectopic pregnancy, the classification of previous tubal inflammation of the ectopic side and other pathologic lesions, the side of the corpus luteum of pregnancy and histology of endometrium, etc. Besides, using stereologic technique the cilia length and cilia density of endosalpinx were studied in 50 cases through image analysis system. Results showed that except for a significant higher frequency of ovarian pregnancy in IUD-users, there was no significant differences between the 2 groups. It indicated that the degree of injury of fallopian tubes and the factors causing the damage were similar in both groups. The authors concluded that IUD does not increase the risk of fallopian tube lesions.

Fallopian Tubes↗
PubMed1993

[Fertility of women after past ectopic pregnancy].

An analysis of the fates of women after passed pregnancy was performed concerning the type of surgery and the microscopic findings in the excised oviducts. The analysis based on the subsequent frequency of intrauterine pregnancies in the operated subjects, incidence of repeat ectopic pregnancies and following sterility. In the group 416 operated women intrauterine pregnancy followed in 31.2% and ectopic pregnancy--in 8.9%, secondary sterility was noted in 29.6%. The performed surgical interventions were analysed in 4 subgroups depending on the range of surgery. A higher rate of intrauterine pregnancies was seen in women after unilateral salpingectomy or unilateral reconstructive-conservative operation. Higher incidence of ectopic pregnancies was seen in women undergoing unilateral salpingectomy and recanalization of the other oviduct. Analysis of the microscopic findings revealed a higher incidence of intrauterine pregnancies in women demonstrating functional changes in the operated oviduct, versus a lower one in those, with inflammatory or endometriosis process in the affected oviduct. No differences could be found--correlated with the microscopic diagnosis.

Fallopian Tubes↗
PubMed1994

Bilateral twin ectopic gestation with intraligamentous and interstitial components. A case report.

Twin ectopic gestations are rare; the majority involve one or both fallopian tubes. The case presented is the first known report of a bilateral twin ectopic pregnancy of this type. The patient experienced a concurrent right broad ligament ectopic pregnancy along with a left interstitial pregnancy. Her history was significant for a left cornual resection eight years previously. This case is additionally noteworthy in that intraligamentous gestations are rare, while interstitial pregnancies following cornual resection are even more uncommon.

Adult↗
PubMed1993

Three consecutive recurrent ectopic pregnancies.

A case of three consecutive repeated ectopic pregnancies is presented in a 36-year-old woman who was being managed for infertility. The first two ectopic pregnancies occurred in the right fallopian tube, and both were treated conservatively. All three ectopic pregnancies were confirmed histopathologically. The aetiology, symptoms and management of the case are discussed, and the literature is reviewed.

Adult↗
PubMed1993

Embryo transfer technique as a cause of ectopic pregnancy in in vitro fertilization.

A randomized prospective study was performed to compare the effects of a midfundal versus a deep fundal transfer technique on subsequent intrauterine and ectopic PRs after IVF. The clinical intra-uterine PR after the deep fundal transfer was 12.4% per cycle with a 1.5% ectopic PR (which represented 12.2% of the pregnancies) versus 14.2% IUPs per cycle with a 0.4% ectopic rate (representing 3% of pregnancies) after midfundal transfers. The midfundal technique appears superior to deep fundal procedures because of a lower percentage of EPs without any sacrifice of the intrauterine PR after midfundal transfers.

Embryo Transfer↗
PubMed1994

Single-dose systemic methotrexate for the treatment of persistent ectopic pregnancy after conservative surgery.

OBJECTIVE: To determine whether a single outpatient methotrexate injection successfully treats persistent ectopic pregnancy. METHODS: Nineteen consecutive patients with increasing beta-hCG titers after conservative surgery for ectopic pregnancy were treated with a single intramuscular methotrexate (50 mg/m2) injection. RESULTS: All 19 patients had resolution of their beta-hCG titers without subsequent surgery. Beta-hCG levels commonly increased during the first 3 days after treatment, but subsequently declined. Two patients required hospital admission for observation and analgesia. One of these two patients had probable self-limited intra-abdominal bleeding and required a blood transfusion. CONCLUSION: A single methotrexate injection is a safe and successful treatment for persistent ectopic pregnancy. Delayed hemorrhage may be a rare complication, and close surveillance is necessary.

Chorionic Gonadotropin↗
PubMed1993

Ectopic pregnancy. An update on technologic advances in diagnosis and treatment.

From 1970 to 1986, the number of ectopic pregnancies in the United States quadrupled. Maternal mortality rates dramatically declined, yet the risk of dying from an ectopic pregnancy is still 10 times that associated with a term delivery and 50 times that associated with a legal elective abortion. Ectopic pregnancy can be a very difficult diagnosis to make, but advances in hCG assays and transvaginal ultrasound scanning allow the diagnosis to be made in 90% of cases before rupture. Conservative surgical and medical management are associated with success rates greater than 95% and resultant pregnancy rates of approximately 60%.

Female↗
PubMed1995

High dose methotrexate infusion with leucovorin rescue for treatment of ectopic pregnancy.

The purpose of this article is to evaluate the effectiveness, side effects, and complications of high dose methotrexate infusion with leucovorin rescue in select patients with ectopic pregnancy. Between January 1991 and November 1994, 28 patients with ectopic pregnancies were prospectively treated with methotrexate (100 mg/m2 intravenous bolus followed by a 200 mg/m2 infusion over six hours) with leucovorin rescue. Twenty-seven of 28 patients (96%) were successfully treated. Only one patient (4%) required a second course of methotrexate to reach a normal hCG titer. One patient failed methotrexate infusion 45 days after treatment at a hCG titer of 12 mIU/mL. No Gynecologic Oncology Group grade 3 or 4 clinical, biochemical or hematologic toxicities occurred. Uterine bleeding and abdominal pain, not requiring transfusion or hospitalization, occurred in 71% and 56% of patients. The authors conclude that high dose methotrexate infusion with leucovorin rescue is a highly effective, well tolerated, nonsurgical treatment for select patients with ectopic pregnancy.

Abdominal Pain↗
PubMed1996

[Atrial fibrillation after coronary artery bypass surgery. The significance of preoperative vagus modulation and ectopic atrial activity].

To investigate the impact of pre-operative autonomic balance and atrial ectopic activity on the risk of atrial fibrillation or flutter after aorto-coronary artery bypass surgery 24-hour Holter monitoring was analyzed in 102 patients before coronary artery bypass grafting. Index for vagal tone was calculated as % successive RR-interval differences > 6%. Twenty-nine (28%) of the 102 patients developed atrial fibrillation or flutter. Independent predictors (90% confidence interval) of postoperative atrial fibrillation or flutter were identified by logistic regression analysis: the independent predictors were older age, relative risk 1.07/year (1.02-1.12), vagal index < 10%, relative risk 4.50 (1.40-14.5), > or= 10 ectopic supraventricular beats/24 hour, relative risk 3.03 (1.05-8.72), and one or more event of non-sustained supraventricular tachycardia, relative risk 3.02 (1.11-8.22). Thus, age of the patient, attenuated preoperative cardiac vagal modulation, ectopic supraventricular beats, and paroxysmal non-sustained supraventricular tachycardia are independent risk factors for the development of atrial fibrillation or flutter after coronary artery bypass surgery.

Atrial Fibrillation↗
PubMed1996

[Fertility after ectopic pregnancy. Results of the first three years of the Auvergne Registry].

The reproductive outcome after ectopic pregnancy is evaluated from a population-based register in the center of France. Since 1992, all the women aged 15-44 years, who permanently reside in the target area and who were treated either by surgical or medical procedures for an ectopic pregnancy in one of the area centers, are registered and prospectively followed until 45 years of age. The analysis presented was based on the 221 women registered between January 1992 and December 1994 who were followed up for at least 6 months, and who were seeking a new pregnancy. The mean follow-up period was 19.8 months. 155 women (70%) obtained a pregnancy. The first conception was intrauterine for 136 women, and 19 had a recurrence of ectopic pregnancy. Risk factors of recurrence were prior spontaneous abortion and prior tubal damage. For those women who conceived, the mean time to obtain pregnancy ("time to pregnancy") was 7.6 months. The one year cumulative intrauterine pregnancy rate (i.e. the probability of obtaining an intrauterine pregnancy within 1 year of seeking pregnancy) was 64%. After multivariate analysis by a Cox regression, the factors associated with lower fertility were aged over 30 years, low educational level, history of infertility and prior tubal damage.

Adolescent↗
PubMed1996

Operative laparoscopy for the treatment of ectopic pregnancy in a residency program.

OBJECTIVE: To compare the effectiveness and safety of operative laparoscopy (OL) when used for the treatment of ectopic pregnancy in the setting of a residency training program. STUDY DESIGN: We retrospectively reviewed records of all patients with diagnostic laparoscopy documenting the presence of an ectopic pregnancy. Patients who met the following criteria were selected: hemodynamic stability, tubal distortion no greater than 5 cm and adequate visualization of the pelvis. The cases performed via OL were compared to the cases performed via laparotomy (LAP). All the surgery had been performed by resident physicians with the attending gynecologist as first assistant/supervisor. RESULTS: Ninety-five cases performed from March 1989 to April 1992 met the above criteria. Group 1 consisted of 61 patients treated with LAP. Group 2 consisted of 34 patients treated with OL. The operating time (76.8 +/- 19.0 vs 76.0 +/- 23.0 min, mean +/- SD) and the estimated blood loss (275.0 +/- 183.7 vs. 70.5 +/- 75.2 ml) were similar for both groups. The hospital stay for the LAP group was longer than for the OL group (3.7 +/- 1.2 vs. 1.4 +/- 0.6 days, P < .001). The surgical complication rate was also higher in the LAP group (23% vs 2.9%, P = .16). CONCLUSION: In our residency program the introduction of OL for the management of ectopic pregnancy has resulted in shorter hospital stays and lower morbidity without increased duration of the surgical episode or increased blood loss.

Blood Loss, Surgical↗
PubMedDate not supplied

Modern lines of management of ectopic pregnancy.

The recent increase in the incidence of ectopic pregnancies was associated with rapid improvement in the diagnostic and therapeutic techniques. Quantitative serum B-HCG radioimmunoassay and high resolution vaginal ultrasonography have facilitated early diagnosis of ectopic pregnancy allowing a more conservative approach to patient management. Different conservative surgical and medical lines of management recently developed were associated with and increased chance of subsequent intrauterine pregnancy with no increase in the incidence of repeat ectopic pregnancy. Outpatient systemic medical treatment seems to be a preferred alternative to conservative surgery. In selected cases, it is associated with a lower complication rate and promising result for fertility.

Female↗
PubMed1997

Serial histopathologic myocardial findings in a patient with ectopic atrial tachycardia-induced cardiomyopathy.

A 17-year-old woman was found to have ectopic atrial tachycardia by her physician. Echocardiography and cardiac catheterization revealed findings resembling dilated cardiomyopathy at the time of initial presentation. The tachycardia was controlled with atenolol only at a dose of 50 mg/day. However, at the age of 22, the presence of ectopic atrial tachycardia was once again confirmed. We successfully performed catheter ablation for persistent ectopic atrial tachycardia. Serial echocardiographic findings showed the left ventricular dimension and function appeared to return to normal 1 year postablation. However, despite pharmacologic control and catheter ablation therapy, histopathology revealed myocardial fibrosis presumably representing permanent damage of the heart secondary to tachycardia 1 year postablation.

Adolescent↗
PubMed1996

Ectopically erupting mandibular first permanent molar: treatment of a case.

This case report presented a rare case of irreversible ectopic eruption of right mandibular first permanent molar in a 6-year-old boy. Distal root resorption of primary second molar was found during routine radiographic examination. Early treatment of ectopically erupting permanent first molar was considered in favor of preventing space loss. Using a modified Humphrey appliance as the correcting appliance, the ectopic eruption of permanent first molar had been successfully uprighted and retained.

Child↗
PubMed1994

Ectopic atrial tachycardia in utero.

BACKGROUND: The antenatal diagnosis of fetal arrhythmias helps direct medical management, which may include intrauterine therapy. Ectopic atrial tachycardia is an unusual arrhythmia in children, and we know of no previous reports of antenatal diagnosis of this particular arrhythmia. CASE: The diagnosis of fetal ectopic atrial tachycardia was suggested by the monitor tracing during labor and was subsequently confirmed by the postpartum behavior of the arrhythmia and its electrocardiographic characteristics. CONCLUSION: Ectopic atrial tachycardia, although uncommon, should be considered in the differential diagnosis of fetal tachycardias. The fetal monitor tracing may be useful in making this diagnosis antenatally, which may help to direct management both before and after birth.

Adult↗
PubMed1997

[Is the treatment of ectopic pregnancy still exclusively surgical?].

At the end of the 19th century, ectopic pregnancy became a surgical procedure. A century later, one third of ectopic pregnancies are treated medically. In the meantime, early detection of ectopic pregnancy became possible due to sensitive serum hCG and progesterone combined assays with transvaginal sonography and a knowledge of risk factors. Consequently, a nonsurgical approach appears to be an attractive alternative to surgery. Expectant management is recommended with a plateau or decreasing hCG and an initial level < or = 1.000 mIU/ml in asymptomatic women. Medical treatment by local or parenteral methotrexate is recommended in patients with clear evidence of an unruptured pregnancy in based on initial hCG and progesterone level, size of hemoperitoneum, ultrasound diameter of hematosalpinx and absence of clinical pain. Laparoscopy remains the gold standard but in prospective randomized trials between medical treatment and laparoscopy, in selected patients, the non-surgical approach appears to be equivalent with a similar reproductive performance.

Contraindications↗
PubMed1996

Differential effects of plasma from normal and ectopic gestation on lymphocyte proliferation.

This study investigated immunoregulatory differences as a result of anatomical changes in the fetomaternal interface. Thirty-one female subjects were recruited from a military tertiary-care facility. Ten subjects were non-pregnant while 21 were pregnant (nine normal and 12 ectopic gestations). Immune tests included one-way mixed lymphocyte cultures with and without maternal plasma, phytohemagglutinin stimulation and lymphocyte phenotypes. Basic statistics and a one-way ANOVA using Tuckey's HSD model were employed. Autologous plasma significantly enhanced the allogeneic responses of first-trimester pregnant females with normal gestations to spouses as well as to control male lymphocytes. This enhancement was not observed in either ectopically-pregnant or non-pregnant subjects. Mitogen stimulation and lymphocyte populations were similar in all three groups. The first trimester of normal pregnancy is characterized by the presence of soluble intrauterine pregnancy-specific lymphocyte-enhancing factors. Ectopic gestation lacks this phenomenon.

Adult↗
PubMed1995

Suspected ectopic pregnancy: expectant management in patients with negative sonographic findings and low serum hCG concentrations.

Between July 1989 and December 1994, we performed a prospective study in 265 patients with suspected ectopic pregnancy to assess the value of expectant management in patients with negative transvaginal sonographic findings and low serum human chorionic gonadotropin (hCG) concentrations. All patients had serum hCG concentrations < 1500 IU/l. Eventually, ectopic pregnancy was diagnosed in 68 patients (25.6%), intrauterine pregnancy in 81 patients (30.6%) and trophoblast in regression in 116 patients (43.8%). Test results of our diagnostic strategy, that integrated the results of serial transvaginal sonography, serum hCG monitoring and expectant management, were good: sensitivity 90%, specificity 98%, likelihood ratio of a positive test result 45 and likelihood ratio of a negative test result 0.1. Expectant management in patients with suspected ectopic pregnancy and low serum hCG concentrations proved to be safe, and it enabled us to avoid untimely invasive interventions in patients with an early intrauterine pregnancy or with trophoblast in regression.

Abdominal Pain↗