[Insertion of the Lippe's loop immediately after abrasio residuorum and interruptio graviditatis].
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Abortion, Incomplete↗
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[Secretion of hCG by mononuclear cells--a specific and essential reaction in pregnancy?].
Mononuclear cells in peripheral blood secrete immunoreactive hCG (ir-hCG) when they are stimulated in in-vitro culture with the proteinkinase C - activator phorbol-myristat-acetate (TPA). We examined the ir-hCG secretion in 61 fertile and 191 pregnant women and 38 men. Mononuclear cells of pregnant women secrete after TPA stimulation significantly more ir-hCG than mononuclear cells on non-pregnant but fertile women. This effect can be detected as early as 23rd days of a menstrual cycle which is accompanied by conception and persisted over the entire duration of a pregnancy. Maximal effects were observed in the 7th to 19th and 30th to 34th weeks of pregnancy. An artefact caused by adhesive serum-hCG could be excluded. The elevated potential of the mononuclear cells to be stimulated remained intact for about 14 days after termination of a normal pregnancy in the first trimester. An ir-hCG secretion similar to that seen in nonpregnant women was found in patients with early abortion. The possible physiological importance of the in-vivo secretion of beta-HCG during pregnancy is discussed.
Abortion, Incomplete↗
Hypervitaminosis A and reproductive disorders in rabbits.
Reproductive abnormalities in New Zealand White rabbits at a large commercial rabbitry were linked to an excess of dietary retinyl acetate. Fetal resorptions, abortions, and stillbirths were common in pregnant does. Examination of aborted and stillborn fetuses disclosed hydrocephalus, microencephaly, and cleft palate. Analysis of the commercially prepared feed disclosed a total vitamin A content of 102,278 IU/kg, of which 97,618 IU was retinyl acetate (recommended total vitamin A concentrations are 6,000 to 12,000 IU/kg). Levels of vitamin A in the plasma of does with reproductive disorders were 517 to 1,667 ng/ml (normal level is 300 ng/ml), and liver levels were 2,070 to 12,854 micrograms/g (normal range is 50 to 300 micrograms/g).
Abortion, Incomplete↗
[Status of laparoscopy in the examination repertoire of small and middle gynecologic departments].
During nearly 2 years 155 laparoscopies were performed in a gynaecological-obstetrical department with 75 beds. The indications and results are discussed. Because of the important advantages, like better diagnosis, reduction of the duration of clinical treatment, reduction of costs and better utilization of clinical capacity laparoscopy especially is suitable for the indications "suspicion on tubal pregnancy", "suspicion on tumor in the lower abdomen", "not clear findings" and "chronic pain in the lower abdomen" in little and middlesized gynaecological departments.
Abortion, Incomplete↗
Doppler color imaging. Obstetric and gynecologic applications.
The addition of pulsed and color Doppler has greatly added to the diagnostic potential for obstetric and gynecologic ultrasound. In addition to improved morphologic detail inherent in the use of EVUS, new information is available on perfusion and the physiologic changes associated with the menstrual cycle and early pregnancy. The absence of luteal flow strongly predicts unsuccessful pregnancy outcome in patients undergoing therapy for infertility. This introduces the possibility of more economic use of expensive treatments. Later in pregnancy, DCI aids in the efficient and accurate performance of Doppler spectral sampling and contributes to the evaluation of structural and functional abnormalities of the fetus, umbilical cord, and placenta. Applications in the evaluation of patients with suspected ectopic pregnancy, incomplete abortion, and pseudosac are welcome additions for clinical problems that currently result in many malpractice suits. Finally, the recognition of neovascular flow, especially in the ovary, raises hope for improved and earlier diagnosis of ovarian cancer.
Color↗
Abortion: epidemiology, safety, and technique.
In 1991, the abortion literature was characterized by articles relating to 1) epidemiologic issues in abortion care, 2) advances in knowledge and experience with medical abortifacients such as mifepristone (RU 486), and 3) cervical ripening prior to abortion with the use of both mifepristone and prostaglandins. Technical methods of achieving termination of pregnancy continue to be similar in the United States, the United Kingdom, and Europe, although induction-abortion times are generally slower in Europe than in the United States. Surgically, dilatation and evacuation procedures continue to be more common in the United States than in other countries. The effectiveness of mifepristone is undisputed, and the recommended dose for early first-trimester termination is being compared with lower dose alternative regimens. There is additional evidence that at least in the short term, the negative psychological sequelae of abortion are infrequent and are inconsequential as a public health issue.
Abortion, Incomplete↗
Intramural pregnancy: a report of 2 cases.
BACKGROUND: Intramural pregnancy is a rare type of ectopic pregnancy and may be easily misdiagnosed as cornual pregnancy or trophoblastic tumor. Hysterectomy is performed due to extensive bleeding and uterine rupture in most cases. The incidence is <1% of ectopic pregnancy. Eighteen cases were reported in the People's Republic of China and 33 in the rest of the world since 1957. For a young woman who wishes to maintain her fertility, it is important to make an early diagnosis and to undertake conservative treatment. CASES: A 29-year-old woman, gravida 3, para 1, was admitted because of missed periods for >70 days, 1 week of mild vaginal bleeding and lower abdominal pain. Her serum beta-human chorionic gonadotropin (beta-hCG) level was 765 U/L. Transvaginal sonography (TVS) revealed an ill-defined mass measuring 3.0 x 3.5 x 2.0 cm within the fundal myometrium adjacent to the covering. At laparotomy, a mass 3 cm in diameter bulged from the left fundal covering and was resected to the surface of myometrium. The patient preserved her fertility through successful repair of the uterus. A 39-year-old woman, gravida 4, para 1, was admitted because of irregular vaginal bleeding for 2 months after intrauterine device insertion. Her serum beta-hCG level was 228 U/L. TVS revealed amorphous echoes in the uterine cavity. We made an initial, presumptive diagnosis of incomplete abortion. Curettage was performed, but no fetal elements were found. The serum beta-hCG level was 360 U/L after 1 week. Computed tomography revealed a trophoblastic tumor with deep invasion of the myometrium. A subradical abdominal hysterectomy was performed and gave the impression of chorionic carcinoma. Pathologic examination revealed diffuse hemorrhage and early invasion of chorionic villi in the fundal myometrium with focal decidual reaction of the endometrium. The diagnosis of intramural pregnancy was made after the operation. CONCLUSION: Both cases of intramural pregnancy were treated successfully.
Abdominal Pain↗
[Delivery and perinatal aspects of pregnant women with pre-eclampsia-eclampsia].
UNLABELLED: Hypertension is the most important cause of disease in the expectant mother and the fetus, and it unfavorably affects the perinatal morbidity and mortality. AIM: To determine the method of delivery of a pregnant women with Praeeclampsia-Eclampsia (PE-E) depending upon the severity, continuity and term of appearance of hypertensive disease during pregnancy and its impact on perinatal morbidity and mortality. MATERIAL AND METHODS: The study covers a two year period (2002-2003), during which 84 pregnant women are treated and deliver with PE-E in the Ist and IInd Obstetrics clinics. Of them 64 (76.20%) are with mild form of PE, 10 (11.90%) with mid severe form and 10 (11.90%) severe form of which 3 had Eclampsia. The pregnancies were followed using echography and cardiotocographic monitoring. RESULTS AND DISCUSSIONS: With the severe forms of PE-E the disease started between 25-30 gestational weeks (60%), while with the mid severe the appearance was between 31-36 g.w. (50%). Persistence of PE > 4 g.w. was observed with severe PE, whereas in mild forms continuity of < 3 g.w. (73.44%) prevailed with its onset after 37 g.w. (57.81%). Normal delivery was attained with 41 pregnancies (48.81%), Caesarean section (CS) with 40 (47.62%), vacuum extraction with 1 (81.19%) and 2 (2.38%) had incomplete aborts. Frequency of CS with the severe forms of PE-E is 80%, with mid severe 50%, and with the mild forms is 42.19%. The most frequent indication of CS is fetal distress--11 (27.50%) and complicated obstetric anamnesis--9 (22.50%). With severe PE-E the most frequent indication is aggravation of symptoms and its non responsiveness to treatment. Born dead are 3 fetuses with severe retardation and body weight < 800 gm. Early gestational age hasn't given us the reason for premature delivery. Death of 1 child, born by CS with 750 gm weight is recorded. The higher rate of CS (3 times more than the median for the clinic--15.16%) can be explained to a degree by the fact that operative delivery by CS in pregnancies with PE-E reduces complications and has an aim to prevent complications to the fetus as well as the mother.
Bulgaria↗
Medical vs. surgical management of early pregnancy failure.
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Abortifacient Agents, Nonsteroidal↗
Cervical ectopic pregnancy: clinical review.
Cervical pregnancy is a rare kind of intrauterine ectopic pregnancy. Diagnosis and treatment of cervical pregnancy have enormously changed in the last 15 years. Before 1980, diagnosis was made when dilation and curettage for presumed incomplete abortion resulted in sudden and uncontrollable hemorrhage. Hysterectomy was practiced in order to save the patient's life. Today, cervical pregnancy is diagnosed by ultrasound (US) during the Ist trimester of pregnancy, so that the patient's fertility can be preserved. Therefore any physician should consider the possibility of a cervical pregnancy in a woman with abdominal pain and vaginal bleeding during the first trimester of pregnancy. In this study we reviewed the literature on the epidemiology, etiology, diagnosis and treatments of cervical pregnancy.
Abortifacient Agents, Nonsteroidal↗
Unilateral ectopic right kidney, an incidental finding during pelvic sonogram.
An ectopic renal kidney was found incidentally during pelvic sonogram of a woman with incomplete abortion. The importance of pelvic ectopic kidney in obstetrics and gynecology and the significance of looking for a contralateral kidney before any pelvic surgery is embarked upon are discussed. A short review of significant differential diagnosis was also made.
Adult↗
[Diagnosis of ovum viability: comparative analysis between ultrasound and chorionic gonadotropin hormone].
In a retrospective study carried out in the Hospital de Gineco-Obstetricia del Centro Médico León, Gto., Instituto Mexicano del Seguro Social, 61 patients were studied in order to compare the sensitivity and specificity values and the correlation coefficient between the hormonal assays (Human Chorionic Gonadotropin, HCG) and the ultrasound scanning. The qualitative concentrations of HCG had a sensitivity of 37.5% and a specificity of 100%. The levels of subunit beta of HCG had sensitivity of 25% and specificity of 100%. The whole correlation coefficient of the hormonal method (HCG) was R = 0.51 (P less than 0.01). The ultrasound monitoring had a sensitivity of 855 and specificity of 100%, with a correlation coefficient R = 0.88 (P less than 0.01). It was concluded that ultrasound scanning has a better sensitivity and higher correlation than human chorionic gonadotropin assays in the diagnosis of ovum vitality.
Abortion, Incomplete↗
[The value of placental histology for the detection of genetically-induced abortions].
The majority of early spontaneous abortions is caused by genetic disorders. Chromosomal aberrations do not only imply characteristical morphologic alterations in embryo/fetus, but also in chorionic villi. Its possible to draw conclusions through the combination of a small amount of histological findings on chorionic villi to explain the kind of aneuploidy. Among 968 early spontaneous abortions 18.3% were defined as genetically caused by histological examination. 87.6% are probably trisomies, 7.3% polyploidies. 5.1% were diagnosed as complete hydatidiform moles with a diploid, androgenetic chromosome set. The value of histological examination of early spontaneous abortion tissue are discussed and it is pointed out to remaining problems. In a different percentage it is possible to establish the type of aneuploid by microscopic examination alone. Frequently there are sings to allow the conclusion there is a developmental disorder like genetic aberration.
Abortion, Incomplete↗
Malaria in pregnancy: clinical features and outcome of treatment.
Over two consecutive malaria seasons in 1987 and 1988, 37 patients were admitted to the Gonder College Hospital with malaria in pregnancy. In 10 patients the diagnosis was missed initially and delayed for up to 72 hours after admission. The differential diagnoses considered on first line included incomplete abortion, labour, postpartum haemorrhage, and fulminant hepatitis in pregnancy. Twelve patients (32.4%) died, five of these died undelivered. Fifteen pregnancies (40.5%) ended up in abortion, preterm delivery with early neonatal death and still birth. This study has shown that malaria in pregnancy can have different clinical manifestations that may mislead the physician. This may delay the diagnosis and initiation of treatment which may have a fatal outcome for both the mother and the baby.
Adolescent↗
Prolonged retention of intrauterine bones.
Two cases of prolonged intrauterine retention of fetal bones are presented to show that antecedent abortion may, though uncommonly, play a role in current gynecologic complaints. In these two cases, symptoms dated to antecedent abortions treated with D&C 13 years and 14 months before diagnosis, respectively. Complaints included secondary infertility, dysmenorrhea, and dysfunctional uterine bleeding. Hysteroscopy was necessary to make the correct diagnosis of retained fetal bones. In both cases, hysteroscopic surgery was unsuccessful in removing all the bony fragments or relieving symptoms. Though retained fetal bones are an uncommon cause of gynecologic problems, these cases show the necessity of hysteroscopy for diagnosis of persistent gynecologic problems when intrauterine pathology is suspect. These cases also demonstrate that although hysteroscopy is extremely useful diagnostically, it may not be successful therapeutically even for the persistent surgeon.
Abortion, Incomplete↗
[A case of complete remission obtained with etoposide in uterine choriocarcinoma].
A 27-year-old female was admitted to Sendai National Hospital complaining of continuous slight genital bleeding for about one and a half year after incomplete abortion. At first visit, urinary hCG was elevated to 32,000 IU/l and ultrasonography revealed a heterogeneous tumor in the uterus body. After abdominal simple total hysterectomy, the sample was diagnosed pathologically as a uterine choriocarcinoma. The patient was treated with 2 courses of MTX, but this regimen was not so effective. Because of persistent elevation of urinary hCG, 2 courses of etoposide were performed and hCG was rapidly reduced to within LH level. Etoposide (25 mg/day per os) was given to the patient for about three months since hospitalization and now complete remission has been obtained.
Administration, Oral↗
Transvaginal sonography in the abnormal first trimester.
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Abortion, Incomplete↗
[Preoperative administration of dinoprost gel for termination of early pregnancy in primigravidas].
A total of 60 primigravid women due to undergo early pregnancy termination (6.5 to 10 weeks) were randomly selected for the intracervical application of 0.5 mg dinoprostone in the form of intracervical gel (Prepidil gel, Upjohn). The gel was inserted 6 hours prior to vacuum aspiration. Before application all women had the cervix closed, i.e. dilated less than Hegar #3. After 6 hours there was noticed a marked cervical softening and dilatation (mean 9.28 mm) in all 60 cases (100%). Twelve (20%) women needed an additional mechanical dilatation which was performed very easily and atraumatically. An incomplete abortion occurred in 14 (23.33%) cases; 35 (58.33%) women had uterine cramps, and in 28 (46.66%) gastrointestinal side effects were recorded. There were no significant changes in the blood pressure or body temperature. During the procedure there were no complications.
Abortion, Induced↗