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At least 649 records · Page 36Linked to original sources
PubMed1975

Endometrial biopsy in the cycle of conception.

The pregnancy outcome of 18 infertile patients inadvertently biopsied during the cycle of conception is reviewed. Fourteen patients delivered term infants, one a premature infant; one patient aborted during the first trimester, and two patients were lost to follow-up. The pregnancy outcome was better than that frequently quoted for infertile patients. A comparison of the present series with those previously reported is made and the author's technique for endometrial biopsy is discussed. The average duration of gestation is calculated using the endometrial biopsy.

Abortion, Incomplete↗
PubMed1979

Gestational outcome of clomiphene-related conceptions.

The experience of the gynecologic endocrinology and infertility clinic at The Johns Hopkins Hospital has been subjected to a nonconcurrent prospective analysis in an attempt to evaluate the gestational fate of clomiphene-related conceptions (study series, n = 86). This latter series was contrasted with a series of pregnancies following bilateral ovarian wedge resection (BOWR) (n = 51) in a comparative analysis of gestational outcome event rates. Post-therapy follow-up was available for varying time spans of up to 15 years. A 12.8% twinning rate constituted the single most important complication of clomiphene therapy, resulting in measurable increments in perinatal morbidity and mortality rates. The observation of a 26.5% spontaneous abortion rate would seem to suggest that clomiphene-related conceptions are at little or more risk for spontaneous abortion than would have been expected from the infertile population under discussion. A 3.1% incidence of post-clomiphene birth defects was not increased as compared with commonly quoted rates for the population at large. The corresponding incidence rates of twinning, spontaneous abortion, and birth defects for the BOWR series were 0%, 21.6%, and 0%, respectively.

Abortion, Incomplete↗
PubMed1981

Serial beta-subunit human chorionic gonadotropin doubling time as a prognosticator of pregnancy outcome in an infertile population.

Prospective evaluation through the use of radioimmunoassay of the beta-subunit of human chorionic gonadotropin (beta-hCG) in blood samples obtained during the first 30 days of gestation was performed on an infertile population at high risk for pregnancy loss. Four hundred and fourteen samples in 281 pregnancies were analyzed. On the basis of single, random beta-hCG samples in asymptomatic patients, 77% of successful pregnancies and 59% of abortions were correctly identified. On the basis of beta-hCG doubling time (mean 2.2 days +/- 1.0 [2 SD]) computed from serial sampling, again in asymptomatic patients, 88% of successful pregnancies and 76% of abortions were correctly identified. beta-hCG doubling time appears to provide a reliable method of evaluating early pregnancy prognosis with significantly greater ability to identify problem pregnancies within the first 30 days of gestation than does single random hCG values.

Abortion, Incomplete↗
PubMed1993

Histopathology of the fallopian tube after local instillation of hyperosmolar glucose solution for unruptured tubal pregnancy.

Because of an incomplete tubal abortion, salpingectomy was performed in a patient 12 days after glucose instillation into an ampullary tubal gestation. Serum hCG levels had progressively declined from 1.122 mIU/mL at first intervention to 37 mIU/mL at the second operation. Histopathology showed marked necrosis of trophoblastic tissue but no discernible damage of the tubal epithelium and tubal wall attributable to the hyperosmolar solution applied 12 days before. This case offers histopathologic evidence that intraluminal glucose instillation for treatment of unruptured tubal pregnancies does not lead to persisting damage of the tubal mucosa.

Adult↗
PubMed1999

Medical management of non-viable early first trimester pregnancy.

OBJECTIVE: To compare the efficacy of intramuscular methotrexate plus vaginal misoprostol to vaginal misoprostol alone in completing abortion in women with non-viable early first trimester pregnancy. METHOD: Twenty-one women with non-viable pregnancy up to 49 days gestation were randomized to receive intramuscular methotrexate, followed 2 days later by vaginal misoprostol or misoprostol alone. We also collected patient satisfaction information. RESULT: Complete abortion occurred in all 12 (100%) women in the combined group and eight of nine (89%, RR = 1.13, CI 0.89-1.42) women in the misoprostol only group. Of the women, 75% rated their experience as good and would choose medical management again. CONCLUSION: Either methotrexate plus misoprostol or misoprostol alone effectively completed abortion in women with non-viable early pregnancy and represent acceptable medical alternatives to surgery or expectant management.

Abortifacient Agents, Nonsteroidal↗
PubMed1983

Unsuspected pregnancy loss in healthy women.

A sensitive and specific radioimmunoassay was used to determine human chorionic gonadotropin (hCG) in serum samples obtained from 91 normal healthy women during 226 ovulatory cycles in which contraception was not being practised. Known conceptions occurred in 85 of these cycles; 74 ended in the births of live normal babies and the remaining 11 aborted spontaneously. Vaginal bleeding occurred at the expected time on the remaining 141 occasions and was accepted as normal menstruation by the patients; but concentrations of hCG consistent with pregnancy were detected in the serum of 7 individuals. Expressed as a proportion of conceptions, about 8% of human pregnancies are lost at such an early stage of development that the patients are unaware that conception has occurred.

Abortion, Incomplete↗
PubMed1982

[Fetal death and benign hemolytic disease of the newborn from anti-Cellano alloimmunization: 2 new case reports].

The first case is provided by a french women (KK, husband k/k) who delivered a first healthy full term infant in 1970 and received one blood unit at this time. In 1972 and 1975, his second and fourth pregnancies ended by spontaneous abortion. In 1974 and 1976, she delivered stillborn infants with hydrops fetalis during the sixth month. In serum, anti-k antibody reacted by the indirect antiglobulin test with a titer of 4 096. In the second case, french women delivered a first full term female infant who had a strongly positive direct antiglobulin test. The mother had received one blood unit ten years before during nephrectomy. Her red blood cell were KK and her husband was kk. She had a anti-Cellano in serum reactive in the indirect antiglobulin test with a titer of 16. The infant developed a mild hyperbilirubinemia and recovered without treatment these two cases confirm the variable effect of maternal anti-k antibody evidenced by few other published cases.

Abortion, Incomplete↗
PubMed1984

Spontaneous abortions and twinning.

The relation between spontaneous abortions and twinning was studied in the years 1980-1981 in 22 towns of the South Moravian Region, Czechoslovakia. Each town has more than 10,000 inhabitants and less than 750 births per year. The number of spontaneous abortions and the number of twin births were evaluated separately for each town and for a time unit of three months. The comparison indicated that the group with a higher number of spontaneous abortions also had a lower number of twin births. The relation between spontaneous abortions and twinning is discussed.

Abortion, Incomplete↗
PubMed1992

The role of ultrasound in gynecological emergencies.

The expanding use of ultrasonography in gynecology puts increasing strain on the resources of ultrasound departments; any mechanism to increase the diagnostic efficiency of the scan and reduce unwarranted investigation would, therefore, be welcome. This prospective study examines the use of abdominal ultrasound examination in gynecological emergencies over a 6-month period in a London teaching hospital. The examination changed the clinical management in 33% of cases where the pregnancy test was positive, but in only 14% where it was negative. In the former group, the confirmation of viable intrauterine pregnancy reassured both patient and clinician in 84% of the cases, making the test a useful investigation in 89% of the total cases where the pregnancy test was positive. When the pregnancy test was negative, the ultrasound scan was more likely to be useful if requested by doctors with gynecological experience. In cases of incomplete spontaneous abortion, ultrasound was not found to be a useful investigation. Access to ultrasound equipment by, and basic ultrasound training of admitting junior doctors with gynecological experience would reduce referrals to the ultrasound department and reduce admissions to hospital, whilst improving appreciation of the role of ultrasound in gynecological emergencies.

Journal Article↗
PubMed1988

[74 pregnancies despite a retained IUD].

The author's study of 74 pregnancies where an IUD had been inserted was unable to find any tangible reason for the failure of the contraceptive in 40 cases. In 26 cases, dislocation of the spiral was established, while in eight cases anatomical changes were presumed to be the reason for conception. Of the 154 "spiral pregnancies" recorded in Upper Austria in the study period (1984-1985), 92 (i.e., 77.3% of the 119 intact intrauterine pregnancies) culminated in termination, while there were 35 extrauterine pregnancies (22.7%). Of the remaining 27 pregnancies which went to term, there was not a single case of septic complication in the mother or of abnormality in the child. In the author's opinion this argument would seem to present a well-founded challenge to the widespread view that, for the sake of the mother or the fetus, termination is to be recommended if an IUD has been inserted.

Abortion, Incomplete↗
PubMed2002

Mortality and morbidity associated with misdiagnosis of ectopic pregnancy in a defined Nigerian population.

Ectopic pregnancies can be very difficult to diagnose at initial admission. This paper reviewed the morbidity and mortality associated with misdiagnosis of ectopic gestation over a 15-year period (1985-99) at Ile-Ife, Nigeria. There were 380 confirmed ectopic pregnancies of 35 857 live births, giving an incidence of 10.5 per 1000 live births. Of the 380 cases, 38 (10%) were misdiagnosed initially at presentation. Mistaken diagnoses include pelvic inflammatory diseases, cholera, acute appendicitis, typhoid enteritis, incomplete septic abortion, uterine fibroid with menorrhagia, malaria, gastroenteritis, peptic ulcer and intestinal obstruction. There were five maternal deaths among the 38 misdiagnosed cases compared to two maternal deaths among the 342 initially correctly diagnosed cases. Significant morbidity included prolonged hospital stay, increased hospital costs and an enterocutaneous fistula. To improve the chances of correct diagnosis at initial admission, accurate menstrual and sexual history should be obtained. Facilities for improved diagnosis such as serum beta HCG and transvaginal ultrasonography should be provided. Colleagues from other specialities should be educated to increase their suspicion of ectopic pregnancy in any woman of childbearing age and perform the appropriate investigations.

Diagnostic Errors↗