PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Pregnancy Trimester, First”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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

At least 127 records · Page 7Linked to original sources
PubMed2004

Laparoscopic radical nephrectomy in first-trimester pregnancy.

We present a case of a 30-year-old pregnant woman with renal cell carcinoma who underwent successful laparoscopic radical nephrectomy at 11 weeks of gestational age. The remainder of the pregnancy was uncomplicated, and the patient gave birth to a healthy baby boy at term. Although previous cases of successful nephrectomy performed in pregnancy for renal cell carcinoma have been reported, we believe this is the first case in which it has been performed laparoscopically. We suggest that when the expertise is available, laparoscopic nephrectomy is a safe alternative to open surgery, with the additional benefits of minimal access surgery.

Adult↗
PubMed2006

The comparison of vessels in elective and spontaneous abortion decidua in first trimester pregnancies: importance of vascular changes in early pregnancy losses.

BACKGROUND: To determine whether adequate trophoblastic migration and maternal placental perfusion occurs in cases of early pregnancy loss, we compared vessels in elective abortion decidua with those in spontaneous abortion decidua. METHODS: Elective abortion decidua at 5-11 weeks (n = 40) were compared with spontaneous abortion decidua at 5-12 weeks (n = 25). Also normal late secretory endometrial biopsy specimens (n = 10) were examined. The cross-sections of veins and arteries were counted in 25 elective and 15 spontaneous abortion materials. The number of the veins that contain trophoblastic fragments and the number of the spiral arteries converted by trophoblasts were determined. Statistical significance by Mann-Whitney U and Spearman's correlation test was p < 0.05. RESULTS: All sets of decidua had dilated veins, but no secretory endometrium did. The ratio of converted spiral arteries to nonconverted arteries was much more in elective abortion decidua (113/938, 12.04%) than in spontaneous abortion decidua (11/511, 2.15%) (p < 0.001). CONCLUSIONS: The presence of converted arteries, dilated veins, and intravenous trophoblastic fragments in decidual specimens were evidence of intervillous circulation and placental perfusion by maternal circulation in the first trimester. Also the insufficient conversion of the arteries in spontaneous abortions might be responsible for many cases of early pregnancy loss.

Abortion, Induced↗
PubMed1990

The use of mifepristone (RU 486) for cervical preparation in first trimester pregnancy termination by vacuum aspiration. World Health Organization. Task Force on Post-ovulatory Methods for Fertility Regulation.

Animal and clinical evidence suggests that the antiprogestin mifepristone may be of potential use for cervical preparation before surgical termination of pregnancy. A double-blind, multicentre study was undertaken of 230 primigravid women with 10-12 weeks amenorrhoea who were randomly assigned to groups given 0 (placebo), 25, 50 or 100 mg mifepristone twice at 24 and 12 h before vacuum aspiration. In mifepristone-treated women the cervix was on average between 0.9 and 1.2 mm more dilated at operation, but the effect was not dose related. High resistance during further mechanical stretching tended to be encountered more often and at a smaller cervical diameter in the placebo group than in the women given mifepristone, but these differences were not statistically significant. In contrast, the ease of dilatation assessed subjectively by the operating surgeons was not only improved by the antiprogestin, but was also dose related. Mifepristone therapy was not associated with any side-effects and only two of the women from the highest dose group experienced preoperative vaginal bleeding. Peroperative blood loss, post-operative complications, the duration of post-operative bleeding and the interval to the first period were similar in the four treatment groups.

Abortion, Induced↗
PubMed1976

First experiences with a (15S)-15-methyl prostaglandin F2alpha vaginal device for termination of early first trimester pregnancy with serial sonographic observations.

A silastic device containing 10 mg (15S)-15-Methyl Prostaglandin F2alpha was administered vaginally in three parous patients under 50 days gestation who requested therapeutic abortion. Painful contractions appeared within one hour and vaginal bleeding within three hours of application. All patients aborted, although in one tissue had to be removed from the uterus. Plasma progesterone concentrations were measured in two patients: they decreased within four hours, then increased slightly and finally decreased 24 hours after administration of the device. Nausea, vomiting, and diarrhea were observed in all three patients. The estimated blood loss was less than 100 ml and no significant hematocrit changes were observed in all patients. In serial sonographic examinations of one patient, the fragmentation and dislodgment of the gestational sac could be observed within six hours after administration of the device. After these albeit limited experiences, it is concluded that the (15S)-15-Methyl PGF2alpha vaginal device is of great potential value for induction of early first trimester abortion.

Abortion, Induced↗
PubMed1992

Spatial distribution of active genes implicated in the regulation of insulin-like growth factor stimulatory loops in human decidual and placental tissue of first-trimester pregnancy.

We have previously shown that the insulin-like growth factor-2 (IGF-2) gene is partially coexpressed with the IGF-1 and -2 receptor genes in proliferative cytotrophoblasts of the human extraembryonic tissue. Here we show that high levels of IGF-2 gene expression are not restricted to the embryonic tissue but can also be found in the decidua compacta. The IGF-2 gene is thus expressed at high levels in the mesenchymal stroma of the decidua to establish potentially short-range communication with primarily IGF-1 receptor-positive mesenchymal stroma cells. Conversely, the glandular and surface epithelia coexpress the IGF-1 receptor and IGF-1 genes, while the IGF-2 gene is not detected above background levels. The potential control mechanisms of these cell-cell signalling pathways were investigated by the analysis of the spatial distribution of active IGF binding proteins (IGFBP) genes. The IGFBP-3 gene is coexpressed with the IGF-2 gene in proliferative cytotrophoblasts of the embryonic placenta. While active IGFBP-1 and -2 genes in our hands cannot be detected in the embryonic placenta, all three IGFBP genes are expressed in complex and overlapping patterns in the decidua compacta. The results are discussed in terms of how the various IGFBP genes may operate in different cell types to restrict IGF local stimulatory pathways.

Blotting, Northern↗
PubMed1987

Ovarian actinomycosis during first-trimester pregnancy.

A case of actinomycotic ovarian abscess ruptured during early gestation and related to IUD use is reported. The patient was treated by antibiotic therapy and oophorectomy. Further evolution of the pregnancy was irrelevant.

Abscess↗
PubMed1991

Transvaginal color Doppler imaging in the assessment of uteroplacental blood flow in the normal first-trimester pregnancy.

Characteristic changes of low resistance and high diastolic blood flow velocity were identified by Doppler studies starting in the early phase of the second trimester. These changes were attributed by some authors to trophoblastic invasion of the uterine vasculature converting the uterus into a low-resistance organ. Because of technical limitations previous studies were confined to the uterine artery and its main branches. With the development of color Doppler and transvaginal ultrasonography we can now identify blood flow in various small vessels in the placental bed. This study was performed to assess the ability of color Doppler ultrasonography to evaluate subtrophoblastic blood flow by color identification in the early phase of normal pregnancy from 5 to 9 weeks' gestation. Results show that the characteristic increase in diastolic blood flow is evident as early as 5 weeks' gestation.

Female↗
PubMed1983

Three methods for gradual cervical dilatation prior to vacuum aspiration in late first trimester pregnancy.

Sixty healthy women at 8 to 12 weeks of gestation were divided into three groups of 20 women each to evaluate three methods for gradual cervical dilatation prior to vacuum aspiration - Group I: Laminaria tent: Group II: Isaptent, and Group III: 250 ug 15-methyl-PGF2 alpha intramuscular injection. The three methods showed comparable cervical dilatation (10.46 mm) over a mean period of 3 hours 40 minutes. Administration of 15-methyl-PGF2 alpha, though relatively simple, had significant gastrointestinal side effects and bleeding per vaginum (P less than 0.001) prior to vacuum aspiration and greater blood loss (P less than 0.01) during vacuum aspiration as compared with the other two groups. No sequelae, immediate or delayed, were encountered. Isaptent indigenously made and relatively inexpensive is a reliable, safe and effective method for gradual dilatation of cervix for 8 to 12 weeks of gestation prior to vacuum aspiration and is the cervical dilator of choice.

Abortion, Induced↗
PubMed1995

Expression of desmin and vimentin intermediate filaments in human decidual cells during first trimester pregnancy.

Human endometrial stromal cells (decidual cells) display dramatic alterations in cell shape and size during decidualization. The present study was designed to demonstrate the expression of two major cytoskeletal elements, desmin and vimentin, in human pregnant endometrial decidual cells. Additionally, stage-dependent variations of those intermediate filaments (IFs) among gestational weeks were also evaluated with regard to the support and maintenance of decidualization. Materials were obtained from legal suction terminations of pregnancies of 3-10 weeks gestation. Tissue specimens were either blocked in paraffin or enzymatically dissociated for isolation of decidual cells which subsequently were cultured as monolayers. Immunoperoxidase and immunofluorescence staining methods were applied by using anti-desmin and anti-vimentin monoclonal antibodies. Both desmin and vimentin expression were observed during the early weeks of pregnancy (3-6 weeks). These two types of IFs were also detected in short-term cultures in a filamentous fashion either within the cell body or at cellular attachment plaques. When decidual cells were cultured for longer periods (40-60 days), the expression of desmin dramatically declined while vimentin expression was maintained in a rather diffuse and more abundant fashion. The in situ expression of desmin and vimentin in later weeks of gestation (7-10 weeks) correlated with immunofluorescence staining of long-term cultured cells in that desmin staining was very weak and mostly undetectable where vimentin expression persisted and was evenly distributed throughout the entire stroma. The results demonstrate the differential expression of two major IFs, desmin and vimentin, in human endometrial stromal cells during decidualization and subsequent placentation. The persistence of vimentin in all stages examined suggests that this IF is probably involved in cell morphology and nucleocytoplasmic integrity. The temporal pattern of desmin expression suggests a role for this IF during the rapid onset of the decidualization process.

Cells, Cultured↗
PubMed2005

Comparison of oral and vaginal misoprostol for cervical ripening before manual vacuum aspiration of first trimester pregnancy under local anesthesia: a randomized placebo-controlled study.

The objective of this prospective randomized placebo-controlled study was to determine the effectiveness of 400 mug oral and 400 mug vaginal misoprostol administration for cervical priming 3 h prior to manual vacuum aspiration (MVA) under local anesthesia for voluntary termination of pregnancy before 10 weeks of gestation in comparison with placebo oral or placebo vaginal administration (n=40 in each group). Postmedication cervical dilatation was similar in the oral (mean, 6.6+/-1.5) and vaginal (mean, 7.2+/-0.8) misoprostol groups but significantly higher compared with the oral (mean, 3.4+/-0.2) and vaginal (mean, 3.6+/-1.9) placebo groups. Duration of the procedure was also significantly shorter in the misoprostol groups in comparison with their placebo counterparts. Preoperative bleeding and side effects were more common in the misoprostol groups, but none required medical intervention. Intraoperative bleeding was less in the vaginal misoprostol group compared with the placebo groups. There was no significant difference in terms of visual analogue scores during the procedure, patient satisfaction, days of postoperative bleeding and rate of postoperative complications among the groups. Cervical priming with misoprostol administered orally or vaginally 3 h before MVA for termination of pregnancy under local anesthesia facilitates the procedure by decreasing the need for cervical dilatation and by shortening its duration without improving patients' pain perception and satisfaction mainly due to side effects.

Abortifacient Agents, Nonsteroidal↗
PubMed1993

Selecting human chorionic gonadotropin immunoassays: consideration of cross-reacting molecules in first-trimester pregnancy serum and urine.

OBJECTIVE: We investigated the variation in human chorionic gonadotropin results found with different commercial kits. Levels of human chorionic gonadotropin and related molecules were determined in pregnancy serum and urine and compared with the specificities of different laboratory, office, and home test kits. STUDY DESIGN: Total human chorionic gonadotropin (nicked+nonnicked), nonnicked human chorionic gonadotropin, free beta subunit, and beta core fragment were measured in 242 serum samples and 125 urine samples from early pregnancies. RESULTS: In serum, in the 2 weeks after the missed period when most pregnancy tests are performed, median levels of total, nonnicked, and beta human chorionic gonadotropin (total+free beta+beta core) were similar (< or = 12% difference). Individual values, however, varied significantly. For nonnicked human chorionic gonadotropin, values ranged from 41% to 145% and for beta from 101% to 145% of the total human chorionic gonadotropin level. In urine individual nonnicked values varied from < 1% to 148% and beta values from 102% to 547% of the total human chorionic gonadotropin level. A survey of 29 kits revealed that 10 were types detecting total human chorionic gonadotropin, five detecting nonnicked only, and 14 were beta assays. CONCLUSIONS: Results from total, nonnicked, and beta human chorionic gonadotropin kits are not necessarily interconvertible. Individual variations in levels of nicked human chorionic gonadotropin, free beta and beta core, and differences in their recognition by immunoassays causes discordant results.

Chorionic Gonadotropin↗
PubMed1990

Randomized trial of the effect of drugs on cervical dilatation for termination of first trimester pregnancy.

A randomized triple-blind and placebo-controlled clinical trial on the effect of lidocaine and Anodyne-lubricant jelly (ALJ) containing dicaine on cervical dilatation is reported. Three-hundred-seventy-two consecutive cases were randomly allocated to 4 groups. The four groups were given: ALJ and placebo (placebo 1); and lidocaine and placebo (placebo 2). ALJ and placebo 1 treatment was by topical application, and lidocaine and placebo 2 by injection. In parous women, a significant difference was found for satisfactory dilatation (SD) rate (p less than 0.01) among four groups. It was unexpected that there were no significant differences between drug and placebo groups, neither between ALJ treatment group and placebo 1 group (p greater than 0.5), nor between lidocaine and placebo 2 (p greater than 0.75). However, the combined SD rate was 60.9% for the topical groups compared with 39.0% for the injection groups (p less than 0.005). The findings suggested that the effect of ALJ on cervical dilatation was not mainly due to dicaine, but associated with the lubricant and the topical treatment.

Abortion, Induced↗