1/22. Ill patient with unknown or hidden pregnancy.Many pregnancies are inadvertently interrupted because diagnostic and therapeutic procedures that are potentially teratogenic are unwittingly instituted. To prevent this ever-present possibility, it is essential that the family physician as well as the hospital's admitting physician know for certain whether a patient in her childbearing years is pregnant. The simple direct question "Are you pregnant?" unfortunately does not always elicit a reliable answer. The patient may not know that she is pregnant, a common occurrence in early pregnancy, or for any of a number of reasons she may choose to conceal her pregnancy. A pregnancy test thus becomes an important diagnostic tool in the armamentarium of every conscientious physician. It should be given routinely to all women of childbearing age before instituting extensive diagnostic x-ray studies, radiation therapy, or chemotherapy that may be contraindicated in pregnancy. Because most contraindicated procedures are performed in a hospital, it is suggested that a pregnancy test on urine be made mandatory on a woman's admission to a hospital.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/22. Successful twin pregnancy in a dual-transplant couple resulting from in-vitro fertilization and intracytoplasmic sperm injection: case report.There are numerous reports of successful pregnancy following liver transplantation. Little information is available regarding the incidence and management of infertility in transplant recipients, particularly the use of artificial reproductive technologies. We present a case of a successful twin pregnancy resulting from in-vitro fertilization with intracytoplasmic sperm injection (IVF/ICSI) in a liver transplant recipient, whose partner was a renal transplant recipient with severe oligozoospermia. With careful evaluation and monitoring, and the involvement of appropriate consultants, artificial reproductive technologies can be safely used in transplant recipient couples experiencing infertility.- - - - - - - - - - ranking = 0.66666666666667keywords = pregnancy (Clic here for more details about this article) |
3/22. Successful planned pregnancy following endometrial ablation with the YAG laser.In selected patients who previously have undergone YAG laser ablation of the endometrium and who have demonstrated normal intrauterine architecture, pregnancy as a planned event may be a reasonable and safe option.- - - - - - - - - - ranking = 0.55555555555556keywords = pregnancy (Clic here for more details about this article) |
4/22. hematometra after thermal balloon endometrial ablation in a patient with cervical incompetence.BACKGROUND: Thermal balloon endometrial ablation is a relatively safe nonsurgical treatment for menorrhagia. hematometra follows this procedure in <3 % of patients, but risk factors for this complication are unclear. CASE: A woman with a history of cervical incompetence during pregnancy later developed cervical occlusion and hematometra after thermal balloon endometrial ablation. Cervical occlusion did not recur after cervical dilatation and temporary placement of a catheter as a stent. CONCLUSION: The normal resistance of the internal cervical os may be an important factor in avoiding thermal damage to the cervix during thermal balloon endometrial ablation. This case suggests that a history of cervical incompetence may be a clinical indicator of decreased cervical resistance.- - - - - - - - - - ranking = 0.11111111111111keywords = pregnancy (Clic here for more details about this article) |
5/22. Early pregnancy uninterrupted by laparoscopic bipolar coagulation of uterine vessels.Laparoscopic bipolar coagulation of uterine vessels (LBCUV) is reported to treat clinically symptomatic myomas that caused severe menorrhagia, but the viability of pregnancy after operation is unknown. A woman with clinically diagnosed uterine myomas, possibly with adenomyosis, had unexpected early pregnancy diagnosed at the time of LBCUV. The procedure resulted in improvement of menorrhagia to normal menstruation and reductions in the volume of both uterus and myomas. The intrauterine pregnancy was terminated at the woman's request. Pregnancy may be possible after LBCUV, although none has been reported.- - - - - - - - - - ranking = 0.77777777777778keywords = pregnancy (Clic here for more details about this article) |
6/22. Uterine necrosis after arterial embolization for postpartum hemorrhage.BACKGROUND: Selective embolization is an effective and reputedly safe method of managing pregnancy-related bleeding. However, we report an ischemic uterine necrosis after arterial embolization. CASE: The patient had heavy postpartum bleeding treated by embolization of the uterine arteries using polyvinyl alcohol particles (diameter 150-250 and 300-600 microm) and gelatin sponge pledgets. Her postoperative recovery was complicated by menorrhagia and pelvic pain. Because of the persistent menorrhagia and risk of infection, a hysterectomy was performed. Histopathology of the hysterectomy specimen revealed massive ischemic myometrial necrosis. CONCLUSION: This complication is most likely related to the small size of the particles used. In the management of postpartum bleeding by arterial embolization, the material of choice is gelatin sponge pledgets, and the use of small particles should be avoided.- - - - - - - - - - ranking = 0.11111111111111keywords = pregnancy (Clic here for more details about this article) |
7/22. Conservative treatment by angiographic artery embolization of an 11-week cervical pregnancy after a period of heavy bleeding.OBJECTIVE: To describe a rare case of conservative treatment of an 11-week cervical pregnancy after a period of heavy bleeding. DESIGN: Case report. SETTING: A university hospital. PATIENT(S): A 33-year-old woman was admitted to our hospital for treatment of a cervical pregnancy. Two-and-a-half years thereafter, she gave birth to a healthy baby by vaginal delivery at 38 weeks of gestation. INTERVENTION(S): Systemic methotrexate treatment, ligation of descending branches of uterine arteries, cervical cerclage, and unilateral internal iliac artery embolization. MAIN OUTCOME MEASURE(S): Transvaginal ultrasound, magnetic resonance imaging, and arteriography findings. RESULT(S): The patient was successfully treated with unilateral internal iliac artery embolization on the same side as the pregnancy in the 11th gestational week. CONCLUSION(S): After failed methotrexate and vessel ligation in cervical pregnancy, unilateral internal iliac artery embolization is an effective and conservative treatment that allows preservation of reproduction potential.- - - - - - - - - - ranking = 0.89472629225007keywords = pregnancy, gestation (Clic here for more details about this article) |
8/22. Successful pregnancy after myomectomy using preoperative adjuvant uterine artery embolization.A 30-year-old-woman presented with uterine leiomyoma and primary sterility. Abdominal myomectomy was performed; however, one cervical leiomyoma was not resected because of a risk of excessive blood loss. Two years after the procedure, a secondary myomectomy using preoperative adjuvant uterine artery embolization (UAE) was performed because of pronounced menorrhagia and her hope for bearing children. The patient's dysmenorrhea disappeared postoperatively and she conceived spontaneously 3 years after the secondary myomectomy. This case suggests that myomectomy using preadjuvant UAE may be an another approach for the treatment of leiomyoma in patients who wish bear children in the future.- - - - - - - - - - ranking = 0.44444444444444keywords = pregnancy (Clic here for more details about this article) |
9/22. Ectopic pregnancy months after laparoscopic supracervical hysterectomy.Although it is an easy diagnosis to eliminate, pregnancy is rarely considered in a woman with acute abdominopelvic pain and history of hysterectomy. A 37-year-old woman was seen because of acute onset of pelvic pain. Her history was significant for laparoscopic supracervical hysterectomy performed 4 months previously. A urine pregnancy test was positive. At diagnostic laparoscopy, an area in the right tube was consistent with ectopic pregnancy. Bilateral salpingectomy was performed, and pathology confirmed an ectopic pregnancy in the right tube. A diagnosis of ectopic pregnancy should be entertained in any woman with pain and intact ovaries.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
10/22. Successful pregnancy after thermal balloon endometrial ablation.BACKGROUND: Thermal balloon ablation is as effective as other electrosurgical modalities used for endometrial ablation. pregnancy rate after endometrial ablation is 0.24-0.68%. We report a near-term viable pregnancy after thermal balloon uterine ablation. CASE: Thermal balloon uterine endometrial ablation was performed on a 38-year-old woman with menorrhagia. She conceived 11 months after the operation and decided to continue the pregnancy. After 35 weeks of uneventful gestation, she spontaneously delivered a liveborn infant. CONCLUSION: Although rare, pregnancy after endometrial ablation is possible. Obstetric complications, such as pathologic placental adherence and fetal demise due to a small, scarred uterine cavity, have been reported. This pregnancy went to 35 weeks without complication despite a three-chambered appearance of the uterus.- - - - - - - - - - ranking = 0.89180759056948keywords = pregnancy, gestation (Clic here for more details about this article) |
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