1/10. Use of acupuncture for managing chronic pelvic pain in pregnancy. A case report.BACKGROUND: Chronic pelvic pain is a health problem that affects many reproductive-age women. During reproduction the dilemma is even more challenging. The growing uterus often exacerbates pain, and treatment is limited by the effect on the fetus. A multispecialty approach and alternative medicine are often effective. Recently, the FDA announced the use of acupuncture and acupressure as officially recognized modalities for treatment of chronic pain in oncology patients. CASE: Chronic pelvic pain in a 23 year-old primigravida at 27 weeks' gestation was incapacitating on narcotics. After organic causes were ruled out, acupuncture was employed successfully. Outpatient management for the duration of the pregnancy included acupuncture and narcotics for breakthrough pain while maintaining activities of daily living. Spontaneous vaginal delivery without complications at 38 5/7 weeks produced a 3,305-g female infant. The pain resolved immediately following delivery. CONCLUSION: This case demonstrates the benefit of combined allopathic with alternative forms of medicine. With the use of acupuncture, narcotic use was limited in this gravida while adding to her quality of life by allowing her to maintain normal activity.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/10. Ectopic pregnancy after cesarean hysterectomy.BACKGROUND: Ectopic pregnancy after a total abdominal hysterectomy is rare and, for this reason, delay in diagnosis may occur when such a patient presents with abdominal pain. CASE: A multiparous patient with a history of cesarean hysterectomy 12 years before presented to the emergency department with abdominal pain and incidental positive urine beta-human chorionic gonadotrophin (hCG). A computed tomography scan revealed a loculated left cystic mass in the pelvis. laparotomy findings revealed a left adnexal mass; pathology revealed chorionic villi consistent with pregnancy. CONCLUSION: Ectopic pregnancy may occur after hysterectomy, but typically presents near the time of surgery and is more commonly associated with vaginal hysterectomy. However, because ectopic pregnancy is possible after hysterectomy, it should be considered in the differential diagnosis of adnexal mass in such a patient.- - - - - - - - - - ranking = 1.6keywords = pregnancy (Clic here for more details about this article) |
3/10. laparoscopy and methylene blue intrauterine injection immediately after undiagnosed conception: effect on pregnancy and neonatal outcome.A 39-year-old woman with infertility and chronic pelvic pain underwent a diagnostic laparoscopy with dye-test performed approximately 7 days after conception. No effects were reported on pregnancy and neonatal outcome.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
4/10. Migration of an intrauterine contraceptive device to the sigmoid colon: a case report.BACKGROUND: copper T intrauterine devices (IUDs) remain the mainstay of family planning measures in developing countries, but have been associated with serious complications such as bleeding, perforation and migration to adjacent organs or omentum. Although perforation of the uterus by an IUD is not uncommon, migration to the sigmoid colon is extremely rare. Here, we report a case of migration of an IUD to the sigmoid colon. CASE REPORT: A 40-year-old woman who had an IUD (copper T), inserted 1 month after delivery, presented, 7 months later, with secondary amenorrhea and transient pelvic cramps. Clinical findings and ultrasonographic examinations of the patient revealed an 8-week pregnancy, while laboratory tests were normal. Transvaginal ultrasonography also visualized the IUD located outside the uterus, near the sigmoid colon, as if it were attached to the bowel. The pregnancy was terminated at the patient's wish; a diagnostic laparoscopy was performed concomitantly, which showed bowel perforation owing to the migration of the IUD. The device, which was partially embedded in the sigmoid colon, was removed via laparoscopy; however, because of bowel perforation, laparotomy was performed to open colostomy. CONCLUSIONS: This case report highlights the continuing need for intra- and postinsertion vigilance, since even recent advances in IUD technique and technology do not guarantee risk-free insertion.- - - - - - - - - - ranking = 0.4keywords = pregnancy (Clic here for more details about this article) |
5/10. infertility due to intrauterine residual fetal bone fragments.A case of intrauterine retention of fetal bone diagnosed 8 years after termination of a pregnancy is presented. The patient had a history of hypermenorrhea infertility, and persistent vaginal discharge beginning after the abortion. Transvaginal sonography demonstrated an intrauterine foreign body. curettage was performed, and fetal bone fragments were found within the removed materials.- - - - - - - - - - ranking = 0.2keywords = pregnancy (Clic here for more details about this article) |
6/10. Isolated torsion of the fallopian tube: a case report and review of the literature.INTRODUCTION: Isolated torsion of the fallopian tube is a very rare condition. It occurs without ipsilateral ovarian involvement associated with pregnancy, haemosalpinx, hydrosalpinx, ovarian or paraovarian cysts and other adnexal alterations or even with an otherwise normal fallopian tube. We document a case of isolated torsion of the right fallopian tube associated with hydrosalpinx. CASE: The patient was a 39-year-old female, para 2, gravida 4, who was presented with acute pelvic pain, nausea and vomiting. Her medical history included an appendectomy and right hydrosalpinx diagnosed five months before admission by hysterosalpingography because of investigation for secondary infertility. The urinary pregnancy test was negative. Pelvic ultrasonography showed a dilated folded right tubular structure measuring 7.8 x 2.7 cm with thickened echogenic walls and mucosal folds protruding into the lumen; the ovaries and uterus were unremarkable. No free fluid in the cul-de-sac was noted. Preoperatively, a diagnosis of twisted right fallopian tube was suspected and an exploratory laparotomy confirmed the diagnosis of isolated torsion of the oviduct. The ipsilateral ovary appeared normal, but the fallopian tube was gangrenous and right salpingectomy was performed. The patient became pregnant three months after surgery. CONCLUSION: Isolated torsion of the fallopian tube should be considered in the differential diagnosis of patients with acute abdomen and previous medical history of hydrosalpinx.- - - - - - - - - - ranking = 0.4keywords = pregnancy (Clic here for more details about this article) |
7/10. Bilateral tubal pregnancy after natural conception: a case report.BACKGROUND: Bilateral tubal pregnancy is very rare and usually follows ovulation stimulation. CASE: A 36-year-old woman with acute pelvic pain underwent emergency laparoscopy for suspected left ruptured tubal pregnancy. Bilateral hematosalpinx with a ruptured left tubal pregnancy and active bleeding from the right fallopian tube was noted during surgery, and bilateral salpingectomy was performed by laparoscopy. Pathologic examination of the left tube confirmed the presence of conception products and trophoblastic tissue. The right salpingectomy specimen contained some trophoblastic tissue resembling an earlier tubal pregnancy encased in a cyst. CONCLUSION: This was a rare case of spontaneous bilateral tubal pregnancy after conception at different times. The explanation of the presentation is uncertain. laparoscopy remains the cornerstone of diagnosis and treatment in the majority of women with a tubal pregnancy; this is especially true in complex cases, such as bilateral tubal pregnancy.- - - - - - - - - - ranking = 2.2keywords = pregnancy (Clic here for more details about this article) |
8/10. Second-trimester tubal pregnancy: a case report.BACKGROUND: Second-trimester tubal pregnancy is an infrequent diagnosis, as these pregnancies often present with symptoms during the first trimester. CASE: A previously asymptomatic woman presented with pelvic pain and vaginal bleeding at 4 months' gestation and was found to have a live, 14-week, tubal pregnancy. CONCLUSION: Second-trimester symptoms, including nausea, vomiting, pelvic or abdominal pain, and vaginal bleeding, necessitate ultrasound to determine the pregnancy location, maintaining suspicion for a tubal or abdominal pregnancy.- - - - - - - - - - ranking = 1.6keywords = pregnancy (Clic here for more details about this article) |
9/10. hematuria and clot retention after transvaginal oocyte aspiration: a case report.OBJECTIVE: To report a case of bladder injury with hematuria and urinary retention after transvaginal oocyte aspiration. DESIGN: Case report. SETTING: Emergency room in a university medical center. PATIENT(S): A 28-year-old woman presented with urinary retention and suprapubic pain 8 hours after oocyte aspiration. INTERVENTION(S): Foley catheter, intravenous fluid bolus, bladder irrigation, and computed tomography with postvoid films that showed a blood clot in the bladder. Patient was discharged home with antibiotics and catheter in place. MAIN OUTCOME MEASURE(S): Clinical follow-up. RESULT(S): Patient passed voiding trial 4 days later and was artificially inseminated. No further hematuria or voiding problems were reported, and she had a successful pregnancy. CONCLUSION(S): patients who elect to undergo oocyte aspiration should be warned about the possibility of bladder injury because of the close proximity of the ovaries to the bladder, and physicians should have an appropriate treatment plan.- - - - - - - - - - ranking = 0.2keywords = pregnancy (Clic here for more details about this article) |
10/10. Laparoscopic adnexal surgery during pregnancy.Adnexal masses diagnosed in a gravid woman sometimes must be surgically evaluated and treated during the pregnancy. A laparoscopic approach may have several advantages over laparotomy, but only one case of laparoscopic adnexal surgery during pregnancy has been previously reported. Two pregnant patients with acute pelvic pain and adnexal masses were treated by operative laparoscopy. One patient had a large benign cystic teratoma and the other had torsion of the fallopian tube secondary to a paratubal cyst. Cystectomies were performed in both women, and in the second patient the tube was reduced and conserved. It appears that with proper care of surgical technique and caution to exclude malignancy, laparoscopy may be performed successfully to remove adnexal masses during the second trimester of pregnancy.- - - - - - - - - - ranking = 1.4keywords = pregnancy (Clic here for more details about this article) |
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