1/12. Heterotopic pregnancy in a spontaneous cycle: do not forget about it!Heterotopic pregnancies are estimated to be less frequent than 1:30000 if no assisted reproduction technologies (art) are performed. After art this entity is more frequent and in the range of 1:100. In the case reported here an ectopic pregnancy was detected in the right fallopian tube at 7 1 weeks of gestation. It was misdiagnosed as an ectopic singleton, and treated by laparoscopic salpingectomy, because of a previous ectopic in the same tube. Rising hCG after laparoscopy during the subsequent days followed by ultrasound evaluation revealed a viable intrauterine pregnancy. The pregnancy continued uneventfully and a healthy child was delivered at term. The problems, which lead to the misdiagnosis are discussed. The problem of rare cases in medicine, and the problems of a 'modern' medicine are discussed.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
2/12. Administration of recombinant follicle stimulating hormone in a woman with allergic reaction to menotropin: a case report.This report describes a patient who experienced a generalized allergic reaction to Pergonal during controlled ovarian hyperstimulation in preparation for an intracytoplasmic sperm injection procedure for treatment of severe male factor infertility. The report describes a successful desensitization protocol which allowed the patient to complete her treatment cycle despite the allergic reaction to Pergonal. Subsequently recombinant follicle stimulating hormone was used successfully in inducing follicular growth in the absence of any allergic reactions. Therefore, this report confirms other studies which have suggested that an allergic reaction to human menopausal gonadotropins is due to impurities in such urine-derived products.- - - - - - - - - - ranking = 0.25keywords = cycle (Clic here for more details about this article) |
3/12. Unilateral ectopic twin pregnancy following an IVF cycle.We report here a 37-year-old woman who underwent ovulation induction and in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment because of infertility who developed vaginal bleeding at the 6th week of gestation. Abdominal ultrasonography was insufficient to distinguish the intrauterine gestational sac. Subsequently, vaginal doppler ultrasonography detected two separate unilateral twin ectopic pregnancies with cardiac activity in both fetuses, which were operated on pelviscopically.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
4/12. Heterotopic pregnancy in a natural conception cycle presenting with tubal rupture: a case report and review of the literature.BACKGROUND: Heterotopic pregnancy is a potentially fatal condition, rarely occurring in natural conception cycles. CASE: We report such a case in a 28-year old para 0, gravida 1 woman with no known risk factors. The ectopic pregnancy was diagnosed after rupturing at 11 weeks, 4 weeks after diagnosis of the intrauterine pregnancy, and resected via laparotomy. A healthy baby was delivered without complications at 40 weeks gestation. CONCLUSION: Heterotopic pregnancy is possible with natural conception and the survival of the intrauterine fetus is feasible.- - - - - - - - - - ranking = 1.25keywords = cycle (Clic here for more details about this article) |
5/12. Heterotopic triplet pregnancy with bilateral tubal and intrauterine pregnancy after IVF.Heterotopic pregnancy in a spontaneous cycle is rare, but the incidence increases with the introduction of assisted reproductive technologies. This report describes a case of combined bilateral tubal and intrauterine pregnancy after IVF and embryo transfer. The diagnostic and therapeutic problems will be discussed both in terms of the case report and the literature. Heterotopic pregnancies after IVF and resulting problems are further reasons to encourage the transfer of only one embryo. This could be difficult to achieve without simultaneously decreasing pregnancy rates, as embryo selection is not permitted in germany.- - - - - - - - - - ranking = 0.25keywords = cycle (Clic here for more details about this article) |
6/12. Delayed implantation. A case report.In cycles in which conception takes place, serum human chorionic gonadotropin (hCG) becomes detectable between 8 and 12 days after ovulation. A delayed appearance of hCG has been reported in a limited number of cases, most of them ending in spontaneous abortion. We encountered a case of ectopic pregnancy characterized by a delayed appearance of hCG and accompanied by a complete, albeit temporary, halt in the steroidogenic activity of the corpus luteum. Although the patient was at risk of developing an ectopic pregnancy, the findings made an early diagnosis extremely difficult.- - - - - - - - - - ranking = 0.25keywords = cycle (Clic here for more details about this article) |
7/12. Heterotopic pregnancy in a natural conception cycle presenting as hematometra.BACKGROUND: Heterotopic pregnancy is a rare event in natural conception cycles. Diagnosis of heterotopic pregnancy requires a high index of suspicion. Described herein is a reported case of a heterotopic pregnancy presenting as hematometra. CASE: A young, multiparous woman, with her last menstrual period 6 weeks before presentation, complained of a dark reddish-brown vaginal discharge and progressive left lower-quadrant discomfort during early pregnancy following a natural conception cycle. An intrauterine mass was observed, and subsequently a heterotopic pregnancy complicated by hematometra was diagnosed with the help of transvaginal ultrasonography and 3-dimensional power Doppler ultrasound angiography. CONCLUSION: women with intrauterine fluid accumulation during pregnancy may be at risk for coexistent ectopic pregnancy. High resolution transvaginal color Doppler sonography may be useful to identify a heterotopic pregnancy preoperatively.- - - - - - - - - - ranking = 1.5keywords = cycle (Clic here for more details about this article) |
8/12. Heterotopic pregnancy in a natural conception cycle. A case report.We report a case of combined intrauterine and tubal pregnancy in a 32 year old para. The patient presented at the Gynaecological emergency unit, with lower abdominal pain, and vaginal bleeding. A pelvic scan confirmed an intrauterine pregnancy. While being managed as a case of threatened abortion, her condition deteriorated and the likelihood of an ectopic pregnancy was entertained. A repeat scan revealed significant peritoneal collection. suggestive of haemoperitoneum, and laparotomy confirmed heterotopic pregnancy. She had a right salpingectomy without complications. The patient had a supervised antenatal care and safe delivery of the intrauterine pregnancy.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
9/12. Combined intra- and extrauterine pregnancy. A diagnostic challenge.A case of combined intrauterine and tubal pregnancy is reported and illustrates the difficulties of correctly diagnosing combined pregnancy. The patient had no signs or symptoms suggestive of a tubal pregnancy at the time of termination of the intrauterine pregnancy. She underwent two repeat uterine evacuation procedures, an ultrasonic examination and a diagnostic laparoscopy before the unruptured tubal pregnancy was diagnosed. Both pregnancies probably occurred during the same menstrual cycle.- - - - - - - - - - ranking = 0.25keywords = cycle (Clic here for more details about this article) |
10/12. Tubal pregnancy following late luteal vaginal hysterectomy.A patient who had a vaginal hysterectomy performed on day 24-25 of her cycle by histological dating was found to have a ruptured left tubal pregnancy 55 days later. The patient used barrier contraception up to the time of hysterectomy, and an undetectable level of beta-HCG was noted the week prior to hysterectomy. The likelihood of delayed tubal implantation having occurred in the same luteal phase as the hysterectomy distinguishes this case from the 27 others previously reported, which are briefly reviewed.- - - - - - - - - - ranking = 0.25keywords = cycle (Clic here for more details about this article) |
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