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[PMID]:29390363
[Au] Autor:Zhang D; Chen A; Gu Y
[Ad] Endereço:Department of Obstetrics & Gynecology, Peking Union Medical College Hospital (PUMCH), Beijing, People's Republic of China.
[Ti] Título:Ruptured secondary abdominal pregnancy after primary laparoscopic treatment for tubal pregnancy: A case report.
[So] Source:Medicine (Baltimore);96(50):e9254, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Most secondary abdominal pregnancies happen after spontaneous abortion of tubal pregnancy or ruptured intrauterine pregnancy. However, we presented a case of ruptured secondary abdominal pregnancy after primary laparoscopic treatment of tubal pregnancy. CASE REPORT: The ectopic pregnant lesion in the affected tube was thoroughly removed in the primary laparoscopy, and nothing abnormal was detected in abdomen or pelvis. Beta human chorionic gonadotropin levels dropped significantly after surgery, but the patient came back again for severe abdominal pain with beta human chorionic gonadotropin increasing, and free peritoneal fluid in the pouch of Douglas was detected at ultrasonography. The secondary laparoscopy was done according to the intraperitoneal hemorrhage and unstable vital signs. The secondary pregnancy was found ruptured in the splenic flexure of the colon. Although several cases of secondary abdominal pregnancies were reported in the literature, herein we describe a case secondary to the salpingotomy of the primary tubal pregnancy. CONCLUSION: After surgery for ectopic pregnancy, the patient's serum beta human chorionic gonadotropin levels should be closely followed until negative. When persistent ectopic pregnancy was suspected after surgery, physicians should keep in mind a rare possibility of secondary abdominal pregnancy.
[Mh] Termos MeSH primário: Laparoscopia
Gravidez Abdominal/diagnóstico por imagem
Gravidez Abdominal/cirurgia
Gravidez Tubária/diagnóstico por imagem
Gravidez Tubária/cirurgia
[Mh] Termos MeSH secundário: Adulto
Gonadotropina Coriônica Humana Subunidade beta/sangue
Feminino
Hemoperitônio/diagnóstico por imagem
Hemoperitônio/cirurgia
Seres Humanos
Gravidez
Ruptura
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Chorionic Gonadotropin, beta Subunit, Human)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009254


  2 / 821 MEDLINE  
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[PMID]:29310411
[Au] Autor:Deng MX; Zou Y
[Ad] Endereço:Department of Radiology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
[Ti] Título:Evaluating a magnetic resonance imaging of the third-trimester abdominal pregnancy: What the radiologist needs to know.
[So] Source:Medicine (Baltimore);96(48):e8986, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: A 33-week abdominal pregnancy is an extremely rare type of ectopic pregnancy that is potentially life-threatening for the mother and fetus. Reports of using magnetic resonance imaging (MRI) in the third-trimester abdominal pregnancy are very few. PATIENT CONCERNS: A 24-year-old woman (gravida 2, para 1, living 0) at 33 weeks' gestation presented to local hospital complaining of vaginal bleeding for 2 months and lower abdominal pain for 2 days. Then, the woman was transferred to our hospital for suspected abdominal pregnancy, which was confirmed at our hospital on ultrasonography and further evaluated in detail on MRI. DIAGNOSES: The woman was diagnosed as having abdominal pregnancy. INTERVENTIONS: The woman was managed surgically, the unviable fetus was removed, and the placenta was left in situ. Then, the woman was managed with fluids, blood transfusion, antibiotics, and systemic methotrexate after surgery. OUTCOMES: At 42 days postoperatively, the affected woman was discharged in a good condition. CONCLUSIONS: By using MRI, we can accurately diagnose an abdominal pregnancy. MRI provides more details than ultrasonography, and explains the possible mechanism of abdominal pregnancy. We advocate using MRI to help surgical planning and improve outcome in cases of abdominal pregnancy.
[Mh] Termos MeSH primário: Imagem por Ressonância Magnética
Gravidez Abdominal/diagnóstico por imagem
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Laparotomia
Gravidez
Terceiro Trimestre da Gravidez
Gravidez Abdominal/cirurgia
Ultrassonografia Pré-Natal
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008986


  3 / 821 MEDLINE  
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[PMID]:28347153
[Au] Autor:Koltai T; Bacskó G
[Ad] Endereço:Szülészeti-Nogyógyászati Osztály, Kenézy Gyula Kórház és Rendelointézet Debrecen.
[Ti] Título:[Live birth resulting from abdominal pregnancy].
[Ti] Título:Hasuri terhesség élo újszülöttel..
[So] Source:Orv Hetil;158(13):508-511, 2017 Apr.
[Is] ISSN:0030-6002
[Cp] País de publicação:Hungary
[La] Idioma:hun
[Ab] Resumo:Advanced abdominal pregnancy is extremely rare. Symptoms are often nonspecific, and the diagnosis is frequently missed. Maternal mortality and morbidity are also very high especially if the condition is not diagnosed and managed properly. In abdominal pregnancy there is a high incidence of fetal malformations. We are presenting a case of a 38 year old primigravida with an undiagnosed advanced abdominal pregnancy carried beyond 36 weeks of gestation. We delivered a 2090 g baby from the abdomen. A relaparotomy was necessary on the third postoperative day because of abdominal bleeding. At the time of discharge both mother and baby were doing well. The publication also provides a literature overview, including definition, epidemiology, diagnosis and therapy. Orv. Hetil., 2017, 158(13), 508-511.
[Mh] Termos MeSH primário: Doenças Assintomáticas
Nascimento Vivo
Gravidez Abdominal/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Parto Obstétrico
Feminino
Seres Humanos
Recém-Nascido
Gravidez
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170808
[Lr] Data última revisão:
170808
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170329
[St] Status:MEDLINE
[do] DOI:10.1556/650.2017.30677


  4 / 821 MEDLINE  
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[PMID]:28337037
[Au] Autor:Young L; Barnard C; Lewis E; Jones M; Furlan J; Karatasiou A; Necas M
[Ad] Endereço:Radiology Registrar, Department of Radiology, Waikato Hospital, Hamilton.
[Ti] Título:The diagnostic performance of ultrasound in the detection of ectopic pregnancy.
[So] Source:N Z Med J;130(1452):17-22, 2017 Mar 24.
[Is] ISSN:1175-8716
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Accurate diagnosis of ectopic pregnancy is essential in reducing maternal mortality and morbidity. Transvaginal ultrasound (TVUS) is the accepted imaging modality of choice for the diagnosis of ectopic pregnancy (EP). AIMS: To assess the effectiveness of transvaginal ultrasound (TVUS) in the detection of EP in consecutive women presenting for ultrasound to a radiology department with a clinical suspicion of EP. METHODS: Retrospective analysis of 585 women presenting for TVUS over a 2.5-year period was performed. Women were classified as having a confirmed EP on the basis of surgery and histology. Women with a suspected EP who were treated medically or expectantly were also included. RESULTS: Eighty-seven women had a confirmed EP and 29 women had a suspected EP. The sensitivity and specificity of ultrasound for the detection of confirmed EP was 88.5% and 96.5% on the initial TVUS and 93.1% and 95.7% with an additional rescan. CONCLUSION: TVUS in the radiology setting of a tertiary hospital has excellent diagnostic performance for the detection of EP.
[Mh] Termos MeSH primário: Gravidez Ectópica/diagnóstico por imagem
Ultrassonografia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Gonadotropina Coriônica Humana Subunidade beta/sangue
Feminino
Seres Humanos
Meia-Idade
Gravidez
Gravidez Abdominal/sangue
Gravidez Abdominal/diagnóstico por imagem
Gravidez Cornual/sangue
Gravidez Cornual/diagnóstico por imagem
Gravidez Ectópica/sangue
Gravidez Tubária/sangue
Gravidez Tubária/diagnóstico por imagem
Estudos Retrospectivos
Sensibilidade e Especificidade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Chorionic Gonadotropin, beta Subunit, Human)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170417
[Lr] Data última revisão:
170417
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170325
[St] Status:MEDLINE


  5 / 821 MEDLINE  
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[PMID]:28293346
[Au] Autor:Bonahy AA; Sabbah H; Abdeljelil AB; Mahmoudi M
[Ad] Endereço:Département Mère et Enfant, Faculté de Médicine de Nouakchott, Mauritanie.
[Ti] Título:[Momified abdominal pregnancy].
[Ti] Título:Grossesse abdominale momifiée..
[So] Source:Pan Afr Med J;25:230, 2016.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:fre
[Ab] Resumo:Lithopedion is a retained abdominal pregnancy that evolves to fetal death and calcification. Its management remains uncodified. Indeed, some authors recommend surgical treatment, while others recommend to wait. We report the case of a 46-year old woman presenting with a pelvic mass revealing a calcified abdominal pregnancy that had been evolving for 8 years.
[Mh] Termos MeSH primário: Calcinose/diagnóstico
Morte Fetal
Gravidez Abdominal/diagnóstico
[Mh] Termos MeSH secundário: Calcinose/patologia
Feminino
Seres Humanos
Meia-Idade
Gravidez
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170330
[Lr] Data última revisão:
170330
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170316
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2016.25.230.10857


  6 / 821 MEDLINE  
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[PMID]:28003233
[Au] Autor:Yip SL; Tan WK; Tan LK
[Ad] Endereço:Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore.
[Ti] Título:Primary omental pregnancy.
[So] Source:BMJ Case Rep;2016, 2016 Dec 21.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:We present a case of primary omental ectopic pregnancy in a 31-year-old woman which was discovered intraoperatively during a diagnostic laparoscopy and subsequently removed via mini-laparotomy. We emphasise the rarity of this diagnosis, and the importance of careful inspection of the abdominal cavity including the omentum should an ectopic pregnancy be suspected when bilateral fallopian tubes and ovaries appear normal during surgical exploration.
[Mh] Termos MeSH primário: Omento/cirurgia
Gravidez Abdominal/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Achados Incidentais
Laparoscopia
Gravidez
Gravidez Abdominal/cirurgia
Ruptura Espontânea
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170306
[Lr] Data última revisão:
170306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161223
[St] Status:MEDLINE


  7 / 821 MEDLINE  
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[PMID]:27932439
[Au] Autor:Greenbaum A; Miskimins R; Coffman B; Paul J
[Ad] Endereço:Department of Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.
[Ti] Título:Management of splenic ectopic pregnancy presenting with massive haemoperitoneum.
[So] Source:BMJ Case Rep;2016, 2016 Dec 08.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Abdominal ectopic pregnancy (EP) accounts for only 1.3% of EPs and occurs when a fertilised ovum implants in an extrapelvic peritoneal location. Primary splenic pregnancy is a rare type of abdominal EP, with only 16 cases previously reported in the literature. Early diagnosis is essential as delay in treatment carries significant potential for morbidity and mortality. We present the case of a 27-year-old woman presenting with left upper quadrant abdominal pain, elevated human chorionic gonadotropin levels, absence of intrauterine gestational sac and massive haemoperitoneum on transvaginal ultrasound. The patient underwent emergent surgical exploration for high suspicion of ruptured abdominal EP. An open splenectomy was performed when the source of bleeding was confirmed to originate from the left upper quadrant. Final pathology confirmed subcapsular gestational sac implantation within the spleen. While two cases of medical management have been reported, splenectomy remains the current definitive management of rare cases of primary splenic pregnancy.
[Mh] Termos MeSH primário: Gerenciamento Clínico
Hemoperitônio/cirurgia
Gravidez Abdominal/cirurgia
Baço
Esplenectomia/métodos
[Mh] Termos MeSH secundário: Adulto
Endossonografia
Feminino
Hemoperitônio/diagnóstico
Hemoperitônio/etiologia
Seres Humanos
Gravidez
Gravidez Abdominal/diagnóstico
Ultrassonografia Pré-Natal
Vagina
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170307
[Lr] Data última revisão:
170307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161210
[St] Status:MEDLINE


  8 / 821 MEDLINE  
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[PMID]:27760569
[Au] Autor:Yoder N; Tal R; Martin JR
[Ad] Endereço:Division of Reproductive Endocrinology & Infertility, Department of Obstetrics, Gynecology, & Reproductive Sciences, Yale University School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA.
[Ti] Título:Abdominal ectopic pregnancy after in vitro fertilization and single embryo transfer: a case report and systematic review.
[So] Source:Reprod Biol Endocrinol;14(1):69, 2016 Oct 19.
[Is] ISSN:1477-7827
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Ectopic pregnancy is the leading cause of maternal morbidity and mortality during the first trimester and the incidence increases dramatically with assisted-reproductive technology (ART), occurring in approximately 1.5-2.1 % of patients undergoing in-vitro fertilization (IVF). Abdominal ectopic pregnancy is a rare yet clinically significant form of ectopic pregnancy due to potentially high maternal morbidity. While risk factors for ectopic pregnancy after IVF have been studied, very little is known about risk factors specific for abdominal ectopic pregnancy. We present a case of a 30 year-old woman who had an abdominal ectopic pregnancy following IVF and elective single embryo transfer, which was diagnosed and managed by laparoscopy. We performed a systematic literature search to identify case reports of abdominal or heterotopic abdominal ectopic pregnancies after IVF. A total of 28 cases were identified. RESULTS: Patients' ages ranged from 23 to 38 (Mean 33.2, S.D. = 3.2). Infertility causes included tubal factor (46 %), endometriosis (14 %), male factor (14 %), pelvic adhesive disease (7 %), structural/DES exposure (7 %), and unexplained infertility (14 %). A history of ectopic pregnancy was identified in 39 % of cases. A history of tubal surgery was identified in 50 % of cases, 32 % cases having had bilateral salpingectomy. Transfer of two embryos or more (79 %) and fresh embryo transfer (71 %) were reported in the majority of cases. Heterotopic abdominal pregnancy occurred in 46 % of cases while 54 % were abdominal ectopic pregnancies. CONCLUSIONS: Our systematic review has revealed several trends in reported cases of abdominal ectopic pregnancy after IVF including tubal factor infertility, history of tubal ectopic and tubal surgery, higher number of embryos transferred, and fresh embryo transfers. These are consistent with known risk factors for ectopic pregnancy following IVF. Further research focusing on more homogenous population may help in better characterizing this rare IVF complication and its risks.
[Mh] Termos MeSH primário: Fertilização In Vitro/efeitos adversos
Gravidez Abdominal/etiologia
Gravidez Abdominal/cirurgia
Transferência de Embrião Único/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Infertilidade Masculina/diagnóstico
Infertilidade Masculina/terapia
Laparoscopia/métodos
Masculino
Gravidez
Gravidez Abdominal/diagnóstico
Gravidez Ectópica/diagnóstico
Gravidez Ectópica/etiologia
Gravidez Ectópica/cirurgia
Fatores de Risco
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170323
[Lr] Data última revisão:
170323
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161021
[St] Status:MEDLINE


  9 / 821 MEDLINE  
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[PMID]:27718286
[Au] Autor:Irani M; Elias RT; Pereira N; Gunnala V; Rosenwaks Z
[Ad] Endereço:Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, USA.
[Ti] Título:Abdominal ectopic pregnancy with undetectable serum ß-human chorionic gonadotropin 9 days following blastocyst transfer.
[So] Source:J Obstet Gynaecol Res;42(12):1886-1888, 2016 Dec.
[Is] ISSN:1447-0756
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:With the availability of the highly sensitive ß-human chorionic gonadotropin (ß-hCG) assays, all pregnancies, including ectopic pregnancies (EP), are expected to have detectable serum ß-hCG at 4 weeks' gestation or 9 days following blastocyst transfer. To our knowledge, this is the first report of a woman who underwent in vitro fertilization, had undetectable serum ß-hCG 9 days after blastocyst transfer, and was then diagnosed with a ruptured abdominal EP and intra-abdominal bleeding 19 days later. This case highlights that the rise in serum ß-hCG might be delayed in abdominal EP compared to intrauterine pregnancy. This delay should raise the suspicion for EP, thus meriting close monitoring. Moreover, in the absence of menstruation, an undetectable serum ß-hCG 9 days post-blastocyst transfer should prompt ß-hCG measurement in 2-3 days to avoid the misdiagnosis of an EP.
[Mh] Termos MeSH primário: Gonadotropina Coriônica Humana Subunidade beta/sangue
Transferência Embrionária
Gravidez Abdominal/sangue
Gravidez Abdominal/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Feminino
Fertilização In Vitro
Seres Humanos
Gravidez
[Pt] Tipo de publicação:CASE REPORTS
[Nm] Nome de substância:
0 (Chorionic Gonadotropin, beta Subunit, Human)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170418
[Lr] Data última revisão:
170418
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161009
[St] Status:MEDLINE
[do] DOI:10.1111/jog.13127


  10 / 821 MEDLINE  
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[PMID]:27587187
[Au] Autor:Hishikawa K; Fukuda T; Inoue H; Kohata Y; Monma M; Ochiai N; Kubo Y; Watanabe R; Ako S; Aihara Y; Kusaka T
[Ad] Endereço:Department of Obstetrics and Gynecology, Shonan Kamakura General Hospital, Kanagawa, Japan.
[Ti] Título:Laparoscopic Management of Abdominal Pregnancy with Local Injection of Vasopressin Solution: A Case Report.
[So] Source:Am J Case Rep;17:637-40, 2016 Sep 02.
[Is] ISSN:1941-5923
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND Laparoscopic treatments of abdominal pregnancy have been reported; however, resection of an implanted gestational sac could lead to massive bleeding and treatment failure. Hemostasis of the resected stump is critical for the success of laparoscopic treatment. CASE REPORT A 32-year-old woman presented to the emergency department with severe abdominal pain. We suspected a ruptured ectopic pregnancy and performed urgent diagnostic laparoscopy. The gestational sac was implanted in the posterior wall of the uterus near the left uterosacral ligament, and bleeding from the gestational sac was noticed. We injected 3 ml of diluted vasopressin solution (0.4 U/ml) directly into the gestational sac and into the posterior uterine wall around the gestational sac. Thereafter, we could resect the gestational product using an ultrasonically activated scalpel. Additional hemostasis in the resected stump was not required. CONCLUSIONS We believe that a local injection of a diluted vasopressin solution helps in maintaining the hemostasis after the laparoscopic resection of the implanted gestational sac in cases of abdominal pregnancy.
[Mh] Termos MeSH primário: Histerectomia/métodos
Laparoscopia/métodos
Hemorragia Pós-Operatória/prevenção & controle
Gravidez Abdominal/cirurgia
Vasopressinas/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Injeções
Gravidez
Gravidez Abdominal/diagnóstico
Vasoconstritores/administração & dosagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Vasoconstrictor Agents); 11000-17-2 (Vasopressins)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160903
[St] Status:MEDLINE



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