Pregnancy-Related Emergencies

2019 ◽  
Author(s):  
Amy Hideko Kaji
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Hyperemesis Gravidarum ◽  
Gestational Trophoblastic Disease ◽  
Treatment Modalities ◽  
Free Fluid ◽  
Molar Pregnancy ◽  
Hypertensive Disorders Of Pregnancy ◽  
Trophoblastic Disease ◽  
Hypertensive Disorders

This review provides an overview of spontaneous abortion, ectopic pregnancy, gestational trophoblastic disease or molar pregnancy, hyperemesis gravidarum, placental abruption, placental previa, hypertensive disorders of pregnancy, and amniotic fluid embolism. Assessment and stabilization, diagnosis, treatment and disposition, and outcomes are discussed. Tables include classifications of abortion or miscarriage, differential diagnosis of patients presenting with vaginal bleeding during pregnancy, risk factors for ectopic pregnancy, treatment modalities for hyperemesis gravidarum, classification of hypertensive disorders of pregnancy, and risk factors for preeclampsia and eclampsia. Figures show ectopic pregnancy on a sonogram, free fluid in hepatorenal fossa on a focused abdominal sonogram in trauma, double decidual sign in a normal intrauterine pregnancy, pseudogestational sac in an ectopic pregnancy, and “snowstorm” appearance of molar pregnancy on a sonogram. This review 5 figures, 13 tables, and 68 references. Keywords: abortion, ectopic, gestational trophoblastic disease, abruption, previa, ecclampsia

Pregnancy-Related Emergencies

2019 ◽  
Author(s):  
Amy Hideko Kaji
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Hyperemesis Gravidarum ◽  
Gestational Trophoblastic Disease ◽  
Treatment Modalities ◽  
Free Fluid ◽  
Molar Pregnancy ◽  
Hypertensive Disorders Of Pregnancy ◽  
Trophoblastic Disease ◽  
Hypertensive Disorders

This review provides an overview of spontaneous abortion, ectopic pregnancy, gestational trophoblastic disease or molar pregnancy, hyperemesis gravidarum, placental abruption, placental previa, hypertensive disorders of pregnancy, and amniotic fluid embolism. Assessment and stabilization, diagnosis, treatment and disposition, and outcomes are discussed. Tables include classifications of abortion or miscarriage, differential diagnosis of patients presenting with vaginal bleeding during pregnancy, risk factors for ectopic pregnancy, treatment modalities for hyperemesis gravidarum, classification of hypertensive disorders of pregnancy, and risk factors for preeclampsia and eclampsia. Figures show ectopic pregnancy on a sonogram, free fluid in hepatorenal fossa on a focused abdominal sonogram in trauma, double decidual sign in a normal intrauterine pregnancy, pseudogestational sac in an ectopic pregnancy, and “snowstorm” appearance of molar pregnancy on a sonogram. This review 5 figures, 13 tables, and 68 references. Keywords: abortion, ectopic, gestational trophoblastic disease, abruption, previa, ecclampsia

scholarly journals Incidence and outcome of gestational trophoblastic disease in lower Egypt

2020 ◽  
Vol 20 (1) ◽  
pp. 73-82
Author(s):  
Ahmed Zakaria ◽  
Reda Hemida ◽  
Waleed Elrefaie ◽  
Ehsan Refaie
Keyword(s):  
Risk Factors ◽  
Patient Characteristics ◽  
Gestational Trophoblastic Disease ◽  
Treatment Modalities ◽  
Progression Rate ◽  
Molar Pregnancy ◽  
Live Births ◽  
Trophoblastic Disease ◽  
Rate Of Progression ◽  
Incidence Risk

Background. Gestational trophoblastic disease (GTD) defines a spectrum of proliferative disorders of trophoblastic epitheli- um of the placenta. Incidence, risk factors, and outcome may differ from one country to another. Objective. To describe incidence, patient characteristics, treatment modalities, and outcome of GTD at Mansoura University which is a referral center of Lower Egypt. Methods. An observational prospective study was conducted at the GTD Clinic of Mansoura University. The patients were recruited for 12 months from September 2015 to August 2016. The patients’ characteristics, management, and outcome were reported. Results. We reported 71 clinically diagnosed GTD cases, 62 of them were histologically confirmed, 58 molar (33 CM and 25 PM) in addition to 4 initially presented GTN cases. Mean age of the studied cases was 26.22 years ± 9.30SD. Mean pre-evacu- ation hCG was 136170 m.i.u/ml ±175880 SD. Most of the cases diagnosed accidentally after abnormal sonographic findings (53.2%). Rate of progression of CM and PM to GTN was 24.2% and 8%, respectively. Conclusion. The incidence of molar pregnancy and GTN in our locality was estimated to be 13.1 and 3.2 per 1000 live births respectively. We found no significance between CM and PM regarding hCG level, time to hCG normalization, and progression rate to GTN. Keywords. Molar pregnancy; incidence; outcome.   

The clinical presentation, treatment, and outcome of patients diagnosed with possible ectopic molar gestation

2004 ◽  
Vol 14 (2) ◽  
pp. 366-369 ◽  
Author(s):  
A. M. Gillespie ◽  
E. A. Lidbury ◽  
J. A. Tidy ◽  
B. W. Hancock
Keyword(s):  
Risk Factors ◽  
Clinical Presentation ◽  
Gestational Trophoblastic Disease ◽  
Surgical Removal ◽  
Molar Pregnancy ◽  
Initial Management ◽  
Trophoblastic Disease ◽  
Treatment Centre ◽  
History Of ◽  
Park Hospital

The objective of this study was to determine the clinical presentation, treatment, and outcome of patients diagnosed with possible ectopic molar gestation registered with the Trophoblastic Disease Screening and Treatment Centre, Weston Park Hospital, Sheffield between 1986 and 2000. From the 5581 women registered, those with a diagnosis of ectopic molar pregnancy were identified from a computer database. Information regarding the relevant history of each patient and the clinical presentation, treatment, and outcomes of gestational trophoblastic disease (GTD) was determined by reviewing referral forms, case notes, and pro formas completed by the referring gynecologist. Histological review of the cases was undertaken where possible. Suspected ectopic molar gestations comprised 31/5581 (0.55%) of registrations. Known risk factors for ectopic pregnancy were identified in 79% of cases. Central histological review confirmed only six cases of GTD: three choriocarcinoma and three early complete moles. Four patients subsequently required chemotherapy. All patients are now in complete remission. We conclude that ectopic GTD is uncommon, with a UK incidence of approximately 1.5 per 1,000,000 births. Initial management is usually surgical removal of the conceptus, pathological suspicion of the diagnosis and registration with a screening center. Chemotherapy may be required and the prognosis is excellent.

scholarly journals Clinicopathological study of Gestational Trophoblastic Disease

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2344-2349
Author(s):  
Ramesh M. Oswal ◽  
Mahendra A. Patil ◽  
Sujata M. Kumbhar ◽  
Jyoti S. Tele ◽  
Atul B. Hulwan
Keyword(s):  
Risk Factors ◽  
Maternal Age ◽  
Hydatidiform Mole ◽  
Gestational Trophoblastic Disease ◽  
Histopathological Study ◽  
Molar Pregnancy ◽  
Complete Hydatidiform Mole ◽  
Trophoblastic Disease ◽  
Complete Mole ◽  
Clinicopathological Study

Several potential etiologic risk factors have been evaluated for the development of complete hydatidiform mole. The two established risk factors that have emerged are extremes of maternal age and prior molar pregnancy. Advanced or very young maternal age has consistently correlated with higher rates of complete hydatidiform mole. Compared to women aged 21- 35 years, the risk of a complete mole is 1.9 times higher for women both more than 35 years and less than 21 years as well as 7.5 times higher for women more than 40 years. (49, 50) The risk of repeat molar pregnancy after 1 mole is about 1% or about 10-20 times the risk for the general population. The present study on the gestational trophoblastic disease (GTD) was carried out as it is one of the fascinating gynaecological tumours. Hence a clinicopathological study of gestational trophoblastic disease was undertaken with relevance to the histopathological study of GTD and clinical correlation.

scholarly journals MOLAR ECTOPIC PREGNANCY;

2013 ◽  
Vol 20 (04) ◽  
pp. 638-641
Author(s):  
SHAMA CHAUDHARY ◽  
IQRA JANGDA ◽  
RUBINA HUSSAIN
Keyword(s):  
Ectopic Pregnancy ◽  
Iliac Fossa ◽  
Hydatidiform Mole ◽  
Gestational Trophoblastic Disease ◽  
Molar Pregnancy ◽  
Trophoblastic Disease ◽  
Beta Hcg ◽  
History Of ◽  
The Right

Ectopic molar pregnancy is a rare occurrence. Clinical diagnosis of a molar pregnancy is difficult but histopathology is thegold standard for diagnosis. The management of ectopic molar pregnancies consists of surgically removing the conceptus, follow up &chemotherapy, if required. We are reporting a case report of a 35-year-old married, nulliparous woman, admitted in emergency with a 6-week history of amenorrhea, severe abdominal pain & an episode of fainting at home. Per abdominal examination revealed tendernessover the right iliac fossa, with guarding & rigidity. Diagnosis of ruptured ectopic pregnancy was made.Emergency laparotomy was done.Histopathological examination, showed tubal ectopic pregnancy with partial hydatidiform mole & a separate corpus luteal cyst.She wasfollowed up with serial beta hCG which became normal within 1 month. Although ectopic molar pregnancy is a rare entity but all ectopicpregnancies should be examined histologically to rule out presence of gestational trophoblastic disease to plan follow-up accordingly inorder to avoid persistent gestational trophoblastic disease which has a chance of malignant conversion.The prognosis of ectopic molarpregnancies is the same as for other forms of gestational trophoblastic disease.

scholarly journals Choriocarcinoma with uterine rupture presenting as acute haemoperitoneum and shock

2017 ◽  
Vol 6 (3) ◽  
pp. 1141 ◽  
Author(s):  
Mamour Gueye ◽  
Mame Diarra Ndiaye Gueye ◽  
Ousmane Thiam ◽  
Youssou Toure ◽  
Mor Cisse ◽  
...  
Keyword(s):  
Young Woman ◽  
Uterine Rupture ◽  
Gestational Trophoblastic Disease ◽  
Uterine Perforation ◽  
Molar Pregnancy ◽  
Rare Neoplasm ◽  
Trophoblastic Disease ◽  
Intraperitoneal Bleeding ◽  
Invasive Mole

Choriocarcinoma is a rare neoplasm and a malignant form of gestational trophoblastic disease. Invasive mole may perforate uterus through the myometrium resulting in uterine perforation and intraperitoneal bleeding. But uterine perforation due to choriocarcinoma is rare. We present a case of a young woman who presented 1 year after uterine evacuation of a molar pregnancy with invasive choriocarcinoma complicated by a uterine rupture and haemoperitoneum.

scholarly journals Prevention of Hypertensive Disorders of Pregnancy—Is There a Place for Metformin?

2021 ◽  
Vol 10 (13) ◽  
pp. 2805
Author(s):  
Elżbieta Poniedziałek-Czajkowska ◽  
Radzisław Mierzyński ◽  
Dominik Dłuski ◽  
Bożena Leszczyńska-Gorzelak
Keyword(s):  
Risk Factors ◽  
Risk Groups ◽  
Trophoblast Invasion ◽  
Pregnancy Induced Hypertension ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Induced Hypertension ◽  
Endothelium Function ◽  
Hypoglycemic Drug ◽  
The Ideal

The possibility of prophylaxis of hypertensive disorders of pregnancy (HDPs) such as preeclampsia (PE) and pregnancy-induced hypertension is of interest due to the unpredictable course of these diseases and the risks they carry for both mother and fetus. It has been proven that their development is associated with the presence of the placenta, and the processes that initiate it begin at the time of the abnormal invasion of the trophoblast in early pregnancy. The ideal HDP prophylaxis should alleviate the influence of risk factors and, at the same time, promote physiological trophoblast invasion and maintain the physiologic endothelium function without any harm to both mother and fetus. So far, aspirin is the only effective and recommended pharmacological agent for the prevention of HDPs in high-risk groups. Metformin is a hypoglycemic drug with a proven protective effect on the cardiovascular system. Respecting the anti-inflammatory properties of metformin and its favorable impact on the endothelium, it seems to be an interesting option for HDP prophylaxis. The results of previous studies on such use of metformin are ambiguous, although they indicate that in a certain group of pregnant women, it might be effective in preventing hypertensive complications. The aim of this study is to present the possibility of metformin in the prevention of hypertensive disorders of pregnancy with respect to its impact on the pathogenic elements of development

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