Modern views on rehabilitation reproductive function of women who undergo an ectopic pregnancy

Caesarean scar ectopic pregnancy (CSEP) is an uncommon form of ectopic pregnancy. This review defines types of CSEP, discusses pathophysiology, clinical presentation and diagnosis and compares common treatment options and outcomes. The pathophysiology is not yet fully understood. One third of patient are asymptomatic. In symptomatic patients vaginal bleeding and pelvic pain which is usually misdiagnosed as threatened or missed abortion. The main principles of treatment for CSEP are early diagnose, quick management, and maintain reproductive function as much as possible. Up to date; no consensus or guidelines for the treatment and management of CSEP. Management of CSEP depends on the clinical presentation and gestational age. Significant controversy exists regarding management, for this reason, several factors should be considered including age of the patient, myometrial thickness, clinical symptoms, hemodynamic status, fertility preservation.

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ECTOPIC PREGNANCY AND ITS LONG-TERM RESULTS

Wiadomości Lekarskie ◽

10.36740/wlek202001127 ◽

2020 ◽

Vol 73 (1) ◽

pp. 139-144

Author(s):

Alla V. Boychuk ◽

Oksana I. Khlibovska ◽

Yuliia B. Yakymchuk

Keyword(s):

Medical Treatment ◽

Ectopic Pregnancy ◽

Reproductive Function ◽

Long Term Results ◽

Fallopian Tubes ◽

Long Term Outcomes ◽

Second Stage ◽

Number Of Patients ◽

Source Of Information

The aim: The purpose of this study was to assess the long-term outcomes of restoration of reproductive function after surgical and medical treatment of ectopic pregnancy, taking into consideration the patency of the fallopian tubes and the incidence of uterine pregnancy. Materials and methods: A two-stage experimental approach was used to address research objectives. In the first stage, a retrospective analysis of 615 histories of patients with ectopic pregnancy has been performed. In a second stage – we examined 140 patients, which were divided into three groups, depending on the type of treatment. The first group consisted of patients with a disturbed ectopic pregnancy, who were treated with laparotomy and tubectomy. The second group included patients with exacerbated ectopic pregnancy, who were operated by laparoscopic access. Lastly, the third group comprised of women with ectopic pregnancy who were treated with methotrexate. The main source of information used for clinical and anamnestic analysis was “medical card-patient” (f. 003 / o). Results: The number of patients diagnosed with ectopic pregnancy increased from 2005 to 2015. In 2005 and 2006, the laparotomy operations were 86.88% and 83.33%, but conservative management only 13,16% and 16,67%, respectively. In 2015, the number of patients treated with methotrexate was more than half (51.35%) compared with 2010 and 2005 increased to 16.97% and 38.19% respectively, and laparotomy operations decreased from 86.88% in year 2005 to 18.92% in year 2015. Conclusions: The data showed that in women who underwent medical treatment with cytostatic, the patency of the fallopian tubes was significantly better than after surgical treatment. In cases of interrupted ectopic pregnancy for which laparotomy with the removal of the motor tube was applied, infertility of tubal peritoneal genesis developed in 60% of cases, which is consistent with the existing literature. Statistical analysis of the structure of ectopic pregnancy showed that in 2005 dominated interrupted ectopic pregnancy, due to late diagnostic and hospitalisation, that led to urgent laparotomy operations rather than conservative treatment.

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Reproductive potential in women after tubal pregnancy operation

Kazan medical journal ◽

10.17816/kazmj66726 ◽

1999 ◽

Vol 80 (3) ◽

pp. 212-213

Author(s):

M. I. Mazitova ◽

L. T. Davletshina ◽

I. M. Mazitov

Keyword(s):

Ectopic Pregnancy ◽

Pregnancy Complications ◽

Reproductive Potential ◽

Reproductive Function ◽

Tubal Pregnancy

The ectopic pregnancy frequency is studied by the data of one of the great puerperal houses in Kazan for 19931997. It is established that following the ectopic pregnancy, the pregnancy comes in each fifth woman; among women wishing to give birth, the pregnancy comes in each second one. Hence, in ectopic pregnancy complications of tuboperitoneal sterility in calculations it is necessary to take into account the womans wish to retain reproductive function.

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OPERATIVE TREATMENT OF ECTOPIC PREGNANCY: FEATURES OF VARIOUS TYPES OF SURGICAL INTERVENTIONS

"Medical & pharmaceutical journal "Pulse" ◽

10.26787/nydha-2686-6838-2020-22-10-68-73 ◽

2020 ◽

pp. 68-73

Author(s):

Sutugina O.N. ◽

Shubin L.B.

Keyword(s):

Surgical Treatment ◽

Maternal Mortality ◽

Ectopic Pregnancy ◽

Fallopian Tube ◽

Reproductive Function ◽

Clinical Situation ◽

Fallopian Tubes ◽

Surgical Interventions ◽

Preg Nancy ◽

The World

Ectopic pregnancy is one of the most pressing prob-lems associated with reproductive problems all over the world. Unfortunately, so far, impaired ectopic pregnancy in some cases leads to maternal mortality. Suspicion of ectopic pregnancy requires a full clinical and diagnostic examination and hospitalization of the patient in the gynecological Department. In most cas-es, ectopic pregnancy is localized in the fallopian tube. Most often, according to the literature, patients with ectopic pregnancy are subjected to surgical treatment, which subsequently negatively affects the reproductive function of women, since the removal of ectopic pregnancy leads to both the removal of the tube and its injury, which increases the risk of repeat-ed ectopic pregnancy. The choice of the type of surgi-cal intervention on the fallopian tube in ectopic preg-nancy should be personalized and appropriate to the specific clinical situation. This paper analyzes various types of surgical interventions on the fallopian tubes in ectopic pregnancy.

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Clinical case of interstitial tubal pregnancy treatment with mifepristone and misoprostol

Pediatrician (St Petersburg) ◽

10.17816/ped86114-117 ◽

2017 ◽

Vol 8 (6) ◽

pp. 114-117 ◽

Cited By ~ 1

Author(s):

Anna A. Malysheva ◽

Viktoriya N. Abramova ◽

Vitaliy A. Reznik ◽

Nikolay N. Ruhljada ◽

Anna N. Taits

Keyword(s):

Surgical Treatment ◽

Drug Treatment ◽

Ectopic Pregnancy ◽

Clinical Case ◽

Reproductive Function ◽

Reproductive Organs ◽

Tubal Pregnancy ◽

Operative Trauma ◽

Treatment Regimens ◽

The Moment

The article presents the experience of drug treatment of inertial tubal pregnancy. Currently, ectopic pregnancy is one of the most serious pathologies of pregnancy, leading to a decrease in the woman's reproductive health and directly threatening her life. In this clinical case, the possibility of treatment of ectopic pregnancy with mifepristone and misoprostol in a hospital of the 3rd level, with a patient's refusal of surgical treatment, has been demonstrated. At the moment, according to clinical recommendations adopted in the Russian Federation, interstitial tubal pregnancy is an indication for surgical treatment. Instructions for the use of mifepristone and misoprostol do not provide indications and treatment regimens for ectopic pregnancy. Medicamentous treatment of ectopic pregnancy is possible only with early diagnosis, in hospital settings and with the patient's voluntary consent. We have demonstrated the possibility to consider drug treatment not only as a therapy for despair, but also as an alternative to surgery leading to operative trauma of the reproductive organs, which is more extensive with the rare localization of interstitial tubal pregnancy, namely not only removal of the fallopian tube, but excision of the uterine tube trunk angle. Operative treatment of ectopic pregnancy leads to various complications that reduce the reproductive function of patients. Conservative treatment, perhaps, will help in the subsequent to avoid complications associated with surgical treatment and preserve the ability to procreate, in women with a burdened obstetric-gynecological anamnesis.

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Ectopic pregnancy: difficulties of timely diagnosis

Clinical review for general practice ◽

10.47407/kr2021.2.7.00089 ◽

2021 ◽

Vol 2 (7) ◽

pp. 52-55

Author(s):

Madina Agaeva ◽

◽

Zoya Agaeva ◽

Keyword(s):

Mortality Rate ◽

Ectopic Pregnancy ◽

Chorionic Gonadotropin ◽

Social Problem ◽

Ultrasound Examination ◽

Reproductive Function ◽

Integrated Approach ◽

Beta Subunit ◽

Treat Ment ◽

Modern Methods

Ectopic pregnancy is an important medical and social problem that threatens not only the reproductive function of women, but also her life. The frequency of ectopic pregnancy does not tend to decrease, however, high alertness with regard to this pathology, an integrated approach to diag-nosis, including the study of clinical data, ultrasound examination, as well as monitoring the level of beta-subunit of chorionic gonadotropin in blood serum, has significantly reduced the maternal mortality rate due to this pathology. At the same time, the existing modern methods of treat-ment make it possible to do without radical operations and preserve the reproductive function of patients.

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Reduction of spermatogonia and testosterone in rat testes flown on space lab-3

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100142864 ◽

1986 ◽

Vol 44 ◽

pp. 248-249

Author(s):

Delbert E. Philpott ◽

W. Sapp ◽

C. Williams ◽

T. Fast ◽

J. Stevenson ◽

...

Keyword(s):

Social Interaction ◽

Social Status ◽

Population Size ◽

Physiological Response ◽

Social Rank ◽

Reproductive Function ◽

Testicular Development ◽

Organ Weights ◽

Reproductive Maturation ◽

Metabolic Activities

Space Lab 3 (SL-3) was flown on Shuttle Challenger providing an opportunity to measure the effect of spaceflight on rat testes. Cannon developed the idea that organisms react to unfavorable conditions with highly integrated metabolic activities. Selye summarized the manifestations of physiological response to nonspecific stress and he pointed out that atrophy of the gonads always occurred. Many papers have been published showing the effects of social interaction, crowding, peck order and confinement. Flickinger showed delayed testicular development in subordinate roosters influenced by group numbers, social rank and social status. Christian reported increasing population size in mice resulted in adrenal hypertrophy, inhibition of reproductive maturation and loss of reproductive function in adults. Sex organ weights also declined. Two male dogs were flown on Cosmos 110 for 22 days. Fedorova reported an increase of 30 to 70% atypical spermatozoa consisting of tail curling and/or the absence of a tail.

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