scholarly journals Acute abdomen caused by adnexal torsion in the first trimester of pregnancy: A case report

2011 ◽  
Vol 139 (3-4) ◽  
pp. 239-241
Author(s):  
Milan Terzic ◽  
Slavica Aksam ◽  
Sanja Maricic ◽  
Nebojsa Arsenovic
Keyword(s):  
Acute Abdomen ◽  
Preoperative Evaluation ◽  
First Trimester ◽  
Free Fluid ◽  
Adnexal Torsion ◽  
Intrauterine Pregnancy ◽  
Diagnostic Dilemma ◽  
Laboratory Findings ◽  
First Trimester Of Pregnancy

Introduction. Adnexal torsion is a rare cause of acute abdominal pain during pregnancy. The clinical and laboratory findings are non-specific. In this paper we present a case of adnexal torsion in the first trimester of pregnancy. Case Outline. On admission, the patient presented signs of acute abdomen. The pain started few hours prior to admission, and was predominantly localized, occasionally irradiating to the central parts of the lower abdomen, accompanied by nausea and vomiting. Ultrasound revealed viable intrauterine pregnancy and right adnexal mass with small amount of free fluid in the Douglas pouch. After short preoperative evaluation, laparotomy and adnexectomy were performed. Surgery and postoperative follow-up were uneventful, and histopathology reported torquated corpus luteum cysts. Conclusion. The diagnosis of adnexal torsion during pregnancy is difficult, and occasionally remains a diagnostic dilemma. Surgery is inevitable, must be prompt, and comprises adnexectomy.

Evaluation of Normal Heart Rate in Early Pregnancy Corresponding to Gestational Age between Six to Eight Weeks

Med Phoenix ◽  
2017 ◽  
Vol 2 (1) ◽  
pp. 34-37
Author(s):  
Akhilesh Kumar Jha ◽  
Bikranta Rimal ◽  
Tarannum Khatun
Keyword(s):  
Heart Rate ◽  
Early Pregnancy ◽  
Well Being ◽  
Clinical Decision ◽  
First Trimester ◽  
Normal Heart ◽  
Normal Heart Rate ◽  
First Trimester Of Pregnancy ◽  
Singleton Pregnancies

Background: Ultrasonography is the reliable and safe way for the evaluation of pregnancy. Heart rate can be detected more confidently from the Ultrasonography. Heart rate is an important parameter for the evaluation of early pregnancy. The purpose of this study was to evaluate the normal heart rate in embryos/fetuses between 6 and 8 weeks of gestation.Method: In our region people are poor and most of them do not know the benefit of regular follow up examination during pregnancy. So most of pregnant women come to our centre at late stage of pregnancy. The number of pregnancy cases is good in our centre but the number of early pregnancy cases coming to regular follow up examination is low. Thus the study was conducted in 51 normal singleton pregnancies undergoing routine ultrasound examination during the first trimester of pregnancy. The duration of study was 6 weeks.Result: Out of 51 singleton pregnancies, 20 cases (39.2%) heart rate were between 131-150 beat per minute and 25 cases (49.0 %) heart rate were between 151-170 beat per minute. However 4 cases (7.8%) were between 110-120 beat per minute and 2 cases (3.9%) were more than 171 beat per minute. There were zero cases above the 180 beat per minute.Conclusion: The result of this study will help to evaluate abnormal and normal fetal heart rate so that early clinical decision whether to continue the pregnancy or terminate it can be taken, as Ultrasonography is only the method used in screening fetal well being in most of the region of our country.Med Phoenix Vol.2(1) July 2017, 34-37

scholarly journals Role of Maternal Serum Glycodelin as Predictor of Ectopic Pregnancy in First Trimester

2018 ◽  
Vol 7 (4) ◽  
pp. 467-470
Author(s):  
Wasan Wajdi Ibrahim ◽  
Afraa Mahjoob Al-Naddawi ◽  
Hayder A. Fawzi
Keyword(s):  
Ectopic Pregnancy ◽  
Predictive Value ◽  
First Trimester ◽  
Maternal Serum ◽  
Intrauterine Pregnancy ◽  
Receiver Operator Curve Analysis ◽  
Medical City ◽  
First Trimester Of Pregnancy ◽  
Control Study

Objectives: Assessment of glycodelin (GD) as a marker for unruptured ectopic pregnancy (EP) in the first trimester of pregnancy. Materials and Methods: This case-control study was conducted during June 2016 to May 2017 in the Obstetrics and Gynecological Department of Baghdad University at Baghdad teaching hospital/medical city complex. In this study, 100 pregnant women in their first trimester of pregnancy were included after clinical and ultrasonic findings. Results: Based on the results, GD levels in EP were significantly lower than those with normal intrauterine pregnancy (1.58 ± 1.18 vs. 30.1 ± 11.9). In addition, using receiver operator curve analysis, the cut-off GD level of 9.5 and less had acceptable validity results (100% sensitivity, 100% specificity, 95% positive predictive value, 100% negative predictive value, and accuracy 100%) to predict EP. Conclusions: In general, serum GD is considered as an excellent predictor of unruptured EP.

Diagnostic dilemma of isolated fallopian tube torsion

2021 ◽  
Vol 14 (7) ◽  
pp. e242682
Author(s):  
Michael Gerard Baracy Jr ◽  
Janie Hu ◽  
Holly Ouillette ◽  
Muhammad Faisal Aslam
Keyword(s):  
Acute Abdomen ◽  
Fallopian Tube ◽  
Differential Diagnoses ◽  
Adnexal Torsion ◽  
Normal Appendix ◽  
Diagnostic Dilemma ◽  
Perimenopausal Women ◽  
Adolescent Patients ◽  
History Of

Paratubal cysts are fluid-filled sacs that grow adjacent to the fallopian tube which can rarely result in torsion. Isolated fallopian tube torsion (IFTT) is a gynaecological emergency that warrants urgent laparoscopic detorsion to salvage the affected tube. IFTT has a proclivity to affect adolescents between the ages of 12 and 15 years and is rarely seen in premenarchal or perimenopausal women. Due to a lack of pathognomonical features, IFTT is difficult to diagnose. Adnexal torsion, including IFTT is a surgical diagnosis and no clinical or imaging criteria is sufficient to diagnose IFTT. Urgent laparoscopy and detorsion are required for preservation of the affected fallopian tube. However, given the diagnostic ambiguity, IFTT diagnosis is often delayed. IFTT should be included in the differential diagnoses for adolescent patients with acute abdomen when imaging demonstrates a normal appendix and ovaries. We report a 15-year-old girl with a 4-day history of abdominopelvic pain and bilateral paratubal cysts resulting in right IFTT.

scholarly journals Umbilical Cord Entanglement: Diagnostic and Clinical Repercussions

2012 ◽  
Vol 6 (3) ◽  
pp. 225-232 ◽  
Author(s):  
Francisco Raga ◽  
Newton G Osborne ◽  
Luiz E Machado ◽  
Francisco Bonilla ◽  
Fernando Bonilla-Musoles ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Three Dimensional ◽  
First Trimester ◽  
Delivery Outcome ◽  
Entire Pregnancy ◽  
Pregnancy And Delivery ◽  
First Trimester Of Pregnancy ◽  
3D Ultrasonography ◽  
Umbilical Cord Entanglement

ABSTRACT The use of three-dimensional (3D) ultrasonography since the first trimester of pregnancy allows the diagnosis and follow-up of cord entanglement throughout the entire pregnancy and delivery. This technology permits a more accurate diagnosis when compared with two-dimensional (2D) ultrasonography or Doppler The vast majority of cord entanglements observed at the end of the first-trimester will persist during the entire pregnancy; delivery outcome is usually not affected by this finding except for cases in which multiple cord entanglement is diagnosed. How to cite this article Martínez-Aspas A, Raga F, Machado LE, Bonilla F Jr, Castillo JC, Osborne NG, Bonilla-Musoles F. Umbilical Cord Entanglement: Diagnostic and Clinical Repercussions. Donald School J Ultrasound Obstet Gynecol 2012;6(3):225-232.

scholarly journals The Wuhan Twin Birth Cohort (WTBC)

2017 ◽  
Vol 20 (4) ◽  
pp. 355-362
Author(s):  
Jinzhu Zhao ◽  
Shaoping Yang ◽  
Anna Peng ◽  
Zhengmin Qian ◽  
Hong Xian ◽  
...  
Keyword(s):  
Cohort Study ◽  
Birth Cohort ◽  
Medical Information ◽  
First Trimester ◽  
Population Based ◽  
Health Examination ◽  
Birth Registry ◽  
Twin Birth ◽  
First Trimester Of Pregnancy

The Wuhan Pre/Post-Natal Twin Birth Registry (WPTBR) is one of the largest twin birth registries with comprehensive medical information in China. It recruits women from the first trimester of pregnancy and their twins from birth. From January 2006 to May 2016, the total number of twins enrolled in WPTBR is 13,869 twin pairs (27,553 individuals). The WPTBR initiated the Wuhan Twin Birth Cohort (WTBC). The WTBC is a prospective cohort study carried out through incorporation of three samples. The first one comprises 6,920 twin pairs, and the second one, 6,949 twin pairs. Both are population-based samples linked to the WPTBR and include pre- and post-natal information from WPTBR. The second sample includes neonatal blood spots as well. Using a hospital-based approach, we recently developed a third sample with a target enrolment of 1,000 twin pairs and their mothers. These twins are invited, via their parents, to participate in a periodic health examination from the first trimester of pregnancy to 18 years. Biological samples are collected initially from the mother, including blood, urine, cord blood, cord, amniotic fluid, placenta, breast milk and meconium, and vaginal secretions, and later from the twins, including meconium, stool, urine, and blood. This article describes the design, recruitment, follow-up, data collection, and measures, as well as ongoing and planned analyses at the WTBC. The WTBC offers a unique opportunity to follow women from prenatal to postnatal, as well as follow-up of their twins. This cohort study will expand the understanding of genetic and environmental influences on pregnancy and twins’ development in China.

scholarly journals A Pragmatic Intervention Using Financial Incentives for Pregnancy Weight Management: Feasibility Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Rebecca Krukowski ◽  
Brandi Johnson ◽  
Hyeonju Kim ◽  
Saunak Sen ◽  
Riad Homsi
Keyword(s):  
Physical Activity ◽  
Data Collection ◽  
Financial Incentives ◽  
Financial Incentive ◽  
Controlled Trial ◽  
Treatment Engagement ◽  
First Trimester ◽  
Adult Women ◽  
First Trimester Of Pregnancy

BACKGROUND Excessive gestational weight gain (GWG) is common and can result in maternal and child health complications. Pragmatic behavioral interventions that can be incorporated into standard obstetric care are needed, and financial incentives are a promising approach. OBJECTIVE The aim of this study is to evaluate the feasibility of recruitment, randomization, and retention, as well as treatment engagement and intervention satisfaction, in a behavioral program. The program provided small incentives for meeting behavioral goals of self-weighing and physical activity as well as larger outcome incentives for meeting GWG goals. METHODS We recruited 40 adult women in their first trimester of pregnancy from February 2019 to September 2019 at an obstetric clinic. Participants were randomized to 3 intervention components using a 2×2×2 factorial design: daily incentives for self-weighing (lottery vs certain loss), incentives for adhering to the Institute of Medicine’s GWG guidelines based on BMI category (monthly vs overall), and incentives for reaching physical activity goals (yes vs no). Participants were asked to complete daily weigh-ins using the Withings Body wireless scale provided by the study, as well as wear a physical activity tracker (Fitbit Flex 2). Feasibility outcomes of recruitment, randomization, and retention, as well as treatment engagement and intervention satisfaction, were assessed. Weight assessments were conducted at baseline, 32-week gestation, and 36-week gestation. RESULTS Participants were enrolled at, on average, 9.6 (SD 1.8) weeks’ gestation. Of the 39 participants who were oriented to their condition and received the intervention, 24 (62%) were Black or African American, 30 (77%) were not married, and 29 (74%) had an annual household income of less than US $50,000. Of the 39 participants, 35 (90%) completed the follow-up data collection visit. Participants were generally quite positive about the intervention components, with a particular emphasis on the helpfulness of, and the enjoyment of using, the e-scale in both the quantitative and qualitative feedback. Participants who received the loss incentive, on average, had 2.86 times as many days of self-weighing as those who received the lottery incentive. Participants had a relatively low level of activity, with no difference between those who received a physical activity incentive and those who did not. CONCLUSIONS A financial incentive–based pragmatic intervention was feasible and acceptable for pregnant women for promoting self-weighing, physical activity, and healthy GWG. Participants were successfully recruited early in their first trimester of pregnancy and retained for follow-up data collection in the third trimester. Participants demonstrated promising engagement in self-weighing, particularly with loss-based incentives, and reported finding the self-weighing especially helpful. This study supports further investigation of pragmatic, clinic-based financial incentive–based interventions for healthy GWG behaviors. CLINICALTRIAL ClinicalTrials.gov NCT03834194; https://clinicaltrials.gov/ct2/show/NCT03834194

Is maternal periconceptional smoking associated with 2D:4D digit ratio in their children?

2017 ◽  
Vol 8 (5) ◽  
pp. 597-603 ◽  
Author(s):  
M. P. Velez ◽  
T. E. Arbuckle ◽  
P. Monnier ◽  
W. D. Fraser
Keyword(s):  
Smoking Prevalence ◽  
First Trimester ◽  
Ventral Surface ◽  
Environmental Chemicals ◽  
Smoking History ◽  
Androgen Exposure ◽  
Periconceptional Period ◽  
First Trimester Of Pregnancy ◽  
The Mean

The 2nd--4th finger ratio (2D:4D) has been proposed as a potential indicator of greater androgen exposure during fetal development. Maternal periconceptional smoking may alter the homeostasis of fetal androgens, which could in turn result in differential development of 2D:4Ds in utero. The aim of the present study was to assess the effect of maternal periconceptional smoking (i.e. 1 year before through the first trimester of pregnancy) on the 2D:4D of children within The Maternal-Infant Research on Environmental Chemicals (MIREC) study. Maternal smoking history was obtained through questionnaires during the first trimester of pregnancy in 2001 women from 10 cities across Canada. The periconceptional smoking prevalence was 12%. A follow-up study was conducted to measure growth and development up to 5 years of age in a subsample of some 800 MIREC children (MIREC-CD Plus), and digital pictures of the ventral surface of both hands were obtained in mothers and children (2–5 years). The 2D:4D was calculated as the ratio of the 2nd and 4th fingers of each hand. Boys had lower mean 2D:4Ds compared with girls in both hands. Age and maternal 2D:4D were strong determinants of the children’s 2D:4D, however, the mean 2D:4D did not differ among children whose mothers had smoked during the periconceptional period compared with those who had not, irrespective of sex. In conclusion, we did not find an association between maternal periconceptional smoking and children’s 2D:4D, although the smoking prevalence was low.

Congenital Rubella and Thrombocytopenia: Report of Two Cases with Initial and Follow-up Viral Cultures

PEDIATRICS ◽  
1965 ◽  
Vol 36 (2) ◽  
pp. 268-270
Author(s):  
WILLIAM D. COCHRAN ◽  
MICHAEL CORNFIELD ◽  
DAVID FRIEDBERG
Keyword(s):  
Tissue Culture ◽  
Kidney Tissue ◽  
Clinical History ◽  
First Trimester ◽  
Clinical Findings ◽  
Congenital Rubella ◽  
Echo Virus ◽  
History Of ◽  
First Trimester Of Pregnancy

Recent advances have made it possible to isolate rubella virus from affected persons and to propagate the virus in tissue culture. The virus may be identified by the unique cytopathogenic changes in human amnion tissue culture by interference with ECHO virus type 11 in monkey kidney tissue culture. Thus an even closer correlation between an active rubella infection in the mother in the first trimester of pregnancy and the clinical findings of the rubella syndrome is now feasible. The rubella epidemic of 1964 can be expected to produce significant numbers of infants with the congenital rubella syndrome. This paper reports the clinical history of two cases of rubella associated with thrombocytopenia in the newborn.

The Value of Targeted Ultrasound for the Primary Evaluation of Breast Symptoms in Pregnant Women of All Ages

2021 ◽  
Vol 3 (5) ◽  
pp. 556-563
Author(s):  
Jamie N Holtz ◽  
Genevieve A Woodard ◽  
Jessica H Hayward ◽  
Kimberly M Ray ◽  
Neeta Kannan ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Breast Imaging ◽  
Imaging Modality ◽  
First Trimester ◽  
Study Cohort ◽  
Targeted Ultrasound ◽  
First Trimester Of Pregnancy ◽  
Primary Evaluation ◽  
Common Malignancy

Abstract Objective Data on breast imaging in symptomatic pregnant women are limited. Our aim was to assess the value of targeted breast US for the primary evaluation of breast symptoms in pregnant women of all ages. Methods This IRB-approved retrospective study included all pregnant patients who underwent targeted US for focal breast symptoms at an academic imaging facility over an 18-year period (2000–2018). Clinical, imaging, and pathology results were reviewed. Malignant outcomes were determined by histology. Benign outcomes were confirmed by pathology or ≥2 years of follow-up. Descriptive statistics and 2 × 2 contingency table analyses were performed at the presentation level. Results The study cohort comprised 178 presentations in 175 pregnant women. Mean age was 34.7 years (standard deviation, 5.2). The majority (153/178, 86.0%) were more than 30 years old. At presentation, 42.1% (75/178) were in the first trimester of pregnancy, 27.0% (48/178) in the second, and 29.8% (53/178) in the third. The most common presenting symptom was a palpable lump (162/178, 91.0%), followed by focal pain (7/178, 3.9%). The vast majority (174/178, 97.8%) of cases were non-malignant. However, targeted US detected all 4 malignancies (cancer detection rate, 22/1000; negative predictive value 136/136, 100%). Sensitivity and specificity were 100% (4/4) and 78.2% (136/174), respectively. Conclusion Benign causes of symptoms in pregnant women were far more common; malignancy was rare, accounting for only 2.2% (4/178) of cases. Targeted breast US detected all malignancies, supporting US as the primary imaging modality for evaluating symptomatic pregnant women, regardless of age.

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