scholarly journals Heterotopic Pregnancy: A Challenge in Early Diagnosis

2019 ◽  
Vol 17 (3) ◽  
pp. 413-415 ◽  
Author(s):  
Roman Karkee ◽  
Amit Sharma ◽  
Binod Dangal
Keyword(s):  
Heterotopic Pregnancy ◽  
Pelvic Surgery ◽  
Maternal Condition ◽  
Fertility Treatments ◽  
Reproductive Techniques ◽  
Life Threatening ◽  
History Of ◽  
Simultaneous Existence ◽  
Life Threatening Event ◽  
Tubal Surgery

Heterotopic pregnancy is the simultaneous existence of intrauterine and extrauterine gestation. It is usually seen in women at risk for ectopic pregnancy or those undergoing fertility treatments. The incidence has dramatically risen to 1 in 3900 of pregnancies via assisted reproductive techniques or ovulation induction, compared to 1 in 30000 of spontaneous conception. Besides this, history of pelvic inflammatory disease (PID), tubal damage, pelvic surgery and prior tubal surgery can increase its risk. Here we present a case of heterotopic pregnancy which was diagnosedafter ectopic gestation ruptured along with compromised intrauterine gestation and maternal condition. Earlier diagnosis before this life-threatening event could have saved the intrauterine fetus.Keywords: Extrauterine pregnancy; heterotopic pregnancy; ruptured ectopic.

scholarly journals Spontaneous Heterotopic Pregnancy: Dual Case Report and Review of Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Annika Chadee ◽  
Shadi Rezai ◽  
Catherine Kirby ◽  
Ekaterina Chadwick ◽  
Sri Gottimukkala ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Rare Complication ◽  
Heterotopic Pregnancy ◽  
Pelvic Surgery ◽  
Intrauterine Pregnancy ◽  
Fertility Treatments ◽  
Populations At Risk ◽  
History Of ◽  
High Index Of Suspicion

Introduction.Heterotopic pregnancy is a rare complication usually seen in populations at risk for ectopic pregnancy or those undergoing fertility treatments. It is a potentially dangerous condition occurring in only 1 in 30,000 spontaneous pregnancies. With the advent of Assisted Reproduction Techniques (ART) and ovulation induction, the overall incidence of heterotopic pregnancy has risen to approximately 1 in 3,900 pregnancies. Other risk factors include a history of pelvic inflammatory disease (PID), tubal damage, pelvic surgery, uterine Mullerian abnormalities, and prior tubal surgery. Heterotopic pregnancy is a potentially fatal condition, rarely occurring in natural conception cycles. Most commonly, heterotopic pregnancy is diagnosed at the time of rupture when surgical management is required.Case.This paper represents two cases of heterotopic pregnancies as well as a literature review.Conclusion.Heterotopic pregnancy should be suspected in patients with an adnexal mass, even in the absence of risk factors. Clinicians must be alert to the fact that confirming an intrauterine pregnancy clinically or by ultrasound does not exclude the coexistence of an ectopic pregnancy. A high index of suspicion in women is needed for early and timely diagnosis, and management with laparotomy or laparoscopy can result in a favorable and successful obstetrical outcome.

Smaller mandibular size in infants with a history of an apparent life-threatening event

2006 ◽  
Vol 149 (4) ◽  
pp. 499-504 ◽  
Author(s):  
Mary H. Horn ◽  
Daniel D. Kinnamon ◽  
Nalton Ferraro ◽  
Martha A.Q. Curley
Keyword(s):  
Life Threatening ◽  
History Of ◽  
Life Threatening Event

scholarly journals Syncope in Children and Adolescents

2017 ◽  
Vol 34 (3) ◽  
pp. 193-198
Author(s):  
Ljiljana Pejčić ◽  
Marija Ratković Janković ◽  
Radmila Mileusnić-Milenović ◽  
Karin Vasić ◽  
Ivana Nikolić
Keyword(s):  
Sudden Death ◽  
Cerebral Hypoperfusion ◽  
Small Subset ◽  
Loss Of Consciousness ◽  
Pediatric Age Group ◽  
Life Threatening ◽  
History Of ◽  
Transient Loss ◽  
Great Fear ◽  
Life Threatening Event

Summary In the pediatric age group, most cases of syncope represent benign, neutrally-mediated alterations in vasomotor tone. Due to the global cerebral hypoperfusion, syncope is defined as a transient loss of consciousness followed by spontaneous recovery and/or a state of presyncope, including dizziness, lightheadedness, pallor, diaphoresis and palpitations which may precede the loss of consciousness. These symptoms could be a sign of a life-threatening event in a small subset of patients, even though most causes of syncope in childhood are benign, and life-threatening causes of syncope generally have cardiac etiology. In all these cases, routine evaluation includes history, physical examination and a 12-lead standard electrocardiogram which should be performed. Further investigation is indicated by worrying features which include syncope that occurs without warning, syncope during exercise, history of familial sudden death, and abnormalities on clinical exam or electrocardiography. The fact is that syncope generates great fear of injury or sudden death among parents and doctors, and the main aim of the present paper is to help the physician involved in the care of children to differentiate the life-threatening causes of syncope from the common, more benign neutrally-mediated syncope.

scholarly journals Silent primary ovarian ectopic pregnancy following ovulation induction: diagnostic dilemma

2021 ◽  
Vol 10 (9) ◽  
pp. 3654
Author(s):  
Kalyani Saidhandapani ◽  
Yashaswi Pandey ◽  
Priya Shaunthini
Keyword(s):  
Ovulation Induction ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Ovarian Pregnancy ◽  
Threatening Condition ◽  
Reproductive Techniques ◽  
Life Threatening ◽  
History Of ◽  
High Index Of Suspicion ◽  
Urine Pregnancy Test

Early diagnosis of an ovarian pregnancy, of all the diagnoses relating to extrauterine gestations, is perhaps a diagnostic challenge faced by an obstetrician and a radiologist. About 0.5% of extrauterine implantations occur in the ovary. Recent studies have demonstrated infertility and Assisted reproductive techniques (ARTs), multiparity, use of intrauterine devices as risk factors for ovarian ectopic. Knowledge pertaining to ovulation induction and risk of ovarian ectopic is even more scant. In this article, we report a case report of ovarian pregnancy following ovulation induction with letrozole. Patient visited with history of missed menstrual period, mild abdominal pain and a weakly positive urine pregnancy test. Provisional diagnosis of right tubal ectopic was made. Diagnosis of ruptured ovarian ectopic was made on explorative laparoscopy which was later confirmed histopathologically. Patient had normal intra and post-operative course. An ovarian ectopic can present as a life-threatening condition and a high index of suspicion can prevent morbidity as well as mortality. Ovarian pregnancy in a primigravida with ovulation induction without an alarming sign, as in this case, is the rarest entity came across till date.

scholarly journals A case of heterotopic pregnancy after clomiphene-induced ovulation

2019 ◽  
Vol 7 ◽  
pp. 2050313X1987379 ◽  
Author(s):  
Hanoof Ali Alqahtani
Keyword(s):  
Case Report ◽  
Fallopian Tube ◽  
Rare Condition ◽  
Assisted Reproductive Techniques ◽  
Considerable Progress ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Induced Ovulation ◽  
Reproductive Techniques ◽  
History Of

Heterotopic pregnancy is a rare condition in which both intrauterine and extrauterine pregnancies occur simultaneously. It was reported to be very rare in normal conceived pregnancy. However, with the considerable progress of the assisted reproductive techniques, the incidence of heterotopic pregnancy increased. Furthermore, the incidence also increases in previous abortions. In this case report, we will present and discuss a patient who had heterotopic pregnancy after clomiphene-induced ovulation as well as a history of previous abortion where the extrauterine fallopian tube ruptured and was managed surgically while the intrauterine pregnancy was preserved.

scholarly journals Olanzapine induced DVT: A Case Report

2014 ◽  
Vol 3 (1) ◽  
pp. 41-42 ◽  
Author(s):  
N Joshi ◽  
PM Singh ◽  
M Thapa ◽  
S Gautam
Keyword(s):  
Atypical Antipsychotics ◽  
Familial History ◽  
Vein Thrombosis ◽  
Psychiatric Setting ◽  
Life Threatening ◽  
History Of ◽  
General Physical ◽  
Deep Vein ◽  
General Physical Health ◽  
Life Threatening Event

Deep Vein Thrombosis (DVT) is a serious life threatening event which might not be paid much attention in Psychiatric setting. In this paper, a case of DVT following the use of Olanzapine is presented. The patient was in good general physical health and had no personal or familial history of DVT. There were no known risk factors for DVT. The patient was not overweight (BMI < 25) but she suffered from DVT after initiating Olanzapine. Conclusion: Risk of DVT exists in patients under treatment with atypical antipsychotics in spite of no pre existing risk factor.DOI: http://dx.doi.org/10.3126/jpan.v3i1.11351 J Psychiatrists’ Association of Nepal Vol .3, No.1, 2014: 41-42

scholarly journals Evaluation of the Diagnostic Accuracy of the Interview and Physical Examination in the Diagnosis of Endometriosis as the Cause of Chronic Pelvic Pain

2021 ◽  
Vol 18 (12) ◽  
pp. 6606
Author(s):  
Jolanta Nawrocka-Rutkowska ◽  
Iwona Szydłowska ◽  
Aleksandra Rył ◽  
Sylwester Ciećwież ◽  
Magdalena Ptak ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Pelvic Pain ◽  
Predictive Value ◽  
Chronic Pelvic Pain ◽  
Reproductive Age ◽  
Pelvic Surgery ◽  
History Of Surgery ◽  
Previous Surgery ◽  
History Of

Background: Chronic pelvic pain affects approximately 15% of reproductive age women. It is mainly caused by adhesions (20–40%). Despite CPP being the main symptom of endometriosis, the disease is confirmed by laparoscopy only in 12–18% of cases. The aim of this study was to evaluate the results of laparoscopy in women with CCP and to assess the sensitivity and specificity of elements of an interview and clinical examination. Materials and methods: The study included 148 women with CPP. Each patient underwent laparoscopy. In laparoscopy, the presence of endometriosis and/or peritoneal adhesions was confirmed. Then, the sensitivity and specificity and the positive and negative predictive value of endometriosis symptoms or abnormalities in the gynecological examination were statistically calculated. Results: After previous surgery, adhesions were found in almost half (47%) of patients. In patients without a history of surgery, adhesions were diagnosed in 6.34% of patients. Endometriosis without coexisting adhesions was more often diagnosed in women without previous surgery (34.9%), compared to 10.58% in the group with a history of surgery (p < 0.05). Conclusions: Intraperitoneal adhesions are most common in women after pelvic surgery and with chronic ailments. The best results for sensitivity, specificity, positive predictive value, and negative predictive value in the diagnosis of endometriosis are found in women with irregular menstruations during which the pain increases. Laparoscopy still remains the primary diagnostic and therapeutic method for these women.

scholarly journals Catheter Ablation of Life-Threatening Ventricular Arrhythmias in Athletes

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 205
Author(s):  
Nicola Tarantino ◽  
Domenico G. Della Rocca ◽  
Nicole S. De Leon De La Cruz ◽  
Eric D. Manheimer ◽  
Michele Magnocavallo ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Ventricular Arrhythmias ◽  
Individual Factors ◽  
Substantial Part ◽  
Arrhythmogenic Substrate ◽  
Life Threatening ◽  
History Of ◽  
Anatomic Distribution ◽  
Artery Disease ◽  
Surveillance Analysis

A recent surveillance analysis indicates that cardiac arrest/death occurs in ≈1:50,000 professional or semi-professional athletes, and the most common cause is attributable to life-threatening ventricular arrhythmias (VAs). It is critically important to diagnose any inherited/acquired cardiac disease, including coronary artery disease, since it frequently represents the arrhythmogenic substrate in a substantial part of the athletes presenting with major VAs. New insights indicate that athletes develop a specific electro-anatomical remodeling, with peculiar anatomic distribution and VAs patterns. However, because of the scarcity of clinical data concerning the natural history of VAs in sports performers, there are no dedicated recommendations for VA ablation. The treatment remains at the mercy of several individual factors, including the type of VA, the athlete’s age, and the operator’s expertise. With the present review, we aimed to illustrate the prevalence, electrocardiographic (ECG) features, and imaging correlations of the most common VAs in athletes, focusing on etiology, outcomes, and sports eligibility after catheter ablation.

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