ABSTRACT
BACKGROUND: Ectopic pregnancy is the leading cause of first-trimester maternal death, accounting for 9% of pregnancy-related deaths. Interstitial (cornual) pregnancies represent 6% of all ectopics but account for a disproportionately higher mortality rate. Surgical management has been the treatment of choice for interstitial pregnancies. A very limited number of articles pre have explored the use of intravenous methotrexate to treat cornual pregnancy as a possible conservative first-line therapy in selected, hemodynamically stable patients. CASE: A patient with a confirmed interstitial pregnancy was treated with intravenous methotrexate. The patient's beta-hCG levels decreased to zero within 9 weeks. CONCLUSION: Intravenous methotrexate was used successfully in the treatment of an interstitial pregnancy without complications.
Subject(s)
Abortifacient Agents, Nonsteroidal/administration & dosage , Methotrexate/administration & dosage , Pregnancy, Ectopic/drug therapy , Abortifacient Agents, Nonsteroidal/adverse effects , Adult , Chorionic Gonadotropin, beta Subunit, Human/blood , Female , Folic Acid Antagonists/administration & dosage , Folic Acid Antagonists/adverse effects , Folic Acid Deficiency/chemically induced , Folic Acid Deficiency/prevention & control , Humans , Infusions, Intravenous , Methotrexate/adverse effects , Pregnancy , Pregnancy, Ectopic/blood , Time Factors , Treatment OutcomeABSTRACT
In 2001, the World Health Organization reported 4.3 million new human immunodeficiency virus (HIV) infections in adults globally, 41% of which were in women. During the year 2000, 27% of newly diagnosed HIV infections in the United States occurred in women. In developed countries, the perception of HIV infection has changed from an acute, lethal infection to a chronic illness; the introduction of highly active antiretroviral therapy has decreased morbidity and mortality, and new drug therapies have dramatically decreased perinatal transmission. In view of these advances, some HIV-infected individuals are considering reproduction. Following the lead of organizations in other developed countries, the American College of Obstetricians and Gynecologists has recently endorsed the use of reproductive technology in HIV-infected patients. Which patients should be offered assisted reproduction and what the optimal methods are of decreasing heterosexual and perinatal HIV transmission must be determined.
Subject(s)
HIV Infections/physiopathology , HIV-1 , Reproductive Techniques, Assisted , Female , HIV Seronegativity , HIV Seropositivity , Humans , Laboratories , Male , ObstetricsABSTRACT
The development of an acute parvovirus B-19 infection during pregnancy can cause pregnancy complications ranging from early pregnancy loss to nonimmune hydrops. There is no treatment, but preventive measures can be used to decrease perinatal mortality. The diagnosis is made on the basis of clinical suspicion and serology. If the fetus exhibits hydrops in the latter part of pregnancy, the main treatment options include either correcting the associated anemia with intrauterine blood transfusion or birth with extrauterine management. Although the serious problems associated with this virus during pregnancy are uncommon, they can be fatal. In view of this, a pregnant woman who is antibody negative should try to avoid contact with large groups of young children in order to decrease contact with potential vectors.
Subject(s)
Parvoviridae Infections/epidemiology , Parvoviridae Infections/transmission , Parvovirus B19, Human/isolation & purification , Pregnancy Complications, Infectious/epidemiology , Pregnancy Outcome , Adolescent , Adult , Age Distribution , Antiviral Agents/therapeutic use , Child , Child, Preschool , Female , Gestational Age , Humans , Incidence , Infectious Disease Transmission, Vertical/prevention & control , Parvoviridae Infections/diagnosis , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/drug therapy , Prenatal Care , Prognosis , Risk AssessmentABSTRACT
BACKGROUND: It is the purpose of this article to describe a suspected association of inadvertent vaccination with varicella vaccine during early pregnancy with the subsequent development of in utero miliary fetal tissue calcifications and fetal hydrops detected by sonogram at 15 weeks of gestation. CASE: This is a case presentation of a pregnant patient who received varicella vaccination during the same menstrual cycle that she became pregnant, and is supplemented by a literary review. The fetus developed miliary fetal tissue calcifications and fetal hydrops detected by a targeted sonogram at 15 weeks gestation. CONCLUSION: Varicella vaccination during early pregnancy may be a cause of miliary fetal tissue calcifications and fetal hydrops.
