ABSTRACT
A case of advanced ectopic pregnancy after in vitro fertilization complicated by an ovarian hyperstimulation syndrome is presented. Methotrexate was given in spite of high levels of hCG and appeared to be successful. Difficulties in the choice between surgical and conservative treatment are discussed.
Subject(s)
Methotrexate/therapeutic use , Ovarian Hyperstimulation Syndrome/etiology , Pregnancy, Ectopic/complications , Adult , Embryo Transfer , Fallopian Tubes/abnormalities , Fallopian Tubes/surgery , Female , Fertilization in Vitro , Humans , Infertility, Female/surgery , Menotropins/administration & dosage , Ovarian Hyperstimulation Syndrome/complications , Ovulation Induction , Pregnancy , Pregnancy, Ectopic/drug therapy , Tissue Adhesions/surgeryABSTRACT
The unicornuate uterus is associated with a poor reproductive outcome and many gynecological problems. We collected data from 45 women with a unicornuate uterus. We found a high abortion rate of 22% in the first trimester and 16% in the second trimester. Premature labor occurred in 18%. The prevalence of infertility and endometriosis in women with a unicornuate uterus was comparable to women without the anomaly.
Subject(s)
Abortion, Spontaneous/etiology , Obstetric Labor, Premature/etiology , Uterus/abnormalities , Adolescent , Adult , Endometriosis/etiology , Female , Humans , Infertility, Female/etiology , Infertility, Male , Male , Pregnancy , Urinary Tract/abnormalitiesSubject(s)
Fetal Diseases/diagnostic imaging , Kyphosis/diagnostic imaging , Lumbar Vertebrae/abnormalities , Ultrasonography, Prenatal , Adult , Ear, External/abnormalities , Female , Hip Dislocation, Congenital , Humans , Infant, Newborn , Kidney Pelvis/abnormalities , Kidney Pelvis/diagnostic imaging , Kyphosis/congenital , Lumbar Vertebrae/diagnostic imaging , Male , PregnancyABSTRACT
The diagnosis of appendicitis is frequently difficult. We studied prospectively the diagnostic accuracy and clinical impact of abdominal ultrasonography in 111 consecutive patients thought to have appendicitis. Ultrasonography was performed with small high-resolution, linear-array transducers, with the abdomen compressed to displace or compress bowel and fat. Among 52 patients later shown in surgery to have appendicitis, ultrasonography was unequivocally positive in 39 (sensitivity, 75 percent). Of 31 patients in whom appendicitis was definitely excluded, none had a positive ultrasound examination (specificity, 100 percent). The sensitivity in those with a perforated appendix (28.5 percent) was much lower than in those with acute nonperforating appendicitis (80.5 percent) or appendiceal mass (89 percent), but the low sensitivity did not influence clinical management, since the need for surgery in patients with a perforated appendix was clinically obvious. Ultrasonography resulted in changes in the proposed management in 29 of the 111 patients (26 percent). It also led to the correct diagnosis in the 16 patients who were found to have a disease other than appendicitis. We conclude that ultrasonography is a useful aid in the diagnosis of appendicitis.
