Subject(s)
Blood Glucose/metabolism , Diabetes, Gestational/diagnosis , Glucose Tolerance Test/methods , Glycated Hemoglobin/metabolism , Prenatal Diagnosis/methods , Bayes Theorem , COVID-19 , Diabetes, Gestational/metabolism , False Negative Reactions , Fasting/metabolism , Female , Humans , Missed Diagnosis/statistics & numerical data , Pandemics , Pregnancy , Pregnancy Trimester, Second , SARS-CoV-2 , United KingdomABSTRACT
BACKGROUND: Removal and changing an intra-uterine device (IUD) involves good history taking, a proper examination and appropriate experience in fitting IUDs. CASE: We present a case of a woman who had two insertions of the levonorgestrel intrauterine system (LNG-IUS) which was diagnosed only at hysteroscopy when she presented with the spontaneous expulsion of a vertical stem of one of the devices. CONCLUSION: This is a unique case where two LNG-IUS were inserted in error and hence it teaches the clinicians the importance of good training and being aware of the possibility of the missing thread which deserves further investigations especially when such cases are encountered in a busy general practice.
Subject(s)
Intrauterine Device Expulsion/etiology , Intrauterine Devices, Medicated , Levonorgestrel , Adult , Equipment Failure , Female , Humans , HysteroscopySubject(s)
Home Childbirth , Trial of Labor , Vaginal Birth after Cesarean , Adult , Female , Humans , PregnancySubject(s)
Abortifacient Agents, Nonsteroidal/administration & dosage , Labor, Induced/methods , Misoprostol/administration & dosage , Self Medication , Uterine Contraction/drug effects , Administration, Intravaginal , Adult , Female , Hospitalization , Humans , Nonprescription Drugs , Pregnancy , TabletsABSTRACT
BACKGROUND: Management of pregnancy in a woman who has had a ruptured uterus on more than one occasion presents a great clinical and ethical challenge to the obstetrician. CASE: This appears to be the first report on complete uterine ruptures in three consecutive pregnancies. CONCLUSION: Prolonged hospital admission, intensive antenatal surveillance, antenatal steroid administration and elective premature delivery may give the best chance for a good outcome in these pregnancies. However, despite all these efforts, there is still a high risk of an unfavorable outcome.
Subject(s)
Uterine Rupture/physiopathology , Uterine Rupture/therapy , Adult , Female , Gestational Age , Humans , Infant, Newborn , Pregnancy , Pregnancy OutcomeSubject(s)
Brain Diseases, Metabolic, Inborn/diagnosis , Fetal Hypoxia/etiology , Hypoxia-Ischemia, Brain/diagnosis , Adult , Diagnosis, Differential , Fatal Outcome , Female , Humans , Hypoxia-Ischemia, Brain/blood , Hypoxia-Ischemia, Brain/cerebrospinal fluid , Infant, Newborn , Lactic Acid/blood , Lactic Acid/cerebrospinal fluid , Male , PregnancyABSTRACT
This study addresses the likelihood of false negative urine pregnancy test results, due to physiological urine dilution as described in some anecdotal reports. In this prospective study 320 pregnancy tests were performed on urine samples of varying concentrations obtained from 40 women, with suspected complications of early pregnancy, who had presented for ultrasound scans. Four different pregnancy tests were used and serum betahCG levels were measured quantitatively. Despite a mean fivefold increase in urine dilution, the pregnancy tests with low betahCG detection limits maintained maximal sensitivity. The detection of betahCG in dilute urine was adversely affected by using pregnancy tests with higher betahCG detection limits and these tests should be used with caution when assessing gynaecological emergencies.
