Predictors of complete miscarriage after expectant management or misoprostol treatment of non-viable early pregnancy in women with vaginal bleeding

ConclusionsComplete miscarriage after expectant management is significantly more likely in embryonic miscarriage than in anembryonic miscarriage. Gestational age, crown-rump-length, and gestational sac diameter are independent predictors of success of expectant management. Predictors of treatment success may help counselling women with early miscarriage.
Source: Archives of Gynecology and Obstetrics - Category: OBGYN Source Type: research

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Discussion –— Cesarean scar ectopic pregnancy (CSEP) or Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy resulting from implantation of a blastocyst within myometrial scar tissue (old uterine scars) in the anterior lower uterine segment (LUS) at the site of prior Cesarean section.— It is considered amongst the rarest type of ectopic pregnancy, although some do not include it in the category of ectopic pregnancy as implantation occurs within the uterus itself.— Incidence is on rise due to increasing numbers of elective Cesarean sections as well as improved detection with tr...
Source: Sumer's Radiology Site - Category: Radiology Authors: Source Type: blogs
ConclusionWe report a case of CSP that, following an initial apparently “successful” treatment with methotrexate, required surgical management due to heavy bleeding.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
We present two cases of abdominal pregnancy, one primary and another secondary, both diagnosed and successfully managed in our institution. The first patient, a para 2 at 14 weeks gestation, presented with abdominal pain, distension, and dizziness, which had started four days prior. The initial radiological scan reported an intrauterine pregnancy with ascites, but a bedside ultrasound revealed an empty uterus and a viable pregnancy located in the Pouch of Douglas (POD). This was a secondary abdominal pregnancy managed successfully by laparotomy. The second patient, a para 3 + 4 miscarriages with seven weeks amenorrhea was ...
Source: Oman Medical Journal - Category: Middle East Health Tags: Oman Med J Source Type: research
Conclusion Hysteroscopic removal of RPOC is a feasible and safe management option of this complication of pregnancy. We strongly suggest avoiding performing blind procedures such as dilation and curettage and favor the adoption of this modality that allows the removal of retained products of conception under direct visualization.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
ConclusionsCSP with positive embryonic/fetal heart activity managed expectantly is associated with a high burden of maternal morbidity including severe hemorrhage, early uterine rupture, hysterectomy and severe AIP. Despite this, a significant proportion of pregnancies complicated by CSP may progress to, or close to, term, thus questioning whether termination of pregnancy should be the only therapeutic option offered to these women. Expectant management of CSP with no cardiac activity may be a reasonable option in view of the low likelihood of maternal complications requiring intervention, although close surveillance is ad...
Source: Ultrasound in Obstetrics and Gynecology - Category: Radiology Authors: Tags: Systematic Review Source Type: research
Authors: Torky HA, Marie H, ElDesouky E, Gebreel S, Raslan O, Moussa AA, Ahmad AM, Zain E, Mohsen MN Abstract Introduction: Misoprostol is used for the medical management of miscarriage as it is more effective in the early stages of pregnancy. Letrozole has an anti-estrogen effect and is used for the pretreatment of miscarriage with misoprostol. Aim: The aim of this study was compare the efficacy and safety of letrozole with placebo pretreatment in the medical management of first trimester missed miscarriage. Design: This was a prospective randomized case-control study. Patients and Methods: Four hundre...
Source: Geburtshilfe und Frauenheilkunde - Category: OBGYN Tags: Geburtshilfe Frauenheilkd Source Type: research
ABSTRACT ObjectiveTo compare vaginal misoprostol treatment with expectant management in early non‐viable pregnancy with vaginal bleeding with regard to complete evacuation of the uterine cavity within 10 days after randomization. MethodsThis was a parallel randomized controlled, open‐label trial conducted in Skåne University Hospital, Sweden. Patients with anembryonic pregnancy or early fetal demise (crown–rump length ≤ 33 mm) and vaginal bleeding were randomly allocated to either expectant management or treatment with a single dose of 800 μg misoprostol administered...
Source: Ultrasound in Obstetrics and Gynecology - Category: Radiology Authors: Tags: Randomized Controlled Trial Source Type: research
ABSTRACT ObjectivesTo compare vaginal misoprostol treatment with expectant management in early non‐viable pregnancies with vaginal bleeding with regard to complete evacuation of the uterine cavity within 10 days. MethodsParallel randomized controlled, open label, trial conducted in Skåne university hospital, Sweden. Patients with anembryonic pregnancy or early fetal demise (crown‐rump length
Source: Ultrasound in Obstetrics and Gynecology - Category: Radiology Authors: Tags: Randomized Controlled Trial Source Type: research
Abstract OBJECTIVES: To compare vaginal misoprostol treatment with expectant management in early non-viable pregnancies with vaginal bleeding with regard to complete evacuation of the uterine cavity within 10 days. METHODS: Parallel randomized controlled, open label, trial conducted in Skåne university hospital, Sweden. Patients with anembryonic pregnancy or early fetal demise (crown-rump length
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research
Conclusion Hysteroscopic removal of RPOC is a feasible and safe management option of this complication of pregnancy. We strongly suggest avoiding performing blind procedures such as dilation and curettage and favor the adoption of this modality that allows the removal of retained products of conception under direct visualization.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
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