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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Substantial numbers of women experience amenorrhea while using the injectable contraceptive depot medroxyprogesterone acetate (DMPA) and this represents a major cause of method discontinuation. In the present study, 100 DMPA acceptors from Bangkok, Thailand, with a history of at least 6 months of drug-induced amenorrhea were randomly assigned to switch their contraceptive method to Cyclofem (a combination of 25 mg of DMPA and 5 mg of estradiol cypionate) or continue with DMPA (150 mg). After 6 months, 82% of Cyclofem users compared with only 10% of DMPA users had experienced some vaginal bleeding. The median time to resumption of vaginal bleeding was 8 weeks in the Cyclofem group. Resumption time was related to the duration of DMPA use, the duration of DMPA-induced amenorrhea, and the user's body mass index. Although 94% of Cyclofem users compared with only 22% of DMPA users experienced minor side effects (breast tenderness, abdominal pain, dysmenorrhea) during the 6-month study period, 34% of these women elected to remain on Cyclofem at the end of the study. On the other hand, 90% of DMPA users opted to continue method use despite amenorrhea. The proven efficacy of Cyclofem justifies a trial in DMPA users concerned about their amenorrhea. This regimen can be expected to induce vaginal bleeding in more than 80% of users after 1-3 months of treatment.
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PMID:Effectiveness of Cyclofem in the treatment of depot medroxyprogesterone acetate induced amenorrhea. 955 47

Cornual ectopic pregnancy is a rare entity, found in 2-4% of all ectopic pregnancies, with an estimates incidence of one in every 2500 to 5000 deliveries. It represents a high rate of maternal mortality because of the growth and secondary rupture of the zone of implantation in advanced gestational ages, resulting in severe hemodynamic decompensation. We realizes a retrospective study from January 1989 to December 1994 at Instituto Nacional de Perinatologia. Only 6 cases of ectopic cornual pregnancies were found out of 35,080 deliveries reported, and of 149 ectopic pregnancies in general. Maternal age, gestational age at time of diagnosis, signs and symptoms, surgical treatment complications, and histopathologic report were some of the data collected. Maternal age in average was found to be 31.5, gestational age at time of diagnosis between 7.1 to 24 weeks. All patients referred diffuse abdominal pain and amenorrhea, with 2 cases of transvaginal bleeding. The 100% of cases required total abdominal hysterectomy as surgical treatment, and the most important complication found was shock, hence no maternal deaths were reported. We found this pathology to have an incidence of 1 of 5846 deliveries at our Institution, representing the 0.01% Of all ectopic pregnancies, we found to have an incidence of 4.02% that agrees with world literature.
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PMID:[Cornual pregnancy]. 958 94

The aim of this study was to elucidate the clinical presentation of ectopic pregnancy in the emergency department and highlight the atypical presentations and pitfalls in its diagnosis. This was a 4-year retrospective descriptive study carried out at a tertiary teaching hospital. Two hundred and seven cases of ectopic pregnancy treated in a tertiary teaching hospital were reviewed. Among the risk factors, 4.9% had a history of tubal ligation. Two patients developed ectopic pregnancy while breastfeeding. Of the patients, 43.7% did not have the triad symptoms of lower abdominal pain, vaginal bleeding and amenorrhoea. One patient presented with rectal bleeding while three patients presented with epigastric pain and central abdominal pain instead of lower abdominal pain. All who had tachycardia (10.4% of all cases) had ruptured ectopic pregnancy. Of the cases, 30% and 49% did not have abdominal pain and rebound tenderness respectively; 37.5% had negative cervical motion tenderness; 3.1% and 2.6% of cases had negative urine HCG and plasma beta HCG tests respectively. Ultrasound missed 1.6% of ectopic pregnancies. Missed pregnancy, normal ultrasound study and diagnosis of other gynaecological conditions were reasons for the delayed diagnosis of 5.8% of cases. There was one mortality. Any female in the reproductive age group with syncope, abdominal symptoms or any of the components of the classical triad must have ectopic pregnancy excluded. Patients with normal ultrasound studies should have their serum beta HCG levels and ultrasound scans repeated until the condition can be completely excluded. Transabdominal or transvaginal ultrasound studies done within the emergency department would enable earlier diagnosis and management.
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PMID:Ectopic pregnancy--a diagnostic challenge in the emergency department. 1114 70

Successful pregnancy in a patient with congenital cervical atresia is a great challenge for assisted reproductive techniques and reproductive medicine. We report a case of successful pregnancy by transmyometrial and transtubal embryo transfer simultaneously after in-vitro fertilization (IVF) in a 33 year-old patient with congenital cervical atresia diagnosed at the age of 18 years. The patient had experienced cyclic abdominal pain and amenorrhoea since she was 13 years old. She had had two unsuccessful attempts to create a new uterovaginal canal in another hospital. At the age of 32 years, she was referred to our unit and had a successful pregnancy after transmyometrial and transtubal embryo transfer. Caesarean section was performed at 36 weeks gestation due to progressive pre-eclampsia and gestational diabetes. A healthy male baby weighing 2812 g was safely delivered. Uterovaginal canalization with amniotic membrane for the covering of the neo-endocervical wall was performed during Caesarean section. Normal menstrual outflow and symptomatic relief have continued for 5 months after the operation. To the best of our knowledge, this is the first reported case of successful pregnancy by transmyometrial and transtubal embryo transfer as well as uterovaginal canalization performed during Caesarean section in a patient with congenital cervical atresia.
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PMID:Successful pregnancy by transmyometrial and transtubal embryo transfer after IVF in a patient with congenital cervical atresia who underwent uterovaginal canalization during Caesarean section: case report. 1115 18

Ovarian hyperstimulation is a recognized complication of ovulation induction with gonadotrophins. The syndrome is becoming more common as the number of women undergoing in-vitro fertilization increases. It is rarely seen in conjunction with clomiphene citrate usage. This case report is of moderate to severe ovarian hyperstimulation in a patient who was treated with clomiphene citrate because of infertility secondary to anovulation. She presented with amenorrhoea for five weeks, lower abdominal pain and a positive urinary human chorionic gonadotrophin (hCG) test. Pelvic ultrasonography was suggestive of a possible ectopic pregnancy with a differential diagnosis of a ruptured ovarian cyst. Diagnostic laparoscopy was done followed by laparotomy. Oophorectomy was performed because the ovary was thought to be complex with solid areas. However, conservative management with avoidance of laparotomy is the recommendation in confirmed cases of ovarian hyperstimulation but this requires a high level of suspicion in patients who have ovulation induction.
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PMID:Ovarian hyperstimulation syndrome associated with clomiphene citrate. 1176 32

A 28 year-old woman presented right upper abdominal pain. She had been pointed out her masculinization and amenorrhea. CT scan and magnetic resonance imaging showed right adrenal tumor. In the endocrinological study, the serum cortisol and testosterone was elevated. Transabdominal right adrenalectomy and nephrectomy was carried out and histopathological diagnosis was adrenocortical carcinoma. The masculine symptom had disappeared after the operation and she has been without recurrence for five years.
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PMID:[A case of adrenocortical carcinoma with masculinization, obtaining long prognosis with surgical treatment alone]. 1196 9

The sequential method of contraception with megestrol acetate with ethinyl estradiol was offered to 61 women for 549 cycles in this study. No pregnancies occurred. Flow was less in 7 women and greater in 3; duration of flow was longer in 5 women and shorter in 3. There were 2 instances of breakthrough bleeding. Persistant postnatal amenorrhea occurred in 1 woman and menorrhagia in another. Random endometrial biopsies showed proliferative activity in the majority of cases. Side effects observed were: nausea, vomiting, giddiness, leucorrhea, headache, weakness and abdominal pain. Most of these symptoms occurred in the first 2 cycles. 29 women dropped out after the first year, and 8 of these women conceived. Ethinyl estradiol was used in .1mg dose, megestrol acetate in 1 mg.
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PMID:Evaluation of sequential method of contraception with megestrol acetate and ethinyl oestradiol. 1215 52

185 women received chlormadinone acetate (a 19-hydroxyprogesterone derivative) .5 mg daily, for 18 months. All (aged 20-40 years) were parous. 180 women were followed through 2280 cycles. Dropout rate was highest in the first cycle (44%), 4% from the sixth to the twelfth cycles, and about 1% after the thirteenth cycle. Side effects were 2%: breakthrough bleeding, amenorrhea, menorrhea, dysmenorrhea, abdominal pain pregnancy, nausea, weakness forgetfulness, giddiness and headache, burning sensation, red spots on skin, and thrombophlebitis. Breakthrough bleeding (14 cases), amenorrhea (12 cases) and weakness (8 cases) were the most frequently reported problems. Phlebitis was seen in 1 case. 40 of the 48 cases of side effects were seen before the sixth cycle. There were 3 pregnancies during the study: 1 woman was pregnant at the beginning of therapy and 2 were due to patient failure. A review of the literature followed, including a discussion on the mode of action of chlormadinone.
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PMID:Chlormadinone acetate as an oral contraceptive. 1225 95

The Indian Contraceptive Testing Unit started making field trials with oral contraceptives in 1964. By June 1968, 958 women were taking oral contraceptives. Combination tablets used contained a minimum amount of progestogen (.5-3 mg) and a suitable amount of estrogen. The 21-tablet pack was found mot suitable. It was found that if a woman missed taking the tablets in the latter half of the cycle usually no harm resulted, but if she missed them at the beginning of the cycle pregnancy might follow as ovulation would not be inhibited. Main contraindications are liver damage, toxic hyperthyroidism, thromboembolic disease, and cancer of the genital tract or breast. Caution is advised for persons with chronic nephritis, a history of eclampsia, hypertension, varicose veins, ophthalmological disorders, or psychic depressive states. Side effects have been less with the smaller doses. The most serious side effect is thromboembolism. Those reported have been leg pain, giddiness, headache, breakthrough bleeding, nausea, vomiting, amenorrhea, abdominal pain, weakness, increased blood pressure, and skin rashes. Others have reported ocular disease and cranial nerve palsy. Sequential therapy has been reported to have a lower incidence of side effects but a higher rate of pregnancy. Low-dose progestogen therapy, the "minipill," does not inhibit ovulation but is effective by causing changes in the endometrium and in the mucus. The chlormadinone in the minipill does not affect lactation. However, the incidence of pregnancy is similar to that with an IUD (Lippes loop) which is 2.6/100 cases. Laboratory tests have been normal, except an increase in the thymol turbidity test. Vaginal cytology has revealed no case of malignancy. Results show that oral contraceptives are suitable for use on a mass scale as a method of population control.
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PMID:Experience with oral contraceptives. 1225 72

A study of intramuscular injections of depo medroxyprogesterone acetate (Depo Provera) as a postpartum contraceptive was undertaken in an attempt to determine the following: 1) the continuation rates for this contraceptive method in a postpartum family planning program; 2) to compare the continuation rates of Depo Provera given as a postpartum contraceptive with other postpartum contraceptive methods, as reported elsewhere; 3) the use-effectiveness of Depo Provera as a postpartum contraceptive method; 4) the side effects of postpartum injections; and 5) the reasons for discontinuation of this method. Between April 1969 and May 31, 1972 there were a total of 325 acceptors at the Family Planning Department of McCormick Hospital in Chiang Mai, Thailand. 217 of the women were acceptors of 3-month injections and 108 women were acceptors of 6-month injections. Of all acceptors, 94.2% received their 1st injection within 5 days of delivery. Cases continuing beyond 12 months were too few in number for significant statistical analysis. There were no known method failure pregnancies. Of the 325 postpartum acceptors of the 3-month and 6-month Depo Provera injections, 152 had discontinued the method by May 31, 1972. Of these, 47 were lost to follow up. The reasons for the discontinuation of the 105 remaining cases were bleeding problems (amenorrhea, prolonged, frequent or heavy bleeding, and irregular periods), other medical reasons (palpitation and dizziness, abdominal pain, pain at injection site, and melasma), and personal reasons.
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PMID:Use of a long-acting injectable contraceptive in a postpartum family planning program. 1226 37


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