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

A pregnancy-related disorder was identified by a rapid radioimmunoassay or serum chorionic gonadotropin in 151 out of 600 women (25%) with lower abdominal pain or bleeding, while a routine pregnancy test in urine was positive in only 7% of these cases. In 60 patients with ectopic pregnancy the rapid hCG-RIA was positive in 90% as compared with 10% for the routine pregnancy test. In patients with evidence of intrauterine pregnancy (80 cases) the rapid hCG-RIA was positive in 99% and routine pregnancy test in 39%. The clinical sensitivity of the hCG-RIA was 95%, specificity 96% and predictive value 88%. These figures should introduce a considerable improvement in the routine diagnosis of early intra- and extrauterine pregnancy-related disorders.
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PMID:[Improved diagnosis of pregnancy-associated gynaecological emergencies via rapid beta-HCG test (author's transl)]. 690 68

We report about the diagnostic reliability of a new commercially available human chorionic gonadotropin (hCG) test, a simple hemagglutination test (discriminatory value: 75 U/I), which can be easily performed in any laboratory (Neo-Pregnosticon). Urine samples of 457 patients with unexplained lower abdominal pain and/or abnormal bleeding were analysed. The diagnostic sensitivity and specificity of the test gave values of 0.993 and 1.0, respectively. The predictive value for positive results was 1.0, and for negative results 0.997. By means of this test, we could determine hCG in urine of 40 out of 41 patients with ectopic pregnancy, in contrast to the currently used urine test (Pregnosticon, discriminatory value: 1000 U/I) which was positive in only about 50% of the cases. Due to its accuracy, this simple test will probably replace in the future the more laborious radioimmunological methods for determination of hCG.
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PMID:[Ectopic pregnancy: diagnostic reliability of a new hCG-test (Neo-Pregnosticon)]. 692 58

Acute salpingitis is an important complication of sexually transmitted disease in young women and should be considered in the differential diagnosis of abdominal pain in all young women. Many organisms, in addition to N. gonorrhoeae, have been associated with this tubal infection giving support to polymicrobial etiology. However, the exact pathophysiologic role of these organisms needs to be clearly defined. The microbiology of acute salpingitis, through direct culture from the site of infection, the fallopian tubes, needs to be clearly elucidated. Early recognition and treatment of acute salpingitis is essential in preventing the major long-term problem, involuntary infertility. Curran has estimated the reproductive outcome for a cohort of adolescent women reaching reproductive age in 1970. By the year 2000, there will have been one episode of salpingitis for every two women; 15% will be hospitalized for salpingitis with over half of these women requiring major gynecologic surgery; 10% will be rendered nonsurgically sterile; and 3% will have experienced an ectopic pregnancy. Adolescent females may be more susceptible to upper genital tract infection than older women due to possible unique biologic characteristics and sexual behaviors. Prospective microbiologically controlled studies of women with salpingitis using laparoscopy need to be developed to evaluate treatment regimens. Until such studies are undertaken, diagnosis, treatment, and fertility in women with acute salpingitis will remain unsatisfactory.
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PMID:Acute salpingitis in the adolescent female. 703 72

From July 1, 1972, to June 30, 1979, 149 patients with ectopic pregnancy were treated at Truman Medical Center. The history and physical findings, diagnostic procedures, etiologic factors and patient management were reviewed. Abdominal pain (98.6%), amenorrhea (74.1%) and irregular vaginal bleeding (56.4%) were the most common presenting symptoms. Abdominal tenderness (97.3%) and adnexal tenderness (98%) were the most common physical findings. Culdocentesis was performed in 118 cases and was positive for nonclotting blood in 94.1%. In 115 cases (78.2%) the ectopic pregnancy was ruptured prior to the time of admission. The incidence of diagnostic error was 35.9%. There were no maternal deaths; however, the incidence of morbidity was 26.5%. Our data reemphasize the need for a high degree of suspicion and early utilization of definitive diagnostic procedures if the morbidity and mortality of ectopic pregnancy are to be reduced.
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PMID:Ectopic pregnancy: a review of 147 cases. 709 61

A case is described wherein a 27 year old woman with a breast lump and an IUD in situ for 12 months complained of a prolonged menstrual period which the physician suggested was caused by the IUD. A dilatation and curettage was performed to remove the IUD and the woman then experienced severe lower abdominal pain. A laparoscopy showed an ectopic pregnancy of 6 weeks in the left fallopian tube; salpingectomy was performed. The author suggests caution in diagnosing a patient with these symptoms for the following reasons: 1) women of childbearing age with lower abdominal pain and unusual menstrual bleeding, even if they have been sterilized, can have an ectopic pregnancy; 2) the absence of amenorrhea can be a trap in failing to disguise pregnancy; 3) ectopic pregnancy should be suspected in a patient with vaginal bleeding, an enlarged uterus, and an IUD, especially if there is pain; and 4) performing a dilatation and curettage does not necessarily mean that the problem has been dealt with.
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PMID:IUDs and IOUs. 711 16

A case of tubal pregnancy occurring 8 years after a modified Pomeroy's tubal sterilization is reported. The gross and microscopic findings of the resected tubes and the possible mode of recanalization are discussed. A 36 year old Thai woman, para 3-0-0-2, with her last para 8 years previously had puerperal tubal sterilization by modified Pomeroy's technique. The patient was seen at Ramathibodi Hospital on March 28, 1975 because of unimproved left lower abdominal pain for 1 week and a few days of vaginal spotting. She had been treated with antibiotics and analgesic previously. Her last normal menstrual period was in early March, 1975. Pelvic examination revealed pus-like, foul smelling vaginal discharge. Cervical excitation pain was positive. The uterine size was normal, deviated to the right side and slightly tender. A tender, ill-defined, soft cystic mass was palpable at the left adnexa extending to the left side of cul-de-sac. The right adnexa was normal. Exploratory laparotomy revealed that the left adnexal mass consisted of blood clots and a ruptured enlarged ampullar portion of the left tube. The left ovary was normal. At the isthmic portion of the left tube which had previously been resected, there was a constriction. The stumps of both cut ends of the right tube were well healed and widely separated. Left salpingo-oophorectomy was performed. The microscopic finding of the left ampulla was ectopic pregnancy. From serial sections of the constriction site of the left tube, there were multiple small lumina lined by low columnar epithelium surrounded by a thin layer of fibromuscular tissue.
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PMID:Ectopic pregnancy after tubal sterilization. Mechanism of recanalization. A case report. 720 May 7

A 25-year-old women presented with a 9-week amenorrhea, lower abdominal pain and a positive pregnancy test. Ultrasonography disclosed an intact pregnancy in the interstitial portion of the right Fallopian tube. Surgical and pathological findings confirmed the diagnosis. The value of ultrasonography in the diagnosis of ectopic pregnancy is emphasized.
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PMID:Ultrasound diagnosis of interstitial pregnancy. 728 9

We reviewed the records of 501 patients with ectopic pregnancy (EP) seen at the Kings County Hospital during a five-year period (January 1973-December 1977). Our population characteristics and anamnestic data correlated well with those reported in the literature, except for lower incidence of a previous pelvic infection. Abdominal pain, amenorrhea, and vaginal bleeding were the most common presenting symptoms. While the ultrasound studies demonstrated adnexal masses of a non-specific nature, the laparoscopy constituted an accurate diagnostic tool. Ruptured EP was found in 339 patients (67.6%). Salpingectomy only was the mode of treatment in 369 cases (73.6%). In 28.4% of the cases there a microscopic evidence of chronic inflammatory changes of the tube. There were two fatalities. This study appears to indicate an increasing incidence of EP in our institution, along with, and despite, a decreasing frequency of chronic pelvic inflammatory disease in these patients.
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PMID:Ectopic pregnancy. A retrospective study of 501 consecutive patients. 732 75

From July 1970 to July 1976, 212 confirmed cases of ectopic pregnancy were seen at Ben Taub General Hospital. Amenorrhea, abdominal pain, and vaginal bleeding were present in most patients, of which 24% demonstrated shock when first seen. The majority (94%) were admitted directly from the Emergency Center, the remainder had been seen initially in the outpatient clinic. The patients ranged in age from 14-42 years; the average age was 26.4. There were 44 primagravidas and 168 multigravidas. Previous pelvic inflammatory disease was found in 127 patients (59.9%). Of the 212 procedures, there were 102 salpingectomies and 80 salpingo-oophorectomies. Total hysterectomy was performed in 29 patients. The right tube was involved in 54.2% of the cases; the left tube was involved in 45.8%. The pregnancy was located in the ampullary portion of the tube in 110 patients (51.8%), the isthmic portion in 64 (30.2%), the cornual portion in 13 (6.1%). In 25 patients (11.8%) the exact site could not be determined. An incidental appendectomy was performed in 51 (24%) patients. Major postoperative complications occurred in 5.2% of patients. 138 patients were Black; 27 Mexican American; 46 Anglo; and, 1 Oriental. There was 1 maternal death in the series.
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PMID:Ectopic pregnancy: a review of 212 cases. 738 71

During 13 months from November 1, 1977, through November 30, 1978, 283 patients underwent radioimmunoassay (RIA) for determination of serum beta-subunit of human chorionic gonadotropin (beta-hCG) to rule out ectopic pregnancy. The records of 234 patients were available for statistical analysis and of these, 188 (80%) had negative results, defined as less than 1 ng/ml. The ectopic group comprised 22 patients, all of whom had elevated beta-hCG levels. There were no false-negative results in either group. Patients with suspected ectopic pregnancy had symptoms similar to patients previously reported in the literature with proved ectopic pregnancies. The most common presenting symptoms of those with suspected ectopic pregnancy were abdominal pain (91%), amenorrhea (76%), irregular bleeding (68%), and andexal mass (55%). Seventy-three patients presented with the classic triad of pain, uterine bleeding, and adnexal mass. Only 10 (14%) had ectopic pregnancies. Urine pregnancy tests were found to be of no benefit in diagnosing ectopic pregnancy and confused the clinicians in some instances. In patients with suspected ectopic pregnancy, a negative beta-hCG, by the RIA technique ruled out ectopic pregnancy in 100% of the cases.
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PMID:beta-hCG as a diagnostic aid for suspected ectopic pregnancy. 739 9


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