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

Beta-HCG in serum was analysed in 64 cases of ectopic tubal pregnancy who wree different groups; ruptured ectopic pregnancy, ectopic pregnancy accompanied by amenorrhea or adnexal mass and ectopic pregnancy without palpable adnexal mass and amenorrhea. The mean HCG levels for the three groups were 8 790 IU/l, 2 580 IU/l and 690 IU/l, respectively, which related more to the symptoms than to the estimated length of pregnancy. Eleven per cent of the women had an IUD and five per cent were taking low dose gestagens. Screening of cases with acute lower abdominal pain or irregular vaginal bleeding with beta-HCG in serum will facilitate an early diagnosis of ectopic pregnancy and be of special value in patients with less typical symptoms.
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PMID:Serum beta-human chorionic gonadotrophin levels in the early diagnosis of ectopic pregnancy. 48 13

Myometrial activity and endometrial blood flow were recorded in a patient with uterine haemorrhage and lower abdominal pain, who turned out to have a tubal pregnancy. The uterine contractions had an amplitude sometimes exceeding 400 mmHg and a duration up to 3.5 min. Thus, strong uterine contractions can appear during pregnancy without the presence of a gestational sac within the uterus. This is contrary to the assumption that processes in the foetal membranes initiate the sequence of events leading to abortion or labour.
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PMID:Myometrial activity and endometrial blood flow in an ectopic pregnancy. 72 82

A case of unilateral gonadoblastoma in association with a ruptured ectopic tubal pregnancy is presented. The patient had normal menstrual history prior to a missed period followed by abdominal pain and the passage of clots. The surgical specimens, in addition to the ruptured tubal pregnancy, showed nodular foci of typical gonadoblastoma in the right ovary, the remainder of the ovarian tissue being normal. The left ovary was subsequently removed and examination revealed normal constituents without evidence of tumor. Cytogenetic evaluation of peripheral leukocytes showed cells with a normal female sex chromatin complement, 46-XX, as well as cells with 45 chromosomes in which one of the X chromosomes was missing.
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PMID:Gonadoblastoma with tubal pregnancy. 94 10

In the two years - 1st January, 1973 to 31st December, 1974 - 533 patients had operation for tubal pregnancy at the Gynaecology Unit of the Korle-Bu Teaching Hospital. About five cases per week were seen during this period. The incidence was 44 for every thousand deliveries at the Hospital. The case notes of 404 of the 533 patients have been reviewed. The age range was 15 to 44 years; 78% were in the 21 to 35 years age group. 81.4% had had pregnancies which went beyond 28 weeks. Only 13.7% had never had an intrauterine pregnancy. Tubal pregnancy is therefore not a disease of the primarily infertile as is commonly thought. There was no significant difference between the incidence on the right side and the incidence on the left side. The ampulla was the commonest site of implantation in the tube (45%). Tubal rupture (89.6%) was commoner than tubal abortion (10.4%). The principal signs and symptoms were abdominal pain, amenorrhoea, abdominal tenderness, abdominal distension, and signs of free fluid in the abdomen, syncope, anomalous vaginal bleeding, pallor and vomiting. The absence of amenorrhoea does not rule out the possibility of an ectopic. On pelvic examination the major signs were tenderness in a fornix and cervical excitation pain. Abdominal paracentesis and culdocentesis if positive are useful in diagnosis; negative results prove nothing. Laparascopy is of great value and should be employed in the difficult case. Beware of the patient in the reproductive age with anomalous vaginal bleeding, vague abdominal pains, syncopic attacks and anaemia. The mortality rate in the series was 0.7%.
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PMID:Tubal pregnancy: a review of 404 cases. 123 87

Fifty-nine women with early unruptured tubal pregnancy were treated by a single local injection of methotrexate at laparoscopy. All 59 patients underwent the procedure without any adverse reaction, 47 (80%) of them needing no laparotomy. Twelve patients required a laparotomy for reasons such as rising beta-hCG levels and abdominal pain with or without rising levels of beta-hCG. Only one patient ruptured the tube. None of the women needed a blood transfusion. We found tubal patency in 19 out of 21 patients at follow up hysterosalpingography. Eleven pregnancies were subsequently reported, one of them tubal. The appearance of the injected tube was absolutely normal in three patients, one at cesarean section and two at repeated laparoscopy. No peritubal adhesions were observed. We suggest that this new technique is a safe and effective alternative to laparotomy in a patient with an early unruptured tubal pregnancy.
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PMID:Methotrexate local injection for unruptured tubal pregnancy: an alternative to laparotomy? 137 64

The diagnosis of tubal pregnancy, whether ruptured or unruptured, often requires a surgical procedure, such as laparoscopy or laparotomy, for confirmation. We compared women with ruptured and unruptured tubal pregnancies to determine whether the clinical presentations, morbidity and surgical complications in the two groups were significantly different. We compared the demographic characteristics, clinical presentations, laboratory findings, morbidity and complications from surgical management in the two groups. Women with ruptured tubal pregnancies had a higher incidence of abdominal pain lasting less than 24 hours, adnexal tenderness and positive culdocentesis from hemoperitoneum as compared to women with unruptured tubal gestations. Abnormal uterine bleeding was observed less frequently in women with ruptured tubal pregnancies as compared to women with unruptured ones despite similar gestational ages at presentation. All the patients with a tubal pregnancy were managed surgically. The morbidity and surgical complication rates in the two groups were not significantly different.
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PMID:Characteristics of indigent women with ruptured and unruptured tubal pregnancies. 143 93

In Ohio, a 33-year old woman who had never had an ectopic pregnancy presented at an emergency facility not physically attached to a hospital with abdominal pain over 24 hours which had become more intense during the preceding 4 hours. She did not have vaginal bleeding, diarrhea, vomiting, or pain while urinating. 2 weeks earlier she had a voluntary intrauterine abortion at 8 weeks' gestation. She had intercourse 1 week before coming to the emergency facility. She had widespread tenderness in her abdomen, especially in the lower areas. Blood cell studies suggested an infection. The attending physician presumed her to have pelvic inflammatory disease (PID) as a result of either sexual intercourse or the elective abortion. The physician called for a urinary beta human chorionic gonadotropin test to determine whether placental tissue remained in the uterus. It was positive. 60 minutes after admission, the supine patient's pain increased and her blood pressure dropped to 80/50 mm Hg from 100/60 mm Hg at admission. After administering Ringer's solution, the health team sat her up and she fainted. A repeat cell count indicated sepsis. Her blood pressure decreased to 60 by Doppler and the physician continued to give her fluids and began dopamine. After the team stabilized her, they transferred her to a hospital. Her private physician examined her and then began surgery. The physician found a tubal pregnancy and removed the affected tube and ovary. She recuperated completely. Combined intrauterine and extrauterine pregnancy occurs once in every 30,000 cases. Previous PID, use of ovulation inducing medication, and in vitro fertilization with embryo transfer increases the likelihood of this type of pregnancy occurring. Physicians should consider this possibility if a woman has any of these histories and a combination of abdominal pain, adnexal mass with pain and tenderness, peritoneal irritation, and an enlarged uterus.
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PMID:Ruptured ectopic pregnancy in a patient with a recent intrauterine abortion. 157 Sep 21

We report a case of woman who was admitted to the hospital for evaluation of abdominal pain, five years after a vaginal hysterectomy. Exploratory laparotomy was performed and tubal pregnancy found. A review of the literature reveals similar complications following supracervical and total or vaginal hysterectomy: it is a rare event and the common aspect of all cases is the inability to accurately diagnose before laparotomy.
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PMID:[Tubal pregnancy after vaginal hysterectomy]. 156 81

Fifteen patients with laparoscopically diagnosed tubal pregnancy and constant or rising plasma beta-hCG levels were treated with prostaglandin F2 alpha and prostaglandin E2. Prostaglandin F2 alpha (5 mgms diluted in 10 cc of isotonic sodium solution) was injected transabdominally with a 22 gauge spinal needle during laparoscopy into the Fallopian tube. Prostaglandin E2 (500 micrograms ms) was given intramuscularly during three consecutive postoperative days. The treatment was defined as successful if plasma beta-hCG levels declined below the lower limit of detection and no further intervention other than prostaglandin application was required. The treatment was successful in eight patients. Six patients underwent laparotomy and salpingotomy because of rising beta-hCG levels. None of the treated patients displayed any adverse reactions following prostaglandin F2 alpha application. One patient underwent explorative laparotomy during the second postoperative day because of lower abdominal pain. During operation, no pathological change could be found. This patient was excluded from the study. In the group treated successfully (n = 8) seven out of eight patients had beta-hCG levels below 2500 mlU/ml preoperatively. In the unsuccessfully treated group (n = 6), four out of six patients had beta-hCG levels above 2500 mlU/ml preoperatively. Mean duration of beta-hCG decline to 10 percent of the maximum preoperative value was 15.8 +/- 8.64 days (mean +/- S.D.). Postoperatively, hysterosalpingography was performed in six out of eight successfully treated patients after three menstrual cycles (one patient had an intrauterine pregnancy, one patient refused written consent). The Fallopian tubes were patent bilaterally in all six patients.
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PMID:[Laparoscopic treatment of tubal pregnancy with prostaglandins]. 169 71

In a prospective randomized study, 21 patients with an unruptured tubal pregnancy were treated with local and systemic injection. On the day of diagnosis, methotrexate (MTX) (1 mg/kg) or sulprostone (500 micrograms) were injected into the gestational sac under transvaginal sonographic control. The systemic component consisted of an intramuscular injection of MTX (1 mg/kg) 3, 5, and 7 days after local injection or of sulprostone (500 micrograms) on the 1st 2 postlocal injection days. Methotrexate therapy was successful in 8 of 12 patients and sulprostone therapy in 6 of 9. Laparoscopy was then performed on the 7 unsuccessful patients: 3 of them had pain and hemoperitoneum and 4 of them had rising human choriogonadotropin (hCG) levels. One stomatitis after MTX and one cramping abdominal pain were observed. Thirteen of 14 successfully treated patients had initial hCG levels less than 5,000 mIU/mL. At subsequent hysterosalpinography, 13 of 14 patients had normal tubal configuration and patency. Three of 10 patients who desired another pregnancy had already achieved a normal intrauterine pregnancy. These results suggest that MTX and sulprostone were equally effective, and medical approach for the unruptured ectopic pregnancy may be restricted to patients with hCG less than 5,000 mIU/mL.
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PMID:Conservative management of ectopic pregnancy: prospective randomized clinical trial of methotrexate versus prostaglandin sulprostone by combined transvaginal and systemic administration. 200 98


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