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Query: UMLS:C0030794 (pelvic pain)
 4,056 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study assesses socio-economic burdens of patients bearing complications arising from induced abortions in the hospitals of Cotonou, Benin, and outlying maternities. The 1-year prospective study took place in three centers. Patients included in the sample were stratified as: certain induced abortion (28.1%), probable induced abortion (19.5%), possible induced abortion (16.1%), spontaneous abortion (25.8%), and threatened abortion (8.7%). The higher number of cases were recruited among patients aged 20-34 years and were mostly married. The major reasons for hospitalization included hemorrhage and lumbar and pelvic pain. Genital hemorrhage was the most frequent complication encountered. Certain induced abortion was most often induced by the patient herself and was mainly due to the unwantedness of the pregnancy. Ignorance was the principal reason given for the non-use of contraception. Finally, the mortality rate was very high at 21/1000.
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PMID:Morbidity and mortality related to induced abortions (a study conducted in hospitals of Cotonou, Benin in 1993). 1215 2

To correlate the position and orientation of different models of MLCu IUDs in utero with incidence of side effects, 35 married, nonlactating, and sexually active women, 18-24 years of age and with regular menstrual periods were studied. All had been pregnant at least once and had had at least 3 menstrual periods after the last delivery or 2 periods after the last abortion. A physical and gynecological examination was performed. The women were divided into 4 groups: 30 women (3 groups of 10 patients) were fitted with standard MLCu 250, short MLCu 250, and MLCu 375 IUDs. The 4th group consisted of 5 women in whom MLCu 250 mini was inserted. Menstrual blood loss collected in cotton pads of constant weight provided by the investigator. The women were carefully instructed on how to collect their menstrual blood, and polyethylene bags were supplied to them. Menstrual blood loss was calculated. Follow-up visits were planned at monthly intervals, and questions about side effects were asked. In 30 women hysterography was done twice. Initially, it was performed following the 1st postinsertion menstruation. A 2nd hysterogram was performed following the 3rd postinsertion menstruation. The IUD was properly oriented in utero in 20 cases (67%). These were fitted with short MLCu 250 (8 cases), MLCu 375 (6 cases), Standard MLCu 250 (4 cases), and mini MLCu 250 (2 cases). The other 2 patients had small uterine cavities fitted with mini devices. Device displacement was noted in 10 cases among those fitted with MLCu 250, Standard (2 cases), MLCu 250 mini (3 cases), MLCu 375 (2 cases). Subjective increased menstrual blood loss was reported in 11 cases. There was no significant difference between pre- and postinsertion menstrual blood loss. Intermenstrual bleeding was reported in 3 cases, 1 fitted with a short MLCu 250 and 2 cases fitted with MLCu 375. Hysterographically the device was properly oriented in 2 cases with a large uterus. 5 cases had a moderate degree of dysmenorrhea, 1 case fitted with short MLCu 250, 3 cases with standard MLCu 250, and 1 case with MLCu 375. Hysterographically the device was displaced in utero in 2 cases, and most of the cases had a large size uterus. All these patients experienced no dysmenorrhea prior to IUD insertion. Moderate deep seated pelvic pain and low abdominal cramps were experienced in 3 cases, a case in each group of those fitted with different models of MLCu 250. Pain was not reported in patients fitted with MLCu 375.
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PMID:Hysterographic orientation of IUDs in relation to menstrual blood loss. 1226 65

Data are reported on the use of the Gyne-T Cu 380-A IUD in 200 women in Novi Sad, Yugoslavia, between 1981-84. 112 women were aged 25-29 years, 74 were 30-34, and 13 were 35-40. The mean age was 29.4 years. None of the women had ever had a spontaneous or illegal abortion, a premature birth, an ectopic pregnancy or a hydatidiform mole. The mean number of births was 1.92 and the mean number of legal abortions was 2.16. Each patient was followed for about 32 months, and 6400 woman months of use were observed. No problems occurred in insertion of the devices. Minor side effects were reported by 15% of the women, including 9 cases of mild pelvic pain during the 1st 7 days after insertion which disappeared without treatment, 14 cases of spotting lasting 4-5 days which also disappeared without treatment, and 7 cases of mild pelvic pain and spotting. Complications occurred in 3 cases: 1 IUD was expelled 24 hours after insertion, an intrauterine pregnancy of 6-7 weeks was diagnosed 3 months after insertion, and a patient who had also become pregnant while using an ML Cu 250 and later an inert Yugoslavian IUD called the Intragal became pregnant 11 months after insertion of the Gyne-T. Based on 6400 woman months of use, the Pearl index is .37. No other secondary effects or complications were observed, but clinical and laboratory research is continuing.
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PMID:[Our experience with Gyne-T Cu 380-A, an intrauterine contraceptive device (1983-1984)]. 1226

354 women seeking abortions were treated at a hospital in Paris between February-September 1988 with 600 mg of RU 486 taken orally in 1 dose and an injection of 500 mg sulprostone 48 hours later. The women all had amenorrhea of less than 49 days. 1/3 were 18-25 years old, 1/2 were 25-35, and 16% were over 35. 206 were nulliparas. 110 were married and the rest were separated, widowed, divorced, or single. Sulprostone was injected early in the morning in the hospital and the women were discharged after expulsion of the products of conception, which occurred usually 2 1/2 to 3 1/2 hours later. If expulsion did not occur, the woman returned in 3 days for a sonogram to confirm uterine vacuity. 13 of the 354 women had RU 486 only. 2 refused the sulprostone and underwent aspiration and 11 experienced spontaneous expulsions in the 48 hours following RU 486 administration. 338 of the women had spontaneous expulsions. 2 pregnancies were terminated but not expelled and aspiration was required. 285 of the women expelled in the hospital within 4 hours of sulprostone administration and the other 55 did so at home 6 or more hours later. RU 486 was very well tolerated. Secondary effects were more common with sulprostone but generally subsided within 3 hours. 70 patients required treatment for uterine pain after sulprostone administration. 150 complained of nausea but only 6 required treatment. 5 women required aspiration of curettage for hemorrhage but none required transfusion. In 3 cases the hemorrhages were due to histologically proven retention. 1 patient developed endometritis 3 days after expulsion and another, who had a history of extrauterine pregnancy, developed salpingitis 15 days after expulsion. Both patients were treated with antibiotics. The method appears to be safe and effective. Its major disadvantages are that it prolongs the amount of time required for abortion and it frequently causes pelvic pain. The responsibility of the patient is also increased.
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PMID:[Clinical trial of pregnancy terminations in 353 patients where amenorrhea was present for less than 49 days by 600 mg of RU 486 (administered orally) and 500 mg of sulprostone (Nalador) administered intramuscularly]. 1228 75

Intrauterine devices (IUDs) have been under much adverse media publicity and many product liability lawsuits have been filed since the mid-1970s, when reports of the association of the Dalkon Shield with septic abortion and pelvic inflammatory disease (PID) surfaced. Yet, worldwide, it is estimated that 70 million women are using IUDs (50 million in China). In Scandinavia they are the most popular form of contraception. An international meeting on the current status of IUDs in New York in 1992 concluded that the IUD is a safe and excellent method of contraception for many women. The newest devices, such as Copper TCu380A and the Multiload Cu375, are the most effective. The risk of PID compared with women using no contraception is elevated by a factor of 7.02 only within the first 20 days after IUD insertion. In Norway, where around 40% of women use IUDs, there has been no increase in subfertility rates compared with the US and UK. A large WHO multicenter study in 1989 found that IUD users were 50% less likely to experience ectopic pregnancy than women using no contraception (90% with Copper TCu 380A). The risk of spontaneous abortion is more than doubled and the risks of preterm delivery increased 10-13% with an IUD in situ; therefore, IUDs should be removed as soon as pregnancy is confirmed. If uterine perforation by the device is suspected, it should be located by ultrasound or x-ray and promptly removed. After contraceptive counselling, even experienced general practitioners can insert IUDs at any time during the menstrual cycle, after induced abortion, or complete spontaneous abortion. Heavy menstrual loss or dysmenorrhea are the most common reasons for removing IUDs. Partial or complete IUD expulsion by uterine contractions is most likely during the first 3 months after insertion. Infection should be suspected in any user who develops pelvic pain.
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PMID:IUDs: current perspectives. 1231 52

Retention of intrauterine fetal bones is a rare finding in patient suffering from abnormal uterine bleeding or secondary infertility. Detailed patient history, pelvic ultrasonography and hysteroscopy are diagnostic tools. Here, we describe a case of postmenopausal persistent uterine bleeding and pelvic pain caused by prolonged retention of fetal bones after a midtrimester abortion 17 years ago.
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PMID:An unusual case of postmenopausal vaginal bleeding: retention of fetal bone. 1255 28

Acute pelvic pain may be the manifestation of various gynecologic and non-gynecologic disorders from less alarming rupture of the follicular cyst to life threatening conditions such as rupture of ectopic pregnancy or perforation of inflamed appendix. In order to construct an algorithm for differential diagnosis we divide acute pelvic pain into gynecologic and non-gynecologic etiology, which is than subdivided into gastrointestinal and urinary causes. Appendicitis is the most common surgical emergency and should always be considered in differential diagnosis if appendix has not been removed. Apart of clinical examination and laboratory tests, an ultrasound examination is sensitive up to 90% and specific up to 95% if graded compression technique is used. Still it is user-depended and requires considerable experience in order to perform it reliably. Meckel's diverticulitis, acute terminal ileitis, mesenteric lymphadenitis and functional bowel disease are conditions that should be differentiated from other causes of low abdominal pain by clinical presentation, laboratory and imaging tests. Dilatation of renal pelvis and ureter are typical signs of obstructive uropathy and may be efficiently detected by ultrasound. Additional thinning of renal parenchyma suggests long-term obstructive uropathy. Ruptured ectopic pregnancy, salpingitis and hemorrhagic ovarian cysts are three most commonly diagnosed gynecologic conditions presenting as an acute abdomen. Degenerating leiomyomas and adnexal torsion occur less frequently. For better systematization, gynecologic causes of acute pelvic pain could be divided into conditions with negative pregnancy test and conditions with positive pregnancy test. Pelvic inflammatory disease may be ultrasonically presented with numerous signs such as thickening of the tubal wall, incomplete septa within the dilated tube, demonstration of hyperechoic mural nodules, free fluid in the "cul-de-sac" etc. Color Doppler ultrasound contributes to more accurate diagnosis of this entity since it enables differentiation between acute and chronic stages based on analysis of the vascular resistance. Hemorrhagic ovarian cysts may be presented by variety of ultrasound findings since intracystic echoes depend upon the quality and quantity of the blood clots. Color Doppler investigation demonstrates moderate to low vascular resistance typical of luteal flow. Leiomyomas undergoing degenerative changes are another cause of acute pelvic pain commonly present in patients of reproductive age. Color flow detects regularly separated vessels at the periphery of the leiomyoma, which exhibit moderate vascular resistance. Although the classic symptom of endometriosis is chronic pelvic pain, in some patients acute pelvic pain does occur. Most of these patients demonstrate an endometrioma or "chocolate" cyst containing diffuse carpet-like echoes. Sometimes, solid components may indicate even ovarian malignancy, but if color Doppler ultrasound is applied it is less likely to obtain false positive results. One should be aware that pericystic and/or hillar type of ovarian endometrioma vascularization facilitate correct recognition of this entity. Pelvic congestion syndrome is another condition that can cause an attack of acute pelvic pain. It is usually consequence of dilatation of venous plexuses, arteries or both systems. By switching color Doppler gynecologist can differentiate pelvic congestion syndrome from multilocular cysts, pelvic inflammatory disease or adenomyosis. Ovarian vein thrombosis is a potentially fatal disorder occurring most often in the early postpartal period. Hypercoagulability, infection and stasis are main etiologic factors, and transvaginal color Doppler ultrasound is an excellent diagnostic tool to diagnose it. Acute pelvic pain may occur even in normal intrauterine pregnancy. This may be explained by hormonal changes, rapid growth of the uterus and increased blood flow. Ultrasound is mandatory for distinguishing normal intrauterine pregnancy from threatened or spontaneous abortion, ectopic pregnancy and other complications that may occur in patients with positive pregnancy test. Incomplete abortion is visualized as thickened and irregular endometrial echo with certain amount of intracavitary fluid. If applied, color Doppler ultrasound reveals low vascular resistance signals in richly perfused intracavitary area. Transvaginal sonography has high sensitivity and specificity in visualization of uterine and adnexal signs of ectopic pregnancy. Color Doppler examination may aid in detection of the peritrophoblastic flow. Furthermore, it facilitates detection of ectopic living embryo, tubal ring or unspecific adnexal tumor. Corpus luteum cysts and leiomyomas are another cause of pelvic pain during pregnancy, which can be correctly diagnosed by ultrasound. Detection of uterine dehiscence and rupture in patients with history of prior surgical intervention on uterine wall relies exclusively on correct ultrasound diagnosis. In patients with placental abruption sonographer detects hypoechoic complex representing either retroplacental hematoma, subchorionic hematoma or subamniotic hemorrhage. In closing, ultrasound has already become important and easily available tool which can efficiently recognize patients with possibly threatening conditions of different origins.
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PMID:[Ultrasonography in acute pelvic pain]. 1276 97

While ectopic pregnancy is a common occurrence, especially in the nonwhite female patient population, heterotopic pregnancy has traditionally been regarded as a rare clinical event until recently, especially with the advent of assisted reproductive procedures. We reported two cases, one in which an intrauterine pregnancy was discovered after a diagnosis of tubal abortion, another in which a patient underwent laparotomy for a tubal ectopic pregnancy with a concomitant previously diagnosed intrauterine pregnancy. The first patient subsequently delivered at term, while the second was lost to follow-up. In both cases, there was a delay in detecting the ectopic pregnancy component. These cases suggest that the clinician maintain a reasonable index of suspicion while evaluating a patient presenting with pelvic pain in the face of a documented intrauterine pregnancy. They also demonstrate the need for prompt and immediate action at the first sign indicating ectopic pregnancy to avoid missing this potentially life-threatening condition.
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PMID:Heterotopic pregnancy in a large inner-city hospital: a report of two cases. 1504 May 18

In this retrospective analysis we studied 1489 women who underwent prenatal invasive diagnostic procedures between January 2000 and December 2002. We examine the influence of risk factors and the incidence of early complications following amniocentesis and chorion villus sampling, in particular the incidence of fetal loss. The study group included 438 women who underwent CVS and 1051 underwent amniocentesis. For each woman we studied anamnestic risk factors (recurrent pregnancy losses, fibroids, twin birth, uterine hematic loss), intraoperative risk factors (repetition of the insertion, transplacental sample, hematic liquid, early bleeding) and postoperative risk factors (pelvic pain, hematic losses, liquid losses, spastic pain, fever). In our data the miscarriage incidence was 1% for CVS and 1.7% for amniocentesis. Our results showed that in relation to CVS, the presence of fibroids gives an OR of miscarriage of 68 (95% C.I.=6.50-659.78; p=0.000). In relation to amniocentesis, the incidence of hematic losses gives an OR of miscarriage of 10 (95% C.I.=1.50-32.94; p=0.04). If these results were confirmed by other experiences, they could induce obstetricians to avoid CVS in these women with uterine fibroids and hence recommend amniocentesis to them. Particular attention has to be taken in those patients with vaginal bleeding following amniocentesis.
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PMID:Early complications of prenatal invasive diagnostics: perspective analysis. 1530 Dec 85

Initially described by Buchbinder and Lipkoff in 1929, esplenosis is the transplant of the splenic heterotopy weave in the abdominal cavity. It is observed after the splenic traumatic rupture and appendectomy. It occurs also during the embryonic development. The most frequent places where it takes place are: the intrathoraxic cavity, intraperitoneal, retroperitoneo, and brain. Although the presence of this ectopic splenic weave is symptomatic, this pathology can be evident by pain in the pelvis or it can be confused with other pathologies such as hemangiomas of intestine, and endometriosis including metastasis carcinoma. It is impossible to predict which patients will develop the splenosis after the splenic trauma. The time of rupture or damage of the splectonomy and the amount of blood in the peritoneal cavity are not related with the number of implants. The symptoms are the clue. When the splenosis is diagnosed incidentally in a symptomatic patient, the complete surgery removal is not indicated. However this surgery is recommended when the abdominal pain or the diagnosis is uncertain. In this paper a case with a secondary pelvic pain, probably due to a tubaric abortion, agreeing with secondary splenosis and a traumatic splenic rupture, is reported.
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PMID:[Splenosis and pelvic pain. A report of a case and literature review]. 1531 Jan 5


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