1/18. Heterotopic pregnancy with term delivery after rupture of a first-trimester tubal pregnancy. A case report.BACKGROUND: Because heterotopic pregnancy is rare, the presence of an intrauterine pregnancy tends to impede early diagnosis and definitive intervention for the ectopic component. Delay in diagnosing the condition and failure to proceed quickly with the requisite anesthesia and surgery can jeopardize both maternal well-being and survival of the intrauterine fetus. CASE: A patient with heterotopic pregnancy carried the intrauterine pregnancy to term following first-trimester rupture of the tubal pregnancy, with hypovolemic shock. CONCLUSION: Prompt diagnosis, rapid fluid and blood resuscitation, heart-sparing anesthesia and gentle, expeditious surgery collectively contributed to the favorable outcome for the mother and surviving infant.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/18. Hypovolaemic shock.Measured blood loss up to 1000 ml is well tolerated by healthy pregnant women. This is partly due to physiological increases in plasma volume and red cell mass during pregnancy. Nevertheless, hypovolaemic shock is a major cause of maternal mortality. Management requires teamwork, co-ordination, speed and adequate facilities to be life-saving. The first priority is rapid fluid replacement. Evidence from randomized trials has established that crystalloids are the fluids of choice over colloids and particularly albumen, which was associated with increased mortality. Rapid access to blood or blood products for transfusion is necessary, as well as laboratory back-up. Further management includes accurate assessment of the site of bleeding; control of the bleeding; diagnosis and management of the underlying condition; supportive therapy; and monitoring of the clinical, haematological and biochemical response to treatment. Bedside diagnostic ultrasound has several applications in the evaluation of obstetric hypovolaemic shock.- - - - - - - - - - ranking = 0.076923076923077keywords = pregnancy (Clic here for more details about this article) |
3/18. Primary splenic pregnancy. A case report.BACKGROUND: Ectopic pregnancy in the upper abdominal organs is very rare but has been known to occur in the liver, spleen and lesser sac. Primary splenic pregnancy is considered the rarest form of extrauterine pregnancy, with only few well-documented cases reported. CASE: Intraperitoneal bleeding and shock resulted from a primary splenic pregnancy in a 37-year-old woman. CONCLUSION: Primary splenic pregnancy usually presents with upper left abdominal pain and intraperitoneal bleeding. It requires an emergency splenectomy and should be considered in the differential diagnosis of acute abdomen in reproductive-age women.- - - - - - - - - - ranking = 0.69230769230769keywords = pregnancy (Clic here for more details about this article) |
4/18. Delivery related rupture of the gravid uterus: imaging findings.Rupture of the gravid uterus is a rare, life-threatening obstetric complication. Major symptoms are hypovolemic shock and abdominal pain during late pregnancy or after vaginal delivery. Immediate surgical therapy is required. We report a case of uterine rupture after vaginal delivery diagnosed by means of ultrasonography and computed tomography.- - - - - - - - - - ranking = 0.076923076923077keywords = pregnancy (Clic here for more details about this article) |
5/18. Postcoital haemoperitoneum: a cause for shock.Postcoital haemoperitoneum rarely occurs without evident vaginal injury. A 21-year-old second gravida woman presented to the ED in shock with a history of 8 weeks amenorrhoea and abdominal pain of 20 h duration. The ultrasound examination revealed a live intrauterine pregnancy and fluid in peritoneal cavity. There was a history of coitus 2 hours prior to the onset of pain. At laparotomy, more than 2 L of free blood was found in the peritoneal cavity. A small bleeding peritoneal vessel in pouch of Douglas was identified and ligated.- - - - - - - - - - ranking = 0.076923076923077keywords = pregnancy (Clic here for more details about this article) |
6/18. Circulatory collapse during laparoscopy.This case report details the intraoperative course of a patient, in her early pregnancy, who had a cardiac arrest during transvaginal insufflation of carbon dioxide (CO2) for laparoscopic tubal ligation. Modern monitoring methods and their ability to detect gas embolism and aid in the diagnosis and treatment of this rare but life-threatening complication are discussed.- - - - - - - - - - ranking = 0.076923076923077keywords = pregnancy (Clic here for more details about this article) |
7/18. ketamine induction and monoamine oxidase inhibitors.A 42-year-old woman taking tranylcypromine, a monoamine oxidase (MAO) inhibitor, was hypovolemic from a ruptured ectopic pregnancy and required an emergency laparotomy. Anesthetic induction with ketamine, an agent with sympathomimetic properties, was used because of her hypovolemia, despite theoretical concerns of precipitating an adrenergic crisis. The patient's hemodynamic course remained unchanged with induction and intubation, and with further fluid and blood administration, satisfactory hemodynamic conditions were obtained. This report is believed to be the first to describe the use of ketamine in a patient taking MAO inhibitors.- - - - - - - - - - ranking = 0.076923076923077keywords = pregnancy (Clic here for more details about this article) |
8/18. Spontaneous rupture of the spleen in late pregnancy.Two cases of spontaneous rupture of the spleen are described. The first patient presented with fetal distress in the second stage of labour; the second with hypovolaemic shock. Both mothers and babies survived.- - - - - - - - - - ranking = 0.30769230769231keywords = pregnancy (Clic here for more details about this article) |
9/18. Bilateral tubal pregnancy in the presence of an IUD: a case report.Bilateral tubal pregnancy was confirmed by histologic examination in a 32-year-old multipara with an intrauterine contraceptive device (IUD) in situ. The patient had developed intraperitoneal bleeding and hypovolemic shock. Bilateral salpingectomy was performed and was followed by a rapid recovery.- - - - - - - - - - ranking = 0.38461538461538keywords = pregnancy (Clic here for more details about this article) |
10/18. Rupture of cornual ectopic pregnancy after dilatation and curretage.A case of a cornual ectopic pregnancy missed at attempted pregnancy termination and with subsequent rupture is presented. The positive pregnancy test at the time of presentation to the emergency department was mistakenly thought to be due to continued detectable blood levels of human chorionic gonadotrophin from the aborted pregnancy. This caused a delay in surgical intervention and subsequent rupture of the ectopic pregnancy with hypovolemic shock.- - - - - - - - - - ranking = 0.69230769230769keywords = pregnancy (Clic here for more details about this article) |
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