Uterine perforation as a rare complication of attempted pregnancy termination with misoprostol - A case report

BACKGROUND: Abortion induced by drugs is now a viable alternative to surgically induced abortion, but it can cause severe complications. CASE: Products of conception were found in the peritoneal cavity after administration of misoprostol. CONCLUSION: The administration of misoprostol for pregnancy termination should be performed carefully in women with uterine wall defects

Ruptured heterotopic interstitial pregnancy: rare case of acute abdomen in a Jehovah's Witness patient

Objective: To report a case of ruptured right heterotopic interstitial pregnancy diagnosed and managed laparoscopically by cornual resection. Design: Case report. Setting: University tertiary care hospital. Patient(s): A 29-year-old female Jehovah's Witness patient with first-trimester acute right lower quadrant abdominal pain. Intervention(s): Emergency laparoscopy was performed, and the site of bleeding was first clamped with a laparoscopic grasper. The lateral tissue was then coagulated and simultaneously transected with the bipolar-cutting probe for control of hemorrhage. Main Outcome Measure(s): The early diagnosis of heterotopic interstitial pregnancy should enable a conservative approach, whether medical or surgical, to be undertaken when treating this rare and potentially fatal condition. Result(s): The treatment of a ruptured heterotopic interstitial pregnancy by laparoscopy was successful with cornual resection. Conclusion(s): Management of a ruptured interstitial pregnancy by laparoscopy was successful with cornual resection and minimal blood loss, and a coexiting intrauterine pregnancy continued satisfactorily. (Fertil Steril (R) 2008; 90: 1200.e15-e17. (C) 2008 by American Society for Reproductive Medicine.

Recombinant human erythropoietin in a triplet pregnancy - A case report

BACKGROUND: Women carrying triplets are at greater risk for both anemia, due to the increased demands of the developing fetuses, and peripartum hemorrhage. Jehovah's witnesses are a unique obstetric population since women of this faith refuse blood transfusion. CASE: A Jehovah's Witness with a triplet pregnancy was successfully administered recombinant human erythropoietin (rHuEpo), 200 IU/kg 3 times per week subcutaneously, in order to correct her peripartum anemia. No side effects Were observed during rHuEpo therapy, and the patient delivered healthy triplets. CONCLUSION: rHuEpo can be safely administered, With a beneficial effect in pregnancy, and seems to be an effective option in preventing transfusions as demonstrated in this case in a Jehovah's Witness

Blind on table internal iliac artery embolization in severe post partum hemorrhage: a case report

A case of a woman that had been transferred to our hospital in hemorrhagic shock secondary to post partum hemorrhage due to uterine atony, automatic abortion and extended vaginal lacerations has been described. Subtotal hysterectomy had already been performed but failed to control bleeding. The authors performed on table blind embolisation of internal iliac arteries in order to control hemorrhage as a life-saving procedure that was successful

The value of a single combined measurement of VEGF, glycodelin, progesterone, PAPP-A, HPL and LIF for differentiating between ectopic and abnormal intrauterine pregnancy

BACKGROUND: To evaluate whether serum concentrations of the non-placental markers vascular endothelial growth factor (VEGF), glycodelin (GLY) and progesterone (P) and the novel placental markers pregnancy-associated plasmaprotein A (PAPP-A), human placental lactogen (HPL) and leukaemia inhibiting factor (LIF) differ in ectopic pregnancy (EP) when compared with abnormal intrauterine pregnancy (aIUP). METHODS: A prospective clinical study was conducted at the University Hospital of Larissa, Greece. The study included 50 patients admitted with failed pregnancy and suspected ectopic pregnancy that were treated with curettage or laparoscopy and classified as histologically confirmed EPs (n = 27) or histologically confirmed aIUPs (n = 21) (mean gestational age of 7.15 and 7.3 weeks, respectively). Two suspected EPs proved to be normal IUPs and were excluded. VEGF, GLY, P, beta-HCG, PAPP-A, HPL and LIF were measured by enxyme-linked immunosorbent assay (ELISA) methods in a single pre-operative blood sample. RESULTS: The median VEGF concentration was 227.2 pg/ml in the EP group versus 107.2 pg/ml in the aIUP group (P < 0.001), with a suggested threshold value of 174 pg/ml for their differential diagnosis. LIF, P, PAPP-A, HPL and GLY serum measurements did not differ significantly between EP and aIUP. CONCLUSION: VEGF serum levels might be a useful marker in differentiating between EPs and aIUPs