Development Of Ectopic Pregnancy Research Articles

TREATMENT EXPERIENCE OF ECTOPIC PREGNANCY

The article presents the results of treatment of ectopic tubal pregnancy. Multiparous with episodes of artificial, involuntary termination of previous pregnancies, ectopic pregnancy in the previous history, inflammatory diseases of the upper portion of the reproductive tract, infertility, diagnostic- therapeutic invasions into the uterine cavity because of benign tumors or underlying processes in the endometrium, relapsing infections of the lower portion of the reproductive tract, and experienced laparotomy/laparoscopy because of surgical pathology are found to be in a high risk group concerning development of ectopic pregnancy. The majority of them (76,5 %) had a lack of pre-gravid training. Expectant tactics of patient management took place in 14,7 % of observations. The majority of cases of ectopic pregnancy (67,7 %) resulted in surgery. Practically in a half of them (43,5 %) organ- preserving surgery of the fallopian tube were performed. According to our studies, effective conservative treatment of ectopic pregnancy with Methotrexate was 50 %. Positive experience with Methotrexate administration was obtained with interpretation of certain symptoms occurring after its use in patients being under our observation.

Abnormally increased DNA methylation in chorionic tissue might play an important role in development of ectopic pregnancy

BackgroundHuman Ectopic Pregnancy (hEP) is the second most common cause of pregnancy-related deaths in the first trimester. Without timely detection, EPs can lead to an increased rate of infertility and an elevated risk for future tubal EPs. In addition, most studies in the field focus on the effect of the fallopian tube (maternal factors) and ignore epigenetic changes in genes and proteins of the embryo, which may also cause EPs. Therefore, the present study hypothesized that embryos also play an important role in the development of EP. The study also speculated that DNA methylation is associated with ectopic pregnancy. Consequently, the effects of DNA methylation on the occurrence and development of ectopic pregnancy were investigated. Moreover, genome-wide DNA methylation of chorionic tissue from ectopic and intrauterine pregnancies was detected using Illumina HumanMethylation450 arrays.ResultsForty-three hypermethylated genes involved in the regulation of adhesion as well as gene transcription and translation were identified. Furthermore, the PPI network showed that AMOTL1, SDR42E1, CAMTA1, PIP5K1C, KIAA1614, TSTD1 and DNER may play important roles in the occurrence and development of ectopic pregnancy. In addition, SDR42E1, CAMTA1 and TSTD1 displayed higher levels of methylation in ectopic pregnancy while PIP5K1C and DNER showed low degrees of methylation.ConclusionsThe study reveals that abnormal increase in methylation may be an early indicator or an inducer of ectopic pregnancy. In addition, AMOTL1, SDR42E1, CAMTA1, PIP5K1C, KIAA1614, TSTD1 and DNER might play important roles in the occurrence and development of ectopic pregnancy. However, the specific molecular mechanisms are still unclear and require further studies.

Conservative therapy of interstitial pregnancy in deep infiltrative endometriosis

This article summarizes data on the prevalence, risk factors and the role of external genital endometriosis in the development of ectopic pregnancy. The existing algorithms for the use of conservative therapy of ectopic pregnancy of rare localizations are discussed. The authors presented a clinical case of using methotrexate in the treatment of a patient with infiltrative endometriosis and trophoblast persistence after laparoscopic removal of interstitial tubal pregnancy.

Deviations of endometrial immune cells during pregnancy in the cow

Deviations of endometrial immune cells during pregnancy in the cow

Role of activins in embryo implantation and diagnosis of ectopic pregnancy: a review.

Embryo implantation is a major prerequisite for the successful establishment of pregnancy. Ectopic implantation outside the intrauterine cavity and the development of ectopic pregnancy (EP) is a major cause of maternal morbidity and occasionally mortality during the first trimester. EP may be induced by failure of tubal transport and/or increased tubal receptivity. Activins, their type II receptors and follistatin have been localised in the human endometrial and tubal epithelium and they are major regulators of endometrial and tubal physiology during the menstrual cycle. Pathological expression of activins and their binding protein, follistatin, was observed in tissue and serum samples collected from EP. Several studies with different designs investigated the diagnostic value of a single measurement of serum activin-A in the differentiation between normal intrauterine and failing early pregnancy and the results are controversial. Nevertheless, the diagnostic value of activins in EP, including the other activin isoforms (activin-B and –AB) and follistatin, merits further research. This review appraises the data to date researching the role of activins in the establishment of normal pregnancy and, pathogenesis and diagnosis of tubal EP.

Analysis of ectopic pregnancy data using marginal and conditional models.

This work is motivated by a longitudinal study of women and their ectopic pregnancy outcomes in Lund, Sweden. In this article, we review and apply the Liang-Zeger methodology to the Lund ectopic pregnancy data set. We further analyse the ectopic pregnancy data using conditional modelling approaches suggested by Rosner and Bonney. From the Lund ectopic pregnancy data, we learned that PID is the strongest predictor of subsequent development of ectopic pregnancy and that there is a monotone relationship between PID severity and ectopic pregnancy. We also learned that the presence of mycoplasma from lower or upper genital tract sites at index laparoscopy is also a strong predictor of ectopic pregnancy. Other correlates of ectopic pregnancy include age at pregnancy and history of gynaecologic surgery.

Increased risk of ectopic pregnancy with maternal cigarette smoking.

As part of a case-control study of ectopic pregnancy, we evaluated the potential etiologic role of cigarette smoking. Maternal cigarette smoking at the time of conception was associated with an increased risk of ectopic pregnancy with a dose-response relationship (adjusted odds ratios: 1.30 to 2.49). On the other hand, partner's smoking was not associated with ectopic pregnancy. The study provides a supplementary argument towards a causal effect of smoking in the development of ectopic pregnancy.

The relationship of smoking and ectopic pregnancy.

A case-control study, using data abstracted between 1983 and 1987 from a large perinatal registry, was conducted to explore the relationship between smoking and ectopic pregnancy. Women with ectopic pregnancy (n = 634) seen at University of Illinois Perinatal Network Hospitals were compared to women who were delivered of a single live-born infant (n = 4287). Adjusted for age and race, women who reported smoking during pregnancy had a greater than twofold risk of ectopic pregnancy (Odds Ratio = 2.5, 95% confidence interval = 1.9, 3.2) compared to women who never smoked. The estimated relative risk rose from 1.4 (95% CI = 0.8, 2.5) for a woman smoking fewer than 10 cigarettes a day to 5.0 (95% CI = 2.9, 8.7) at one and a half or more packs of cigarettes per day (p-value for trend less than 0.001). Although further basic and epidemiologic research is necessary, the observed dose-response relation strengthens the argument that smoking may be a causal factor in the development of ectopic pregnancy.

Intramural ectopic pregnancy implanting in adenomyosis

The clinical course of this 33-year-old gravida presenting at 16 weeks' gestation with hemoperitoneum was typical for suspected uterine rupture. Pathologic examination of the hysterectomy specimen supports the diagnosis of intramural pregnancy, representing the 15th case reported to date in the literature. Furthermore, there was histologic evidence of adenomyosis both within the sinus tract leading to the implantation site and throughout the myometrium. Documentation of implantation and development of ectopic pregnancy in adenomyotic myometrium should alert the clinician to the possibility of this rare pregnancy complication.