oxytocin and Pregnancy--Ectopic

Topics: Adult; Cesarean Section; Clinical Trials as Topic; Drug Evaluation; Female; Fetal Death; Humans; Oxytocin; Pregnancy; Pregnancy Trimester, Third; Pregnancy, Ectopic

Premature rupture of the membranes was diagnosed in a 27-year-old nullipara at 24 weeks' gestation. Medical induction of abortion (because of sepsis) was attempted and failed. The products of conception were removed surgically per vagina; that procedure was followed by an intractable hemorrhage. Subtotal hysterectomy and repair of the left common iliac artery and vein were performed to stop the bleeding. In retrospect the case was diagnosed as a left ligamentary ectopic pregnancy with uterine rupture and erosion of the left common iliac vessels.. A case report of a ligamentary ectopic pregnancy that failed to respond to prostaglandin E2 for induced abortion for sepsis at 24 weeks is presented. The 27-year-old nullipara had normal ultrasound findings for gestational age up to 21 weeks gestation. She had consulted at 5 weeks for abdominal pain and bleeding, at 14 weeks again for abdominal pain, shoulder pain and vaginal bleeding, although both times the pain and bleeding resolved spontaneously. She was seen again at 16 and 21 weeks gestation, when ultrasound scans were normal for dates. At 24 weeks, she experienced vaginal discharge of blood and tissue, and was managed as premature rupture of membranes. She became septic 12 days later. She was treated with transcervical PGE2 and iv oxytocin without response for 3 days. Surgical evacuation was successful, but bleeding persisted. During laparotomy she had a large left broad ligament hematoma, a left ruptured uterus, and open left internal iliac artery and vein. These were repaired, and she received 40 units of blood, 8 platelets and 14 of plasma. Only after histology was the diagnosis of ligamentary pregnancy made. The lack of response to PG for abortion should raise suspicion of ectopic pregnancy, although preoperative diagnosis of ligamentary pregnancy is extremely rare.

Topics: Abortion, Therapeutic; Adult; Female; Fetal Membranes, Premature Rupture; Humans; Oxytocin; Pregnancy; Pregnancy, Ectopic; Prostaglandins E

Ovarian tissues (n = 26) obtained at surgery were assayed for oxytocin (OT) concentrations in different parts of the ovary by a specific and sensitive RIA after homogenization and extraction with 0.4 M acetic acid. Chromatography of the extract on a Sephadex G-25 column revealed a single peak identical to synthetic OT, as measured by RIA. Corpora lutea of the menstrual cycle had 10.8-53.0 ng immunoreactive OT/g tissue (n = 7), while those of early pregnancy had a concentration of 106.0 ng/g (n = 1). Ovarian stromal tissue had either undetectable or lower concentrations of OT (0-21.0 ng/g; n = 5) than the corpus luteum from the same ovary. While a luteoma of term pregnancy (n = 1), a benign cystadenoma (n = 2), and an endometriotic cyst (n = 1) had no detectable immunoreactive OT, the concentrations of immunoreactive OT were 20.0 ng/g in a thecoma, 1.4, 20.0, and 60.0 ng/g in preovulatory follicles (n = 3), and 41.0 and 37.0 ng/g in polycystic ovaries (n = 2). In one patient with premature ovarian failure, the ovaries had 9.0 ng/g and undetectable immunoreactive OT. These findings indicate the presence of immunoreactive OT in human ovaries, with significant concentrations in the corpus luteum and preovulatory follicles. It is probable that these tissues produce OTs or an OT-like material which may function as an ovarian luteolytic agent.

Topics: Chorionic Gonadotropin; Corpus Luteum; Female; Humans; Menstruation; Ovarian Follicle; Ovarian Neoplasms; Ovary; Ovulation; Oxytocin; Polycystic Ovary Syndrome; Pregnancy; Pregnancy, Ectopic; Thecoma; Tissue Distribution

Topics: Abortion, Threatened; Adult; Broad Ligament; Diagnosis, Differential; Female; Fetal Growth Retardation; Humans; Oxytocin; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy, Ectopic; Ultrasonography

A case of pregnancy in an unattached rudimentary uterine horn is presented. The pregnancy carried to term, ruptured without causing shock, resulted in fetal demise, and was discovered 6 weeks later at laparotomy. Some of the factors associated with rudimentary uterine horns are discussed.

Topics: Adult; Clindamycin; Female; Fetal Death; Humans; Oxytocin; Pregnancy; Pregnancy Complications, Infectious; Pregnancy, Ectopic; Prostaglandins E; Rupture, Spontaneous; Uterus

Topics: Abortion, Induced; Abortion, Therapeutic; Adult; Amnion; Female; Humans; Injections; Oxytocin; Pregnancy; Pregnancy Trimester, Second; Pregnancy, Ectopic; Urea; Uterine Rupture; Uterus

Eighteen cases of advanced extra-uterine pregnancy are reported. The difficulty of diagnosis is discussed; the only symptoms of any help were amenorrhoea, lower abdominal pain, postmaturity and failed induction of labour. The physical findings were variable and none were absolutely reliable. In 17 cases the fetus was dead on admission and early laparotomy was performed, and in 17 patients it was possible to remove the placenta completely.

Topics: Adult; Amenorrhea; Female; Humans; Labor, Induced; Middle Aged; Oxytocin; Palpation; Placenta; Pregnancy; Pregnancy, Ectopic; Pregnancy, Prolonged; Radiography; Time Factors

Of 16 consecutive cases of previous sterilization treated by tubal surgery fifteen women tested had patent Fallopian tubes. Over 18 months since operation there were four full-term pregnancies and two abortions among 11 patients. At interview with the patient it is important to emphasize that reconstruction of the tubes is a major operation and carries an increased subsequent hazard of ectopic pregnancy.

Topics: Abortion, Spontaneous; Adult; Anti-Bacterial Agents; Contraception; Fallopian Tubes; Female; Fertility; Humans; Hysterosalpingography; Kymography; Oxytocin; Pregnancy; Pregnancy, Ectopic; Sterilization, Tubal; Uterus

Topics: Adult; Blood; Enzymes; Female; Fetal Death; Humans; Labor, Obstetric; Oxytocin; Pre-Eclampsia; Pregnancy; Pregnancy, Ectopic; Pregnancy, Multiple; Uterine Inertia

Topics: Abdomen; Female; Humans; Oxytocin; Pregnancy; Pregnancy, Abdominal; Pregnancy, Ectopic; Pregnancy, Prolonged