-
Ginekologia Polska 2018Diastasis recti abdominis is a condition in which both rectus abdominis muscles disintegrate to the sides, this being ac-companied by the extension of the linea alba... (Review)
Review
Diastasis recti abdominis is a condition in which both rectus abdominis muscles disintegrate to the sides, this being ac-companied by the extension of the linea alba tissue and bulging of the abdominal wall. DRA may result in the herniation of the abdominal viscera, but it is not a hernia per se. DRA is common in the female population during pregnancy and in the postpartum period. There is a scant knowledge on the prevalence, risk factors, prevention or management of the abovemen-tioned condition. The aim of this paper is to present the methods of DRA treatment based on the results of recent studies.
Topics: Abdominoplasty; Conservative Treatment; Exercise Therapy; Female; Humans; Pregnancy; Pregnancy Complications; Prolotherapy; Prune Belly Syndrome
PubMed: 29512814
DOI: 10.5603/GP.a2018.0016 -
Ugeskrift For Laeger Apr 2020This review summarises the knowledge of abdominal ectopic pregnancy (AEP), which is a rare condition with higher morbidity and mortalilty than other types of ectopic... (Review)
Review
This review summarises the knowledge of abdominal ectopic pregnancy (AEP), which is a rare condition with higher morbidity and mortalilty than other types of ectopic pregnancies. The condition can be primary, if the pregnancy implants directly on to an abdominal site, or it can be secondary after a tubar abortion. AEP differs from tubal pregnancies by a normal level of human chorionic gonadotropin and rare vaginal bleeding, which causes a diagnostic delay. In an early pregnancy the treatment is laparoscopic removal, but in second and third trimester pregnancies laparotomy is preferred, if possible preceded by MRI for mapping of vascular involvement and location of placenta.
Topics: Abortion, Induced; Chorionic Gonadotropin; Delayed Diagnosis; Female; Humans; Pregnancy; Pregnancy, Ectopic; Pregnancy, Tubal
PubMed: 32286219
DOI: No ID Found -
Emergency Medicine Clinics of North... Nov 2021Abdominal pain is a common reason for emergency department visits, with many patients not receiving a definitive diagnosis for their symptoms. Non-gastrointestinal... (Review)
Review
Abdominal pain is a common reason for emergency department visits, with many patients not receiving a definitive diagnosis for their symptoms. Non-gastrointestinal causes need to be considered in the workup of abdominal pain. A high index of suspicion is needed in order to develop a broad differential, and a thorough history and physical examination is paramount. This article will discuss some of these diagnoses, including can't miss diagnoses, common non-abdominal causes, and rare etiologies of abdominal pain.
Topics: Abdominal Pain; Acute Coronary Syndrome; Adrenal Gland Diseases; Anemia, Sickle Cell; Angioedemas, Hereditary; Aortic Diseases; COVID-19; Diabetic Ketoacidosis; Diagnosis, Differential; Emergency Service, Hospital; Female; Heart Failure; Herpes Zoster; Humans; IgA Vasculitis; Lead Poisoning; Migraine Disorders; Ovarian Torsion; Pelvic Inflammatory Disease; Pneumonia; Porphyria, Acute Intermittent; Pregnancy; Pregnancy, Ectopic; Pulmonary Embolism; Thyrotoxicosis; Uremia
PubMed: 34600641
DOI: 10.1016/j.emc.2021.07.003 -
Reproductive Biology and Endocrinology... Jun 2021The aim of this study was to investigate characteristics associated with ectopic pregnancy (EP) that could be utilized for predicting morbidity or mortality.
PURPOSE
The aim of this study was to investigate characteristics associated with ectopic pregnancy (EP) that could be utilized for predicting morbidity or mortality.
METHODS
This was a retrospective analysis of pregnancy-related records from a tertiary center over a period of ten years. Data on age, gravidity, parity, EP risk, amenorrhea duration, abdominal pain presence and location, β-human chorionic gonadotropin (β-HCG) level, ultrasound findings, therapeutic intervention, exact EP implantation site and length of hospital stay (LOS) were obtained from the database. The LOS was used as a proxy for morbidity and was tested for an association with all variables. All statistical analyses were conducted with Stata® (ver. 16.1, Texas, USA).
RESULTS
The incidence of EP in a cohort of 30,247 pregnancies over a ten-year period was 1.05%. Patients presented with lower abdominal pain in 87.9% of cases, and the likelihood of experiencing pain was tenfold higher if fluid was detectable in the pouch of Douglas. Only 5.1% of patients had a detectable embryonic heartbeat, and 18.15% had one or more risk factors for EP. While most EPs were tubal, 2% were ovarian. The LOS was 1.9 days, and laparoscopic intervention was the main management procedure. The cohort included one genetically proven dizygotic heterotopic pregnancy (incidence, 3.3 × 10) that was diagnosed in the 7th gestational week. The only association found was between the β-HCG level and LOS, with a linear regression β coefficient of 0.01 and a P-value of 0.04.
CONCLUSION
EP is a relatively common condition affecting approximately 1% of all pregnancies. β-HCG correlates with EP-related morbidity, but the overall morbidity rate of EP is low regardless of the implantation site. Laparoscopic surgery is an effective therapeutic procedure that is safe for managing EP, even in cases of heterotopic pregnancy.
Topics: Abdominal Pain; Abortifacient Agents, Nonsteroidal; Adult; Cesarean Section; Chorionic Gonadotropin, beta Subunit, Human; Douglas' Pouch; Female; Humans; Incidence; Intrauterine Devices; Laparoscopy; Length of Stay; Methotrexate; Middle Aged; Pregnancy; Pregnancy, Ectopic; Pregnancy, Heterotopic; Pregnancy, Ovarian; Pregnancy, Tubal; Reproductive Techniques, Assisted; Retrospective Studies; Risk Factors; Salpingectomy; Salpingostomy; Smoking; Young Adult
PubMed: 34059064
DOI: 10.1186/s12958-021-00761-w -
Proceedings (Baylor University. Medical... Mar 2021Abdominal pregnancy is a rare form of ectopic pregnancy with high morbidity and mortality. There are a limited number of case reports of abdominal ectopic pregnancies....
Abdominal pregnancy is a rare form of ectopic pregnancy with high morbidity and mortality. There are a limited number of case reports of abdominal ectopic pregnancies. We present a case of a 29-year-old woman who presented to her obstetrician at 17 weeks' gestation with abdominal pain. A sonogram and confirmatory magnetic resonance imaging demonstrated an abdominal ectopic pregnancy. The patient underwent exploratory laparotomy with removal of the ectopic pregnancy. Our case presents an opportunity to discuss a rare form of ectopic pregnancy and the importance of proper diagnosis and treatment to reduce morbidity and mortality.
PubMed: 34219949
DOI: 10.1080/08998280.2021.1884932 -
Annals of Medicine and Surgery (2012) Feb 2023Abdominal pregnancy is a rare form of ectopic pregnancies, accounts less than 1% of all types of ectopic pregnancy. Its significance comes from high morbidity and...
UNLABELLED
Abdominal pregnancy is a rare form of ectopic pregnancies, accounts less than 1% of all types of ectopic pregnancy. Its significance comes from high morbidity and mortality rates.
CASE PRESENTATION
We present a case of a 22-year-old shocked patient with acute abdominal pain underwent laparotomy, abdominal pregnancy implanted into the posterior wall of the uterus diagnosis was made, and appropriate follow-up was offered.
CLINICAL DISCUSSION
Acute abdominal pain may be the main symptom of the abdominal pregnancy. The diagnosis was made by direct visualization of the products of conception and pathological study confirmed.
CONCLUSION
The first case of abdominal pregnancy is implanted into the posterior wall of the uterus. Follow-up is recommended until β-human chorionic gonadotropin levels become undetectable.
PubMed: 36845821
DOI: 10.1097/MS9.0000000000000245 -
Journal of Visceral Surgery Dec 2015Abdominal emergencies during pregnancy (excluding obstetrical emergencies) occur in one out of 500-700 pregnancies and may involve gastrointestinal, gynecologic,... (Review)
Review
Abdominal emergencies during pregnancy (excluding obstetrical emergencies) occur in one out of 500-700 pregnancies and may involve gastrointestinal, gynecologic, urologic, vascular and traumatic etiologies; surgery is necessary in 0.2-2% of cases. Since these emergencies are relatively rare, patients should be referred to specialized centers where surgical, obstetrical and neonatal cares are available, particularly because surgical intervention increases the risk of premature labor. Clinical presentations may be atypical and misleading because of pregnancy-associated anatomical and physiologic alterations, which often result in diagnostic uncertainty and therapeutic delay with increased risks of maternal and infant morbidity. The most common abdominal emergencies are acute appendicitis (best treated by laparoscopic appendectomy), acute calculous cholecystitis (best treated by laparoscopic cholecystectomy from the first trimester through the early part of the third trimester) and intestinal obstruction (where medical treatment is the first-line approach, just as in the non-pregnant patient). Acute pancreatitis is rare, usually resulting from trans-ampullary passage of gallstones; it usually resolves with medical treatment but an elevated risk of recurrent episodes justifies laparoscopic cholecystectomy in the 2nd trimester and endoscopic sphincterotomy in the 3rd trimester. The aim of the present work is to review pregnancy-induced anatomical and physiological modifications, to describe the main abdominal emergencies during pregnancy, their specific features and their diagnostic and therapeutic management.
Topics: Abdominal Pain; Diagnosis, Differential; Digestive System Diseases; Emergencies; Female; Humans; Laparoscopy; Pregnancy; Pregnancy Complications
PubMed: 26527261
DOI: 10.1016/j.jviscsurg.2015.09.017 -
Seminars in Plastic Surgery Aug 2018Diastasis recti is a relatively common condition in which there is a midline abdominal bulge that can affect a variety of individuals. The etiology and diagnosis is well... (Review)
Review
Diastasis recti is a relatively common condition in which there is a midline abdominal bulge that can affect a variety of individuals. The etiology and diagnosis is well understood and optimal management depends on the degree of severity. Patients at high risk for diastasis recti include multiparous women, obese patients, and those with multiple previous operations. Diagnosis includes clinical examination and assessment of symptoms. Physical characteristics include a midline abdominal bulge without a fascial defect. Classification systems are based on the degree of separation between the paired midline rectus and myofascial deformity. Optimal management varies and includes simple plication of the midline defect, extensive plication of the anterior abdominal wall, and sometimes the use of resorbable or nonresorbable mesh.
PubMed: 30046291
DOI: 10.1055/s-0038-1661380 -
Acta Obstetricia Et Gynecologica... Nov 2019Normal pregnancy leads to a state of chronically increased intra-abdominal pressure. Obstetric and non-obstetric conditions may increase intra-abdominal pressure... (Review)
Review
Normal pregnancy leads to a state of chronically increased intra-abdominal pressure. Obstetric and non-obstetric conditions may increase intra-abdominal pressure further, causing intra-abdominal hypertension and abdominal compartment syndrome, which leads to maternal organ dysfunction and a compromised fetal state. Limited medical literature exists to guide treatment of pregnant women with these conditions. In this state-of-the-art review, we propose a diagnostic and treatment algorithm for the management of peripartum intra-abdominal hypertension and abdominal compartment syndrome, informed by newly available studies.
Topics: Abdominal Cavity; Adult; Compartment Syndromes; Critical Illness; Female; Fetal Monitoring; Humans; Incidence; Intra-Abdominal Hypertension; Maternal Mortality; Needs Assessment; Peripartum Period; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Prognosis; Risk Assessment; Treatment Outcome
PubMed: 31070780
DOI: 10.1111/aogs.13638