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Heterotopic Pregnancy
A heterotopic pregnancy is a complication of pregnancy in which both extrauterine ( ectopic) pregnancy and intrauterine pregnancy occur simultaneously. It may also be referred to as a combined ectopic pregnancy, multiple‑sited pregnancy, or coincident pregnancy. The most common site of the extrauterine pregnancy is the fallopian tube. However, other sites of implantation include the cervix, ovary, and abdomen. Although heterotopic pregnancies were once thought to be a rare phenomenon, the incidence has increased due to the increasing use of assisted reproductive technologies. Cause In a heterotopic pregnancy there is one fertilized ovum which implants normally in the uterus, and one fertilized ovum which implants abnormally, outside of the uterus. Pathogenesis In the general population, the major risk factors for heterotopic pregnancy are the same as those for ectopic pregnancy: * Previous history of ectopic pregnancy * Tubal surgery * Pelvic inflammatory disease * U ...
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Obstetrics
Obstetrics is the field of study concentrated on pregnancy, childbirth and the postpartum period. As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a surgical field. Main areas Prenatal care Prenatal care is important in screening for various complications of pregnancy. This includes routine office visits with physical exams and routine lab tests along with telehealth care for women with low-risk pregnancies: Image:Ultrasound_image_of_a_fetus.jpg, 3D ultrasound of fetus (about 14 weeks gestational age) Image:Sucking his thumb and waving.jpg, Fetus at 17 weeks Image:3dultrasound 20 weeks.jpg, Fetus at 20 weeks First trimester Routine tests in the first trimester of pregnancy generally include: * Complete blood count * Blood type ** Rh-negative antenatal patients should receive RhoGAM at 28 weeks to prevent Rh disease. * Indirect Coombs test (AGT) to assess risk of hem ...
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Constipation
Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The Human feces, stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement. Complications from constipation may include hemorrhoids, anal fissure or fecal impaction. The normal frequency of bowel movements in adults is between three per day and three per week. Babies often have three to four bowel movements per day while young children typically have two to three per day. Constipation has many causes. Common causes include slow movement of stool within the colon, irritable bowel syndrome, and pelvic floor disorders. Underlying associated diseases include hypothyroidism, diabetes, Parkinson's disease, celiac disease, non-celiac gluten sensitivity, Vitamin B12 deficiency, vitamin B12 deficiency, colon cancer, diverticulitis, and inflammatory bowel disease. Medications associated with constipation in ...
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Gamete Intrafallopian Transfer
Gamete intrafallopian transfer (GIFT) is a tool of assisted reproductive technology against infertility. Eggs are removed from a woman's ovaries, and placed in one of the fallopian tubes, along with the man's sperm. The technique, first attempted by Steptoe and Edwards and later pioneered by endocrinologist Ricardo Asch, allows fertilization to take place inside the woman's uterus. With the advances in IVF the GIFT procedure is used less as pregnancy rates in IVF tend to be equal or better and do not require laparoscopy when the egg is put back. Method It takes, on average, four to six weeks to complete a cycle of GIFT. First, the woman must take a fertility drug to stimulate egg production in the ovaries. The doctor will monitor the growth of the ovarian follicles, and once they are mature, the woman will be injected with human chorionic gonadotropin (hCG). The eggs will be harvested approximately 36 hours later, mixed with the man's sperm, and placed back into the woman's f ...
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In Vitro Fertilization
In vitro fertilisation (IVF) is a process of fertilisation in which an egg is combined with sperm in vitro ("in glass"). The process involves monitoring and stimulating the ovulatory process, then removing an ovum or ova (egg or eggs) from the ovaries and enabling sperm to fertilise them in a culture medium in a laboratory. After a fertilised egg (zygote) undergoes embryo culture for 2–6 days, it is transferred by catheter into the uterus, with the intention of establishing a successful pregnancy. IVF is a type of assisted reproductive technology used to treat infertility, enable gestational surrogacy, and, in combination with pre-implantation genetic testing, avoid the transmission of abnormal genetic conditions. When a fertilised egg from egg and sperm donors implants in the uterus of a genetically unrelated surrogate, the resulting child is also genetically unrelated to the surrogate. Some countries have banned or otherwise regulated the availability of IVF treatme ...
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Assisted Reproduction
Assisted reproductive technology (ART) includes medical procedures used primarily to address infertility. This subject involves procedures such as in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and cryopreservation of gametes and embryos, and the use of fertility medication. When used to address infertility, ART may also be referred to as fertility treatment. ART mainly belongs to the field of reproductive endocrinology and infertility. Some forms of ART may be used with regard to fertile couples for genetic purpose (see preimplantation genetic diagnosis). ART may also be used in surrogacy arrangements, although not all surrogacy arrangements involve ART. The existence of sterility will not always require ART to be the first option to consider, as there are occasions when its cause is a mild disorder that can be solved with more conventional treatments or with behaviors based on promoting health and reproductive habits. Procedures General With ART, the p ...
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Ovulation Induction
Ovulation induction is the stimulation of ovulation by medication. It is usually used in the sense of stimulation of the development of ovarian follicles to reverse anovulation or oligoovulation. Scope The term ''ovulation induction'' can potentially also be used for: * Final maturation induction, in the sense of triggering ''oocyte release'' from relatively mature ovarian follicles during late follicular phase. In any case, ovarian stimulation (in the sense of stimulating the development of oocytes) is often used in conjunction with triggering oocyte release, such as for proper timing of artificial insemination. * Controlled ovarian hyperstimulation (stimulating the development of multiple follicles of the ovaries in one single cycle), has also appeared in the scope of ovulation induction. Controlled ovarian hyperstimulation is generally part of in vitro fertilization, and the aim is generally to develop multiple follicles (optimally between 11 and 14 antral follicles measu ...
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Prevalence
In epidemiology, prevalence is the proportion of a particular population found to be affected by a medical condition (typically a disease or a risk factor such as smoking or seatbelt use) at a specific time. It is derived by comparing the number of people found to have the condition with the total number of people studied and is usually expressed as a fraction, a percentage, or the number of cases per 10,000 or 100,000 people. Prevalence is most often used in questionnaire studies. Difference between prevalence and incidence Prevalence is the number of disease cases ''present ''in a particular population at a given time, whereas incidence is the number of new cases that ''develop ''during a specified time period. Prevalence answers "How many people have this disease right now?" or "How many people have had this disease during this time period?". Incidence answers "How many people acquired the disease uring a specified time period". However, mathematically, prevalence is propor ...
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Salpingostomy
Salpingectomy refers to the surgical removal of a fallopian tube. This may be done to treat an ectopic pregnancy or cancer, to prevent cancer, or as a form of contraception. This procedure is now sometimes preferred over its ovarian tube-sparing counterparts due to the risk of ectopic pregnancies. For contraceptive purposes, this procedure is an irreversible form of sterilization and more effective than tubal ligation. Classification Salpingectomy is different from and predates both salpingostomy and salpingotomy. The latter two terms are often used interchangeably and refer to creating an opening into the tube (e.g. to remove an ectopic pregnancy), but the tube itself is not removed. Technically, the creation of a new tubal opening (, after the Latin word for 'mouth') by surgery would be a ''salpingostomy'', while the incision into the tube to remove an ectopic is a ''salpingotomy''. Indications Salpingectomy was performed by Lawson Tait in 1883 in women with a bleeding e ...
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Sensitivity And Specificity
In medicine and statistics, sensitivity and specificity mathematically describe the accuracy of a test that reports the presence or absence of a medical condition. If individuals who have the condition are considered "positive" and those who do not are considered "negative", then sensitivity is a measure of how well a test can identify true positives and specificity is a measure of how well a test can identify true negatives: * Sensitivity (true positive rate) is the probability of a positive test result, conditioned on the individual truly being positive. * Specificity (true negative rate) is the probability of a negative test result, conditioned on the individual truly being negative. If the true status of the condition cannot be known, sensitivity and specificity can be defined relative to a " gold standard test" which is assumed correct. For all testing, both diagnoses and screening, there is usually a trade-off between sensitivity and specificity, such that higher sensiti ...
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Transvaginal Ultrasound
Vaginal ultrasonography is a medical ultrasonography that applies an ultrasound transducer (or "probe") in the vagina to visualize organs within the pelvic cavity. It is also called transvaginal ultrasonography because the ultrasound waves go ''across'' the vaginal wall to study tissues beyond it. Uses Vaginal ultrasonography is used both as a means of gynecologic ultrasonography and obstetric ultrasonography. It is preferred over abdominal ultrasonography in the diagnosis of ectopic pregnancy. It also can be used to evaluate patients with post-menopausal bleeding. The finding on transvaginal ultrasound of a thin endometrial lining gives the physician a 99% negative predictive value that the patient does not have endometrial cancer. If a patient had a prior endometrial sampling that was inconclusive, then a transvaginal ultrasound can be used to triage a woman with post-menopausal bleeding. See also * Gynecologic ultrasonography * Vaginal bleeding, Post-menopausal bleeding ...
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Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is a group of inflammatory conditions of the colon and small intestine, with Crohn's disease and ulcerative colitis (UC) being the principal types. Crohn's disease affects the small intestine and large intestine, as well as the mouth, esophagus, stomach and the anus, whereas UC primarily affects the colon and the rectum. Signs and symptoms In spite of Crohn's and UC being very different diseases, both may present with any of the following symptoms: abdominal pain, diarrhea, rectal bleeding, severe internal cramps/muscle spasms in the region of the pelvis and weight loss. Anemia is the most prevalent extraintestinal complication of inflammatory bowel disease (IBD). Associated complaints or diseases include arthritis, pyoderma gangrenosum, primary sclerosing cholangitis, and non-thyroidal illness syndrome (NTIS). Associations with deep vein thrombosis (DVT) and bronchiolitis obliterans organizing pneumonia (BOOP) have also been reported. ...
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