Ectopic pregnancy: a review

Rana, Poonam; Kazmi, Imran; Singh, Rajbala; Afzal, Muhammad; Al-Abbasi, Fahad A.; Aseeri, Ali; Singh, Ram Pratap; Khan, Ruqaiyah; Anwar, Firoz

doi:10.1007/s00404-013-2929-2

Cited by 113 publications

(113 citation statements)

References 120 publications

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“…In this scenario, the extravillous CTB subpopulation penetrates the uterine wall and spiral arteries to the degree that is required to sustain pregnancy for varying periods of time, but short of the duration of normal pregnancy. This may be a result of the highly invasive nature of these placental cells (37), which enables them to anchor not only to the uterus, but also to ectopic sites that they penetrate in search of a blood supply (38). Thus, we concluded that failed decidualization restricts the depth of CTB invasion such that pregnancy is maintained but ends in sPE.…”

Section: Discussionmentioning

confidence: 85%

Defective decidualization during and after severe preeclampsia reveals a possible maternal contribution to the etiology

Garrido-Gómez

Domı́nguez

Quiñonero

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

250

193

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In preeclampsia (PE), cytotrophoblast (CTB) invasion of the uterus and spiral arteries is often shallow. Thus, the placenta’s role has been a focus. In this study, we tested the hypothesis that decidual defects are an important determinant of the placental phenotype. We isolated human endometrial stromal cells from nonpregnant donors with a previous pregnancy that was complicated by severe PE (sPE). Compared with control cells, they failed to decidualize in vitro as demonstrated by morphological criteria and the analysis of stage-specific antigens (i.e., IGFBP1, PRL). These results were bolstered by global transcriptional profiling data that showed they were transcriptionally inert. Additionally, we used laser microdissection to isolate the decidua from tissue sections of the maternal–fetal interface in sPE. Global transcriptional profiling revealed defects in gene expression. Also, decidual cells from patients with sPE, which dedifferentiated in vitro, failed to redecidualize in culture. Conditioned medium from these cells failed to support CTB invasion. To mimic aspects of the uterine environment in normal pregnancy, we added PRL and IGFBP1, which enhanced invasion. These data suggested that failed decidualization is an important contributor to down-regulated CTB invasion in sPE. Future studies will be aimed at determining whether this discovery has translational potential with regard to assessing a woman’s risk of developing this pregnancy complication.

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Section: Discussionmentioning

confidence: 85%

Defective decidualization during and after severe preeclampsia reveals a possible maternal contribution to the etiology

Garrido-Gómez

Domı́nguez

Quiñonero

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

250

193

View full text Add to dashboard Cite

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“…It refers to the pregnancy occurring outside the uterine cavity that constitutes 1.2-1.4 % of reported pregnancies [6].…”

Section: Resultsmentioning

confidence: 99%

An unusual tubal pregnancy implantation

Piazze¹,

Recchia²,

Bratta³

et al. 2018

J Pregnancy Reprod

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“…The EP presents a major health problem for women of child-bearing age, constituting 1.2-1.4% of all reported pregnancies. Most specified risk factors are of maternal origin: pelvic inflammatory disease, Chlamydia trachomatis infection, smoking, tubal surgery, induced conception cycle as well as endometriosis [8]. During the past 40 years, its incidence has been steadily increasing concomitant with increased sexually transmitted disease (STD) rates and associated salpingitis (inflammation of the Fallopian tubes).…”

Section: Introductionmentioning

confidence: 99%

Ectopic Pregnancy: Diagnosis, Prevention and Management

Abdulkareem¹,

Eidan²

2017

Obstetrics

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An ectopic pregnancy (EP) falls within the area of the gynecological emergency and/or reproductive management of women, which is the implantation of fertilized ovum outside the endometrial cavity. The etiology of EP concentrated mainly on factor causes delayed transport of the fertilized ovum through the fallopian tube (favors implantation in tubal mucosa), thus giving rise to EP. This chapter describes the causes, diagnosis, prevention and the guidelines to improve the management of women who may have an EP, a major gynecological emergency that is a cause of morbidity or even mortality of women in first trimester. Three types of EP are diagnosed: tubal, cervical and ovarian; tubal is the main type. Identification of the signs and symptoms of acute and chronic EP in women, involving classical clinical trials or other symptoms common to early pregnancy, as well as evaluating the most important congenital and acquired factors related with EP, were discussed. Explanation of the most accurate methods used to diagnose the pregnancy including serum beta hCG and progesterone levels, medical history, ultrasonography, pregnancy tests and laparoscopy was also clarified. The evaluation of the most effective management tools of EP, including methotrexate administration and surgery (laparotomy and laparoscopy), was obviously explained.

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Ectopic pregnancy: a review

Abstract: It was concluded that review data reflect a decrease in surgical treatment and not an actual decline in EP occurrence so that further new avenues are needed to explore early detection of the EP.

Cited by 113 publications

References 120 publications

Defective decidualization during and after severe preeclampsia reveals a possible maternal contribution to the etiology

Defective decidualization during and after severe preeclampsia reveals a possible maternal contribution to the etiology

An unusual tubal pregnancy implantation

Ectopic Pregnancy: Diagnosis, Prevention and Management

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