Bilateral round ligament varicosities mimicking an inguinal hernia in pregnancy: case report

A 22-year-old pregnant woman presented with a painful swelling in the right groin. Sonography was performed to confirm a presumptive diagnosis of inguinal hernia based on physical examination. Gray-scale sonography examination revealed bilateral inguinal cystic lesion expanding with the Valsalva maneuver. Color Doppler imaging demonstrated multiple prominent vessels with retrograde venous flow during Valsalva maneuver. Bilateral round ligament varicosities were diagnosed and inguinal hernia was excluded by sonographic findings. Round ligament varicosities should be considered in the differential diagnosis of groin swelling during pregnancy.     

异位妊娠药物保守治疗适应证的新评分法研究

目的 :探讨彩色多普勒超声 (CDFI)筛选适合药物保守治疗异位妊娠的临床价值。方法 :4 8例生命体征平稳的异位妊娠患者 ,在行CDFI检查后接受甲氨喋呤 (MTX) 5 0mg/m2 单次肌肉注射配合口服米非司酮 15 0mg ,随访直至临床结局。分析成功与失败病例CDFI的特点和绒毛膜促性腺激素 (hCG)水平 ,并制作CDFI评分。结果 :CDFI能直接反映胚胎生命力 ,CDFI图像和血清hCG水平不同者 ,保守治疗成功率有很大差异。结论 :CDFI评分可应用于适合保守治疗异位妊娠病例的筛选。对评分 >9者因失败率高 ,不推荐药物保守治疗。     

Effectiveness of a Comprehensive Psychoeducational Intervention With Pregnant and Parenting Adolescents: A Pilot Study

PROBLEM: Little is known about the effectiveness of a comprehensive psychoeducational intervention on depression, self-esteem, and parenting attitudes/beliefs of at-risk pregnant and parenting adolescents. METHODS: Adolescents (N = 41) attending either a residential treatment facility (RTF) or a rural alternative school (RAS) participated in a psychoeducational parenting group using Bavolek's Nurturing Program during Phase I. Phase II included health promotion issues, infant massage, and CPR. FINDINGS: Using the Parenting Semantic Differential and the AAPI-2, there was significant improvement in parenting attitudes and beliefs. No significant change was found in self-esteem. CONCLUSIONS: A comprehensive psychoeducational parenting group can be effective in changing parenting attitudes and beliefs, which suggests an ultimate improvement in health promotion and disease prevention in adolescent women and their children.     

异位妊娠药物保守性治疗130例临床分析

目的寻找一种简单有效、成功率高的异位妊娠保守性药物治疗方法。方法64例患者（对照组）采用米非司酮25mg，2次／d，口服，连用5d。66例患者（观察组）米非司酮用法同上，同时联合应用氨甲喋呤（MTX）50mg/m^2，单次肌肉注射。对两组治疗结果进行比较。结果对照组成功率73．43％，观察组成功率95．45％，明显高于对照组（P〈0．01）。结论米非司酮联合应用MTX治疗异位妊娠，成功率高，副作用小，可做为临床异位妊娠保守治疗的首选方案。     

多种方法治疗输卵管妊娠176例分析

目的 探讨输卵管妊娠的最佳治疗方法。方法 回顾分析176例输卵管妊娠患者不同治疗方法的临床效果。结果 开腹及腹腔镜手术成功率100％，药物保守治疗中MTX组成功率82．6％（19／23），米非司酮组成功率84．6％（11／13），期待疗法成功率100％。结论 严格掌握各种治疗方法的适应证及禁忌证，选择合适的治疗方法会取得良好的临床效果。     

妊娠合并静脉血栓栓塞的预防和护理

静脉血栓疾病会导致严重的并发症,并且妊娠妇女的静脉血栓栓塞的发生率要远高于非妊娠妇女。本文回顾了近年来关于妊娠期静脉血栓疾病的发病原因、预防及护理的相关文献,并得出以下结论：妊娠期和产后血液的特殊状态,以及分娩期所造成的血管损伤导致了妊娠期静脉血栓栓塞的高发;而加强孕期保健,积极筛查,早期识别,早期处理,鼓励自然分娩及积极的对症处理是防治妊娠期静脉血栓疾病的关键。     

Cervical ectopic pregnancy diagnosed by point-of-care emergency department ultrasound

Background

Although rare, cervical ectopic pregnancy (EP) represents a potentially lethal variation of a common first-trimester disease entity.

Case Report

We report a case of low abdominal pain and vaginal bleeding diagnosed as a cervical EP by point-of-care ultrasound.

Conclusion

Familiarity with cervical EP and its sonographic appearance is essential for emergency physicians because it can be easily mistaken for an intrauterine pregnancy or other obstetric/gynecologic pathology, such as an incomplete abortion or nabothian cyst. The management of each of these differs substantially, making accurate diagnosis crucial.