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Adnexal/Ovarian Torsion
Published in Botros Rizk, A. Mostafa Borahay, Abdel Maguid Ramzy, Clinical Diagnosis and Management of Gynecologic Emergencies, 2020
Hajra Takala, Mona Omar, Ayman Al-Hendy
The fallopian tubes, also known as uterine tubes or salpinges, are paired muscular structures connecting the ovaries with the uterus, located at the superior aspect of the broad ligament. Fallopian tubes have two portions, an extrauterine portion (fimbria, infundibulum, ampulla, and isthmus) and an intramural portion (interstitial). The tube's length measures approximately 8 to 15 cm; however, the intramural portion measures 1.5 to 2 cm long. The tube's diameter is usually <1 cm. The supporting mesentery is known as the mesosalpinx [1, 2, 6].
Female sterilisation
Published in Suzanne Everett, Handbook of Contraception and Sexual Health, 2020
Using hysteroscope a guide wire places a flexible microinsert into each fallopian tube. The microinsert causes scar tissue to form and occlusion of the fallopian tube; this process can take three months, so alternative contraception is advised for three months following the procedure. The procedure is performed under local anaesthetic and takes ten minutes by a specially trained doctor. Occlusion of the fallopian tubes should be confirmed by ultrasound or X-ray (some women may need a hysterosalpingogram) before this method can be relied on to prevent conception (NICE, 2009). Essure is a small titanium metal coil that can be fitted this way and available in the UK (Figure 15.1).
Anatomy & Embryology
Published in Manit Arya, Taimur T. Shah, Jas S. Kalsi, Herman S. Fernando, Iqbal S. Shergill, Asif Muneer, Hashim U. Ahmed, MCQs for the FRCS(Urol) and Postgraduate Urology Examinations, 2020
The female reproductive tract is made up of the uterus, a pair of ovaries and fallopian tubes, and the vagina. The uterus measures roughly 8 × 6 cm and lies in front of the rectum and over the dome of the bladder. It consists of the upper fundus, middle body and lower cervix. It is anchored by the round ligament of uterus, which originates at the uterine horns, leaves the pelvis at the deep inguinal ring, passes through the inguinal canal and continues on to the labia majora where its fibres attach to the mons pubis. Each fallopian tube extends laterally from the side of the uterus at the junction between the fundus and body. There are four anatomical parts: Infundibulum – ‘Funnel shaped’ lateral end, which opens into the peritoneal cavity. Fimbriae surround the mouth of the tube to collect ova from the ovary.Ampulla – Site of fertilisation.Isthmus – Involved with the transport of gametes in both directions.Uterine – Within the wall of the uterus.
The efficacy of mifepristone combined with methotrexate for the treatment of ectopic pregnancy: a systematic review and meta-analysis*
Published in Annals of Medicine, 2022
Qiling Su, Huiyan Feng, Tian Tian, Xiaoqian Liao, Yunhui Li, Xiaomao Li
Ectopic pregnancy (EP) is when a blastocyst is implanted outside the uterus, and most are fallopian tube pregnancies. EP is a common clinical acute abdominal disease in obstetrics and gynaecology, as well as one of the primary causes of maternal death. In recent years, the incidence of EP has increased year by year and has shown a trend of patients of younger age, which makes it important to effectively save patients’ lives and furthest preserve their fallopian tube function and fertility. literature reports that the minimum age of onset of EP is 16 years old [1], the incidence rate in pregnant women is 2% while the mortality rate accounts for about 10% of the total maternal deaths [2]. In Liu Ying’s study, the incidence rate increased from 2.48% in 2005 to 4.36% in 2012, and the proportion of conservative treatment increased from 7.14% to 20.73% [3]. The proportion under 20 years old in the later group increased from 1.1% 10 years ago to 4.5%. Unmarried women increased from 21.5% to 41.4%; The number of childless women rose from 45.7% to 66.8% [4]. Therefore, patients with EP tend to be younger, unmarried and childless.
A rare and unusual case of bilateral tubal ectopic pregnancies
Published in Journal of Obstetrics and Gynaecology, 2022
Benjamin Rowlatt, Masqood Saeed, Jonathan Chester
An ectopic pregnancy occurs when a fertilised oocyte implants anywhere outside of the endometrial cavity, most commonly found unilaterally in the ampulla of the fallopian tube. The condition has an incidence of 11/1000 in the UK and remains a significant cause of maternal mortality (Elson et al. 2016). Bilateral tubal ectopic pregnancy (BTP) is a rare form of this condition, which has an estimated incidence of only 1 in 200,000 pregnancies (Hoffmann et al. 2016). This can occur spontaneously or can be associated with assisted reproductive techniques, of which the latter has a higher incidence (Jena et al. 2016). Diagnosis of this condition can be challenging; hence, identification of BTP usually occurs during surgery (Jena et al. 2016). The most widely accepted diagnostic criterion, suggested by Norris (1953), is the histological demonstration of chorionic villi in both fallopian tubes.
Germline Gene Editing: Minding the Past and the Future
Published in The American Journal of Bioethics, 2020
Or take reproductive technologies. In vitro fertilization (IVF) was initially developed as a way to overcome infertility problems caused when the woman’s fallopian tubes were damaged. Although some raised concerns that IVF and associated technologies would lead to many other purposes, proponents of the technology argued that it was possible to make ethically relevant distinctions that could be used to evaluate the permissibility and impermissibility of various IVF interventions. Soon, however, IVF became a solution not just to infertility caused by blocked fallopian tubes, but also to other fertility problems including inability to produce eggs and endometriosis. Moreover, it quickly expanded to address not only various fertility problems in women–who had to run the risks of these interventions—but also to address male factor infertility. As we know, the uses of IVF have continued to increase beyond fertility problems. Fine grained distinctions regarding IVF interventions—e.g., what problem is being treated; who runs the risks; whether there are other options—have hardly led to drawing finer grained lines of permissibility based on those ethically relevant differences.