China
Africa
Explore chapters and articles related to this topic
Is Abortion Medically Necessary?
Published in Nicholas Colgrove, Bruce P. Blackshaw, Daniel Rodger, Agency, Pregnancy and Persons, 2023
In the first instance, it should be noted women tend to find out they are pregnant in the sixth week of pregnancy, by which time the fetus is approximately 7.8 to 12.6 mm (i.e., visible to the naked eye; Branum and Ahrens 2017; Yamada et al. 2010). Moreover, even if delivery in the usual sense of such a small fetus may be impractical, salpingotomy is available, whereby a cut is made into the fallopian tube, which is then irrigated with saline so that the fetus detaches from the tube (Mol et al. 2014). Salpingectomy is also available. Under other circumstances, methotrexate can be administered to cause the fetus to detach from where it has implanted. Whether some or any of these methods truly differ from abortion in ontologically or morally significant ways will be considered later. Whether some or all these methods fall under our definition of abortion as intentional feticide requires complex analysis. It is a contested area of ethics. Only once I have properly addressed intention later in this chapter will I be able to show that it is not necessary to perform an abortive act to manage ectopic pregnancy.
Hard Cases for Critics of Abortion
Published in Christopher Kaczor, The Ethics of Abortion, 2023
In the past, doctors regularly used salpingectomy, the removal of the entire fallopian tube with the embryo inside it, to treat ectopic pregnancy. At later stages of ectopic pregnancy, when the fallopian tube has already been badly damaged, salpingectomy is still medically indicated.
Ectopic Pregnancy: Extrauterine Pregnancy and Pregnancy of Unknown Location
Published in Botros Rizk, A. Mostafa Borahay, Abdel Maguid Ramzy, Clinical Diagnosis and Management of Gynecologic Emergencies, 2020
A salpingectomy may well be performed in patients who no longer wish to have children. In these cases, it also helps to prevent a relapse. Salpingectomy involves complete extraction of the tube [3] and can be performed in cases of tubal rupture, unstoppable bleeding after salpingotomy, a large EP, tubal pregnancies, or insufficient surgical skills.
Prognostic value of hysterosalpingography after salpingostomy in patients with hydrosalpinx
Published in Journal of Obstetrics and Gynaecology, 2023
Wen-Xi Yao, Du-Zhou Zheng, Wei-Feng Liu, Mi-Mi Zhou, Li Liu, Ming-Jin Cai
Salpingostomy is distal tubal plastic surgery to manage hydrosalpinx using scissors, electrosurgery or laser (Gomel and Wang 1994), with the aim of preserving the fallopian tubes and allowing the patient to attempt natural conception. During surgery, the distal tube is incised and opened in the avascular area, and the newly created ostium is sutured back to the mesosalpinx (Ng and Cheong 2019). However, pregnancy rates and outcomes in various reports differ (Gomel 2015). It is admitted that pregnancy rate and outcome are associated with patient age, tubal stage, adhesion stage, the operative technique used and infection by Chlamydia (Audebert and Pouly 2014). In addition, scholars have found that most natural pregnancies after salpingostomy in patients with hydrosalpinx occur within 18 months (Chu et al.2015).
Extratubal secondary trophoblastic implants (ESTI) following laparoscopic bilateral salpingectomy for ectopic pregnancy: problems that have been neglected for a long time
Published in Gynecological Endocrinology, 2022
It should be noted that Robson et al. [17] did not choose direct surgery at first, but MTX im, unfortunately, 2 days later the patient hemoglobin dropped, emergency laparoscopy was adopted. ESTI can secrete active β-HCG, implant, and erode peritoneum, omentum, and blood vessels, which lead to acute lower abdominal pain and severe hemorrhagic shock. The authors thought that an initial dose of MTX following salpingectomy or salpingotomy for EP where rupture or spillage of trophoblastic tissue was a high risk, which could be considered after re-operation. In our clinical practices, salpingectomy is cleaner treatment for ectopic pregnancy. So, we could not use MTX directly, because we do not know where the localization of trophoblastic tissue. Pregnancy of unknown location is a transient state in the diagnostic process, leading to a final diagnosis of viable or nonviable intrauterine pregnancy, ectopic pregnancy, or persistent pregnancy of unknown location (high), which is strongly recommended in the guidelines classification [18]. At the same time, imaging diagnostic examinations are limited for ESTI. Our patient has been removed bilateral tubes due to ectopic pregnancy twice. Therefore, diagnosis laparoscopy is needed for biopsy identification what cause this clinical problem.
Lymphadenectomy in Primary Fallopian Tube Cancer is Associated with Improved Survival
Published in Journal of Investigative Surgery, 2022
Yao Xiao, Yue-xi Liu, Ruo-nan Li, Xing Wei, Qing-miao Wang, Qiu-ying Gu, Hua Linghu
It is difficult to accurately distinguish the origin of the tumor when it is in the advanced stage. As a result, several patients with PFTC are misdiagnosed and treated as EOC, and thus presents a challenge to the comprehensive understanding of PFTC. Recently, the identification of PFTC has increased because of studies that indicate that microscopic intraepithelial lesions might be the origin of serous high-grade carcinomas [6–8]. According to a previous study [9], the incidence of ovarian carcinomas has decreased by 1.7-fold in the last 20 years, while tubal carcinomas have increased more than 10-fold. Based on this, several trials have studied and confirmed the feasibility and significant survival benefits of salpingectomy as a risk-reducing surgery for OC in high-risk women [10,11].