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Reviews
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What are the main claims of the paper and how important are they?
Claims that ectopic occurred in both fallopian tubes simultaneously. Important? IF you work long enough in obstetrics, you get used to the unusual.
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Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.
Interesting
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Are the claims properly placed in the context of the previous literature?
I would have liked the authors to find a reference for advanced maternal age being an independent risk factor for ectopic. I doubt it is. In a population where monogamous relationships are the norm, and birth control is not used, such as religious communities, ectopic pregnancy does not occur 22/1000 and is not associated with advanced maternal age.
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Do the results support the claims? If not, what other evidence is required?
Yes
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If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?
Although it was scientifically interesting, that did not justify delaying removing the fetus at 8 weeks, instead of waitiing until 9 weeks.
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Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?
Yes
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Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?
NA
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Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?
No
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Other Comments:
N/A
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Competing interests:
No
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Invited by the author to review this article? :
No -
Have you previously published on this or a similar topic?:
No
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References:
None -
Experience and credentials in the specific area of science:
Certified Nurse Midwife, with 70 first author papers in midwifery related topics
- How to cite: Cohain J S.Advanced Maternal Age is not an Independent Risk Factor for Ectopic Pregnancy[Review of the article 'Bilaternal Cornual Ectopic Pregnancy ' by Najimudeen M].WebmedCentral 2013;4(2):WMCRW002483
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What are the main claims of the paper and how important are they?
Nil
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Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.
Nil
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Are the claims properly placed in the context of the previous literature?
Not applicable
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Do the results support the claims? If not, what other evidence is required?
Probably diagnosis is supported; there was no access to ultrasound reports (although referred to in the text).
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If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?
Not relevant since it is case report. However, if the author's facility has any algorithm for approach in early pregnancy, reference to it would be informative.
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Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?
Management of an individual case.
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Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?
Nothing special to write and claim about.
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Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?
No, There are quite a few language related and typographical errors.
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Other Comments:
Compilation of cornual - uni and bilateral pregnancies reported across the facilities, the review of their management and a suggestion based on the outcome of review would be worthwhile.
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Competing interests:
No
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Invited by the author to review this article? :
No -
Have you previously published on this or a similar topic?:
No
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References:
None -
Experience and credentials in the specific area of science:
Consultant Obstetrician Gynecologist
- How to cite: Kushtagi P .Bilateral Cornual Ectopic Pregnancy - A Comment on the Published Case Report[Review of the article 'Bilaternal Cornual Ectopic Pregnancy ' by Najimudeen M].WebmedCentral 2013;4(2):WMCRW002482
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What are the main claims of the paper and how important are they?
This is a case report with no claims.
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Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.
This is acase report with no claims.
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Are the claims properly placed in the context of the previous literature?
Case report with no claims.
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Do the results support the claims? If not, what other evidence is required?
No results or claims in this case report.
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If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?
No protocol provided in this case report.
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Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?
No methodology provided in this case report.
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Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?
1. Past history is important in this case.
2. Detailed investigation presented in schedual would be more neet and clear.
3. Stating the way to treat the patient is not the way to provide discussion.
4. A lot of grammer and speling mistakes.
5. Pictures of ultrasound investigations would help.
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Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?
No it is not, this is single case report with limited information and no effort in discussion.
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Other Comments:
1. Past history is important in this case.
2. Detailed investigation presented in schedual would be more neet and clear.
3. Stating the way to treat the patient is not the way to provide discussion.
4. A lot of grammer and speling mistakes.
5. Pictures of ultrasound investigations would help. -
Competing interests:
None
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Invited by the author to review this article? :
No -
Have you previously published on this or a similar topic?:
No
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References:
None -
Experience and credentials in the specific area of science:
Author, Referee and Consultant Obstetrician and Gynaecologist
- How to cite: Othman M .Case Report[Review of the article 'Bilaternal Cornual Ectopic Pregnancy ' by Najimudeen M].WebmedCentral 2013;4(1):WMCRW002443
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The authorsclaim to report a case of bilateral cornual ectopic pregnancy without any associated predisposing factors like IUCD,Previous ectopic pregnancy ,PID,IVF although no mention of history of smoking is done which has proven as an important predisposing factor for tubal prregnancies besides subclinical infection with chlamydia trachomatis whiuch can be confirmed by serology ,and although important even the presence of second sac remains debatable without the figures provided as mentioned in text and second sac may be an artefact and without the photographs ine cant comment and the management also for a para1 patient should have been more conservative in the view of patient requirinf future fertility and danger of rupture uterus with the way it was managed.
Although bilateral cornual ectopic pregnancies are rare and that too spontaneous ones lot of cornual pregnancies have been reported with more sophisticated conservative management.
1. Lazard et al-Cornual resection for interstitial pregnancy by laparoendoscopic single site surgery(LESS)-Fertil Steril 2011;95:2432e5-8. where LESS performed using single incision laporoscopic surgery(SILS).
2. Smorgick et al-Combined local and systemic methotrexate treatment of viable ectopic pregnancies-outcome of 31 caes-J Clin Ultrasound 2008;36:545-50
3. Halperin et al-Conservative management of ectopic pregnancy with fetal cardiac activity by combined local(sonographically guided)and systemic onjection of methotrexate.-where 6/8 pts diagnosed with ectopic with cardiac activity succeeded to conceive within 6 mths following combined local and systemic injection of methotrexate.as compared to Smorogicks study who concluded combined MTX asministration was more effective for viable CS pregnancy but less for viable interstitial pregnancies although only 3 patients were studied.
4. Svirsky et al-Twin tubal pregnancy-a rising complication?-Fert Steril 2010;94:190.e13-6.where they found 4/163 tubal pregnancies in a 2 year period and concluded 3/4 cases identified in a 2 yr period following ART were TWIN Ntubal pregnancies and prompted study of epidemiology for rising incidence of twin tubal pregnancies and better treatrment modalities.Svirsky et al emphasized on safety of MTX in Reprod Toxicol 2009;27:85-7
Yes
No-although it is reported twin cornual ectopic pregnancies without proper figures/photographs of ultrasonography and laporotomy one cannot confirm the presence of 2nd nonviable sac claomed which may be an artefact-hence the author should provide figures to support the claim.
It's a case report
It's a case report
No.Firstly the diagnosis of bilateral tubal pregnancy is debatable and secondly even if it was the management for a patient desiring future fertility is not optimum with risk of rupture uterus.
The authors need to correct the grammatical errors like page 1 line 1 was needs to be omitted,line5-had undergone for was underwent,and correct spelling of cornual on line 25,26,28 and 33.Thet shoulkd provide the figure 1-4 mentioned in text to confirm the actual presence of a second sac in tube atleast in laporotomy picture or refute the diagnosis of bilateral cornual pregnancy.It is not difficult to do these although factors like a previous IUCD itself becomes a predisposing factor for subclinical PID but they should try to arrange for serology of C.trachomatis which maybe difficult in a peropheral centre and would be possible only in a proper teachiung institute or expensive and patient may not afford.
No.Firstly the diagnosis of bilateral tubal pregnancy is debatable and secondly even if it was the management for a patient desiring future fertility is not optimum with risk of rupture uterus.
Recently Prokineticins receptot 1 and2 have been implicated in the pathophysiology if increasing ectopic pregnancies in smokers and infections by C,trachomatis with PROKR1 and PROKR2 being invreased respectively in the twi mentioned conditrions and in an institute situation it woulkd be good to look foe PROK,activin A and Interleukin 1levels to further study the pathophysiology of such cases of twin tubal pregnancies.
None
No
Yes
Hetrotropic tubal secondary abdominal pregnancy with intrauterine twin pregnancies resulting in live twin births following laporotomy for secondary abdominal pregnancy following IVF. -Presented at the world conference on fallopian tube held at kolkata in 2005.
No