Mature solid tubal teratoma producing β-HCG simulating a ruptured tubal ectopic pregnancy

2016 ◽  
Vol 198 ◽  
pp. 165-166
Author(s):  
Diana Dopico Vázquez ◽  
Ana Pereda Ríos ◽  
Cristina Freire Calvo ◽  
Pedro Rodríguez Barro ◽  
Cristina Guillán Maquieira ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Tubal Ectopic Pregnancy ◽  
Β Hcg

scholarly journals Unexpected rupture of an expectantly managed tubal ectopic pregnancy: a reminder for enhanced diligence

2019 ◽  
Vol 12 (12) ◽  
pp. e230876
Author(s):  
Amenda Ann Davis ◽  
Kusum Lata ◽  
Akshita Panwar ◽  
Alka Kriplani
Keyword(s):  
Ectopic Pregnancy ◽  
Chorionic Gonadotropin ◽  
Expectant Management ◽  
Close Monitoring ◽  
Original Diagnosis ◽  
Tubal Ectopic Pregnancy ◽  
Β Hcg ◽  
Ectopic Pregnancies ◽  
Asymptomatic Women ◽  
Low Serum

Expectant management of tubal ectopic pregnancies is a feasible and possibly preferable method of management in asymptomatic women with low serum β-human chorionic gonadotropin (hCG). This involves serial monitoring of β-hCG until negative, after which it is deemed as spontaneously resolved ectopic pregnancy. We describe a case of tubal ectopic pregnancy which was expectantly managed with an initial β-hCG of 585 mIU/mL until undetectable. This patient presented with ruptured ectopic pregnancy 8 weeks after the original diagnosis, at the level of 5 mIU/mL. This highlights the importance of close monitoring in the expectant management of tubal ectopic pregnancies, with the incorporation of imaging, even when serial β-hCG shows a persistently reducing trend.

scholarly journals A Rare Case of Bilateral Tubal Ectopic Pregnancy Following Intracytoplasmic Sperm Injection-Embryo Transfer (ICSI-ET)

2020 ◽  
Vol 42 (03) ◽  
pp. 165-168
Author(s):  
Ferruh Acet ◽  
Ege Nazan Tavmergen Goker ◽  
Ismet Hortu ◽  
Gulnaz Sahin ◽  
Erol Tavmergen
Keyword(s):  
Ectopic Pregnancy ◽  
Embryo Transfer ◽  
Tubal Pregnancy ◽  
Serum Progesterone ◽  
Tubal Ectopic Pregnancy ◽  
Vitro Fertilization ◽  
Reproductive Techniques ◽  
History Of ◽  
Β Hcg

AbstractBilateral tubal ectopic pregnancy is a very rare form of ectopic pregnancy. The incidence is higher in women undergoing assisted reproductive techniques or ovulation induction. We report the case of bilateral tubal ectopic pregnancy. The patient was 30 years old and had a 3-year history of infertility; she was referred to the in-vitro fertilization (IVF) program because of tubal factor infertility. A pregnancy resulted from the transfer of two embryos during an artificial cycle. Despite the increase in β-hCG values during the follow-up, 22 days after the embryo transfer, the β-hCG levels were 2,408 U/L and the serum progesterone (P4) level was 10.53 ng/ml. After application with methotrexate, β-hCG levels did not decrease effectively. Moreover, the sonographic screening revealed a suspicious bilateral tubal focus for ectopic pregnancy. A mini-laparotomy was performed and a bilateral tubal pregnancy was found. In the case of unilateral tubal pregnancy after the transfer of two embryos, the situation of the other tube should be systematically checked and β-hCG levels should be monitored.

scholarly journals Comparison of outcome in medical versus expectant management in unruptured tubal pregnancy with β-hCG 1000-3000 IU/L

2020 ◽  
Vol 9 (6) ◽  
pp. 2239
Author(s):  
Sidra Arshad ◽  
Sonia Andeel ◽  
Samia Asghar ◽  
Sana Hafeez ◽  
Sana Asghar ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Medical Management ◽  
Expectant Management ◽  
Tubal Pregnancy ◽  
Free Fluid ◽  
Tubal Ectopic Pregnancy ◽  
Group A ◽  
The Mean ◽  
Β Hcg ◽  
Group B

Background: Ectopic pregnancy (EP) is an important cause of maternal morbidity as well as mortality in the 1st trimester. This study was done to compare outcome in medical versus expectant management in patients with unruptured tubal pregnancy having β-hCG 1000-3000 IU/L.Methods: In this randomized controlled trial, 82 (41 in each group) women with tubal ectopic pregnancy (TEP) having β-hCG levels between 1000-3000 IU/L and 18 to 40 years of age were enrolled. Women having non-tubal pregnancy, ruptured ectopic pregnancy, heterotopic pregnancy, hypersensitivity to methotrexate were excluded. Included women were randomly assigned to either Group-A (expectant management) or Group-B (medical management). Outcome was measured after one week and considered successful if patient had β-hCG levels negligible i.e. <10 IU/L and complete resolution on ultrasonography (absence of adnexal mass, pelvic free fluid, gestational sac).Results: Overall mean age was 30.65±6.37 years. The mean gestational age in Group-A was 7.12±2.12 weeks and 7.63±2.41 weeks in Group-B. The mean β-hCG levels in Group-A was 1984.63±515.81 IU/L and 1937.33±519.68 IU/L in Group-B. Outcome was successful in 90.24% in Group-A and 63.41% in Group-B (p-value=0.004).Conclusions: Expectant management is associated with better outcome as compared to medical management in tubal ectopic pregnancy having β-hCG between 1000-3000 IU/L.

Comparison of Successful Outcome in Medical Versus Expectant Management in Patients with Unruptured T. P. having Β-Hcg 1000-3000 Iu/L

2021 ◽  
Vol 15 (10) ◽  
pp. 2729-2932
Author(s):  
Bilqees Akhtar Malik ◽  
Andleeb Arshad ◽  
Misbah Kausar Javaid
Keyword(s):  
Ectopic Pregnancy ◽  
Medical Management ◽  
Expectant Management ◽  
Successful Outcome ◽  
Military Hospital ◽  
Free Fluid ◽  
Tubal Ectopic Pregnancy ◽  
Group A ◽  
Β Hcg ◽  
Group B

Objective: To compare the successful outcome in medical versus expectant management in patients with unruptured tubal pregnancy having β-hcg 1000-3000 IU/L. Materials & Methods: In this randomized controlled trial, total 90 patients of ectopic pregnancy having age 18-40 years and having size of ectopic mass< 4cm were selected from the Department of Obstetrics & Gynecology Combined Military Hospital, Bahawalpur from March 20 to September 20. Group A included patients in which expectant management was done while Group B included the patients in which medical management (single intramuscular injection of methotrexate in a dose of 50mg/m2) was done. After one week, successful outcome was compared between the both groups. Results: Total 90 women with tubal ectopic pregnancy were selected for this study. Comparison of successful outcome between the bot study groups was done. Mean age of the patients was 31.66 ± 6.44 years, mean gestational age was 7.83 ± 2.33 weeks and mean β-hcg levels 1565.45 ± 517.89 IU/L. In study group A, outcome was found successful in 40 (88.89%) patients and 31 (68.89%) patients of group B was found with successful outcome. After applying chi-square test, difference of successful outcome between the both groups was found statistically significant with p value 0.037. Conclusion: This study concluded that expectant management is associated with better outcome (β-hcg levels negligible i.e. <10 IU/L and complete resolution on ultrasonography (absence of adnexal mass, pelvic free fluid, gestational sac) within one week) as compared to medical management in women with tubal ectopic pregnancy having β-hcg between 1000-3000 IU/L Keywords: Ectopic pregnancy, methotrexate, expectant, resolution

scholarly journals Case Report of an Undisturbed Ectopic Pregnancy with Very High Human Chorionic Gonadotrophin (β-hCG)

2021 ◽  
Vol 33 (3) ◽  
pp. 41-45
Author(s):  
Gulmeen Raza ◽  
Maha Abdelwahab Ghorabah
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Cesarean Section ◽  
Ectopic Pregnancy ◽  
Fallopian Tube ◽  
Chorionic Gonadotrophin ◽  
Human Chorionic Gonadotrophin ◽  
Tubal Ectopic Pregnancy ◽  
Β Hcg ◽  
Very High

This is a case report of a patient with an undisturbed ectopic pregnancy and very high levels of human chorionic gonadotrophin (β-HCG). The patient presented to the emergency room at 9+1 weeks of gestation with mild abdominal pain and vaginal bleeding. She had an obstetric history of two previous cesarean section deliveries. On presentation, her human chorionic gonadotropin (β-HCG) was measured to be 26,530 mIU/ml, and after 18 hours, the β-HCG level was 25,660 mIU/ml. An ultrasound scan revealed no evidence of intrauterine pregnancy, a left ovarian cyst measuring 2.86 cm x 2.17 cm, and the presence of a mixed mass near the ovary measuring 3.92 cm x3.62 cm. The patient was diagnosed with a left tubal ectopic pregnancy and was taken for an immediate laparoscopy. Intraoperatively, the left tubal ectopic pregnancy was undisturbed and measured about 4-5 cm involving more than half of the fallopian tube. The mixed mass, along with the left fallopian tube, was removed as a whole. Keywords: Abdominal pain, Cesarean Section, Ectopic-pregnancy, Laparoscopy, Tubal pregnancy, Ultrasonography

scholarly journals Outcome of Methotrexate Management in Tubal Ectopic Pregnancy: A Retrospective Study in Women's Hospital in Qatar

2015 ◽  
Vol 9 (2) ◽  
pp. 118-122
Author(s):  
M Gasim ◽  
Mohamed Diai ◽  
Mohammed Taha ◽  
Mona Alsaadi ◽  
Prem Chandra ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Ectopic Pregnancy ◽  
Success Rate ◽  
Obstet Gynecol ◽  
Tubal Ectopic Pregnancy ◽  
Institutional Review ◽  
Beta Human Chorionic Gonadotropin ◽  
Β Hcg ◽  
Study Inclusion

ABSTRACT Objective Ectopic pregnancy case fatalities have decreased dramatically, although incidence has remained steady over years. Advancement in early diagnosis methods and introduction of methotrexate (MTX) in the management has led to such improvement. Different protocols, such as single, two dose and multiple doses of MTX has been indorsed by the American congress of obstetrics and gynecology. Here at Women's Hospital in Qatar we use single dose protocol. However, there no previous report on the outcome of MTX in term success rate in Qatar. Methods A retrospective study on patients diagnosed with tubal ectopic pregnancy between Jan 2008 and Dec 2010 were conducted. Institutional review board of Hamad Medical Corporation, Qatar, approved this study. Statistical analysis were done using SPSS Inc. Ver 20, Chicago, IL. Results Two hundred and forty-eight file met the study inclusion and exclusion criteria, but only 196 completed their followup until beta-human chorionic gonadotropin (â-hCG) less than 15 IU/L. Methotrexate prescribing has increased three times over the study period. The success rate for MTX was 89% and it was positively correlated with lower initial β-hCG levels. However, six out six patients with in β-hCG levels more than 10,000 IU/L were successfully treated with MTX. Conclusion Methotrexate is effective method of treatment in stable patients. Further studies are required to investigate role of MTX in patients with high β-hCG levels (> 10,000 IU/L). How to cite this article Gasim M, Diai M, Taha M, Alsaadi M, Chandra P, Mohamed A, Bayo AI, Ahmed B. Outcome of Methotrexate Management in Tubal Ectopic Pregnancy: A Retrospective Study in Women's Hospital in Qatar. Donald School J Ultrasound Obstet Gynecol 2015;9(2):118-122.

scholarly journals Tubal Stump Ectopic: A Case Report on Repeat Ipsilateral Tubal Ectopic Pregnancy

2021 ◽  
pp. 1-3
Author(s):  
Maryam Rahim ◽  
Maryam Rahim ◽  
Shikha Aggarwal
Keyword(s):  
Abdominal Pain ◽  
Northern Ireland ◽  
Ectopic Pregnancy ◽  
Adnexal Mass ◽  
Tubal Ectopic Pregnancy ◽  
Mild Abdominal Pain ◽  
Pouch Of Douglas ◽  
Β Hcg ◽  
Laparoscopic Salpingectomy ◽  
Infrequent Event

Background: Tubal Stump Ectopic is an infrequent event with critical obstetrical consequences. A case is illustrated from Northern Ireland in which an ectopic pregnancy was discovered in the tubal stump previously undergone salpingectomy. Case Facts: A 34-year-old woman (G2 E1) with a tubal stump ectopic of a previous cornual excision two years prior, presented to EPAU complaining of mild abdominal pain and 6 weeks amenorrhoea. She was clinically stable (β-hCG 1407 mIU/mL), while TVUS revealed no evidence of IUP or adnexal mass but fluid in the Pouch of Douglas. Laparoscopic salpingectomy was performed after a diagnosis of tubal stump ectopic. Inference: Women who has had a previously ectopic pregnancy are at a significantly greater probability of relapse. To correctly and quickly identify the implanted location, a TVUS should be conducted. Laparoscopic diagnostic salpingectomy should be performed through excision by diathermy to prevent the risk of EP in the tubal stump.

Role of Serum β-HCG doubling in Diagnosis of Early Pregnancy and its Management Strategy

2020 ◽  
Vol 16 ◽  
Author(s):  
Divya Mirji ◽  
Shubha Rao ◽  
Akhila Vasudeva ◽  
Roopa P.S
Keyword(s):  
Ectopic Pregnancy ◽  
Early Pregnancy ◽  
Management Strategy ◽  
Transvaginal Ultrasound ◽  
Expectant Management ◽  
First Trimester ◽  
Intrauterine Pregnancy ◽  
Β Hcg ◽  
Pregnancy Of Unknown Location

Background: Pregnancy of unknown location (PUL) is defined as the absence of intrauterine or extrauterine sac and Beta Human Chorionic Gonadotropin levels (β-HCG) above the discriminatory zone of 1500 mIU/ml. It should be noted that PUL is not always an ectopic; however, by measuring the trends of serum β-HCG, we can determine the outcome of a PUL. Objective: This study aims to identify the various trends β-HCG levels in early pregnancy and evaluate the role of β-HCG in the management strategy. Methods: We conducted a prospective observational study of pregnant women suspected with early pregnancy. Cases were classified as having a pregnancy of unknown location (PUL) by transvaginal ultrasound and ß-HCG greater than 1000 mIU/ml. Expectant management was done until there was a definite outcome. All the collected data were analyzed by employing the chi-square test using SPSS version 20. Results: Among 1200 women who had early first trimester scans, 70 women who fulfilled our criteria of PUL and ß-HCG > 1000 mIU/ml were recruited in this study. In our study, the mean age of the participants was 30±5.6yrs, and the overall mean serum ß-HCG was 3030±522 mIU/ml. The most common outcome observed was an ectopic pregnancy, 47% in our study. We also found the rate of failing pregnancy was 27%, and that of intrauterine pregnancy (IUP) was 25%. Overall, in PUL patients diagnosed with ectopic pregnancy, 9% behaved like IUP, and 4% had an atypical trend in their ß-HCG. Those who had an IUP, 11% had a suboptimal increase in ß-HCG. Conclusion: PUL rate in our unit was 6%. Majority of the outcome of PUL was ectopic in our study. Every case of PUL should be managed based on the initial ß-HCG values, clinical assessments and upon the consent of the patient.

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