Does Methotrexate Lead to a Pathological Reaction in the Fallopian Tube When Administered to a Patient with an Ectopic Pregnancy?

2016 ◽  
Vol 23 (7) ◽  
pp. S169
Author(s):  
Y Gil ◽  
A Zubkov ◽  
A Cohen ◽  
Y Kopolivich ◽  
I Levin
Author(s):  
V.N. Demidov, N.V. Mashinets

Two rare observations of disturbed ectopic pregnancy in isthmic part of the fallopian tube for a 5 weeks of gestation are presented. Clinical and echographic signs of this pathology are considered.


2021 ◽  
Vol 20 (4) ◽  
pp. 12-16
Author(s):  
Aml El-Shabrawy ◽  
◽  
Ahmed Elsheikh ◽  
Samy Gebreel ◽  
Mohammed Elsokkary ◽  
...  

Objective. Ectopic pregnancy adversely affects the patency of the fallopian tube and consequently the future pregnancy. There are different options of conservative treatment of tubal pregnancy such as methotrexate and salpingostomy [1]. There is little information on the success rate of maintaining tubal patency after methotrexate and salpingostomy [2]. Therefore, the aim of this study is to evaluate the ipsilateral tubal patency using HyCoSy after treatment of tubal pregnancy with methotrexate therapy versus salpingostomy. Patients and methods. This was a case-series study conducted in Ain Shams and Al-Azhar University Maternity Hospitals to evaluate the ipsilateral tubal patency using hysterosalpingo-contrast sonography (HyC0Sy) following salpingostomy and medical treatment of tubal pregnancy. This study included patients who were admitted to Ain Shams and Al-Azhar University Maternity Hospitals for having tubal pregnancy and were treated either with methotrexate or salpingostomy over a 4-year period between January 2017 and December 2020. The patients seeking fertility were re-evaluated for fallopian tubes patency by hysterosalpingogram 3 months after discharge. The study included 2 groups of women: group I (n = 200): women who were treated with methotrexate, and group II (n = 140): women who underwent salpingostomy. Results. HSG was performed in 200 cases of patients with tubal pregnancy who were treated with methotrexate and 140 cases of patients who underwent salpingostomy. The patency of the ipsilateral tube was 85% after methotrexate treatment and 84.2% after salpingostomy. There was no statistically significant difference between the two groups. Conclusion. The findings suggest similar success rate in maintaining the patency of the fallopian tube with either methotrexate or salpingostomy. Key words: ectopic pregnancy, hysterosalpingography, methotrexate, infertility, salpingostomy


2020 ◽  
Vol 11 (6) ◽  
pp. 710-711
Author(s):  
M. Ginzburg

To the Vorrat l. a woman was brought in a state of collapse with a diagnosis of an ectopic pregnancy; pulse 144, barely perceptible. The rupture occurred in 18 hours, there were fainting, vomiting. The abdomen is not distended, soft, the tumor cannot be felt from the outside, and per vaginam examination is not done to speed up the operation. When the abdomen was opened, the tissues were found bloodless: none of the vessels showed blood; a few pounds of liquid blood spilled out of the peritoneal cavity; clamps were placed on the stretched right fallopian tube and broad ligament, and the fallopian tube was excised along with the ovary; the rupture was near the uterus. The operated woman recovered, although W. did not count on it.


2018 ◽  
Vol 46 ◽  
pp. 5
Author(s):  
Jia-San Zheng ◽  
Zheng Wang ◽  
Jia-Ren Zhang ◽  
Shuang Qiu ◽  
Ren-Yue Wei ◽  
...  

Background: Ectopic pregnancy mainly refers to tubal pregnancy and abdominal pregnancy. Tubal pregnancy presents as an implanted embryo that develops in the fallopian tubes, and is relatively common in humans. In animals, tubal pregnancy occurs primarily in primates, for example monkeys. The probability of a tubal pregnancy in non-primate animals is extremely low. Abdominal pregnancy is a type of ectopic pregnancy that occurs outside of the uterus, fallopian tube, ovary, and ligament(broad ligament, ovarian ligament, suspensory ligament).This paper describes two cases of ectopic pregnancy in cats.Cases: Cat 1. The presenting sign was a significant increase in abdominal circumference. The age and immune and sterilization status of the cat were unknown. On palpation, a 4 cm, rough, oval-shaped, hard mass was found in the posterior abdomen. Radiographic examination showed three high-density images in the posterior abdomen. The fetus was significantlycalcified and some feces was evident in the colon. The condition was preliminarily diagnosed as ectopic pregnancy. Cat 2. The owner of a 2-year-old British shorthair cat visited us because of a hard lump in the cat’s abdomen. The cat had a normal diet and was drinking normally. Routine immunization and insect repulsion had been implemented. The cat had naturally delivered five healthy kittens two months previous. Radiographs showed an oval-shaped mass with a clear edge in the middle abdominal cavity. Other examinations were normal. The case was preliminarily diagnosed as ectopic pregnancy, and the pregnancy was surgically terminated. The ectopic pregnancies were surgically terminated. During surgery, the structures of the uterus and ovary of cat 1 were found to be intact and the organs were in a normal physiological position.Cat 1 was diagnosed with primary abdominal pregnancy. In cat 2, the uterus left side was small and the fallopian tube on the same side was both enlarged and longer than normal. Immature fetuses were found in the gestational sac. Thus, cat 2 was diagnosed with tubal ectopic pregnancy based on the presenting pathology.Discussion: Cats with ectopic pregnancies generally show no obvious clinical symptoms. The ectopic fetus can remain within the body for several months or even years. Occasionally, necrotic ectopic tissues or mechanical stimulation of the ectopic fetus can lead to a systemic inflammatory response, loss of appetite, and apathy. The two cats in our reportshowed no significant clinical symptoms. To our knowledge, there have been no previous reports of the development of an ectopic fetus to maturity, within the abdominal cavity of felines, because the placenta of cats cannot support the growth and development of the fetus outside of the uterus. Secondary abdominal ectopic pregnancy, lacking any signs of uterine rupture is likely associated with the strong regenerative ability of uterine muscles. A damaged uterus or fallopian tube can quickly recover and rarely leaves scar tissue. In the present report, cat 1 showed no apparent scar tissue, nor signs of a ruptured ovary or fallopian tubes. It was diagnosed with primary ectopic abdominal pregnancy, which could arise from the descent of the fertilized egg from the fallopian tube into the abdominal cavity. There was an abnormal protrusion in left of the fallopian tubes in cat 2, to which the gestational sac was directly connected. Based on pathological examination of the uterus, fallopian tubes, and gestational sac, the cat was diagnosed with a tubal pregnancy. Placental tissues and signs of fetal calcification were observed in both the fallopian tube and gestational sac.Keywords: tubal pregnancy, abdominal pregnancy, feline, ectopic fetus, fallopian tube, gestational sac.


Author(s):  
Tanjona Andriamanetsiarivo Ratsiatosika ◽  
Romuald Randriamahavonjy ◽  
Baco Abdallah Abasse ◽  
Mahefarisoa Fnat ◽  
Ibrahim Housni ◽  
...  

Ectopic pregnancy is a life-threatening condition occurring in 1-2% of all pregnancies. The most common site of implantation for an ectopic pregnancy is the fallopian tube. Authors report a case of recurrent ipsilateral ectopic pregnancy following right partial salpingectomy of a 29-Year-Old woman that led to tubal rupture. The pregnancy was conceived spontaneously. Diagnostic of ruptured ectopic pregnancy was done after clinical and ultrasonography examination. The presence of a massive hemoperitoneum with a positive pregnancy urinary test that lead us to the diagnosis of ectopic pregnancy. She underwent a laparotomy for a suspicion of ruptured ectopic pregnancy. The ectopic pregnancy was identified in the left remnant fallopian tube. Partial salpingectomy, removal of tubal stump, and resection of the uterine cornua, was performed. The postoperative recovery was uneventful. She has stayed for five days at the Hospital. All patients, even though they have already received a definitive contraception by tubal section and ligature or unilateral or by bilateral salpingectomy for any reason, must seek an ectopic pregnancy in case of pelvic pain, vaginal bleeding and/ or amenorrhea. Authors propose to carry a total salpingectomy after a chosen surgical treatment.


1990 ◽  
Vol 5 (8) ◽  
pp. 1023-1024 ◽  
Author(s):  
Rifky R. Guirgis ◽  
William Fiamanya ◽  
Talha Al-Shawaf ◽  
Ian L. Craft

2020 ◽  
Vol 7 (1) ◽  
pp. 12-16
Author(s):  
Naheed Fatema ◽  
Zannatul Ferdosh ◽  
Sherajum Munira ◽  
KAM Mahbub Hasan ◽  
Nasim Iftekhar Mahmud ◽  
...  

Background: Management of ectopic pregnancy is very crucial issue for the survival of the patients. Objective: The purpose of the present study was to observe the surgical management and per-operative findings of women with ectopic pregnancy. Methodology: This cross-sectional study was carried out in the inpatient Department of Obstetrics and Gynaecology at Bangladesh Medical College Hospital, Dhaka, Bangladesh from January 2009 to December 2009 for a period of one (1) year. All clinically suspected cases of ectopic pregnancy within the reproductive age admitted in the department of Obstetrics and Gynaecology at the Bangladesh Medical College Hospital, Dhaka were included in the present study. In most of the cases, laparoscopy or laparotomy was done to confirm the diagnosis and manage the cases. Result: A total number of 48 cases of ectopic pregnancy women were recruited for this study. The highest number of ectopic pregnancy occurs in the ampulla of the fallopian tube which was 27(58.3%) cases. The right tube had been found to be affected more than the left which was 30(62.5%) cases and 18(37.5%) cases respectively. Most of the patients were presented with ruptured tubal pregnancy which was 30(62.5%) cases. Opposite tube was normal looking in 25(52.1%) cases. Unilateral salpingectomy and salpingectomy with contra lateral tubectomy were operated in 32(66.7%) cases and 10(20.8%) cases respectively. Conclusion: In conclusion most of the ectopic pregnancy is occurred in the site of ampulla of fallopian tube in right side which are mostly surgically managed by unilateral salpingectomy. Journal of Current and Advance Medical Research 2020;7(1): 12-16


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