scholarly journals Cornual Heterotopic Pregnancy after Bilateral Salpingectomy and Uterine Septum Resection Resulting in Term Delivery of a Healthy Infant

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Serkan Oral ◽  
Yaşam Kemal Akpak ◽  
Nilay Karaca ◽  
Ali Babacan ◽  
Kadir Savan
Keyword(s):  
Ectopic Pregnancy ◽  
Transvaginal Ultrasound ◽  
Uterine Cavity ◽  
Heterotopic Pregnancy ◽  
Simultaneous Occurrence ◽  
Free Fluid ◽  
Uterine Septum ◽  
Bilateral Salpingectomy ◽  
Live Fetus

Heterotopic pregnancy is the simultaneous occurrence of two or more implantation sites. A 25-year-old infertile patient with a history of bilateral salpingectomy, uterine septum resection, and left cornual resection was diagnosed with heterotopic pregnancy in her secondin vitrofertilization trial. She attended our clinic when she was 7-week pregnant, complaining initially of severe abdominal pain. Findings associated with peritoneal irritation were positive during the physical examination. Transvaginal ultrasound revealed right cornual ectopic pregnancy with a live fetus in the middle of the uterine cavity. Also free fluid was noted in the pelvis. A diagnosis of heterotopic pregnancy with rupture of the cornual pregnancy was made. She underwent emergency laparoscopy with aspiration of the ruptured ectopic pregnancy, suturing to the entire visible cornual margins, and assurance of good haemostasis. Her recovery was uneventful and she continued receiving care in our obstetric unit. She delivered a healthy newborn by cesarean section at term.

scholarly journals Heterotopic pregnancy after in vitro fertilization and embryo transfer: A case report

2012 ◽  
Vol 140 (7-8) ◽  
pp. 511-514 ◽  
Author(s):  
Radmila Sparic ◽  
Snezana Buzadzic ◽  
Rajka Argirovic ◽  
Danijela Bratic ◽  
Darko Plecas
Keyword(s):  
Abdominal Pain ◽  
In Vitro Fertilization ◽  
Ectopic Pregnancy ◽  
Transvaginal Ultrasound ◽  
Reproductive Age ◽  
Heterotopic Pregnancy ◽  
Vitro Fertilization ◽  
Life Threatening ◽  
In Pregnancy

Introduction. Heterotopic pregnancy is a life-threatening complication of pregnancy defined as coexistent intrauterine and ectopic gestation. Its diagnosis is frequently overlooked and delayed. Case Outline. A 28-year-old woman experienced acute abdominal pain in pregnancy achieved by in vitro fertilization. Since all previous checkups indicated a normal course of pregnancy, the ectopic pregnancy was not suspected on admission. However, due to persistent hypotension, this diagnosis was also considered. Transvaginal ultrasound performed by an experienced obstetrician revealed an adnexal mass highly indicative of ectopic pregnancy. No fetal heart beats were visualized and the diagnosis of a missed abortion was made. A prompt laparotomy revealed a ruptured right ampullary pregnancy, and salpingectomy was performed. Conclusion. Although rare, heterotopic pregnancy should be considered in the differential diagnosis of abdominal pain in pregnancy. Every physician treating women of reproductive age should bear in mind the possibility of heterotopic pregnancy not only in patients with predisposing risk factors but also in those without them.

Ovarian ectopic pregnancy after in vitro fertilisation treated by laparoscopic excision with ovarian preservation

2020 ◽  
Vol 13 (11) ◽  
pp. e236680
Author(s):  
Kelly Ribeiro ◽  
Tarek El Shamy ◽  
Tariq Miskry
Keyword(s):  
Ectopic Pregnancy ◽  
Histopathological Examination ◽  
Early Recognition ◽  
Transvaginal Ultrasound ◽  
Lower Abdominal Pain ◽  
In Vitro Fertilisation ◽  
Free Fluid ◽  
Laparoscopic Excision ◽  
Life Threatening

A 42-year-old woman presented with lower abdominal pain and fainting episodes 36 days after in vitro fertilisation and embryo transfer. Transvaginal ultrasound revealed a large amount of free fluid in the pouch of Douglas and no evidence of an intrauterine gestational sac or adnexal mass suggestive of ectopic pregnancy. A presumed haemorrhagic corpus luteal cyst was seen in the left ovary. Laparoscopic exploration revealed a left ovarian haemorrhagic mass, which was excised with preservation of the ovary. Histopathological examination confirmed an ovarian ectopic pregnancy (OEP). OEP is rare but potentially life-threatening, as it can lead to internal haemorrhage. Its diagnosis is challenging as preoperative and intraoperative findings can be evocative of the far more frequent haemorrhagic corpus luteal cyst and histopathology is often necessary to confirm the diagnosis. Early recognition of OEP is crucial to reduce maternal morbidity and mortality, and allow treatment that preserves fertility as much as possible.

scholarly journals Heterotopic Pregnancy after In Vitro Fertilisation and Embryo Transfer Post-unilateral Salpingectomy: A Case Report and Literature Review

2022 ◽  
Author(s):  
Arjola Agolli ◽  
Hanyou Loh ◽  
Olsi Agolli
Keyword(s):  
Embryo Transfer ◽  
Clinical Symptoms ◽  
Transvaginal Ultrasound ◽  
Reproductive Age ◽  
Heterotopic Pregnancy ◽  
In Vitro Fertilisation ◽  
Simultaneous Occurrence ◽  
Intrauterine Pregnancy ◽  
Reproductive Techniques

Heterotopic pregnancy (HP) is the simultaneous occurrence of intrauterine and ectopic pregnancies (EP). The incidence of HPs occurring spontaneously ranges from 1 in 10,000 to 1 in 30,000. However, this incidence is reported to be 1 in 100 pregnancies following artificial reproductive techniques. HP is a potentially life-threatening condition that is frequently misdiagnosed, as most diagnoses for HPs are delayed, and are only made after rupture of the EP. A high index of suspicion is, therefore, required for an accurate and timely diagnosis in order to reduce maternal morbidity and mortality, which currently stands at 1 in 200,000 live births. The most common risk factors include pelvic inflammatory disease, previous EP, assisted reproduction techniques, and ovarian hyperstimulation syndrome. Transvaginal ultrasound is the gold standard for diagnosis. As detection of an intrauterine pregnancy often leads to the mistaken exclusion of a concomitant EP, a careful transvaginal scanning of the uterus and appendages should be performed in all females of reproductive age with a positive pregnancy test and red flags in anamnesis, and/or with clinical symptoms. Routine transvaginal ultrasound at Day 27 after embryo transfer could facilitate the diagnosis of HP; however, symptoms onset before or after Day 27 are clues to early diagnosis. MRI can be very helpful in diagnosing atypical cases.

scholarly journals HETEROTOPIC PREGNANCY – CASE REPORT

2020 ◽  
Vol 73 (4) ◽  
pp. 828-830
Author(s):  
Michal Swiniarski ◽  
Monika Sadkowska ◽  
Grzegorz Roman ◽  
Lukasz Szeszko ◽  
Olimpia Sipak-Szmigiel
Keyword(s):  
Caesarean Section ◽  
Ectopic Pregnancy ◽  
First Trimester ◽  
Tubal Pregnancy ◽  
Heterotopic Pregnancy ◽  
Simultaneous Occurrence ◽  
Free Fluid ◽  
Intrauterine Pregnancy ◽  
Normal Delivery ◽  
Reproductive Techniques

Heterotopic pregnancy is the simultaneous occurrence of intrauterine and ectopic pregnancy. This situation is very rare (1:30 000 pregnancies), while recently, with the development of assisted reproductive techniques, the incidence has increased to 1:100 – 1:500 pregnancies. The aim of the study is to present the situation of coexistence of intrauterine pregnancy and ruptured tubal pregnancy. The case concerns a 32-year-old patient in the 12th week of the second pregnancy in whom the only risk factor was the state after Caesarean section and thus possible intraperitoneal adhesions. The ultrasound revealed normal intrauterine pregnancy and a very large amount of free fluid in the smaller pelvis. After immediate surgical intervention, a ruptured right tubal pregnancy was found. Right fallopian tube was removed. After the operation, the patient with the preserved intrauterine pregnancy was discharged from the ward. Further intrauterine pregnancy was normal. Delivery by Caesarean section. Conclusions: The described case indicates that the existence of intrauterine pregnancy does not exclude the existence of ectopic pregnancy and emphasizes the great importance of correctly and accurately carried out ultrasound examination in the first trimester of pregnancy along with appendicitis assessment. Early diagnosis of heterotopic pregnancy reduces the risk of complications.

Heterotopic pregnancy; case report

2019 ◽  
Vol 7 (05) ◽  
Author(s):  
Vipul R. Khandagale
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Adnexal Mass ◽  
Heterotopic Pregnancy ◽  
Free Fluid ◽  
Threatening Condition ◽  
Life Threatening ◽  
Ectopic Pregnancies ◽  
High Index Of Suspicion ◽  
Low Risk Women

Heterotopic pregnancy is a rare clinical condition in which intrauterine and extrauterine pregnancies occur at the same time. It can be a life threatening condition and easily missed with the diagnosis. We present the case of a 37 year old patient who was treated for a heterotopic pregnancy with live intrauterine gestation and ruptured left adnexal gestation.The ectopic pregnancy was not suspected at her initial presentation. A high index of suspicion is needed in women with risk factors for an ectopic pregnancy and in low risk women who have free fluid with or without an adnexal mass with an intrauterine gestation.It is difficult to estimate exactly the incidence of ectopic pregnancies, but on an average it is approximately 1:300 normal pregnancies worldwide.

scholarly journals Cervical Twin Heterotopic Pregnancy: Overview of Ectopic Pregnancies and Scanning Detection Algorithm

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 969
Author(s):  
Antonios Koutras ◽  
Zacharias Fasoulakis ◽  
Michail Diakosavvas ◽  
Athanasios Syllaios ◽  
Athanasios Pagkalos ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Uterine Cavity ◽  
Medical Abortion ◽  
First Trimester ◽  
Detection Algorithm ◽  
Heterotopic Pregnancy ◽  
Cervical Canal ◽  
Mortality And Morbidity ◽  
Gestational Sac ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is the leading cause of gestation-related deaths during the first trimester. Cervical twin heterotopic pregnancies, when ectopic, constitute a small and rare part of gynecological surgery. Case Presentation: A 30-year-old pregnant woman (gravida 3, para 2) presented with mild pain in the lower abdomen and traces of bleeding per vaginum for three days. Transvaginal ultrasonography revealed a balloon-shaped cervical canal with a visible gestational sac measuring 3.5 × 3.9 cm. A second gestational sac was seen in the uterine cavity. The measurements of the gestational sacs corresponded to 7 + 4 weeks’ pregnancy. A decision for medical abortion with mifepristone and misoprostol was made. However, due to an incomplete abortion and continuous bleeding, a curettage was performed. Conclusions: Spontaneous heterotopic pregnancy with the ectopic pregnancy located in the cervix is an extremely rare clinical condition requiring urgent treatment in order to reduce maternal mortality and morbidity and preserve fertility.

Caution with bilateral salpingectomy and consideration of tubal stump ectopic in IVF

2020 ◽  
Vol 13 (11) ◽  
pp. e235893
Author(s):  
Swee Lin Yip ◽  
Shahul Hameed Mohamed Siraj ◽  
Jerry Kok Yen Chan
Keyword(s):  
Ectopic Pregnancy ◽  
Cystic Mass ◽  
In Vitro Fertilisation ◽  
Beta Human Chorionic Gonadotropin ◽  
Life Threatening ◽  
History Of ◽  
Bilateral Salpingectomy ◽  
Ectopic Pregnancies ◽  
The Right

We report a 35-year-old female patient with a history of bilateral salpingectomy from ectopic pregnancies presenting with a positive serum beta-human chorionic gonadotropin (bhCG) result following in vitro fertilisation (IVF) treatment. Apart from per vaginal spotting, she remained asymptomatic. Initial ultrasound showed an empty uterus with a cystic mass on the right side of the uterus. Serum beta-hCG was trended. A follow-up pelvic ultrasound 1 week later showed a live pregnancy in the right adnexa. A diagnostic laparoscopy was performed, which revealed an unruptured right stump ectopic pregnancy that was successfully removed. As a stump ectopic pregnancy can be a potentially life-threatening occurrence, we emphasise caution with salpingectomy and the consideration of tubal stump ectopic pregnancies following IVF treatment.

Infrahepatic Implantation of an Ectopic Pregnancy

2021 ◽  
pp. 1-3
Author(s):  
Peter Kern ◽  
Paula Ulrich ◽  
Rainer Kimmig ◽  
Peter Kern
Keyword(s):  
Ectopic Pregnancy ◽  
Close Contact ◽  
Blood Clot ◽  
Abdominal Cavity ◽  
Uterine Cavity ◽  
Greater Omentum ◽  
Free Fluid ◽  
Fallopian Tubes ◽  
Lower Abdomen ◽  
The Right

Background: Ectopic pregnancies occur predominantly in the fallopian tubes or ovaries. Very rarely, the distal part of the greater omentum may have close contact to the fallopian tubes and implantation of the embryo may occur in this part of the greater omentum. In the absence of signs of pregnancy in the uterus or the fallopian tubes, the greater omentum has to be closely examined for ectopic pregnancy. Case Presentation: A 22-year-old woman in her 4th week of pregnancy presents with spotting and severe pain in the right lower abdomen with a history of 2 cesarean sections. The sonographic examination showed a normal uterus with a thin endometrial line. The uterine cavity did not present with any signs of a gestational sac. A great amount of free fluid in the Douglas cavity suspicious of a hemoperitoneum. ßhCG-values in serum was highly elevated up to 16749 mU/ml and confirmed the suspicion of an ectopic pregnancy. A diagnostic laparoscopy was performed, during which a blood clot reaching from the right lower abdomen to the greater omentum was detected. After removing the blood clot, a normal-sized uterus with regular ovaries and no signs of a pregnancy in the fallopian tubes were seen. However, an abdominal adhesion in the right upper part of the omentum close to the liver with bleeding was seen. While examining the abdominal cavity for the cause of bleeding, a small cystic lesion adherent to the greater omentum – close the offspring from the colon – representing an ectopic pregnancy became apparent. A partial omentectomy of 9,5 cm x 5,5 cm x 2,5 cm was performed with the finding of trophoblast and embryoblast implantated in the infrahepatic part of the greater omentum. Conclusion: In cases of ectopic pregnancy with hemoperitoneum, special care has to be taken examining not only the fallopian tubes or ovaries but also the greater omentum, which may harbour an implanted trophoblast and embryoblast – even in the upper part directly beneath the liver – as presented in this case. In cases of ruptured ectopic pregnancy of the greater omentum, the cases may be dealt with laparoscopic partial omentectomy if the case is early detected.

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