scholarly journals Spontaneous Heterotopic Pregnancy: Dual Case Report and Review of Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Annika Chadee ◽  
Shadi Rezai ◽  
Catherine Kirby ◽  
Ekaterina Chadwick ◽  
Sri Gottimukkala ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Rare Complication ◽  
Heterotopic Pregnancy ◽  
Pelvic Surgery ◽  
Intrauterine Pregnancy ◽  
Fertility Treatments ◽  
Populations At Risk ◽  
History Of ◽  
High Index Of Suspicion

Introduction.Heterotopic pregnancy is a rare complication usually seen in populations at risk for ectopic pregnancy or those undergoing fertility treatments. It is a potentially dangerous condition occurring in only 1 in 30,000 spontaneous pregnancies. With the advent of Assisted Reproduction Techniques (ART) and ovulation induction, the overall incidence of heterotopic pregnancy has risen to approximately 1 in 3,900 pregnancies. Other risk factors include a history of pelvic inflammatory disease (PID), tubal damage, pelvic surgery, uterine Mullerian abnormalities, and prior tubal surgery. Heterotopic pregnancy is a potentially fatal condition, rarely occurring in natural conception cycles. Most commonly, heterotopic pregnancy is diagnosed at the time of rupture when surgical management is required.Case.This paper represents two cases of heterotopic pregnancies as well as a literature review.Conclusion.Heterotopic pregnancy should be suspected in patients with an adnexal mass, even in the absence of risk factors. Clinicians must be alert to the fact that confirming an intrauterine pregnancy clinically or by ultrasound does not exclude the coexistence of an ectopic pregnancy. A high index of suspicion in women is needed for early and timely diagnosis, and management with laparotomy or laparoscopy can result in a favorable and successful obstetrical outcome.

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 Management outcomes of ectopic pregnancy depending on different treatment modalities: a cohort study

2021 ◽  
Vol 10 (3) ◽  
pp. 842
Author(s):  
Shawqi H. Alawdi ◽  
Mayada Roumieh ◽  
Marwan Alhalabi
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Single Dose ◽  
Ectopic Pregnancy ◽  
Surgical Intervention ◽  
Expectant Management ◽  
Pelvic Surgery ◽  
Dose Methotrexate ◽  
Significant Difference ◽  
History Of

Background: Ectopic pregnancy is the most common cause of maternal morbidity and mortality during the first trimester of pregnancy. The present study aimed to review and evaluate the management outcomes of ectopic pregnancy in Damascus University Maternity Hospital, Syria.Methods: A retrospective cohort study was performed on women referring to Damascus University Hospital of Obstetrics and Gynecology (OBGYN) for ectopic pregnancy. Patients were assigned into groups by method of treatment: expectant management (Group 1), single-dose methotrexate regimen (Group 2), two-dose methotrexate regimen (Group 3), and surgical intervention (Group 4). Parameters assessed were risk factors for ectopic pregnancies, transvaginal ultrasonography findings, serum human chorionic gonadotropin (hCG) levels on Days 0, 4, 7, and types of surgical intervention in women that underwent any surgical intervention. A treatment modality was considered successful when hCG levels declined to less than 5 mIU/L without further administration of methotrexate dose or need for surgery.Results: Seventy-seven women with ectopic pregnancy were admitted to the hospital during the study period. Groups 1, 2, 3, and 4 constituted 20.8%, 13.0%, 6.5% and 59.7% of the patients respectively. The most common encountered risk factors for ectopic pregnancy in the patients were history of previous intra-abdominal or pelvic surgery (57.1%) and history of miscarriage (41.6%). A statistically significant difference in the serum hCG concentrations measured on day 0, day 4, and day 7 were observed between the groups.Conclusions: The success rate in ectopic pregnancy treatment was 56.25% for the expectant management, 70% for the single-dose methotrexate regimen, and 40% for two-dose methotrexate regimen.

Risk Factors for Ectopic Pregnancy: A Multi-center Case Control Study

2021 ◽  
Author(s):  
Nooria Atta ◽  
Fahima Aram ◽  
Nafisa Naseri ◽  
Mahbooba Sahak
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ectopic Pregnancy ◽  
Case Control Study ◽  
Case Control ◽  
Pelvic Surgery ◽  
Control Group ◽  
Case Group ◽  
History Of ◽  
Control Study

Abstract Background: Ectopic pregnancy (EP) is defined as a pregnancy in which fertilized oocyte implants outside the endometrial cavity. Although there is no known etiology for ectopic pregnancy, some risk factors of EP have been determined. It has been evident that ectopic pregnancy can be of multifactorial origin. This multicenter research aims to study risk factors associated with increased risk of ectopic pregnancy in women living in Kabul. Methods: A multicenter case control study was conducted in five tertiary maternity hospitals located in Kabul, Afghanistan. A total of 457 pregnant women were included in this study. In the case group, women with diagnosed ectopic pregnancy, while in control group women with intrauterine pregnancy were included. For each case in this study, two controls were enrolled. Results: The mean (SD) age of women in case group was 27.9 (6) years while in control group it was 26.4 (5.5) years. This difference was not statistically significant. We found a significant association between history of abortion and EP (Adj. OR=1.57; 95%CI: 1.02, 2.42). Having history of abdominal/pelvic surgery was a risk factor for EP with adjusted OR 1.94 (95%CI: 1.15, 3.30). In this study we found an increasing risk of EP in women of 35 years or older compared to younger women (Crude OR=2.26; p= 0.024). In women reporting prior EP, the chance of its recurrence was increased (Crude OR= 9.64; 95%CI: 1.1, 83.2). No association of gravidity and parity was found with EP incidence. Conclusions: In this study we found a statistically significant association between history of abdominal/pelvic surgery and EP. In addition, history of abortion was suggested as a risk factor for ectopic pregnancy. In case of having a previous EP probability of its recurrence will be increased. Women with advanced age having other potential risk factors will be facing higher risk of EP.

scholarly journals ECTOPIC PREGNANCY : A MAJOR CAUSE OF MATERNAL MORTALITY?

2003 ◽  
Vol 42 (147) ◽  
pp. 151-155
Author(s):  
Rajshree Jha ◽  
M Singh ◽  
A Rana ◽  
A Singh ◽  
S Bastola
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Pelvic Surgery ◽  
Transvaginal Sonography ◽  
Pregnancy Risk ◽  
Abdominal Tenderness ◽  
Presenting Symptoms ◽  
History Of

ABSTRACTSeventyeight cases of ectopic pregnancy were studied retrospectively at Tribhuvan University TeachingHospital during April 1993 - December 1996. The overall incidence of etopic pregnancy was 0.86% livebirths. Grandmultipara were found to be at a low risk for ectopic pregnancy. A history of infertility andprevious pelvic surgery were positive risk factors. The most common presenting symptoms were abdominalpain (90%), history of amenorrhoea (46%), abnormal uterine bleeding (40%). On examination adenexaltenderness (72%), abdominal tenderness (68%), pallor (53%) and cervical excitation (33%) were the mostfrequent findings. Adenexal mass was noted in 22% cases and in 35 % cases the size of the uterus could notbe assessed. Ultrasonography and transvaginal sonography proved to be valuable diagnostic aids. Twomaternal deaths (2.6 %) due to ectopic pregnancy occurred in the hospital during this period.Key Words: Ectopic pregnancy, risk factors, sonography.

scholarly journals Association of Risk Factors of Ectopic Pregnancy

2017 ◽  
Vol 1 (2) ◽  
pp. 26-32
Author(s):  
Dur e Shehwar ◽  
Lubna Zubair
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Low Socioeconomic Status ◽  
Uterine Cavity ◽  
Pelvic Surgery ◽  
Contraceptive Device ◽  
Assisted Reproductive Technique ◽  
History Of ◽  
Tubal Disease ◽  
Reproductive Technique

Abstract:Background: Ectopic pregnancy is the implantation of a fertilized ovum anywhere outside the uterine cavity. Around 95% of ectopic pregnancies occur in the Fallopian tubes. Most of these are occurring in the ampulla region. Other sites include the interstitial or the corneal region of the myometrium, cervix, ovary, peritoneal cavity (abdominal pregnancy) and in caesarean section scars. The objective of this study was to see the association of different risk factors of ectopic pregnancy.Methodology: It was a case-control study. The data was collected from Obstetrics & Gynaecology department Jinnah Hospital, Lahore and the study was completed at Gulab Devi PGMI, Lahore. For the analysis of data, SPSS version 16.00 was used.Results: 180 pregnant females were taken in which 90 were cases and 90 were controls. 16 females were more than 35 years in age of which 16% females had ectopic pregnancy. There were 3 females had history of smoking in which 3% females had ectopic pregnancy. There were 82 females who had history of pelvic surgery in which 43% female had ectopic pregnancy. There were 17 females have had history of previous ectopic pregnancy of which 14% were having ectopic pregnancy. There were 6 females have had history of IUCD (Intra uterine contraceptive device) of which 6% females were having ectopic pregnancy. There were 23 females who had history of PID (Pelvic inflammatory disease) of which 26% females were having ectopic pregnancy. There were 2 females have had history of tubal disease and had ectopic pregnancy. There were 21 females who had history of ART (Assisted reproductive technique) in which 3% females were presented with ectopic pregnancy. There was 1 female who had history of endometriosis in which 2% females were presented with ectopic pregnancy.There were 16 females have had history of low socioeconomic status of which 9% females were presented with ectopic pregnancy. There was 1 female who had history of tuberculosis and having ectopic pregnancy.Conclusion: In the present study age more than 35 years, smoking, previous ectopic pregnancy, insertion of IUCD, PID, assisted reproductive technique, tubal disease, history of pelvic surgery, endometriosis and tuberculosis had a great association with ectopic pregnancy.

scholarly journals Heterotopic Pregnancy: A Challenge in Early Diagnosis

2019 ◽  
Vol 17 (3) ◽  
pp. 413-415 ◽  
Author(s):  
Roman Karkee ◽  
Amit Sharma ◽  
Binod Dangal
Keyword(s):  
Heterotopic Pregnancy ◽  
Pelvic Surgery ◽  
Maternal Condition ◽  
Fertility Treatments ◽  
Reproductive Techniques ◽  
Life Threatening ◽  
History Of ◽  
Simultaneous Existence ◽  
Life Threatening Event ◽  
Tubal Surgery

Heterotopic pregnancy is the simultaneous existence of intrauterine and extrauterine gestation. It is usually seen in women at risk for ectopic pregnancy or those undergoing fertility treatments. The incidence has dramatically risen to 1 in 3900 of pregnancies via assisted reproductive techniques or ovulation induction, compared to 1 in 30000 of spontaneous conception. Besides this, history of pelvic inflammatory disease (PID), tubal damage, pelvic surgery and prior tubal surgery can increase its risk. Here we present a case of heterotopic pregnancy which was diagnosedafter ectopic gestation ruptured along with compromised intrauterine gestation and maternal condition. Earlier diagnosis before this life-threatening event could have saved the intrauterine fetus.Keywords: Extrauterine pregnancy; heterotopic pregnancy; ruptured ectopic.

scholarly journals Heterotropic pregnancy: a common masquerade than ever thought?

2021 ◽  
Vol 10 (12) ◽  
pp. 1410
Author(s):  
Ayodele A. Olaleye ◽  
Boniface N. Ejikeme ◽  
Eziaha E. Okeke ◽  
Nwabunike E. S. Ede ◽  
Bartholomew I. Olinya ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Exploratory Laparotomy ◽  
Heterotopic Pregnancy ◽  
Multiple Gestation ◽  
Intrauterine Pregnancy ◽  
Vacuum Aspiration ◽  
Products Of Conception ◽  
History Of ◽  
One Year ◽  
Attending Physician

Heterotopic pregnancy, coexistence of living or dead intrauterine pregnancy, single or multiple, with extra-uterine pregnancy located in the oviduct, ovary, uterine cornua, cervix or rarely peritoneal cavity. Heterotropic pregnancy is relatively uncommon in spontaneous conception with 1 in 30,000 cases reported, the incidence of heterotopic pregnancy increases to 1 in 3900 when conception is enhanced with various assisted reproduction techniques (ART). It is an ectopic pregnancy coexisting with intrauterine pregnancy. But is the incidence of heterotropic pregnancy rising? A case was reported from our centre in 2018 by Ejikeme et al, and we have recorded another two cases in the period of one year. Ectopic pregnancy has been described as a great masquerader, which makes diagnosis and management of heterotropic pregnancy a dilemma to attending physician. We present a case of an unbooked 26 years old G4P3+0 who has no family history of multiple gestation and presented at gestational age of 8 weeks and 5 days with 2 days history of abdominal pain and vaginal bleeding and 2 hours history of loss of consciousness. She later had exploratory laparotomy with left salpingectomy and manual vacuum aspiration of Retained Products of Conception with good outcome. In conclusion, spontaneous heterotropic pregnancy is a rare occurrence, however with advent of artificial reproductive technology and increase incidence of pelvic inflammatory disease, the incidence could be higher than earlier suspected.

scholarly journals Review of ectopic pregnancy at tertiary care center: 2 years analysis

2020 ◽  
Vol 9 (10) ◽  
pp. 4036
Author(s):  
Suman S. Sharma ◽  
Ashish V. Gokhale ◽  
Shonali Agarwal ◽  
Dimpi Modi ◽  
Kajal Gedia
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Diagnostic Methods ◽  
Pelvic Surgery ◽  
Contraceptive Device ◽  
Identifiable Risk Factor ◽  
History Of ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is defined as any intra or extra-uterine pregnancy in which the fertilized ovum implants at an aberrant site which is inconducive to its growth and development. It is a catastrophic and life-threatening condition and one of the commonest acute abdominal emergencies affecting approximately 2% of all pregnancies. The purpose of this study is to review cases of ectopic pregnancy and determine: incidence, high risk factors, types of clinical presentation, diagnostic methods, management, morbidity and mortality.Methods: The present study, conducted over a period of 2-year, total number of deliveries was 16,144 and total number of ectopic pregnancies was 116. More than half of the cases (56.04%) had one or the other identifiable risk factor. Results: Amongst the various risk factors studied, history of previous pelvic surgery (15.43%), history of Pelvic inflammatory disease (PID) (12.9%), use of Intrauterine contraceptive device (IUCD) (10.3%) and either spontaneous or induced abortion (7.76%) has been found. History of self-administered medical termination of pregnancy (MTP) pill was present in 3.45%. Repeat ectopic pregnancies were seen in 1.72%. There was no identifiable risk factor in 49.63% of cases.Conclusion: Ectopic pregnancy is a major challenge in obstetrical practice because of its varied clinical presentation. It can be diagnosed early by keeping a high index of suspicion. Undue delay in referral reduces significant morbidity and improves the chances of preserving future fertility. Mass education regarding safe abortion practices and post abortal care should be promoted. Unsupervised usage of MTP pill intake should be condemned. 

scholarly journals Laparoscopic Management of Tubal Ectopic of Heterotopic Pregnancy

2017 ◽  
Vol 34 (4) ◽  
pp. 218-221
Author(s):  
Eti Saha ◽  
Jharna Das ◽  
Mollik Moniruzzaman ◽  
Citta Ranjan Bachher
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Experience ◽  
Rare Complication ◽  
Rare Disorder ◽  
Laparoscopic Procedure ◽  
Heterotopic Pregnancy ◽  
Successful Outcome ◽  
Intrauterine Pregnancy ◽  
Post Operative Period ◽  
Natural Conception

A heterotopic pregnancy is a rare complication of pregnancy in which both extra-uterine (ectopic pregnancy) and intrauterine pregnancy occur simultaneously. The prevalence of heterotopic pregnancy is estimated at 0.6- 2.5: 10,000 pregnancy. It is a challenge for obstetrician to manage the tubal pregnancy without interruption of intrauterine pregnancy. Here we describe a case who had left tubal alive ectopic pregnancy & also intrauterine alive pregnancy simultaneously after a natural conception. This patient was managed successfully with laparoscopic left salpingectomy, and intrauterine pregnancy has been continuing. There are some precautions during laparoscopic procedure & post operative period which can help for continuation of intrauterine pregnancy. In our clinical experience, this is an extreme rare disorder and we feel interest to report this case. A heterotopic pregnancy can result from a natural conception; it requires a high index of suspicious for early and timely diagnosis; a timely intervention can result in a successful outcome of the intrauterine fetus.J Bangladesh Coll Phys Surg 2016; 34(4): 218-221

Intraorbital Abscess: A Rare Cause of Orbit Compression

FACE ◽  
2021 ◽  
pp. 273250162110050
Author(s):  
Samuel Ruiz ◽  
Rizal Lim
Keyword(s):  
Pediatric Population ◽  
Rare Complication ◽  
Disease Process ◽  
Rare Condition ◽  
External Drainage ◽  
Direct Extension ◽  
Life Threatening ◽  
History Of ◽  
High Index Of Suspicion ◽  
Prompt Diagnosis

Introduction: Intraorbital abscess is a rare complication of rhinosinusitis that affects most commonly the pediatric population. It is thought to be caused by direct extension or venous spread of infections from contiguous sites and can lead to life-threatening complications, like permanent visual loss and cerebral abscesses. Objectives: Intraorbital abscess is a rare condition that requires prompt diagnosis and treatment to avoid serious complications. Our objectives are to provide an overview of this rare disease process and its management including our successful treatment experience. Case Description: We present a 2 case report of a 13-year-old pediatric male and a 66-year-old male with history of chronic sinusitis who presented with a right intraorbital abscess successfully treated with external drainage with decompression of the orbit. Conclusion: When intraorbital abscess is encountered, a high index of suspicion is needed to allow prompt and accurate diagnosis for this infrequent condition. Timely surgical drainage of the abscess is needed to prevent the development of fatal complications.

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