scholarly journals Uterine Rupture with Cesarean Scar Heterotopic Pregnancy with Survival of the Intrauterine Twin

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Kimberly R. Lincenberg ◽  
Eric R. Behrman ◽  
James S. Bembry ◽  
Christine M. Kovac
Keyword(s):  
Ectopic Pregnancy ◽  
Uterine Rupture ◽  
Placental Abruption ◽  
Heterotopic Pregnancy ◽  
Multiple Gestation ◽  
Cesarean Scar ◽  
Safe Management ◽  
Life Threatening ◽  
Emergent Cesarean Section ◽  
Ruptured Uterus

Background. Heterotopic pregnancy is a multiple gestation with both intrauterine and ectopic fetuses. A cesarean scar ectopic pregnancy is when the fetus has implanted over the previous hysterotomy site. A known complication of cesarean scar ectopic pregnancy is uterine rupture, which can cause great morbidity and mortality. Case. 28-year-old G5P3105 at 10 weeks with a dichorionic diamniotic gestation was found to have a ruptured uterus with expulsion of a cesarean scar ectopic pregnancy and retention of the intrauterine fetus. After uterine repair, the singleton gestation reached viability was delivered by emergent cesarean section for placental abruption. Conclusion. Safe management of cesarean ectopic pregnancy requires early diagnosis by ultrasonography. With early detection, management can focus on preventing maternal morbidity of uterine rupture and life-threatening hemorrhage.

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 The Challenge of the Non-Compliant Patient: A Case of Caesarean Section Scar Ectopic Pregnancy

2021 ◽  
pp. 1-3
Author(s):  
Jessica Audet ◽  
Brittany Noel Robles ◽  
Nicolle M Arroyo Lluberas ◽  
Jessica Audet ◽  
Daniel Faustin ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Emergency Laparotomy ◽  
Pharmacological Management ◽  
Compliant Patient ◽  
Life Saving ◽  
Close Observation ◽  
Life Threatening ◽  
History Of ◽  
Ruptured Uterus

Ectopic pregnancy is a quite common and life-threatening pregnancy. The most common site of ectopic implantation of a fertilized embryo is the fallopian tube. In extremely rare situations, the embryo can implant in other locations, which makes the diagnosis and management even more complex. Although close observation of a new pregnancy is key in the diagnosis and treatment of an ectopic pregnancy, there is still a major risk of life-threatening outcomes. This is a case report of a 31-year-old patient with a history of multiple pregnancies who presented to a community hospital in the spring of 2021 with an ectopic caesarean scar pregnancy. A diagnosis of ectopic pregnancy was on a timely basis, and surgical management was advised. Upon refusal of treatment and admission, pharmacological management was initiated, but patient compliance challenged the success of the therapy. Patient non-compliance to close follow-up resulted in a ruptured uterus. Emergency laparotomy with supracervical hysterectomy was performed as a life-saving procedure.

scholarly journals Cesarean Scar Ectopic Pregnancy: The Lurking Danger in Post Cesarean Failed Medical Abortion

2020 ◽  
Author(s):  
Monika Anant ◽  
Anita Paswan ◽  
Chandrajyoti Chandrajyoti
Keyword(s):  
Cesarean Section ◽  
Ectopic Pregnancy ◽  
Medical Abortion ◽  
Accurate Diagnosis ◽  
Tertiary Level ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Life Threatening ◽  
Missed Diagnosis ◽  
Level Hospital

Cesarean scar pregnancy (CSP) is a potentially life threatening ectopic pregnancy where a missed diagnosis is commoner than an accurate diagnosis. Incidence of Ectopic pregnancy is 1 – 2 % and cesarean scar ectopic occurs in about (0.05%) 1 in 2000 of all pregnancies. With increasing cesarean section rates worldwide, CSP is bound to increase with its dreaded complications like uterine rupture and catastrophic hemorrhage. Three patients misdiagnosed as incomplete miscarriages in post cesarean pregnancies in other centers were found to be CSP in Gynaecology department of a tertiary level hospital. All three patients were managed successfully, two surgically and one medically.  

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 Double Trouble: Heterotopic Pregnancy

2014 ◽  
Vol 6 (3) ◽  
pp. 167-170
Author(s):  
Shruthi Krishnamoorthy ◽  
G Usha Rani ◽  
O Syamala ◽  
Rukshana LNU ◽  
Naveen Alexander
Keyword(s):  
Ectopic Pregnancy ◽  
Assisted Reproductive Technology ◽  
South Asian ◽  
Surgical Intervention ◽  
Case Series ◽  
First Trimester ◽  
Reproductive Technology ◽  
Heterotopic Pregnancy ◽  
Life Threatening ◽  
Threatening Situation

ABSTRACT A heterotopic pregnancy is defined as the presence of a combined intrauterine and ectopic pregnancy. Its estimated incidence is as between 1/7000 and 1/30,000 pregnancies. It is also reported to be as high as 1% after the use of assisted reproductive technology. Heterotopic pregnancies are diagnostic and therapeutic challenges for obstetricians. If they continue without diagnosis, a life-threatening situation may occur even when timely surgical intervention with laparotomy is performed. Here, we report a case series of three patients having three different scenarios, who were diagnosed with heterotopic pregnancies in the first trimester and managed successfully. How to cite this article Krishnamoorthy S, Rani GU, Syamala O, Rukshana, Alexander N. Double Trouble: Heterotopic Pregnancy J South Asian Feder Obst Gynae 2014;6(3):167-170.

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.

scholarly journals Kehamilan Pada Jejas Luka Sesar: Diagnosis Yang Akurat Dan Keberhasilan Dalam Tatalaksana Secara Konservatif

2020 ◽  
Vol 4 (1) ◽  
pp. 114-119
Author(s):  
Satrio Budhi Purnomo ◽  
Dovy Djanas
Keyword(s):  
Ectopic Pregnancy ◽  
Conservative Therapy ◽  
Ultrasound Examination ◽  
Transvaginal Ultrasound ◽  
Bladder Wall ◽  
Cervical Canal ◽  
Intrauterine Pregnancy ◽  
Cesarean Scar ◽  
Life Threatening ◽  
History Of

Reported case in a woman aged 30 years, with a history of cesarean scar four years ago, diagnosed with gravid two by one gravid 7-8 weeks with gestation on cesarean scar. The patient had a history of accidental trauma two days prior to the complaint of bleeding from the genitals. Several obstetricians have examined but still obtained different results (intrauterine pregnancy and ectopic pregnancy). An accurate diagnosis is critical to the success of the management of a patient with a pregnancy with this life-threatening cesarean scar. With a precise and accurate transvaginal ultrasound examination, the diagnostic criteria with ultrasound on previous surgical scars have been fulfilled in this patient, including an empty uterus, an empty cervical canal image, growth of a gestational pouch in the anterior lower segment of the uterus, and the absence of myometral image between the bladder wall and the gestational pocket. On B-HCG examination, the result was 58,808.70 mlU / mL. Conservative therapy with metrotrexate (MTX) 50 mg / m2 intramuscularly. After giving metrotrexate (MTX) therapy for four times, the results of B-HCG decreased significantly with 21.530, 12 mlU / mL, 2,949.47 mlU / mL, and 593.61 mlU / mL, respectively. After administration of metrotrexate (MTX) therapy, there was a decrease in the size of the gestational bag. Keywords: Ectopic, Pregnancy, Methotrexate, Cesarean Section

scholarly journals Cesarean Scar Ectopic Pregnancy: Diagnosis With Ultrasound

2020 ◽  
Vol 4 (1) ◽  
pp. 65-68
Author(s):  
Taryn Hoffman ◽  
Judy Lin
Keyword(s):  
Ectopic Pregnancy ◽  
Maternal Death ◽  
Uterine Rupture ◽  
Rare Case ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Cesarean Sections ◽  
Pregnancy Diagnosis ◽  
Cesarean Scar ◽  
Life Saving

We present a rare case of cesarean scar ectopic pregnancy as diagnosed by transvaginal ultrasonography. Cases such as this are rare, but they are becoming more commonly detected with the growing frequency of cesarean sections, improving technology, and provider proficiency with point-of-care ultrasound. Quick identification of this dangerous diagnosis can be life saving for the patient, as the outcomes of ruptured cesarean ectopic pregnancy may include significant hemorrhage, uterine rupture, and possibly maternal death.

scholarly journals THE ROLE OF ULTRASOUND IN PREVENTING THE LIFE-THREATENING EMERGENCIES ASSOCIATED WITH REPEATED CESAREAN SECTION

2021 ◽  
Vol 2 (2) ◽  
pp. 51-56
Author(s):  
Sucu Roxana ◽  
Bordeianu Ion
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Uterine Rupture ◽  
Subsequent Pregnancy ◽  
Ultrasound Measurement ◽  
Third Trimester ◽  
Cesarean Scar ◽  
The Third ◽  
Ultrasound Evaluation ◽  
Life Threatening

Ultrasonographic evaluation of the hysterorrhaphy scar is an extremely important element in current obstetrical practice, especially in patients who still want a future pregnancy. The purpose of our study was to evaluate the ultrasound findings of the cesarean scar in the third trimester of pregnancy that can reduce the life-threatening emergencies caused by repeated cesarean section such as uterine rupture of abnormal placental adhesions. We conducted a prospective study that included patients who gave birth by caesarean section and presented at a subsequent pregnancy to be monitored during pregnancy. The study was realized during 2016-2020at the Bucur Maternity Hospital, 'Saint John', Bucharest.  A number of 57 patients were included in the analyzed group. A number of 12 pregnant women (21%) monitored both in weeks 30-34 and intraoperatively presented contractions and areas of dehiscence, while 30 (52.6%) pregnant women showed neither contractions nor areas of dehiscence. Women with contractions had an average scar thickness measured in the third trimester of 3.81 mm (SD 1.62, CI: [3.32; 4.30]), and those without contractions a thickness of 4.58 mm (SD 1.25, CI: [3.78; 5.37]. Intraoperatively we identified 3 cases with incomplete uterine rupture. Those cases were previously diagnosed with hysterorraphy scar between 0.15-0.5 cm. The repeated ultrasound evaluation of the cesarean scar is a good predictive factor for the intraoperative quality of the cesarean scar. With the third trimester ultrasound measurement of the uterine scar thickness, the uterine rupture may be avoided.

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