scholarly journals Vaginal Delivery at Term in a Woman with a Spontaneous Heterotopic Pregnancy Treated with Laparoscopic Salpingectomy

2020 ◽  
Vol 2020 ◽  
pp. 1-5 ◽  
Author(s):  
Michail Diakosavvas ◽  
Nikolaos Blontzos ◽  
Georgios Daskalakis ◽  
Athanasios Protopapas ◽  
Nikolaos Kathopoulis ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Vaginal Delivery ◽  
Clinical Symptoms ◽  
Lower Abdominal Pain ◽  
Major Complication ◽  
Heterotopic Pregnancy ◽  
Clinical Image ◽  
Intrauterine Pregnancy ◽  
Beta Hcg ◽  
Laparoscopic Salpingectomy

Background. The coexistence of an intrauterine pregnancy and an ectopic pregnancy (heterotopic pregnancy) is an extremely rare, yet major, complication during pregnancy. The early diagnosis of a heterotopic pregnancy is of great importance for fetal viability, maternal safety, and the progression of an uncomplicated intrauterine pregnancy. Case Presentation. We report a case of a naturally conceived heterotopic tubal pregnancy in a 37-year-old primigravida. The patient presented with continuous, dull, lower abdominal pain and a positive urine pregnancy test which was conducted a week prior to the start of the pain. The patient was hospitalized, and based on the clinical image and after strict monitoring, she was diagnosed with a heterotopic pregnancy. She was treated with laparoscopic salpingectomy after the rupture of the ectopic pregnancy while the desired intrauterine gestation continued without any complications. The pregnancy resulted in the birth of a healthy infant through vaginal delivery. Discussion. Strict monitoring with multiple sonographic evaluations should always be conducted in women with abnormal serum beta-hCG, adnexal abnormalities, or clinical symptoms, while heterotopic pregnancy should be in differential diagnosis and treatment should not be delayed since emerge management is important for the progression of the intrauterine pregnancy.

HETEROTOPIC PREGNANCY WITH INEVITABLE ABORTION (RIGHT ADNEXAL LIVE ECTOPIC AND COEXISTING INTRAUTERINE TRIPLETS WITH ABSENT FETAL CARDIAC ACTIVITY)

2021 ◽  
pp. 58-59
Author(s):  
Jayanta Sarkar ◽  
Mini Sengupta
Keyword(s):  
Ectopic Pregnancy ◽  
Abdominal Cavity ◽  
Lower Abdominal Pain ◽  
Cardiac Activity ◽  
Exploratory Laparotomy ◽  
Sudden Onset ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Short Period ◽  
The Right

Heterotopic pregnancy describes the occurrence of two or more pregnancies in different implantation sites simultaneously, intrauterine pregnancy coexists withectopic pregnancies (ampullary in 80%). A 27-year-old women (P ,L1) presented to the emergency department with a complaint of sudden onset of right-sided lower abdominal pain with 1+1 vaginal bleeding and had a short period of Amenorrhea. Ultrasonography demonstrated three intrauterine gestational sacwith foetal pole noted but Cardiac activity was absent . The right adnexa showed a heteroechoic area andmoderate amount of free uid was present in the lower abdominal cavity. Ectopic pregnancy was disturbed. An emergency exploratory laparotomy was performed under general anesthesia. Haemoperitoneum was found with a ruptured righttubal ectopic pregnancy as well. Both the ovaries appeared normaland a corpus luteal cyst was presentin right ovary. Right sided salpingectomy was performed with removal of the ectopic mass,heamostasis secured ,on table blood transfusion had been given.Suction evacuation had also been performed by manual vacuum aspirationon same sitting.Both the specimen send for histopathology. Histology conrmedGestational sac suggestive of an intra uterine pregnancy coexists with ectopic pregnancy. Left tube and both ovaries were found healthy. Episodes of PID also have a strong correlation with occurrence of ectopic gestation. Once diagnosis of heterotrophic pregnancy has been made the management is essentially surgical.

scholarly journals Heterotopic Pregnancy: A Clinical Case Report

1970 ◽  
Vol 39 (3) ◽  
Author(s):  
S Chowdhury ◽  
T Chowdhury
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Ectopic Pregnancy ◽  
Clinical Examination ◽  
Clinical Case ◽  
Lower Abdominal Pain ◽  
Tubal Pregnancy ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Ectopic Pregnancies

Heterotopic pregnancy is coexistence of intrauterine and extrauterine pregnancies that is ectopic pregnancies. It is said to be rare. Here we report a case of 27 years old woman with heterotopic pregnancy. Patient had a typical presentation of severe lower abdominal pain following amenorrhoea for 2½ months. On clinical examination, there was suspicion of ectopic pregnancy but ultrasonography revealed early intrauterine pregnancy along with right tubal pregnancy with huge collection in abdomen . Immediate laparotomy was done and diagnosis was confirmed as a case of heterotopic pregnancy.DOI: http://dx.doi.org/10.3329/bmj.v39i3.9950 BMJ 2010; 39(3)

scholarly journals Laparoscopic Management of an Abdominal Pregnancy

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Aarthi Srinivasan ◽  
Suzanne Millican
Keyword(s):  
Ectopic Pregnancy ◽  
Transvaginal Ultrasound ◽  
Lower Abdominal Pain ◽  
Pain Patient ◽  
Prior History ◽  
Intrauterine Pregnancy ◽  
Beta Hcg ◽  
Maternal Morbidity And Mortality ◽  
History Of ◽  
The Right

Background. Ectopic pregnancy is one of the leading causes of significant maternal morbidity and mortality. Abdominal surgeries increase the risk of postoperative adhesions. We here present a case of omental ectopic pregnancy in a patient with a prior history of cesarean section.Case. A 20-year-old female presented with a two-day history of crampy lower abdominal pain. Patient was hemodynamically stable with a beta HCG of 1057 mI/mL. Transvaginal ultrasound did not show an intrauterine pregnancy but revealed an ill-defined mass in the midline pelvis extending to the right of the midline. Diagnostic laparoscopy revealed large clots in the pelvis with normal uterus and adnexa. Intra-abdominal survey revealed an omental adhesion close to the right adnexa with a hematoma. Partial omentectomy was completed and the portion of the omentum with the hematoma was sent to pathology for confirmation. Final pathology confirmed the presence of chorionic villi consistent with products of conception.Conclusion. Omental ectopic pregnancy is a rare diagnosis and often missed. We recommend careful intra-abdominal survey for an ectopic pregnancy in the presence of hemoperitoneum with normal uterus and adnexa. This can be safely achieved using laparoscopy in early gestational ages when the patient is hemodynamically stable.

SPONTANEOUS HETEROTOPIC PREGNANCY WITH UNSTABLE VITALS: A CASE REPORT

2021 ◽  
pp. 35-36
Author(s):  
Anshika Agarwal
Keyword(s):  
Early Diagnosis ◽  
Vaginal Bleeding ◽  
Clinical Symptoms ◽  
Transvaginal Ultrasound ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Spontaneous Conception ◽  
Beta Hcg ◽  
Maternal Morbidity And Mortality ◽  
Life Threatening

A spontaneous heterotopic pregnancy is a rare obstetric entity which can be life threatening if early diagnosis is missed. There is co-existing intra uterine and extra uterine pregnancy, most often tubal and rarely cervical or ovarian. It is extremely rare in spontaneous conception but incidence is increasing with the use of ART’s. Early diagnosis is difcult probably because of the lacking clinical symptoms. It usually presents as a ruptured ectopic pregnancy. Timely diagnosis and intervention is of utmost importance to prevent maternal morbidity and mortality. Abdominal pain, swelling, peritoneal irritation, enlarged uterus, vaginal bleeding, pallor, tachycardia, features of shock may be a few presenting features. With the advances in technology, transvaginal ultrasound proves to be a great diagnostic tool in early diagnosis of heterotopic pregnancy. Serum beta-hcg levels is of importance. Intervention can be medical or surgical depending on the hemodynamic condition of the patient and the viability of the intrauterine pregnancy. Heterotopic pregnancy is an unusual diagnosis and so is often ignored in the presence of an intrauterine pregnancy. But as it can prove to be life threatening so its diagnosis as a differential should always be kept in mind. Early diagnosis and prompt and effective treatment can save a life or two!

scholarly journals Laparoscopic management of heterotopic pregnancy in an IVF conception

2018 ◽  
Vol 7 (3) ◽  
pp. 1255 ◽  
Author(s):  
Nitin H. Shah ◽  
Riddhi J. Shah ◽  
Swapnali Kshirsagar
Keyword(s):  
Minimally Invasive ◽  
Spinal Anaesthesia ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Laparoscopic Management ◽  
Reproductive Techniques ◽  
Laparoscopic Salpingectomy

Heterotopic Pregnancy cases are on the rise in the era of Artificial Reproductive Techniques and managing these pregnancies can be challenging especially in safeguarding the precious intrauterine pregnancy. These were traditionally managed by laparotomy and there are few cases reported wherein salpingectomy is done laparoscopically. We would like to report this case of a 7 weeks intrauterine pregnancy with 5 weeks tubal ectopic treated by laparoscopic salpingectomy under spinal anaesthesia while safeguarding the intrauterine viable gestation. In the light of increased incidence of abnormal implantations and growing demand and expertise of minimally invasive surgeries, laparoscopy is the treatment of choice for heterotopic pregnancies, especially in the interest of the intrauterine pregnancy.

scholarly journals Diagnosis of Heterotopic Pregnancy Using Ultrasound and Magnetic Resonance Imaging in the First Trimester of Pregnancy: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Sue Yazaki Sun ◽  
Edward Araujo Júnior ◽  
Julio Elito Júnior ◽  
Liliam Cristine Rolo ◽  
Felipe Favorette Campanharo ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Power Doppler ◽  
Uterine Cavity ◽  
Lower Abdominal Pain ◽  
First Trimester ◽  
Heterotopic Pregnancy ◽  
Resonance Imaging ◽  
Good Continuation ◽  
Intrauterine Pregnancy

Heterotopic pregnancy is a condition characterized by implantation of one or more viable embryos into the uterine cavity while another one is implanted ectopically, particularly into the uterine tube. Its occurrence has increased drastically over the last few years due to assisted reproduction procedures. In general, the diagnosis is made during the first trimester by using endovaginal two-dimensional ultrasound (2DUS), through observing a complex para- or retrouterine mass in association with a viable uterine pregnancy. However, under some conditions such as atypical ultrasonographic presentations, 2DUS does not clarify the situation whereas magnetic resonance imaging (MRI) of the pelvis is able to do so. We present the case of a pregnant woman in her fifth pregnancy, with a clinical condition of lower abdominal pain and pallor. Endovaginal 2DUS showed a complex voluminous mass in the left pelvic region in association with a viable intrauterine pregnancy. 2DUS in power Doppler mode showed “ring” vascularization, compatible with an ectopic gestational sac. MRI was of great importance in that it suggested that the mass had hematic content, which together with the clinical features, indicated that laparotomy should be performed. This surgical choice was essential for the woman to achieve a clinical improvement and for good continuation of the intrauterine pregnancy.

scholarly journals Term Broad Ligament Pregnancy with a Healthy Newborn

2019 ◽  
Vol 31 (1) ◽  
pp. 60-63
Author(s):  
Md Akbar Hossain ◽  
Farida Begum ◽  
Sultana Jahan ◽  
Israt Sharmin ◽  
Nazifatur Raihana
Keyword(s):  
Ectopic Pregnancy ◽  
Broad Ligament ◽  
Lower Abdominal Pain ◽  
Abdominal Pregnancy ◽  
Intrauterine Pregnancy ◽  
College Hospital ◽  
Rare Type ◽  
Healthy Newborn ◽  
Life Threatening ◽  
Life Threatening Complication

Introduction: Broad ligament pregnancy also known as inter ligamentous pregnancy is a rare type of ectopic pregnancy. It is one type of secondary abdominal pregnancy. Although ultrasonography is usually helpful in making the diagnosis but it is mostly established during laparotomy. Very few successful live births have been reported in this condition, where such pregnancies reached term and with live birth of a baby. Case Report: A case of 30 year old 2nd gravida of 38 weeks gestation with lower abdominal pain for 20 hours was admitted into Sher-E-Bangla Medical College Hospital, Barishal; Bangladesh. She was suggested for caesarean section as the ultrasonogram revealed transverse lie with complete placenta praevia. Intraoperative diagnosis of right sided broad ligament pregnancy was made and an incision was given on the anterior leaf of the broad ligament and a male live fetus was extracted. Post operative period was uneventful. Both mother and baby were discharged on seventh postoperative day in good health condition. Discussion: Broad ligament pregnancy usually results from rupture of tubal pregnancy through the tubal serosa and the mesosalpinx, with secondary implantation of trophoblast between the leaves of broad ligament. Incidence of broad ligament pregnancy is reported as 1 in 300 ectopic pregnancies. The prognosis is poor with the risk of dying from an abdominal pregnancy is 7.7 times higher than from other forms of ectopic pregnancy and often results from a delay in diagnosis. Trans-vaginal rather than transabdominal ultrasonography is superior in the evaluation of ectopic pregnancy. If there is no intrauterine pregnancy on ultrasonography and the ectopic sac is beside the lower part of the uterus a strong suspicion of broad ligament ectopic should be considered. Very rarely such pregnancy may reach up to term. Bleeding from placental implantation site is the most life-threatening complication during laparotomy. Conclusion: Abdominal pregnancy with resultant healthy newborn is very rare. High level of suspicion, careful clinical and ultrasound examinations are the routine means of diagnosis. Bleeding is the single most important life-threatening complication for the mother. Early diagnosis and proper management are vital in order to decrease maternal morbidity. Medicine Today 2019 Vol.31(1): 60-63

scholarly journals Study of diagnosis and management of ectopic pregnancy

2019 ◽  
Vol 8 (6) ◽  
pp. 2465
Author(s):  
Seema Patel ◽  
Ajesh Desai
Keyword(s):  
Abdominal Pain ◽  
Surgical Treatment ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Lower Abdominal Pain ◽  
Age Group ◽  
Obstetrics And Gynaecology ◽  
Beta Hcg ◽  
Adnexal Pathology ◽  
A Prospective Study

Background: Diagnosis of ectopic pregnancy was frequently missed. Aim of the study was to determine the clinical presentation, and treatment associated with ectopic pregnancy.Methods: This is a prospective study which was carried out at Obstetrics and Gynaecology department, GMERS SOLA civil hospital from August 2017 to October 2018. Total 416 patients were admitted during study period out of them 50 patients diagnosed with ectopic pregnancy were enrolled in the study and information was collected and analysed.Results: 80% patients were between the age group of 21-30 years. 56% patients were nulliparous. Amenorrhea (92%) with lower abdominal pain (94%) is the most common presenting symptom. 26% of patients show typical triad of amenorrhea, abdominal pain and bleeding per vagina. UPT and USG were most commonly performed investigations. 96% cases showed UPT positive. 100% USG showed adnexal pathology. Serum beta-hCG was done in 37 patients as an aid for diagnosis and to decide the line of management. Conservative medical management with Injection MTX was done in 4 patients of which 1 patients required laparotomy later on. Surgical management was done in 90% of patients. Laparoscopic management was done in 54% of cases.Conclusions: Early diagnosis and timely intervention in the form of conservative or surgical treatment will help in reducing the morbidity and mortality associated with ectopic pregnancy.

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