scholarly journals Spontaneous heterotopic pregnancy with tubal rupture

2017 ◽  
Vol 6 (11) ◽  
pp. 5148 ◽  
Author(s):  
Spandana J. C. ◽  
Suresh S. Kanakannavar ◽  
Umashankar K. M. ◽  
Manuja N.
Keyword(s):  
Maternal Morbidity ◽  
Surgical Intervention ◽  
Heterotopic Pregnancy ◽  
Successful Outcome ◽  
Intrauterine Pregnancy ◽  
Pregnant Females ◽  
Maternal Morbidity And Mortality ◽  
Threatening Condition ◽  
Life Threatening ◽  
Ultrasound Assessment

Heterotopic pregnancy is the coexistence of intrauterine pregnancy (IUP) and extrauterine gestation. It is a rare and dangerous life-threatening condition that is difficult to diagnose and easily missed. The incidence in the general population is estimated to be 1 in 30,000. We report a case of a 24-year-old multigravida who was seen in the emergency department with a diagnosis of a ruptured ectopic pregnancy. A careful ultrasound assessment led to the diagnosis of a heterotopic pregnancy despite lack of any notable risk factors. Immediate surgical intervention with supportive measures resulted in a successful outcome. An obstetrician should keep in mind the occurrence of a heterotopic pregnancy while dealing with pregnant females. It also demonstrates that early diagnosis is essential in order to salvage the intrauterine pregnancy and avoid maternal morbidity and mortality.

scholarly journals Heterotopic pregnancy: case report of a successful first trimester metacyesis management and a viable third trimester outcome

2018 ◽  
Vol 8 (1) ◽  
pp. 332
Author(s):  
Arvind Kumar Singh ◽  
Shazia Khan
Keyword(s):  
Case Report ◽  
Maternal Morbidity ◽  
Assisted Reproductive Technologies ◽  
First Trimester ◽  
Reproductive Technologies ◽  
Heterotopic Pregnancy ◽  
Third Trimester ◽  
Intrauterine Pregnancy ◽  
The Past ◽  
Maternal Morbidity And Mortality

Heterotopic pregnancies are rare combined intra and extrauterine pregnancies, the incidence of which has shown an increase over the past decade with the rising trend in assisted reproductive technologies (0.75-1.5%). Authors report a case of a 29 year old primigravida, a post IVF conception who presented at 6 weeks POG with a ruptured tubal and a viable intrauterine pregnancy. She underwent an emergency laparoscopic right salpingectomy and continued with her intrauterine pregnancy successfully till term. The article emphasizes the need of scanning the adnexa carefully in early pregnancy to diagnose and manage heterotopic pregnancy as early as possible to prevent catastrophic haemorrhage and maternal morbidity and mortality later.

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 Successful live birth after heterotopic ruptured cornual pregnancy with twin intrauterine gestation in an in vitro fertilization conception

2019 ◽  
Vol 8 (12) ◽  
pp. 5057
Author(s):  
Venus Bansal ◽  
Muskaan Chhabra ◽  
Rahul Chopra ◽  
Pooja Prajapati
Keyword(s):  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Omental Patch ◽  
Vitro Fertilization ◽  
Ultrasound Findings ◽  
Life Threatening ◽  
Intraperitoneal Bleeding ◽  
High Index Of Suspicion ◽  
Preterm Rupture Of Membranes

Heterotopic pregnancies, especially in the cornual region which were a rarity till recent times, have become a more common occurrence due to increasing practice of assisted reproduction. Optimal management of such cases is imperative to manage the risk of hypotension and shock in case of rupture and to judiciously preserve the intrauterine pregnancy. Here we are reporting a case of IVF conception of twin intrauterine pregnancy with a cornual heterotopic pregnancy. Patient presented to the emergency department with features of acute abdomen, haemoperitoneum and shock. Ultrasound findings were suggestive of rupture of cornual heterotopic pregnancy, 1500 ml haemoperitoneum with live twin intrauterine gestation. Patient was resuscitated with iv fluids blood transfusion. Immediate laparotomy was done and cornual site repaired and covered with an omental patch while preserving the intrauterine gestations. Thereafter, pregnancy was carefully monitored with a high index of suspicion for rupture of site of cornual repair with advancing gestational age. Patient was readmitted at 24 weeks with pain abdomen and cornual site was found to be 4mm in thickness. She was managed conservatively till 27 weeks when she had preterm rupture of membranes and emergency LSCS was done. She delivered healthy twin male babies, 780 gmb and 795 gm respectively. This case demonstrates that cornual heterotopic pregnancy is a diagnosis which may be easily missed and can present as a life-threatening complication if it ruptures and significant intraperitoneal bleeding occurs. However, it is possible to successfully manage these cases with timely intervention, proper uterine reconstruction and monitoring of intrauterine gestation.

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.

(Un) conventional complicated pancreatitis

2021 ◽  
Vol 75 (1) ◽  
pp. 61-67
Author(s):  
Michal Rybár ◽  
Ivo Horný
Keyword(s):  
Acute Pancreatitis ◽  
Multidisciplinary Approach ◽  
Pancreatic Necrosis ◽  
Surgical Intervention ◽  
Secondary Infection ◽  
Abdominal Ultrasound ◽  
Stent Migration ◽  
Endoscopic Extraction ◽  
Threatening Condition ◽  
Life Threatening

Acute pancreatitis is sudden inflammatory disease of pancreas, which can vary from a mild form to severe life threatening condition. The management of pancreatitis usually consists of intensive care and multidisciplinary approach, often including surgical intervention or digestive endoscopy. In this article, we present a 68-year-old female with recidivous acute pancreatitis who underwent a series of endoscopic examinations and at the end also an unusual surgical intervention due to numerous complications. At first, it seemed that there was an idiopatic etiology because neither an anamnesis of alcohol consumption nor metabolic risks or CT signs of cholelithiasis were found. The condition was complicated by the development of acute necrotic collection, gastrointestinal bleeding and development of walled-off pancreatic necrosis (WOPN). Later, the biliary etiology was revealed after cholecystolithiasis was found on abdominal ultrasound. The WOPN was endoscopically drained because of the local compression syndrome. After the drainage, we noticed two cases of stent migration and the secondary infection of the WOPN. At the end, the migrated stents caused transient bowel obstruction and were stuck in the distal ileum. After three unsuccessful attempts to endoscopic extraction, the condition was solved by surgical intervention and double enterotomy was performed. The postoperative care was not easy anyway, being complicated by the dehiscence of the surgical wound with the need of opening the wound and use the VAC system to heal it up.

scholarly journals Spontaneous Heterotopic Pregnancy: Case Report and Literature Review

Medicina ◽  
2020 ◽  
Vol 56 (8) ◽  
pp. 365 ◽  
Author(s):  
Miglė Černiauskaitė ◽  
Brigita Vaigauskaitė ◽  
Diana Ramašauskaitė ◽  
Mindaugas Šilkūnas
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Laboratory Tests ◽  
Heterotopic Pregnancy ◽  
Fallopian Tubes ◽  
Lower Abdomen ◽  
Healthy Baby ◽  
Extrauterine Pregnancy ◽  
Threatening Condition ◽  
Life Threatening

Heterotopic pregnancy is defined as a condition when intrauterine and extrauterine pregnancy occur simultaneously. It is a life-threatening condition that requires immediate and accurate diagnostics and treatment. We present a case of a 28-year-old primigravida female who conceived spontaneously and at her seventh week of gestation and was presented to the emergency department with weakness and acute pain in lower abdomen. Laboratory tests and transvaginal ultrasonography revealed the diagnosis of heterotopic pregnancy. Urgent laparoscopic salpingotomy was chosen as a treatment option. The ectopic pregnancy was successfully removed with the preservation of the intrauterine embryo and fallopian tubes. The course of pregnancy after the surgery was without complications, and a healthy baby was delivered at the 39th week of gestation. When treated properly and on time, a heterotopic pregnancy can result in live childbirth with favorable outcomes for both the child and the mother.

scholarly journals Dieulafoy's lesion: current trends in diagnosis and management

2010 ◽  
Vol 92 (7) ◽  
pp. 548-554 ◽  
Author(s):  
M Baxter ◽  
EH Aly
Keyword(s):  
Literature Search ◽  
Surgical Intervention ◽  
Therapeutic Endoscopy ◽  
Gi Bleeding ◽  
Dieulafoy’S Lesion ◽  
Valuable Alternative ◽  
Diagnosis And Management ◽  
Current Trends ◽  
Threatening Condition ◽  
Life Threatening

BACKGROUND Dieulafoy's lesion is a relatively rare, but potentially life-threatening, condition. It accounts for 1–2% of acute gastrointestinal (GI) bleeding, but arguably is under-recognised rather than rare. Its serious nature makes it necessary to include it in the differential diagnosis of obscure GI bleeding. The aim of this study was to review the current trends in the diagnosis and management of Dieulafoy's lesion. MATERIALS AND METHODS Using Medline, a literature search was performed for articles published in English, using the search words ‘Dieulafoy'(s)’ and ‘gastrointestinal bleeding’. All retrieved papers were analysed and the findings are summarised in this review. RESULTS There is no consensus on the treatment of Dieulafoy's lesions. Therapeutic endoscopy can control the bleeding in 90% of patients while angiography is being accepted as a valuable alternative to endoscopy for inaccessible lesions. Currently, surgical intervention is kept for failure of therapeutic endoscopic or angiographic interventions and it should be guided by pre-operative localisation. CONCLUSIONS Advances in endoscopy have increased the detection of Dieulafoy's lesions and decreased the mortality from 80% to 8.6%. There are recent encouraging reports on the successful use of laparoscopic surgery in managing symptomatic Dieulafoy's lesions.

scholarly journals Heterotopic Pregnancy in a Natural Conception

2010 ◽  
Vol 1 (1) ◽  
pp. 41-43 ◽  
Author(s):  
Sumeet N Baheti ◽  
K Jayakrishnan
Keyword(s):  
Abdominal Pain ◽  
Hemorrhagic Shock ◽  
Transvaginal Ultrasound ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Abnormal Pregnancy ◽  
Emergency Laparoscopy ◽  
Life Threatening ◽  
Natural Conception ◽  
High Index Of Suspicion

ABSTRACT Heterotopic pregnancy is rare in natural conception and most often presents as life threatening emergency like acute abdomen and hemorrhagic shock. In early unruptured stages, it presents nonspecifically, mimicking normal or abnormal pregnancy manifestations. A high index of suspicion and a definitive search for it even after confirming normal intrauterine gestation is needed. This little effort ensures a timely diagnosis and management thus preventing catastrophe. We hereby report a primigravida with unruptured heterotopic pregnancy following a natural conception, who presented as nonspecific abdominal pain. Transvaginal ultrasound was inconclusive. Emergency laparoscopy clinched the diagnosis and allowed conservative salpingostomy and continuation of intrauterine pregnancy.

scholarly journals RARE CASE OF FETAL MIDGUT VOLVULUS DETECTED BY WHIRPOOL SIGN ON ROUTINE ANTENATAL ULTRASOUND.

2021 ◽  
pp. 66-67
Author(s):  
Meghna Barmase
Keyword(s):  
Case Report ◽  
Poor Prognosis ◽  
Rare Case ◽  
Surgical Intervention ◽  
Midgut Volvulus ◽  
Antenatal Ultrasound ◽  
Caesarean Section Delivery ◽  
Threatening Condition ◽  
Life Threatening ◽  
Mesenteric Vessels

Fetal midgut volvulus is an extremely rare life threatening condition with poor prognosis. It often remains undiagnosed on antenatal ultrasound and manifest as intestinal obstruction in both antenatal and post natal period. Following is the case report of intrauterine midgut volvulus causing proximal obstruction of stomach and duodenum. The infant survived postnatally after caesarean section delivery with prompt and appropriate surgical intervention. Twisting of bowel loops around the mesenteric vessels suggestive of whirpool sign was the most signicant clue leading to the diagnosis of volvulus.

scholarly journals Comparative study of neuroimaging features and clinical symptoms in patients with eclampsia

2021 ◽  
Vol 10 (11) ◽  
pp. 4171
Author(s):  
Neha Meena ◽  
Suman Meena ◽  
Khushbu Meena ◽  
Savitri Verma
Keyword(s):  
Ct Scan ◽  
Maternal Morbidity ◽  
Clinical Symptoms ◽  
Occipital Lobe ◽  
Study Data ◽  
Morbidity And Mortality ◽  
Computed Tomographic ◽  
High Risk Factors ◽  
Maternal Morbidity And Mortality ◽  
Life Threatening

Background: Eclampsia is a life-threatening emergency that remains a major cause for feto-maternal morbidity and mortality. The purpose of our study was to access various computed tomographic scan (CT) findings in eclampsia patients and compare neurological symptoms with radiological findings. Methods: A prospective analytical study was undertaken in department of obstetrics and gynecology, J. K. Lon hospital, Kota during the period of 2019-2020. Women who presented as eclampsia and admitted in indoor wards were included in the study. Data analyzed included various maternal and fetal parameters, CT scan findings and outcome of pregnancy. Results: The incidence of eclampsia was 1.1% of total deliveries. High risk factors associated with eclampsia were primigravida (70%), maternal age (70% in 21-25 years age group), illiteracy (64%), inadequate antenatal care (96%), early gestation (68%). On CT scan findings 52% patients had abnormal CT scan findings of which most common was cerebral edema (57.7%). Parieto-occipital lobe was most common region to be affected. Altered sensorium was found to be significantly associated with abnormal CT scan findings.Conclusions: Eclampsia is a major cause of fetal and maternal morbidity and mortality.  CT scan in eclampsia have significant role in early diagnosis of patients with cerebral pathologies and these CT scan findings were associated with the level of consciousness and number of convulsive episodes.  Thus, CT scan helps in further management of these patients by multidisciplinary approach.

Sign in / Sign up

Export Citation Format

Share Document