scholarly journals Caesarean scar ectopic pregnancy

2018 ◽  
Vol 7 (5) ◽  
pp. 2038
Author(s):  
T. Ramani Devi ◽  
T. Sweta ◽  
C. Archana Devi
Keyword(s):  
Ectopic Pregnancy ◽  
Conservative Management ◽  
Abdominal Cavity ◽  
Delayed Diagnosis ◽  
Reproductive Age ◽  
Mortality And Morbidity ◽  
Caesarean Scar ◽  
Future Fertility ◽  
Laparoscopic Excision ◽  
Life Threatening

Ectopic pregnancy is a common cause of mortality and morbidity among the women of reproductive age group. Tubal pregnancy is the commonest.  It can occur in cervix, ovaries, previous caesarean scar, interstitial portion of the tube and abdominal cavity. Here we report a case of caesarean scar ectopic pregnancy which was managed conservatively. 31 yrs old gravid 3 previous 1 LSCS and 1 tubal ectopic come for antenatal consultation at 35 days of gestation. UPT was Positive. USG showed no evidence of intra uterine sac. Repeat scan after 10 days showed a gestational sac at the lower uterine segment scar. Hence it was decided for conservative management, injection methotrexate 50 mgm X 2 doses given. This was followed by misoprost vaginal insertion. Since patient did not expel the sac, injection PG F2 alpha 125 mg x 2 doses were given. Patient expelled the products of conception partially. This was followed by hysteroscopic guided evacuation.Caesarean scar ectopic was reported in 1978. Early diagnosis is by TV USG / MRI. Early ectopic can be treated medically. In delayed diagnosis, laparoscopic excision of the scar has to be done. In rupture of the scar site ectopic pregnancy laparotomy is indicated. In the event of heavy bleeding, hysterectomy has to be done. After conservative management and excision of the scar, fertility is not altered. Caesarean section scar pregnancy is a rare form of ectopic pregnancy which can lead to life threatening complications leading to mortality and morbidity. Treatment has to be individualized according to the gestational age, haemodynamic stability and desire for future fertility.

Twelve Week Ruptured Interstitial Ectopic Pregnancy

2020 ◽  
Vol 1 (1) ◽  
pp. 23-26
Author(s):  
Sadık Kükrer ◽  
Ayfer Pepekal Kukrer ◽  
Eren Haytoğlu ◽  
Erdal Yılmaz
Keyword(s):  
Maternal Mortality ◽  
Ectopic Pregnancy ◽  
Reproductive Age ◽  
Tubal Ectopic Pregnancy ◽  
Mortality And Morbidity ◽  
Life Threatening ◽  
Gestational Sac ◽  
Interstitial Ectopic Pregnancy ◽  
Ectopic Pregnancies ◽  
Related Mortality

Despite advancements in management and diagnosis, ruptured ectopic pregnancy is still a major reason for pregnancy-related mortality and morbidity. 2% of all pregnancies are ectopic pregnancy and interstitial ectopic pregnancy rate is 2-4% among all ectopic pregnancies. We should consider about it as an essential characteristic in each female of reproductive age that presents with the triad of amenorrhoea, unusual vaginal bleeding and abdominal irritation. It ruptures at a more sophisticated stage of gestation when compared with tubal ectopic pregnancy. Bleeding in interstitial ectopic pregnancy rupture is above that other ectopic pregnancies, also its life-threatening. Interstitial ectopic pregnancy rupture is two to five times greater compared to maternal mortality rate than tubal ectopic pregnancy rupture. Developing gestational sac causes uterine disruption and following hemorrhagic shock, resulting in morbidity and mortality. Clinics that aim to reduce maternal mortality should be much more concerned about convenient disclosure of this abnormal pregnancy condition.

scholarly journals Caesarean Scar Pregnancy - A Rare Case Report

2016 ◽  
Vol 27 (2) ◽  
pp. 83-86 ◽  
Author(s):  
Razia Sultana ◽  
Saiful Islam ◽  
Nurjahan
Keyword(s):  
Case Report ◽  
Caesarean Section ◽  
Ectopic Pregnancy ◽  
Transvaginal Sonography ◽  
Emergency Laparotomy ◽  
Colour Doppler ◽  
Caesarean Scar ◽  
Incomplete Abortion ◽  
Rare Case Report ◽  
Life Threatening

Objective:The aim is to publish the case report of the rarely occurring and life threatening ectopic pregnancy developing in a Caesarean section scar causing uterine rupture.Methods and Results: This patient was diagnosed initially as a case of incomplete abortion. Other possible diagnoses were molar pregnancy, mass in the cervix. She was admitted in hospital for evacuation and curettage. During the procedure she developed severe pervaginal bleeding leading to hypovolumic shock. So decision was taken for emergency laparotomy. After opening the abdomen rupture was found in the lower uterine segment extending upto upper part of cervix. So hysterectomy was performed and histopathology confirmed the diagnosis of ectopic pregnancy that developed in a Caesarean section scar Analysis of the women’s obstetric history revealed that she had been previously operated because of breech presentation.Conclusion: Heightened awareness of the possibility of pregnancy in caesarean scar and early diagnosis by means of transvaginal sonography along with colour doppler can improve outcome and minimize the need for emergency extended surgeryBangladesh J Obstet Gynaecol, 2012; Vol. 27(2) : 83-86

scholarly journals Laparoscopic excision of caesarean scar ectopic pregnancy

2015 ◽  
Vol 60 (3) ◽  
pp. 111
Author(s):  
B.R.G.D.N.K. Biyagama ◽  
A. Fernando ◽  
K.C.D.P. Silva ◽  
M. Kobalakrishnan ◽  
U.N. Wijenayake
Keyword(s):  
Ectopic Pregnancy ◽  
Caesarean Scar ◽  
Laparoscopic Excision

scholarly journals LETROZOLE - NOVEL DRUG FOR MEDICAL MANAGEMENT FOR TUBAL ECTOPIC PREGNANCY

2020 ◽  
pp. 1-2
Author(s):  
Rana Choudhary ◽  
Seema Pandey ◽  
Priyanka Vora
Keyword(s):  
Ectopic Pregnancy ◽  
Medical Management ◽  
Maternal Morbidity ◽  
First Trimester ◽  
Tubal Ectopic Pregnancy ◽  
Future Fertility ◽  
Life Threatening ◽  
Diagnostic Modalities ◽  
Ectopic Pregnancies ◽  
Novel Drug

Ectopic pregnancy is one of the most common life-threatening conditions leading to increased maternal morbidity and mortality in the first trimester. With advances in diagnostic modalities, one can now diagnose most ectopic pregnancies before their rupture and other catastrophic events. Methotrexate is the most common drug used for medical management but has adverse effects and needs strict monitoring. We report a case of tubal ectopic pregnancy which was successfully managed with letrozole. We were able to prevent maternal morbidity, reduce cost of therapy and preserve future fertility in our patient.

scholarly journals A clinical study of ectopic pregnancy in a tertiary care hospital

2018 ◽  
Vol 7 (11) ◽  
pp. 4461
Author(s):  
Arati Behera ◽  
Ranjita Ghadei ◽  
Rudra Narayan Bal
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
Medical Practitioner ◽  
High Risk Group ◽  
Reproductive Age ◽  
Common Symptom ◽  
Care Hospital ◽  
Age Group ◽  
Future Fertility

Background: Ectopic pregnancy is a life-threatening emergency commonly encountered by medical practitioner. Diagnosis is frequently missed and should be considered in any women in the reproductive age group with abdominal pain or vaginal bleeding. The aim of the study is to assess the incidence, clinical presentation, risk factors, methods of diagnosis, treatment, outcome and complications.Methods: This was a prospective study at S.C.B. Medical college from January to December 2017. Parameters like age, parity, gestational period, risk factors, clinical presentations, findings on ultrasonogram and at surgery with morbidities associated with diagnosed cases of ectopic pregnancy (n=93) were noted and analysed with SPSS-19 software.Results: Incidence of ectopic pregnancy was 18/1000 deliveries. Maximum cases were in age group of 21 to 30 years (54.8 %) and parous (76.3%). Common risk factors were having history of abortions (46.2%), previous tubal sterilization (24.7%), having one or more caesarean section (17.2%) and h/o infertility (16.1%). Most common symptom was pain abdomen (96.8%). Commonest site was ampullo-isthmic region of tube and rupture was the commonest mode of presentation. All underwent laparotomy and unilateral salpingectomy was done in 86 % of cases. It contributed to 3.27 % of total maternal deaths.Conclusions: Suspicion in high risk group can direct one to investigate and diagnose early, thereby reducing morbidity, mortality and improving the prospect of future fertility.

scholarly journals Successful Treatment of Uterine Arteriovenous Malformation due to Uterine Trauma

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Burak Karadag ◽  
Onur Erol ◽  
Ozgur Ozdemir ◽  
Aysel Uysal ◽  
Ahmet Sukru Alparslan ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Uterine Artery ◽  
Massive Bleeding ◽  
Reproductive Age ◽  
Uterine Arteries ◽  
Future Fertility ◽  
First Choice ◽  
Uterine Arteriovenous Malformation ◽  
Life Threatening ◽  
Extensive Lesion

Uterine arteriovenous malformation (AVM) is defined as abnormal and nonfunctional connections between the uterine arteries and veins. Although the patients typically present with vaginal bleeding, some patients may experience life-threatening massive bleeding in some circumstances. The treatment of choice depends on the symptoms, age, desire for future fertility, and localization and size of the lesion; however, embolization of the uterine artery is the first choice in symptomatic AVM in patients at reproductive age with expectations of future fertility. We report a case of acquired AVM (after D/C) with an extensive lesion, which was successfully treated with bilateral uterine artery embolization (UAE).

scholarly journals Angular Pregnancy Presenting as Cornual Ectopic Pregnancy

2014 ◽  
Vol 26 (1) ◽  
pp. 63-65
Author(s):  
Sankar Prosad Biswas ◽  
Suravi Halder ◽  
Feroja Banu Shirin
Keyword(s):  
Ectopic Pregnancy ◽  
Invasive Surgery ◽  
Uterine Cavity ◽  
Round Ligament ◽  
Obstetric Complication ◽  
Interstitial Pregnancy ◽  
Future Fertility ◽  
Life Threatening ◽  
Gestational Sac ◽  
Medicine Today

Angular pregnancy is a rare obstetric complication that can be life threatening. In this situation, gestational sac is implanted in the lateral angle of the uterine cavity, medial to the uterotubal junction and round ligament. Angular pregnancy is distinguished from interstitial pregnancy by anatomically, where embryo is implanted lateral to round ligament. The report presented here describes a case of angular pregnancy that was suspected by ultrasound and confirmed during surgery. Laparoscopy can be useful for guiding dilatation & curettage in angular pregnancy and may circumvent the need for invasive surgery or hysterectomy. It has an impact on future fertility. DOI: http://dx.doi.org/10.3329/medtoday.v26i1.21318 Medicine Today 2014 Vol.26(1): 63-65

scholarly journals A rare case of lower segment scar pregnancy

2020 ◽  
Vol 9 (6) ◽  
pp. 2610
Author(s):  
Jaydeep Bhatu ◽  
Nikhil A. Anand ◽  
Ankita B. Chaudhari
Keyword(s):  
Ectopic Pregnancy ◽  
Histopathological Examination ◽  
False Negative ◽  
Lower Uterine Segment ◽  
Caesarean Scar ◽  
Anterior Position ◽  
Threatening Condition ◽  
Life Threatening ◽  
Gestational Sac ◽  
Ectopic Pregnancies

Caesarean scar ectopic is one of the rarest of all ectopic pregnancies. The incidence of caesarean scar ectopic has increased due to increase in number of caesarean deliveries. A 31-year-old woman (G4P3003) presented from an outside facility to Sola Civil Hospital with vaginal bleeding and discharge with no abdominal pain or any discomfort. The gestational sac was located in an anterior position toward the anterior lower uterine segment at the level of prior caesarean scar with little visible myometrium noted anterior to the gestational sac in the lower uterine segment and Tissue was sent for histopathological examination and diagnosis of caesarean scar ectopic pregnancy was confirmed. Reports found that It is life threatening condition, causes excessive hemorrhage and risk of uterine rupture. The diagnosis of this type of ectopic pregnancy is very difficult and false negative diagnosis can lead to major complications.

scholarly journals CPK: The new tool in the diagnosis of ectopic pregnancy

2017 ◽  
Vol 6 (6) ◽  
pp. 2507
Author(s):  
Suvarna Jyothi Ganta ◽  
Sunanda R. Kulkarni ◽  
Vidya Muralidhar
Keyword(s):  
Maternal Mortality ◽  
Ectopic Pregnancy ◽  
Diagnostic Dilemma ◽  
Diagnostic Efficacy ◽  
Mortality And Morbidity ◽  
Appropriate Treatment ◽  
Future Fertility ◽  
Maternal Mortality And Morbidity ◽  
The Mean ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is still a diagnostic dilemma presenting with various complaints. The classic triad of amenorrhea, abdominal pain, vaginal bleeding and /or syncope is not always seen. Misdiagnosis can lead to delay in treatment, blood loss is found to be the major cause of death. Early and accurate diagnosis is critical in bringing down the maternal mortality and morbidity. Prompt and effective treatment of an ectopic pregnancy can help preserve the chances of future healthy pregnancies. Aim of present study was to investigate whether creatinine phosphokinase (cpk) can be used as an effective diagnostic tool in the early diagnosis of ectopic pregnancy which can help in decreasing the maternal mortality and morbidityMethods: This observational comparative three group clinical study was conducted at Chinmaya Mission Hospital, Bangalore, between May 2016 to January 2017.120 women in their early trimester were studied of which 40 were diagnosed cases of ectopic pregnancies, 40 women presented with intrauterine abortive pregnancies and 40 women had normal healthy pregnancies. Serum CPK, serum B-HCG, vaginal scans were done in all, along with routine investigations.Results: The mean CPK values in normal, abortive and ectopic pregnancies were 36.92±6.44, 43.95±11.96 and 91.55±30.43 respectively. It was found to be significantly higher in ectopic Pregnancies. Also, the mean CPK in ruptured and unruptured ectopic pregnancy were 97.26±25.97 and 63.82±34.92 respectively.Conclusions: Present study shows that maternal CPK levels are significantly higher in women with ectopic pregnancies. CPK can serve as the reliable biochemical marker to diagnose ectopic pregnancy particularly ruptured. CPK can be used to increase the diagnostic efficacy in ectopic pregnancy, which followed by rapid and appropriate treatment can reduce the mortality, morbidity and preserve future fertility.

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