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 triplet pregnancy with intrauterine monochorionic-monoamnionic twins

2016 ◽  
Vol 5 (2) ◽  
pp. 117-119
Author(s):  
Alexander Kotlyar ◽  
Jennifer Eaton ◽  
Katherine Singh ◽  
Uma Perni
Keyword(s):  
Abdominal Pain ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Heterotopic Pregnancy ◽  
Second Trimester ◽  
Triplet Pregnancy ◽  
Intrauterine Pregnancy ◽  
Chorionic Villi ◽  
Prior Use ◽  
Unusual Phenomenon

Abstract Heterotopic pregnancies are an unusual phenomenon, which have recently become more prevalent with assisted reproductive technologies (ART). Triplets that are part of a heterotopic pregnancy are exceedingly rare. Here, we describe a case of a woman who presented at 15+1 weeks of gestational age with a known monochorionic-monoamniotic intrauterine pregnancy with several days of abdominal pain with an otherwise unremarkable gastrointestinal (GI) assessment. Salpingectomy was performed, and pathology revealed chorionic villi within the fallopian tube consistent with a heterotopic triplet pregnancy. This pregnancy was conceived spontaneously. Even without the prior use of ART, physicians need to be aware of the risk of heterotopic pregnancy in a patient with a known twin gestation. In addition, this case highlights how heterotopic triplets can present even within the second trimester.

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 Case Report of Ruptured Non-Communicating Right Rudimentary Horn Pregnancy: An Acute Emergency

2011 ◽  
Vol 54 (3) ◽  
pp. 125-126 ◽  
Author(s):  
Che Hasnura Che Hassan ◽  
Abdul Kadir Abdul Karim ◽  
Nor Azlin Mohamed Ismail ◽  
Mohd Hashim Omar
Keyword(s):  
Case Report ◽  
Acute Abdomen ◽  
Vaginal Delivery ◽  
Maternal Morbidity ◽  
Hypovolemic Shock ◽  
Provisional Diagnosis ◽  
Intrauterine Pregnancy ◽  
Rudimentary Horn ◽  
Maternal Morbidity And Mortality ◽  
Ruptured Uterus

Ruptured pregnancy in the rudimentary horn of women who have had a vaginal delivery is rare and unpredictable. However, when undiagnosed, this condition could lead to maternal morbidity and mortality. We report a pregnancy at 19 weeks gestation presented with acute abdomen and hypovolemic shock. She was initially thought to have an intrauterine pregnancy with the provisional diagnosis of a ruptured uterus. Intraoperatively, a ruptured non-communicating right rudimentary horn with ex utero pregnancy was discovered.

Gestational diabetes mellitus and macrosomia: An analysis of secondary data

2018 ◽  
Vol 1 (2) ◽  
pp. 94-98
Author(s):  
Mufdlilah Mufdlilah ◽  
Fijri Rachmawati
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Maternal Morbidity ◽  
Secondary Data ◽  
Case Control ◽  
Health Issues ◽  
Control Approach ◽  
The Past ◽  
Maternal Morbidity And Mortality

Excessive fetal weight is considered as a health issues because it increases perinatal and maternal morbidity and mortality. The prevalence of macrosomia worldwide has increased over the past 2 to 3 decades. This study aimed to determine correlation between the incidence of gestational diabetes mellitus and macrosomia among pregnant women. The design of this study was analytical with a case control approach. Data used to analyze the incidence of macrosomia based on secondary data from 2014-2018. This research suggested that diabetes mellitus in pregnancy has a significant relationship with the incidence of macrosomia.

scholarly journals Venomous Snakebite in Pregnancy and Good Outcome –A Case Report

2016 ◽  
Vol 27 (2) ◽  
pp. 86-88
Author(s):  
Mohammad Ali ◽  
Md Robed Amin ◽  
Mohammad Belalul Islam ◽  
Mohammad Haresur Rahman ◽  
Md Mahbubul Islam Mojumdar
Keyword(s):  
Case Report ◽  
Maternal Morbidity ◽  
Medical Literature ◽  
Morbidity And Mortality ◽  
Good Outcome ◽  
Fetal Wastage ◽  
Maternal Morbidity And Mortality ◽  
In Pregnancy

Worldwide occurrence of snakebite in pregnancy is little known in medical literature. Furthermore to the best of our knowledge there is no case report on Krait envenomation in pregnancy in Bangladesh. It carries significant fetal wastage and maternal morbidity and mortality. Here we report a mutligravida aged 27 years at her 24 weeks of gestation with krait bite with neuroparesis with good obstetrical outcome.Bangladesh J Medicine Jul 2016; 27(2) : 86-88

scholarly journals Ruptured Cesarean Scar Pregnancy: A Case Report

2019 ◽  
Vol 57 (217) ◽  
Author(s):  
Prishita Shah ◽  
Rosina Manandhar ◽  
Meena Thapa ◽  
Rachana Saha
Keyword(s):  
Case Report ◽  
Uterine Rupture ◽  
First Trimester ◽  
Emergency Laparotomy ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Maternal Morbidity And Mortality ◽  
Subsequent Loss ◽  
Ectopic Pregnancies ◽  
Previous Cesarean

Cesarean scar pregnancy is a rare variant of ectopic pregnancy where the fertilized ovum gets implanted in the myometrium of the previous cesarean scar. The incidence of CSP among ectopic pregnancies is 6.1% and it is seen in approximately 1 in 2000 normal pregnancies.As trophoblastic invasion of the myometrium can result in uterine rupture and catastrophic hemorrhage termination of pregnancy is the treatment of choice if diagnosed in the first trimester. Expectant treatment has a poor prognosis and may lead to uterine rupture which may require hysterectomy and subsequent loss of fertility. We present a case report of a 24year old femaleG2P1L1with ruptured cesarean scar pregnancy who underwent emergency laparotomy and subsequently hysterectomy. In this case report, we aim to discuss ruptured cesarean scar pregnancy as obstetric emergency and methods by which we can make an early diagnosis that can be managed appropriately as to prevent maternal morbidity and mortality.

Puerperal sub-acute uterine inversion: a rare case report

2017 ◽  
Vol 6 (8) ◽  
pp. 3709
Author(s):  
Reena Sharma ◽  
Kapil Malhotra ◽  
Poojan Dogra ◽  
Anil Kumar ◽  
Sushruti Kaushal ◽  
...  
Keyword(s):  
Case Report ◽  
Maternal Morbidity ◽  
Rare Case ◽  
Morbidity And Mortality ◽  
Uterine Inversion ◽  
Peripheral Hospital ◽  
Third Stage ◽  
Maternal Morbidity And Mortality ◽  
Rare Case Report

Puerperal uterine inversion is a complication of third stage of labour, which can lead to maternal morbidity and mortality due to haemorrhage shock and infection. Early cases can be managed by manual reposition of uterus but neglected or late cases of uterine inversion are managed by Haultain`s repair. Here we are presenting a case of subacute uterine inversion referred from peripheral hospital managed by Haultain’s technique.

scholarly journals P21 PBPK modeling in pregnancy: achievements, shortcomings and future perspectives

2019 ◽  
Vol 104 (6) ◽  
pp. e25.2-e25
Author(s):  
A Dallmann ◽  
P Mian ◽  
P Annaert ◽  
M Pfister ◽  
K Allegaert ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pbpk Model ◽  
Multiple Pregnancy ◽  
First Trimester ◽  
Model Verification ◽  
Pbpk Modeling ◽  
Third Trimester ◽  
The Past ◽  
Pbpk Models

BackgroundPhysiologically-based pharmacokinetic (PBPK) models are considered a promising approach to better characterize and anticipate the effect of physiological changes on pharmacokinetics in pregnant women. Consequently, multiple pregnancy PBPK models have been developed and verified over the past years. Using acetaminophen (paracetamol) as example, PBPK modeling can provide specific insights into the expected pharmacokinetic changes throughout pregnancy.MethodsTo obtain an overview of pregnancy PBPK models, the scientific literature was systematically screened for publications with a focus on pharmaceutical applications using relevant keywords. Additionally, a pregnancy PBPK model for acetaminophen was developed with the Open Systems Pharmacology software suite (www.open-systems-pharmacology.org) following an established workflow. After model verification around gestational week 30, the model was scaled to earlier stages of pregnancy and molar dose fractions converted to acetaminophen metabolites were estimated for each trimester.ResultsOver the past years, more than 60 different pregnancy PBPK models for more than have 40 drugs been published. More than 70% of these models were developed for the third trimester, while few models have been applied to the first trimester. The developed PBPK model for acetaminophen indicated that the median dose fraction of acetaminophen converted to the reactive metabolite N-acetyl-p-benzoquinonimine (NAPQI) was 11%, 9.0% and 8.2% in the first, second and third trimester, respectively, while for non-pregnant women a value of 7.7% was simulated.ConclusionWhile the overall availability and quality of pregnancy PBPK models is varying considerably, the efforts to establish such models are promising in that they reflect an increased awareness of the necessity to better characterize pharmacokinetics during pregnancy. This is illustrated by the developed PBPK model for acetaminophen where information on NAPQI-formation in vivo is hitherto lacking. Although PBPK models are not a substitute for clinical trials, they constitute an important tool for clinicians in case of missing or incomplete information.Disclosure(s)Nothing to disclose

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.

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