scholarly journals Spontaneous heterotopic pregnancy: a case report

2021 ◽  
Vol 11 (1) ◽  
pp. 262
Author(s):  
Shikha Sharma ◽  
Anu Bala Chandel ◽  
Anupam Sharma ◽  
Aditi Ranaut
Keyword(s):  
Clinical Examination ◽  
Heterotopic Pregnancy ◽  
Emergency Laparotomy ◽  
Multiple Gestation ◽  
Careful Evaluation ◽  
Tubal Ectopic Pregnancy ◽  
Early Gestation ◽  
Pain Abdomen ◽  
Gestational Sac ◽  
Period Of Gestation

Heterotopic pregnancy is defined as multiple gestation in which intrauterine and extrauterine gestational sacs co-exist. The extra uterine gestational sac is most commonly tubal ectopic pregnancy. We presented case of a 26 years old multigravida who presented to emergency with complaints of pain abdomen and giddiness for 2-3 days. She was at period of gestation (POG) 7 weeks and on clinical examination patient was anxious with mild pallor, mildly tachycardiac and blood pressure (BP) was 90/60 mm of Hg. After thorough clinical examination and sonography diagnosis of heterotopic pregnancy with ruptured tubal ectopic was made. She was taken up for Emergency laparotomy after investigations and consent. Left salpingectomy was done and she was discharged with a single intrauterine live pregnancy on 6th post op day. For early detection of cases of heterotopic pregnancy careful evaluation of adnexa is mandatory in early gestation scan.

scholarly journals A case report of heterotopic pregnancy

2021 ◽  
Vol 11 (1) ◽  
pp. 269
Author(s):  
Keerathana R. ◽  
Sundar Narayanan S.
Keyword(s):  
Case Report ◽  
Adnexal Mass ◽  
Heterotopic Pregnancy ◽  
Laboratory Findings ◽  
Healthy Baby ◽  
Beta Hcg ◽  
Gestational Sac ◽  
High Index Of Suspicion ◽  
Period Of Gestation ◽  
Natural Cycles

Heterotopic pregnancy is the presence of both intrauterine and extrauterine (ectopic) implantation as described by Reece in 1983 and is extremely rare. It accounts for 1 per 30000, in natural cycles and 9 per 10000, in assisted reproduction cycles. The aim of this report is to introduce this case as it poses a challenge to diagnosis due to its complex clinical and laboratory findings. A primigravida aged 30 at 6 weeks period of gestation, reported with minimal bleeding per vaginum. On performing a physical examination her vitals were stable and no significant findings were noted except for an enlarged uterus corresponding to 6 weeks with posterior forniceal fullness. Her beta-hCG was 23765 IU/ml and ultrasound showed a live intrauterine gestation with left adnexal mass- likely ectopic gestational sac. Laparoscopy showed a left tubal pregnancy and salpingectomy was done. The postoperative period was uneventful and she was discharged with a single live intrauterine gestation of 6-7 weeks. She carried on with her pregnancy and delivered a healthy baby at term. The diagnosis is possible only in cases when there is a high index of suspicion by the treating clinician. The adnexa must be inspected carefully in the confirmatory ultrasound. The early timely diagnosis gives a good maternal outcome and hence crucial in the management.

scholarly journals Successful conservative management of a rare case of ruptured cornual ectopic pregnancy

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Sreelatha S ◽  
Sumayya Sana ◽  
Pruthvi S ◽  
Yashaswini . ◽  
Shruthi K ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Severe Pain ◽  
Hypovolemic Shock ◽  
Medical Emergency ◽  
Emergency Laparotomy ◽  
Cornual Pregnancy ◽  
Rare Type ◽  
Pain Abdomen ◽  
Ectopic Pregnancies ◽  
Period Of Gestation

Cornual pregnancy is a rare type of ectopic pregnancy with incidence of about 2-4% of all ectopic pregnancies. The mortality rate is about 2-2.5%. The diagnosis and management is challenging and frequently constitute a medical emergency. We report a case of a 33year old second gravida, para 1, living 1 with previous LSCS with 13weeks 2days period of gestation presenting to the casualty with complaints of severe pain abdomen and signs of hypovolemic shock. Ultrasound revealed gross hemoperitoneum with ruptured right adnexal gestation. Emergency laparotomy was done and cornual end was found ruptured and was sutured successfully and hemostasis achieved. Intra operative two units of packed cells was transfused. Patient was discharged stable on post-op day 7.

Ovarian Ectopic Pregnancy: A Rare Case Report

2016 ◽  
Vol 1 (1) ◽  
pp. 23-24
Author(s):  
HK Premi ◽  
Sonika Dahiya ◽  
Shabina Khan ◽  
Sana Amrin ◽  
Sugandh Srivastava
Keyword(s):  
Case Report ◽  
Ectopic Pregnancy ◽  
Rare Case ◽  
Adnexal Mass ◽  
Emergency Laparotomy ◽  
Tubal Ectopic Pregnancy ◽  
Ovarian Pregnancy ◽  
Pain Abdomen ◽  
Rare Case Report ◽  
Ectopic Pregnancies

ABSTRACT Ovarian pregnancy is the most common type of non-tubal ectopic pregnancy. Ovarian ectopic pregnancy incidence after natural conception ranges from 1 in 2000 to 1 in 60,000 deliveries and accounts for 3% of all ectopic pregnancies. Here, we report a rare case of ruptured ectopic pregnancy. A 30 years old, G2P1+0L1 was admitted with amenorrhea of 1½ months and severe pain abdomen. Self urinary pregnancy test (UPT) was positive. Ultrasonography (USG) revealed it sided adnexal mass. Emergency laparotomy was done and a diagnosis of ovarian ectopic pregnancy was made. How to cite this article Dahiya S, Khan S, Premi HK, Amrin S, Srivastava S. Ovarian Ectopic Pregnancy: A Rare Case Report. Int J Adv Integ Med Sci 2016;1(1):23-24.

scholarly journals Rare heterotopic pregnancy after frozen embryo transfer: a case report and literature review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xianping Wang ◽  
Ding Ma ◽  
Yangang Zhang ◽  
Yanhua Chen ◽  
Yuxia Zhang ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Left Kidney ◽  
Frozen Embryo Transfer ◽  
Heterotopic Pregnancy ◽  
Psoas Major Muscle ◽  
History Of ◽  
Gestational Sac ◽  
Β Hcg ◽  
Ectopic Pregnancies ◽  
Psoas Major

Abstract Background Heterotopic pregnancy occurred after frozen embryo transfer with two D3 embryos, and the case had a history of bilateral salpingectomy due to salpingocyesis. An ectopic heterotopic pregnancy was implanted in the left psoas major muscle, which has not been previously reported. Case presentation A 33-year-old woman presented with left back pain after curettage due to foetal arrest in the uterus without vaginal bleeding and spotting, and painkillers relieved the pain initially. When the painkillers ceased to work, the patient returned to the hospital. The β-human chorionic gonadotropin (β-hCG) level remained increased compared with the time of curettage, and a diagnosis of retroperitoneal abdominal pregnancy was suggested by ultrasonography and computerized tomography (CT) with the gestational sac implanted in the left psoas major muscle at the left hilum level. Laparotomy was performed to remove the ectopic pregnancy. During the operation, we carefully separated the adipose tissue between the space of the left kidney door and left psoas major muscle, peeled away the gestational sac that was approximately 50 mm × 40 mm with a 25-mm-long foetal bud, and gave a local injection of 10 mg of methotrexate in the psoas major muscle. Fifty days later, β-hCG decreased to normal levels. Conclusion It is necessary to pay more attention to the main complaints to exclude rare types of ectopic pregnancies of the pelvis and abdomen after embryo transfer.

scholarly journals Acute presentation of ruptured ovarian cyst secondary to torsion with ipsislateral concomitant ectopic pregnancy: A case report

2014 ◽  
Vol 3 (2) ◽  
pp. 54-56
Author(s):  
Mahendra R Pandey ◽  
Neeva Ojha
Keyword(s):  
Acute Abdomen ◽  
Ovarian Cyst ◽  
Emergency Laparotomy ◽  
Hospital Emergency ◽  
Obstetrics And Gynaecology ◽  
History Of ◽  
Gestational Sac ◽  
One Year ◽  
The Right ◽  
Urine Pregnancy Test

Twenty-one year unmarried regularly menstruating lady without history of amenorrhea presented with acute abdomen in TU Teaching Hospital –Emergency Department. On evaluation urine pregnancy test was positive. Urgent ultrasound revealed multiloculated cystic lesion measuring 8.5 x 8 x 6.7 cms in the right adnexa anterolateral to the uterus with no intrauterine gestational sac. She underwent emergency laparotomy with right salpingo-oophorectomy. On laparotomy there was twisted and ruptured right ovarian cyst with unruptured ampullary pregnancy on the same side. There was coexistence of these two conditions which presented as acute abdomen. DOI: http://dx.doi.org/10.3126/njog.v3i2.10834 Nepal Journal of Obstetrics and Gynaecology Vol.3(2) 2008; 54-56

scholarly journals PSIV-13 Basal endogenous loss, standardized total tract digestibility, and retention of Ca in sows change throughout gestation, but microbial phytase reduces basal endogenous loss of Ca by gestating sows

2019 ◽  
Vol 97 (Supplement_2) ◽  
pp. 185-186
Author(s):  
Su A Lee ◽  
Carrie L Walk ◽  
Hans H Stein
Keyword(s):  
Calcium Carbonate ◽  
Repeated Measures ◽  
Fixed Effects ◽  
Sole Source ◽  
Late Gestation ◽  
Phosphorus Retention ◽  
Early Gestation ◽  
Microbial Phytase ◽  
Period Of Gestation ◽  
P Retention

Abstract The objective was to test the hypothesis that standardized total tract digestibility (STTD) of Ca and Ca and P retention and the response to microbial phytase in diets fed to sows are constant throughout gestation. Thirty-six sows (parity = 3.3) were allotted to 4 diets on d 7 post-breeding. Two corn-based diets in which calcium carbonate was the sole source of Ca and 2 Ca-free diets were formulated without or with phytase (500 units per kg). Sows were housed individually in metabolism crates during early-gestation, mid-gestation, and late-gestation, and feces and urine were quantitatively collected. Data were analyzed by repeated measures using a model that included phytase, period of gestation, and the interaction between phytase and period as fixed effects, and block and replicate as random effects. Interactions between period and phytase were not observed. The basal endogenous loss (BEL) of Ca was greater (P < 0.05) in early-gestation than in mid- and late-gestation, but phytase reduced (P = 0.002) BEL of Ca and tended (P = 0.099) to increase apparent total tract digestibility (ATTD) of P in the Ca-free diet. Phytase did not affect ATTD of DM, STTD of Ca, ATTD of P, or Ca and P retention in sows fed the diet containing calcium carbonate (Table 1). The ATTD of DM was not affected by period, but Ca retention and ATTD of Ca and P were least (P < 0.05) in mid-gestation, followed by early- and late-gestation, and the STTD of Ca in mid-gestation was also reduced (P < 0.05) compared with early- or late-gestation. Phosphorus retention was greater (P < 0.05) in late-gestation than in the earlier periods. In conclusion, BEL of Ca, STTD of Ca, ATTD of P, and Ca and P retention in sows change throughout gestation regardless of use of phytase. http://www.conferenceharvester.com/

scholarly journals Profile of Ectopic Pregnancy at Kathmandu Model Hospital

2016 ◽  
Vol 10 (2) ◽  
pp. 10-13
Author(s):  
HK Pradhan ◽  
G Dangal ◽  
A Karki ◽  
R Shrestha ◽  
K Bhattachan
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Discharge Summary ◽  
Reproductive Age ◽  
Emergency Laparotomy ◽  
Average Hospital ◽  
Pain Abdomen ◽  
Number Of Patients ◽  
History Of ◽  
Age Range

Aims: The study was done to analyze the epidemiology, diagnosis and treatment aspect of patients with ectopic pregnancy at Kathmandu Model Hospital.Methods: This was a retrospective study of patients with ectopic pregnancy who received treatment at Kathmandu Model Hospital from January 2008 to September 2015. Data were analyzed from patient records and discharge summary. Delivery number was obtained from maternity record.Results: There were 61 cases of ectopic pregnancy with the hospital incidence of 1.46%. Highest number of patients 20 (32.79%) were in the age range of 28-32 years. Most of the patients were nullipara 22 (36.06%) or with parity two 20 (32.79%). Some risk factors were found in 29 (47.54%) cases. The commonest risk factor was pelvic inflammatory disease in 12 (19.67%). All presented with pain abdomen, 48 (78.68%) had per vaginal bleeding, 17 (27.87%) presented in shock. Cervival excitation was present in 38 (62.29%). Urine for pregnancy test was positive in all and 37 (60.66%) had ultrasonography. Ten (16.39%) patients underwent emergency laparoscopic surgery and 40 (65.57%) had emergency laparotomy. Salpingectomy was required in 53 (86.89%) cases. The average hospital stay was 5 days.Conclusions: The study showed that ectopic pregnancy could occur at any reproductive age without obvious risk factors. Although not all patients gave history of amenorrhoea, pain abdomen was present in all.

scholarly journals Cervical Twin Heterotopic Pregnancy: Overview of Ectopic Pregnancies and Scanning Detection Algorithm

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 969
Author(s):  
Antonios Koutras ◽  
Zacharias Fasoulakis ◽  
Michail Diakosavvas ◽  
Athanasios Syllaios ◽  
Athanasios Pagkalos ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Uterine Cavity ◽  
Medical Abortion ◽  
First Trimester ◽  
Detection Algorithm ◽  
Heterotopic Pregnancy ◽  
Cervical Canal ◽  
Mortality And Morbidity ◽  
Gestational Sac ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is the leading cause of gestation-related deaths during the first trimester. Cervical twin heterotopic pregnancies, when ectopic, constitute a small and rare part of gynecological surgery. Case Presentation: A 30-year-old pregnant woman (gravida 3, para 2) presented with mild pain in the lower abdomen and traces of bleeding per vaginum for three days. Transvaginal ultrasonography revealed a balloon-shaped cervical canal with a visible gestational sac measuring 3.5 × 3.9 cm. A second gestational sac was seen in the uterine cavity. The measurements of the gestational sacs corresponded to 7 + 4 weeks’ pregnancy. A decision for medical abortion with mifepristone and misoprostol was made. However, due to an incomplete abortion and continuous bleeding, a curettage was performed. Conclusions: Spontaneous heterotopic pregnancy with the ectopic pregnancy located in the cervix is an extremely rare clinical condition requiring urgent treatment in order to reduce maternal mortality and morbidity and preserve fertility.

scholarly journals A rare case report: heterotopic pregnancy with ovarian ectopic pregnancy

2018 ◽  
Vol 7 (3) ◽  
pp. 1243
Author(s):  
Manuja N. ◽  
Ashok Devoor ◽  
Umashankar .
Keyword(s):  
Ectopic Pregnancy ◽  
Rare Case ◽  
Heterotopic Pregnancy ◽  
Missed Abortion ◽  
Extrauterine Pregnancy ◽  
Pain Abdomen ◽  
Rare Case Report ◽  
Reproductive Techniques ◽  
Natural Conception ◽  
High Index Of Suspicion

Heterotopic Pregnancy(HP) is defined as the occurrence of intrauterine and extrauterine pregnancy simultaneously. Incidence varies from 1 in 8000 to 30,000 natural conceptions. HP is common with artificial reproductive techniques and is very rare in natural conception. A high index of suspicion is helpful in diagnosis and appropriate management. We report a case of HP in a 28-year-old woman presented with 2 and half months amenorrhoea, pain abdomen and bleeding per vagina with TAS showing intra uterine single missed abortion and ovarian ectopic pregnancy.

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