scholarly journals Endosurgical treatment techniques of progressive tubal pregnancy

2006 ◽  
Vol 5 (1) ◽  
pp. 73-75
Author(s):  
I. D. Yevtushenko ◽  
S. V. Rybnikov

Research purpose: to increase the efficiency of endosurgical treatment of women with progressive tubal pregnancy. Research method: prospective analysis. Research subjects: in 75 female patients, to whom salpingotomy and salpingorrhaphy had been per-formed, tubal patency was found; in 10% - tubal patency was laboured; in 9,5% of patients there was an obstruction. In 52,9% of women, to whom salpingotomic orifice was not sutured, tubal patency was found; in 32,4% of patients tubal patency was disturbed; in 14,7% the fallopian tube was obstructed and in 17,6% of patients tubo-peritoneal fistula formed. Uterine pregnancy rate of salpingotomy and salpingorrhaphy - 34,1%, of women, to whom salpingotomic orifice was not sutured - 20,6%. Performance of endoscopic salpingotomy with suture of the defect at isthmial and ampullar location of the fetal ovum helps to increase the efficien-cy of surgical treatment of the ectopic pregnancy.

2021 ◽  
Vol 20 (4) ◽  
pp. 12-16
Author(s):  
Aml El-Shabrawy ◽  
◽  
Ahmed Elsheikh ◽  
Samy Gebreel ◽  
Mohammed Elsokkary ◽  
...  

Objective. Ectopic pregnancy adversely affects the patency of the fallopian tube and consequently the future pregnancy. There are different options of conservative treatment of tubal pregnancy such as methotrexate and salpingostomy [1]. There is little information on the success rate of maintaining tubal patency after methotrexate and salpingostomy [2]. Therefore, the aim of this study is to evaluate the ipsilateral tubal patency using HyCoSy after treatment of tubal pregnancy with methotrexate therapy versus salpingostomy. Patients and methods. This was a case-series study conducted in Ain Shams and Al-Azhar University Maternity Hospitals to evaluate the ipsilateral tubal patency using hysterosalpingo-contrast sonography (HyC0Sy) following salpingostomy and medical treatment of tubal pregnancy. This study included patients who were admitted to Ain Shams and Al-Azhar University Maternity Hospitals for having tubal pregnancy and were treated either with methotrexate or salpingostomy over a 4-year period between January 2017 and December 2020. The patients seeking fertility were re-evaluated for fallopian tubes patency by hysterosalpingogram 3 months after discharge. The study included 2 groups of women: group I (n = 200): women who were treated with methotrexate, and group II (n = 140): women who underwent salpingostomy. Results. HSG was performed in 200 cases of patients with tubal pregnancy who were treated with methotrexate and 140 cases of patients who underwent salpingostomy. The patency of the ipsilateral tube was 85% after methotrexate treatment and 84.2% after salpingostomy. There was no statistically significant difference between the two groups. Conclusion. The findings suggest similar success rate in maintaining the patency of the fallopian tube with either methotrexate or salpingostomy. Key words: ectopic pregnancy, hysterosalpingography, methotrexate, infertility, salpingostomy


2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Panayotis Xiromeritis ◽  
Chrysoula Margioula-Siarkou ◽  
Dimosthenis Miliaras ◽  
Ioannis Kalogiannidis

Tubal pregnancy concerns 97% of all ectopic pregnancies. Treatment can be either surgical (salpingostomy or salpingectomy) or medical (methotrexate administration). We present a case of a pseudotubal pregnancy after methotrexate treatment of a previous ectopic pregnancy. A37-year-old woman was diagnosed with ectopic pregnancy in the left Fallopian tube. A year ago, she had an ectopic pregnancy in the right tube, which was successfully treated with intramuscular methotrexate. During laparoscopy, two tubal masses were revealed, one in each Fallopian tube, and bilateral salpingectomy was performed. Histological analysis confirmed tubal pregnancy in the left Fallopian tube and presence of endosalpingitis in the right tube with no signs of chorionic villi. The optimal management of such cases has not yet been clarified. However, evaluation of tubal patency after a medically treated ectopic pregnancy would permit proper counsel of the patient on her fertility options, in order to choose the appropriate method of conception to achieve and accomplish a future pregnancy.


2018 ◽  
Vol 46 ◽  
pp. 5
Author(s):  
Jia-San Zheng ◽  
Zheng Wang ◽  
Jia-Ren Zhang ◽  
Shuang Qiu ◽  
Ren-Yue Wei ◽  
...  

Background: Ectopic pregnancy mainly refers to tubal pregnancy and abdominal pregnancy. Tubal pregnancy presents as an implanted embryo that develops in the fallopian tubes, and is relatively common in humans. In animals, tubal pregnancy occurs primarily in primates, for example monkeys. The probability of a tubal pregnancy in non-primate animals is extremely low. Abdominal pregnancy is a type of ectopic pregnancy that occurs outside of the uterus, fallopian tube, ovary, and ligament(broad ligament, ovarian ligament, suspensory ligament).This paper describes two cases of ectopic pregnancy in cats.Cases: Cat 1. The presenting sign was a significant increase in abdominal circumference. The age and immune and sterilization status of the cat were unknown. On palpation, a 4 cm, rough, oval-shaped, hard mass was found in the posterior abdomen. Radiographic examination showed three high-density images in the posterior abdomen. The fetus was significantlycalcified and some feces was evident in the colon. The condition was preliminarily diagnosed as ectopic pregnancy. Cat 2. The owner of a 2-year-old British shorthair cat visited us because of a hard lump in the cat’s abdomen. The cat had a normal diet and was drinking normally. Routine immunization and insect repulsion had been implemented. The cat had naturally delivered five healthy kittens two months previous. Radiographs showed an oval-shaped mass with a clear edge in the middle abdominal cavity. Other examinations were normal. The case was preliminarily diagnosed as ectopic pregnancy, and the pregnancy was surgically terminated. The ectopic pregnancies were surgically terminated. During surgery, the structures of the uterus and ovary of cat 1 were found to be intact and the organs were in a normal physiological position.Cat 1 was diagnosed with primary abdominal pregnancy. In cat 2, the uterus left side was small and the fallopian tube on the same side was both enlarged and longer than normal. Immature fetuses were found in the gestational sac. Thus, cat 2 was diagnosed with tubal ectopic pregnancy based on the presenting pathology.Discussion: Cats with ectopic pregnancies generally show no obvious clinical symptoms. The ectopic fetus can remain within the body for several months or even years. Occasionally, necrotic ectopic tissues or mechanical stimulation of the ectopic fetus can lead to a systemic inflammatory response, loss of appetite, and apathy. The two cats in our reportshowed no significant clinical symptoms. To our knowledge, there have been no previous reports of the development of an ectopic fetus to maturity, within the abdominal cavity of felines, because the placenta of cats cannot support the growth and development of the fetus outside of the uterus. Secondary abdominal ectopic pregnancy, lacking any signs of uterine rupture is likely associated with the strong regenerative ability of uterine muscles. A damaged uterus or fallopian tube can quickly recover and rarely leaves scar tissue. In the present report, cat 1 showed no apparent scar tissue, nor signs of a ruptured ovary or fallopian tubes. It was diagnosed with primary ectopic abdominal pregnancy, which could arise from the descent of the fertilized egg from the fallopian tube into the abdominal cavity. There was an abnormal protrusion in left of the fallopian tubes in cat 2, to which the gestational sac was directly connected. Based on pathological examination of the uterus, fallopian tubes, and gestational sac, the cat was diagnosed with a tubal pregnancy. Placental tissues and signs of fetal calcification were observed in both the fallopian tube and gestational sac.Keywords: tubal pregnancy, abdominal pregnancy, feline, ectopic fetus, fallopian tube, gestational sac.


Author(s):  
Tanjona Andriamanetsiarivo Ratsiatosika ◽  
Romuald Randriamahavonjy ◽  
Baco Abdallah Abasse ◽  
Mahefarisoa Fnat ◽  
Ibrahim Housni ◽  
...  

Ectopic pregnancy is a life-threatening condition occurring in 1-2% of all pregnancies. The most common site of implantation for an ectopic pregnancy is the fallopian tube. Authors report a case of recurrent ipsilateral ectopic pregnancy following right partial salpingectomy of a 29-Year-Old woman that led to tubal rupture. The pregnancy was conceived spontaneously. Diagnostic of ruptured ectopic pregnancy was done after clinical and ultrasonography examination. The presence of a massive hemoperitoneum with a positive pregnancy urinary test that lead us to the diagnosis of ectopic pregnancy. She underwent a laparotomy for a suspicion of ruptured ectopic pregnancy. The ectopic pregnancy was identified in the left remnant fallopian tube. Partial salpingectomy, removal of tubal stump, and resection of the uterine cornua, was performed. The postoperative recovery was uneventful. She has stayed for five days at the Hospital. All patients, even though they have already received a definitive contraception by tubal section and ligature or unilateral or by bilateral salpingectomy for any reason, must seek an ectopic pregnancy in case of pelvic pain, vaginal bleeding and/ or amenorrhea. Authors propose to carry a total salpingectomy after a chosen surgical treatment.


2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Mara Clapp ◽  
Jaou-Chen Huang

Background. Surgery is sometimes required for the management of tubal ectopic pregnancies. Historically, surgeons used electrosurgery to obtain hemostasis. Topical hemostatic sealants, such as FloSeal, may decrease the reliance on electrosurgery and reduce thermal injury to the tissue.Case. A 33-year-old G1 P0 received methotrexate for a right tubal pregnancy. The patient became symptomatic six days later and underwent a laparoscopic right salpingotomy. After multiple unsuccessful attempts to obtain hemostasis with electrocoagulation, FloSeal was used and hemostasis was obtained. Six weeks later, a hysterosalpingogram (HSG) confirmed tubal patency. The patient subsequently had an intrauterine pregnancy.Conclusion. FloSeal helped to achieve hemostasis during a laparoscopic salpingotomy and preserve tubal patency. FloSeal is an effective alternative and adjunct to electrosurgery in the surgical management of tubal pregnancy.


2020 ◽  
Vol 7 (1) ◽  
pp. 4-9
Author(s):  
I. V. Gadayeva ◽  
I. D. Khokhlova ◽  
T. A. Dzhibladze

Ectopic pregnancy is the most common cause of emergency conditions in gynecology. The main clinical manifestations of ectopic pregnancy, in the background of signs of pregnancy, are the menstrual irregularities, delayed menstruation, spotting (the most classic clinical picture), pain syndrome (with and without irradiation to the rectum, thigh) of varying intensity (depending on the type of the ectopic pregnancy), signs of intra-abdominal bleeding. The key to successful treatment is timely diagnosis and qualified, adequate medical care. The main laboratory and instrumental methods for diagnosing the ectopic pregnancy are the determination of the -subunit of hCG in blood serum (diagnostic accuracy of 85%) and ultrasound (diagnostic accuracy of 78100%). The treatment of ectopic pregnancy is surgical, the laparoscopic access is preferred. Laparotomy access is indicated for severe adhesions, hemorrhagic shock caused by significant intraperitoneal bleeding. The surgical intervention during tubal pregnancy is tubectomy. Tubotomy (retention of the fallopian tube) is irrational, since the operated fallopian tube causes a recurrence of tubal pregnancy.


2005 ◽  
Vol 54 (5S) ◽  
pp. 101-101
Author(s):  
I. V. Sheshunov ◽  
D. V. Danilov ◽  
D. N. Subbotin ◽  
А. А. Rozuvan

Material and methods. To assess the psychological reaction to the stress connected to the laparoscopic intervention Spilberg - Hanyn scale have been used. Comparative analysis was used in two groups of patients with fallopian tube rupture (as a result of tubal gestation). In the Ist group there were 15 patients who had undergone laparoscopic surgery. In the IInd group there were 15 patients who had undergone laparotomy. In both groups average age of patients was 28 3,1 and 30 2,3 respectively. We estimated correlation between degree of anxiety and risk appraisal for surgical treatment of patients with ectopic pregnancy in both groups.


GYNECOLOGY ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 71-75
Author(s):  
Larisa E Fitisheva ◽  
Vadim G Mozes ◽  
Igor S Zaharov ◽  
Kira B Mozes

Aim. To evaluate the effectiveness of the anti-adhesive barrier in the form of a gel based on carboxymethylcellulose 5 mg and sodium hyaluronate 2.5 mg with various techniques of surgical treatment of ectopic tubal pregnancy. Materials and methods. A randomized study was conducted on 98 women who underwent laparoscopic resection of the ampulla of the fallopian tube, together with a embryo, followed by neostomatoplasty or salpingostomy with or without an anti-adhesive barrier. The primary outcome of the study was the incidence of uterine pregnancy and its outcomes at 18 months of follow-up; secondary outcomes were the frequency of adhesions in the pelvis, the frequency of patency of the operated fallopian tube according to second look laparoscopy with chromohydrotubation by 3 months of follow-up. Results. At 3 months of follow-up, the use of an anti-adhesion barrier reduced the incidence of postoperative adhesions in the area of the operated fallopian tube and the degree of adhesions in the pelvis; increased the frequency of patency of the operated fallopian tube when performing laparoscopic resection of a portion of the ampulla of the fallopian tube, followed by neostomatoplasty. By the 18th month of observation, no statistically significant difference in the incidence of spontaneous pregnancy and its outcomes in the studied women was detected. Conclusion. Use of 5 mg carboxymethylcellulose and 2.5 mg sodium hyaluronate anti-adhesive barrier with various organ-preserving methods of surgical treatment of ectopic tubal pregnancy reduces the frequency and extent of postoperative adhesions in the area of the operated fallopian tube, in the small pelvis, but does not increase fertility in the postoperative period.


2021 ◽  
Vol 8 ◽  
Author(s):  
Lei Nian ◽  
De-Hong Yang ◽  
Jie Zhang ◽  
Han Zhao ◽  
Cai-Fen Zhu ◽  
...  

Objective: This study aims to investigate the clinical efficacy of laparoscopy and hysteroscopy in the treatment of tubal-factor infertility (TFI) to provide a basis for predicting postoperative pregnancy rates.Methods: The clinical data of 336 patients who underwent laparoscopy and hysteroscopy for TFI between February 2018 and December 2018 in the Department of Reproductive Gynecology at the First People's Hospital of Yunnan were retrospectively analyzed. After implementing the inclusion and exclusion criteria, 278 patients were included in the study. The patients were grouped according to pelvic adhesions, hydrosalpinx, twisted fallopian tubes, and fimbriae structure. The impact of the extent of fallopian tube diseases on postoperative pregnancy outcomes was analyzed.Results: Of the 278 patients, 129 got pregnant (pregnancy rate = 46.4%). Pelvic adhesions, hydrosalpinx, twisted/folded fallopian tubes, and damage to the fimbriae of the fallopian tubes were found to affect the natural pregnancy rate after surgery, and it decreased significantly with the aggravation of the disease (P < 0.001). Of the 129 patients who had natural pregnancies, 29 had ectopic pregnancies (ectopic pregnancy rate = 22.48%). Twisted/folded fallopian tubes and damage to the fimbriae structure significantly increased the incidence of postoperative ectopic pregnancy (P < 0.001).Conclusion: Laparoscopy and hysteroscopy are effective treatments for TFI. Pelvic adhesions, twisted/folded fallopian tubes, hydrosalpinx, and damage to the fimbriae of the fallopian tubes can affect postoperative pregnancy outcomes and lead to failure of a natural pregnancy after the operation. The incidence of ectopic pregnancy increases with the degree of fallopian tube twisting/folding and the degree of damage to the fimbriae of the fallopian tubes.


Sign in / Sign up

Export Citation Format

Share Document