scholarly journals 27 Weeks Abdominal Pregnancy wıth Mısdıagnosed at the Fırst Center, A Case Report

2019 ◽  
Vol 4 (09) ◽  
Author(s):  
Recep ERİN ◽  
Kadri TEZEL ◽  
Ahmed ISAK ◽  
Samira AHMED ◽  
Mustafa KUŞAK
Keyword(s):  
Abdominal Pregnancy ◽  
Successful Management ◽  
Intrauterine Pregnancy ◽  
Incorrect Diagnosis ◽  
Maternal Morbidity And Mortality ◽  
Life Threatening ◽  
Failed Induction ◽  
Ectopic Pregnancies ◽  
The Right ◽  
High Index Of Suspicion

Abdominal pregnancy is a potentially life threatening form of ectopic gestation and is seen in 1% of all ectopic pregnancies. It’s a major cause of maternal morbidity and mortality and the potential mortality can be reduced seriously with early diagnosis and treatment. It is rarely seen in advanced pregnancy weeks due to detectability on ultrasonography in early weeks. We aimed to present a rare, misdiagnosed, abdominal pregnancy. We present a case of 20 years old primigravida with 27 weeks abdominal pregnancy who presented at the emergency room with abdominal pain and minimal vaginal bleeding. She was referred from another hospital after 2 days failed induction for incorrect diagnosis of intrauterine dead fetus. The ultrasonography was performed and seen a normal uterus with no intrauterine pregnancy but seen a single extra uterine fetus with 27 weeks gestational age lying in the peritoneal cavity on the right side. We managed successfully with laparotomy. Abdominal pregnancy is rare, and successful management depends on a high index of suspicion. Ultrasonography and serial human chorionic gonadotrophin may help in the diagnosis. Teamwork, a multidisciplinary approach and expert opinion cannot be overemphasised to ensure successful management of these cases.

scholarly journals Second trimester Abdominal Pregnancy: A Case Report in a Resource Limited Setting

2021 ◽  
Vol 8 (2) ◽  
pp. 1-4
Author(s):  
Jimah B Bashiru ◽  
Keyword(s):  
Abdominal Ultrasound ◽  
High Index ◽  
Emergency Laparotomy ◽  
Abdominal Pregnancy ◽  
Resource Limited ◽  
Life Threatening ◽  
History Of ◽  
The Right ◽  
High Index Of Suspicion ◽  
Prompt Diagnosis

Introduction: Abdominal pregnancy is a rare form of ectopic pregnancy with very high feto-maternal morbidity and mortality. Diagnosis and management can pose difficulties in low-resource centres. High index of suspicion is vital in making a prompt diagnosis. Case Presentation: A 23year old, gravida 2, para 1, who presented with a two-day history of severe abdominal pain was referred from a satellite clinic. Abdominal ultrasound scan revealed a live 18week 5day intra-abdominal pregnancy. Emergency laparotomy showed an intact gestational sac at the superior aspect of the uterus with massive hemoperitoneum. The placenta was attached to the right ovary, omentum, and fimbriae of the right fallopian tube. Conclusion: Abdominal pregnancy is a rare occurrence and requires a high index of suspicion for prompt diagnosis. Massive hemoperitoneum can be life threatening and prompt surgical intervention is key in saving the life of the mother.

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.

Uterine Arterio-Venous Malformation: A Rare Post Mortem Finding in a Young Female

2021 ◽  
Vol 11 (11) ◽  
pp. 130-133
Author(s):  
Sumiti Gupta ◽  
Renuka Verma ◽  
Rajnish Kalra
Keyword(s):  
Vaginal Bleeding ◽  
Venous Malformation ◽  
Young Female ◽  
Uterine Bleeding ◽  
Post Mortem ◽  
Dysfunctional Uterine Bleeding ◽  
Maternal Morbidity And Mortality ◽  
Life Threatening ◽  
Arterio Venous Malformation ◽  
High Index Of Suspicion

Uterine arterio-venous malformation is one of the differentials of dysfunctional uterine bleeding that can result in life-threatening emergency with sudden, unexpected massive vaginal bleeding. We describe a case of 20-year old female, who presented with sudden heavy vaginal bleeding and was diagnosed with uterine arterio-venous malformation on post-mortem examination. High index of suspicion is required to make a timely diagnosis for appropriate management and to avoid maternal morbidity and mortality. Key words: Uterine arterio-venous malformations, embolization, dysfunctional uterine bleeding.

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 A Case of Live Birth after Uterine Reconstruction for Recurrent Cornual Ectopic Pregnancy following IVF Treatment

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Deivanayagam Maruthini ◽  
Vinay Sharma
Keyword(s):  
Ectopic Pregnancy ◽  
Elective Caesarean Section ◽  
Muscle Thickness ◽  
Singleton Pregnancy ◽  
Intrauterine Pregnancy ◽  
Future Pregnancy ◽  
Ectopic Pregnancies ◽  
The Right ◽  
Pregnancy And Birth ◽  
Myometrial Thickness

We present a case of recurrent ruptured right cornual ectopic pregnancies conceived after IVF. Following the second episode, a sonohysterography was undertaken to identify possible areas of scar weakness that may rupture with uterine distension in a future pregnancy. The scan revealed asymmetrical muscle thickness in the cornual regions, the right (6 mm) being thinner than the left (1.6 cm). Subsequently, an elective laparotomy was undertaken, and the cornua were reconstructed and thickened in several layers by bringing the laterally retracted myometrial fibres onto the reconstruction site. A sono-hysterography after surgery showed satisfactory (3-4 cm) myometrial thickness all around. A further cycle of IVF resulted in a singleton pregnancy. Pelvic scans confirmed normal intrauterine pregnancy without any myometrial thinning. She was delivered by an uneventful elective caesarean section at term. We propose that, in those who intend to have further pregnancies after a cornual ectopic pregnancy, a sono-hysterography is possibly the best investigative tool to assess myometrial integrity. This case demonstrates that in women with areas of muscle weakness it is possible to successfully perform an interval elective reconstructive surgery on the uterus that can result in an uneventful pregnancy and birth.

scholarly journals Peripartum cardiomyopathy: a rare complication in a teenage pregnancy

2021 ◽  
Vol 10 (7) ◽  
pp. 2854
Author(s):  
Uma Chourasia ◽  
Jyoti Nath Modi
Keyword(s):  
Multidisciplinary Team ◽  
Teenage Pregnancy ◽  
Rare Complication ◽  
Clinical Findings ◽  
Peripartum Cardiomyopathy ◽  
Team Approach ◽  
Successful Management ◽  
Emergency Cesarean ◽  
Life Threatening ◽  
High Index Of Suspicion

The aim of this case report was to present a rare case of peripartum cardiomyopathy (PPCM) in an adolescent primigravida, and discuss its presentation and successful management. PPCM is a relatively rare yet life threatening cardiac complication of pregnancy. It often remains undiagnosed as its symptoms may simulate the physiological symptoms of pregnancy and peripartum period. An early diagnosis is crucial for improving survival. We herein report an unusual case of PPCM in an young and otherwise healthy primigravida. A 19-year-old primigravida presented at 33 weeks of gestation with, severe pre-eclampsia with dyspnea, cough and discomfort in the chest. Based on clinical findings and ECG, the echocardiography was done, and a definitive diagnosis of PPCM was made. The patient was managed for heart failure and preeclampsia by a multidisciplinary team. Emergency cesarean was done for obstetric indication and patient was managed conservatively in intensive care unit. Patient improved clinically and was discharged at day 10. Peripartum cardiomyopathy though typically associates with advanced maternal age can occur in very young women as well. A high index of suspicion for PPCM is recommended on a background of `severe preeclampsia with breathlessness. Timely echocardiography for diagnosis, and a multidisciplinary team approach are a key to successful management. Clinical significance of the study was to shed new light on the unusual presentation of PPCM and to contribute to the existing knowledge of PPCM.

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 Undiagnosed Case of Klippel-Trenaunnay Syndrome Presenting as Extensive Heterotrophic Ossification and Flexion Deformity of Right Lower Limb Requiring Amputation : A Case Report

2021 ◽  
Vol 59 (241) ◽  
pp. 938-941
Author(s):  
Kushal Gautam ◽  
Sangharsha Thapa ◽  
Anu Radha Twayana ◽  
Lokendra Chhantyal ◽  
Puskar Poudel ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Recurrent Infection ◽  
Flexion Deformity ◽  
Life Threatening ◽  
Clinical Triad ◽  
Chronic Severe Pain ◽  
The Right ◽  
High Index Of Suspicion ◽  
Asymptomatic Disease ◽  
Variable Presentation

Klippel-Trenaunnay Syndrome is a rare disease characterized by a clinical triad of capillary malformation, soft tissue and bony hypertrophy, and atypical varicosity. This syndrome ranges from asymptomatic disease to life-threatening bleeding, embolism, and deformities. Management includes early diagnosis, prevention, and treatment of complications. We present a case of a 43-year-old male presenting with pain, swelling and deformity of the right leg for 30 years. On examination, diffusely enlarged tender right limb with several dark patchy discolorations, multiple tortuous vessels were found. Right leg X-ray showed heterotrophic ossification and distortion of ankle joint. Due to chronic severe pain, recurrent infection, contracture and flexion deformity of right leg, the patient underwent above knee amputation. This case focuses on the variable presentation and multiple problems faced by patients with Klippel-Trenaununay Syndrome as they get diagnosed late and shows the importance of high index of suspicion for early diagnosis and prevention of complications.

Caution with bilateral salpingectomy and consideration of tubal stump ectopic in IVF

2020 ◽  
Vol 13 (11) ◽  
pp. e235893
Author(s):  
Swee Lin Yip ◽  
Shahul Hameed Mohamed Siraj ◽  
Jerry Kok Yen Chan
Keyword(s):  
Ectopic Pregnancy ◽  
Cystic Mass ◽  
In Vitro Fertilisation ◽  
Beta Human Chorionic Gonadotropin ◽  
Life Threatening ◽  
History Of ◽  
Bilateral Salpingectomy ◽  
Ectopic Pregnancies ◽  
The Right

We report a 35-year-old female patient with a history of bilateral salpingectomy from ectopic pregnancies presenting with a positive serum beta-human chorionic gonadotropin (bhCG) result following in vitro fertilisation (IVF) treatment. Apart from per vaginal spotting, she remained asymptomatic. Initial ultrasound showed an empty uterus with a cystic mass on the right side of the uterus. Serum beta-hCG was trended. A follow-up pelvic ultrasound 1 week later showed a live pregnancy in the right adnexa. A diagnostic laparoscopy was performed, which revealed an unruptured right stump ectopic pregnancy that was successfully removed. As a stump ectopic pregnancy can be a potentially life-threatening occurrence, we emphasise caution with salpingectomy and the consideration of tubal stump ectopic pregnancies following IVF treatment.

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