scholarly journals Catastrophic presentation of spontaneous heterotopic pregnancy

2020 ◽  
Vol 0 ◽  
pp. 1-4
Author(s):  
Sunita Dubey ◽  
Aayushi Kaushal
Keyword(s):  
Ectopic Pregnancy ◽  
Adnexal Mass ◽  
Final Diagnosis ◽  
Heterotopic Pregnancy ◽  
Healthy Baby ◽  
Spontaneous Conception ◽  
Pain Abdomen ◽  
Beta Human Chorionic Gonadotropin ◽  
Reproductive Techniques

Heterotopic gestation is an uncommon entity with natural conception; however, rising trends have been seen with the use of artificial reproductive techniques. We are reporting a case of 22-year-old G3P1A1L1 who presented to us at 9 weeks of gestation with complaints of mild pain in the left adnexa from 3 days. Subsequently, her pain was increased in intensity and spread over to whole abdomen. She was referred with the left adnexal mass with persistent pain abdomen. On admission, ultrasound revealed single live intrauterine fetus with the left adnexal mass with fetal node along with hemoperitoneum. She underwent laparotomy and successfully managed with the left side salpingectomy along with blood transfusion. Later, she delivered a healthy baby at term. Ectopic pregnancy should be the first differential diagnosis when no other cause suspected in patients with adnexal mass. Follow-up ultrasound should be done in patients with persistent and localized pain in abdomen even in spontaneous conception. Diagnostic laparoscopy may be the reasonable option to make a final diagnosis as beta-human chorionic gonadotropin is not a reliable test to diagnose ectopic pregnancy in heterotopic pregnancy.

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.

scholarly journals Heterotopic Quadruplet Pregnancy. Literature Review and Case Report

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 483
Author(s):  
Brîndușa Cimpoca ◽  
Amira Moldoveanu ◽  
Nicolae Gică ◽  
Corina Gică ◽  
Anca Marina Ciobanu ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Ectopic Pregnancy ◽  
Assisted Reproductive Techniques ◽  
Heterotopic Pregnancy ◽  
Management Options ◽  
Reproductive Techniques ◽  
Natural Conception

Heterotopic pregnancy is the condition where both intrauterine and ectopic pregnancy are present. It rarely occurs after natural conception, but is more common with assisted reproductive techniques, when more than one embryo is transferred. Quadruplet heterotopic pregnancy is exceedingly rare. Methods: A literature review was conducted aiming to highlight the diagnosis difficulties and the management options in heterotopic quadruplet pregnancies. Results: Nine relevant studies were identified by researching PubMed up to 2021 for “heterotopic quadruplet pregnancy”, “quadruplet intrauterine and ectopic pregnancy”, “synchronous intrauterine and ectopic pregnancy”. Conclusions: In this paper, we present a case of heterotopic quadruplet pregnancy and address the difficulty in diagnosing this condition and make formal recommendations.

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.

scholarly journals Case of Ruptured Ectopic Pregnancy in the Uterosacral Ligament and Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Yasmin Abedin ◽  
Kanchi Chadha
Keyword(s):  
Ectopic Pregnancy ◽  
Adnexal Mass ◽  
Uterosacral Ligament ◽  
Free Fluid ◽  
Fallopian Tubes ◽  
Review Of The Literature ◽  
Chorionic Villi ◽  
Beta Hcg ◽  
Beta Human Chorionic Gonadotropin ◽  
Potential Risk Factors

Pregnancies that implant on the uterosacral ligament are rare. Here, we describe a case of ruptured ectopic pregnancy in the left uterosacral ligament in a patient with potential risk factors including possible endometriosis and recent hysteroscopic procedure. A 29-year-old female, para 0, presented to the emergency department with generalized abdominal pain. Pelvic examination was significant for fullness in the posterior cul-de-sac. Laboratory values were significant for beta-human chorionic gonadotropin (hCG) level of 6311 mIU/mL. Sonogram findings were significant for no intrauterine gestation, a 6.9×4.6×4.7 cm3 complex left adnexal mass, and moderate free fluid within the posterior cul-de-sac. The patient underwent laparoscopy, which revealed hemoperitoneum and unremarkable bilateral fallopian tubes and ovaries. An abnormal area was noted in the left uterosacral ligament. Tissue was bluntly removed and pathologically confirmed as chorionic villi within the left uterosacral ligament. After one week, her beta-hCG decreased to 784 mIU/mL. After two weeks, she was seen as an outpatient and was doing well without any symptoms. More information is required regarding these unique pregnancies to help understand the pathophysiology and determine the management.

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.

A positive urine pregnancy test (UPT) with adnexal mass; ectopic pregnancy is not the ultimate diagnosis

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Mohd Faizal Ahmad ◽  
Muhammad Azrai Abu ◽  
Kah Teik Chew ◽  
Kun Leng Sheng ◽  
Mohd Asyraf Zakaria
Keyword(s):  
Ectopic Pregnancy ◽  
Adnexal Mass ◽  
Case Reports ◽  
First Trimester ◽  
Pregnancy Test ◽  
First Case ◽  
Positive Urine ◽  
Disease Free ◽  
Urine Pregnancy Test

Abstract A positive urine pregnancy test (UPT) with adnexal mass in ectopic pregnancy is not the ultimate diagnosis. The incidence of ectopic pregnancy is about 27 per 1000 pregnancies [1]. On average, about 6–16% will present to an emergency department with first-trimester bleeding and abdominal pain [2]. On presenting with these symptoms with the simultaneous presence of an adnexal mass and an empty uterus, a UPT is of paramount importance to determine whether the symptoms are pregnancy related or not. When the UPT is positive, an ectopic pregnancy is not the only diagnosis as the rare entity of non-gestational ovarian choriocarcinoma (NGOC) should be considered. Here we present two case reports of NGOC, which were initially diagnosed as ectopic pregnancy. The first case is a 16-year-old girl, with vaginal bleeding and an adnexal mass due to an ovarian choriocarcinoma, She underwent unilateral oophorectomy and received multiple courses of chemotherapy. She is disease free without evidence of recurrence or metastasis after 12 months of follow-up. The second patient is also 16 years old and presented with an acute abdomen. She was diagnosed as a ruptured luteal cyst and underwent partial oophorectomy. When the pathologist diagnosed a choriocarcinoma she received multiple courses of chemotherapy, but thereafter an advanced disease was diagnosed with evidence of distant metastasis.

scholarly journals Endometrial stromal sarcoma in a 20-year-old woman

2019 ◽  
Vol 12 (12) ◽  
pp. e228874
Author(s):  
Rubina Sohail ◽  
Shahlla Kanwal ◽  
Adnan Murtaza ◽  
Bushra Haq
Keyword(s):  
Adnexal Mass ◽  
Stage Iv ◽  
Endometrial Stromal Sarcoma ◽  
Final Diagnosis ◽  
Sexually Active ◽  
Uterine Sarcomas ◽  
Stromal Sarcoma ◽  
Pelvic Wall ◽  
The Right

Endometrial stromal sarcoma (ESS) is an uncommon and challenging condition comprising 10% of all uterine sarcomas and found in women 42–58 years of age. ESS is difficult to diagnose in young women as it masquerades as a leiomyoma. We report this tumour in a 20-year-old woman presenting with heavy and prolonged menses and urinary retention. She was not sexually active and did not give consent for pelvic examination. A preoperative diagnosis of a submucous leiomyoma with an adnexal mass was made. At laparotomy, the leiomyoma was found to be wedged between the cervix and the vagina, and was removed vaginally. A 5–6 cm retroperitoneal mass was adherent to the right pelvic wall, which was also removed. Histopathology of both specimens revealed ESS. The final diagnosis according to the International Federation of Gynaecology and Obstetrics classification was stage IV ESS. After oncology consult, she was referred for chemotherapy. She is now on follow-up.

scholarly journals Management of adnexal masses: save the ovaries

2017 ◽  
Vol 6 (12) ◽  
pp. 5540
Author(s):  
Chitra Champawat ◽  
Reena Jatin Wani
Keyword(s):  
Ectopic Pregnancy ◽  
Open Surgery ◽  
Adnexal Mass ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Age Group ◽  
Adnexal Masses ◽  
Pain Abdomen ◽  
Common Diagnosis

Background: Adnexal mass is a common presenting complaint in gynaecology. Total 1318 cases were operated over two and a half years (January 2015-June 2017), out of which 195 (14.7%), were for adnexal mass.Methods: To review cases of adnexal masses who underwent surgery over the period of two and a half year in a tertiary care hospital with respect to presentation, aetiology, type of surgeries and fertility preservation.Results: There were totally 195 patients, mostly of age group 26-45 years affected by adnexal mass. Most common presentation was pain abdomen (70 cases i.e. 79.5%). Ectopic pregnancy (115 cases i.e. 58.9%) was the most common diagnosis, followed by ovarian cyst (71 cases i.e. 36.4%). Most cases were treated by open surgery. Laparoscopic management was done for 33 cases (17.9%). Except in unavoidable situations active effort were made to conserve ovaries. Oophorectomy was done in 22 cases (11.2%) and in 173 cases (i.e. 88.8%) fertility preservation was done. Malignancy was seen in 4 (2%), which were managed by open surgery.Conclusions: Ectopic pregnancy was the most common aetiology of adnexal mass, and laparoscopy and its known benefits to patients is the best approach if available. For cases with suspected malignancy, open surgery will remain a safer option.

scholarly journals Role of methotrexate in ectopic pregnancy

2020 ◽  
Vol 10 (1) ◽  
pp. 84
Author(s):  
Munjal J. Pandya ◽  
Neha V. Ninama ◽  
Chirag V. Thummar ◽  
Meet K. Patel
Keyword(s):  
Ectopic Pregnancy ◽  
Success Rate ◽  
Surgical Intervention ◽  
Cost Effective ◽  
First Trimester ◽  
Medical College ◽  
Beta Human Chorionic Gonadotropin ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is an acute emergency in obstetric if not timely diagnosed and timely treated. Ectopic pregnancy is leading cause of death in first trimester. Ectopic pregnancy can be managed surgically or medically. Medical management with Methotrexate administration avoids anesthesia in surgery, is cost effective and also offers success rate comparable to surgical management. Aim and objectives were to study the role of methotrexate in ectopic pregnancyMethods: This will be a retrospective observational study conducted in Obstetrics and Gynecology department of AMC MET medical college. Study group constitutes of 30 females with ectopic pregnancy. Preliminary blood investigations, ultrasonography and beta-human chorionic gonadotropin (b-hcg) level will be tested. Patients will be treated with single dose of methotrexate 50 mg/M2. Follow up b-hcg level will be done after 48 hours. Response and tolerance to methotrexate will be monitored.Results: The success rate of methotrexate therapy in our study was 83.33% (n=25) and 16.66% (n=5) required surgical intervention with tubal ruptured and abdominal pain.Conclusions: Methotrexate treatment of ectopic pregnancies is safe and effective with no major side effects. It has the advantage of tubal conservation and saves patients from surgical intervention.

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.

Sign in / Sign up

Export Citation Format

Share Document