Ectopic pregnancy în rudimentary horn: early diagnosis and management

2018 ◽  
Vol 20 (2) (1) ◽  
pp. 20-22
Author(s):  
Aida Petca ◽  
Alina Veduţa ◽  
Mehedintu Claudia ◽  
Nicoleta Măru ◽  
Răzvan Petca ◽  
...  

Pregnancy in rudimentary horn is a rare clinical entity with an incidence ranging from 1:76.000 to 1:140.000 preg­nan­cies. The symptomatology that accompanies pregnancy de­ve­loped in rudimentary horn is similar to that of ectopic preg­nan­cies or may evolve as a normal pregnancy. It is dif­ficult to diagnose in the first trimester of pregnancy when conservative treatment is possible, with minimal mor­bi­di­ty, frequently evolving until the second trimester when clinically manifests as a uterine rupture syndrome and it is accompanied by intraperitoneal hemorrhage and he­mor­rhagic shock. It is desirable that the diagnosis of these pregnancies to be established as early as possible in the first trimester of pregnancy and they will be terminated as soon as they have been diagnosed with certainty.

Author(s):  
Milan R. Shingala ◽  
Bhavesh B. Airao

Unicornuate uterus with noncommunicating rudimentary horn occurs due to incomplete fusion of mullerian ducts. This malformation results from the defective fusion of the duct with the contra-lateral side. This rudimentary horn may or may not have functional cavity. Pregnancy in this horn is a rare phenomenon usually resulting in rupture during second trimester of pregnancy. IT is a rare condition that can lead to a catastrophic outcome when it rupture. Prerupture diagnosis of pregnancy in rudimentary horn with ultrasonography is technically difficult, with sensitivity of 30%. Pregnant rudimentary horn can present with wide range of symptoms that may be similar to ectopic pregnancy or may remain silent with features of normal pregnancy.1-2 We report a case of ruptured non-communicating rudimentary horn at 19 weeks in pregnant lady. In our opinion, routine excision of rudimentary horn should be undertaken during non-pregnant state laparoscopically. However, those women who refuse should be adequately counselled regarding potential complications and if pregnancy occurs in rudimentary horn, first trimester laparoscopic excision should be done.


2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Anis Fadhlaoui ◽  
Mohamed Khrouf ◽  
Kais Nouira ◽  
Anis Chaker ◽  
Fethi Zhioua

Background. Intramural pregnancy is a rare form of ectopic pregnancy, difficult to diagnose and generally complicated by uterine rupture.Case. A 38-year-old woman, gravida 5 para 1, was diagnosed with intramural pregnancy by ultrasound and confirmed with MRI. A uterine rupture occurred, which lead to laparotomy and a conservative treatment.Conclusion. Early diagnosis is necessary for conservative treatment.


2017 ◽  
Vol 5 (4) ◽  
pp. 78-80
Author(s):  
S Kaudel

Uterine rupture in first and second trimester in a non-scarred uterus is usually associated with Mullerian anomalies like rudimentary horn pregnancy. Such rudimentary horn pregnancy is difficult to diagnose antenatally but it carries grave consequences for the mother and fetus. Here is a case of undiagnosed ruptured rudimentary horn pregnancy in unicornuate uterus in Gravida 2 Para 0+1 lady at 18 week gestation who was admitted in Emergency with Shock and diagnosis was confirmed at laparotomy. 


Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 95-OR
Author(s):  
CÉCILIA LÉGARÉ ◽  
VÉRONIQUE DESGAGNÉ ◽  
FRÉDÉRIQUE WHITE ◽  
MICHELLE S. SCOTT ◽  
PATRICE PERRON ◽  
...  

Author(s):  
Diana Massalska ◽  
Katarzyna Ozdarska ◽  
Tomasz Roszkowski ◽  
Julia Bijok ◽  
Anna Kucińska-Chahwan ◽  
...  

Abstract Purpose To establish the distribution of diandric and digynic triploidy depending on gestational age. Methods 107 triploid samples tested prospectively in a single genetic department during a four-year period were analyzed for parental origin of triploidy by Quantitative Fluorescent Polymerase Chain Reaction (QF-PCR) (n=95) with the use of matching parental samples or by MS-MLPA (n=12), when parental samples were unavailable. Tested pregnancies were divided into three subgroups with regard to the gestational age at spontaneous pregnancy loss: <11 gestational weeks, 11–14 gestational weeks, and >14 gestational weeks. Results Diandric triploidy constituted overall 44.9% (46.5% in samples miscarried <11 gestational weeks, 64.3% in samples miscarried between 11 and 14 gestational weeks, and 27.8% in pregnancies which survived >14 gestational weeks). Conclusions The distribution of diandric and digynic triploidy depends on gestational age. The majority of diandric triploid pregnancies is lost in the first trimester of pregnancy. In the second trimester, diandric cases are at least twice less frequent than digynic ones.


2019 ◽  
Vol 12 (5) ◽  
pp. e228493 ◽  
Author(s):  
Bedayah Amro ◽  
Ghassan Lotfi

Spontaneous uterine rupture during early pregnancy is an extremely rare occurrence and may vary in presentation and course of events, hence the clinical diagnosis is often challenging. We present our experience with two such cases of spontaneous uterine rupture in the first trimester of pregnancy without any identifiable underlying risk factors. The first case was at 12 weeks of gestation and the second case was at 6 weeks gestational age (GA). Both cases were diagnosed and managed by the laparoscopic approach. We are reporting the earliest documented GA in which spontaneous uterine rupture occurred. So far, the earliest GA reported in the literature according to our knowledge was at 7+3 weeks. Access to a laparoscopic facility is crucial in the early definitive diagnosis and prompt management of these cases, since this may significantly reduce the risk of severe morbidity and mortality.


2018 ◽  
Vol 7 (4) ◽  
pp. 467-470
Author(s):  
Wasan Wajdi Ibrahim ◽  
Afraa Mahjoob Al-Naddawi ◽  
Hayder A. Fawzi

Objectives: Assessment of glycodelin (GD) as a marker for unruptured ectopic pregnancy (EP) in the first trimester of pregnancy. Materials and Methods: This case-control study was conducted during June 2016 to May 2017 in the Obstetrics and Gynecological Department of Baghdad University at Baghdad teaching hospital/medical city complex. In this study, 100 pregnant women in their first trimester of pregnancy were included after clinical and ultrasonic findings. Results: Based on the results, GD levels in EP were significantly lower than those with normal intrauterine pregnancy (1.58 ± 1.18 vs. 30.1 ± 11.9). In addition, using receiver operator curve analysis, the cut-off GD level of 9.5 and less had acceptable validity results (100% sensitivity, 100% specificity, 95% positive predictive value, 100% negative predictive value, and accuracy 100%) to predict EP. Conclusions: In general, serum GD is considered as an excellent predictor of unruptured EP.


2019 ◽  
Vol 3 (1) ◽  
pp. 62-64 ◽  
Author(s):  
Justine Stremick ◽  
Kyle Couperus ◽  
Simeon Ashworth

Tubal ectopic pregnancies are commonly diagnosed during the first trimester. Here we present a second-trimester tubal ectopic pregnancy that was previously misdiagnosed as an intrauterine pregnancy on a first-trimester ultrasound. A 39-year-old gravida 1 para 0 woman at 15 weeks gestation presented with 10 days of progressive, severe abdominal pain, along with vaginal bleeding and intermittent vomiting for two months. She was ultimately found to have a ruptured left tubal ectopic pregnancy. Second-trimester ectopic pregnancies carry a significant maternal mortality risk. Even with the use of ultrasound, they are difficult to diagnose and present unique diagnostic challenges.


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