Differential-diagnostic and therapeutic challenges in the management of ruptured corpus luteum cyst with undiagnosed intrauterine pregnancy in the early first trimester and ruptured ovarian pregnancy

Corpus luteum cyst is common in early pregnancy and seldom exceeds 5 cm in diameter; many of which resolve before the end of the first trimester of pregnancy. Giant corpus luteum cyst in third trimester is very rare especially in naturally-conceived pregnancies. We hereby report a rare case of twisted giant corpus luteum cyst in the third trimester in a 33-year-old multigravida. She presented with acute abdominal pain and vomiting at a gestational age of 34 weeks. Ultrasound scan revealed a twisted giant right ovarian cyst. She underwent an emergency cesarean delivery and right oophorectomy. Histology report showed features that were diagnostic of corpus luteum cyst.

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Ruptured corpus luteum cyst in early pregnancy: A case report

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1310689v ◽

2013 ◽

Vol 141 (9-10) ◽

pp. 689-692 ◽

Cited By ~ 1

Author(s):

Snezana Vidakovic ◽

Milan Dokic ◽

Zoran Vilendecic ◽

Maja Djakonovic-Maravic

Keyword(s):

Ectopic Pregnancy ◽

Corpus Luteum ◽

Early Pregnancy ◽

Lower Abdominal Pain ◽

Transvaginal Sonography ◽

Intrauterine Pregnancy ◽

Positive Pregnancy Test ◽

Uterine Curettage ◽

Wait And See ◽

Corpus Luteum Cyst

Introduction. Transvaginal sonography and human chorionic gonadotropin (hCG) testing are cornerstones of modern clinical practice in cases with the suspected ectopic pregnancy. In unclear cases, if the level of hCG is above the discriminatory zones, the use of uterine curettage is recommended. There is an increasing concern that strict observation of the guidelines would potentially harm otherwise normal early intrauterine pregnancies in certain cases. Case Outline. A 35-year-old woman was admitted to hospital due to a severe lower abdominal pain. Based on the positive pregnancy test and sonographic exams which failed to demonstrate intrauterine pregnancy, the diagnosis of ectopic pregnancy was presumed. Laparoscopy revealed ruptured corpus luteum cyst and the diagnosis was confirmed on histopathological finding. Postoperatively, normal intrauterine gestation was visualized. Conclusion. Since the diagnosis of early pregnancy and its complications can be misleading, in unclear cases, we support the expectative ?wait and see? management consisting of serial hCG testing and repeated ultrasound examinations. Avoidance of uterine curettage in such unclear cases would further reduce the possibility of normal early pregnancy interruption.

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Role of Serum β-HCG doubling in Diagnosis of Early Pregnancy and its Management Strategy

Current Women s Health Reviews ◽

10.2174/1573404816999200905140919 ◽

2020 ◽

Vol 16 ◽

Author(s):

Divya Mirji ◽

Shubha Rao ◽

Akhila Vasudeva ◽

Roopa P.S

Keyword(s):

Ectopic Pregnancy ◽

Early Pregnancy ◽

Management Strategy ◽

Transvaginal Ultrasound ◽

Expectant Management ◽

First Trimester ◽

Intrauterine Pregnancy ◽

Β Hcg ◽

Pregnancy Of Unknown Location

Background: Pregnancy of unknown location (PUL) is defined as the absence of intrauterine or extrauterine sac and Beta Human Chorionic Gonadotropin levels (β-HCG) above the discriminatory zone of 1500 mIU/ml. It should be noted that PUL is not always an ectopic; however, by measuring the trends of serum β-HCG, we can determine the outcome of a PUL. Objective: This study aims to identify the various trends β-HCG levels in early pregnancy and evaluate the role of β-HCG in the management strategy. Methods: We conducted a prospective observational study of pregnant women suspected with early pregnancy. Cases were classified as having a pregnancy of unknown location (PUL) by transvaginal ultrasound and ß-HCG greater than 1000 mIU/ml. Expectant management was done until there was a definite outcome. All the collected data were analyzed by employing the chi-square test using SPSS version 20. Results: Among 1200 women who had early first trimester scans, 70 women who fulfilled our criteria of PUL and ß-HCG > 1000 mIU/ml were recruited in this study. In our study, the mean age of the participants was 30±5.6yrs, and the overall mean serum ß-HCG was 3030±522 mIU/ml. The most common outcome observed was an ectopic pregnancy, 47% in our study. We also found the rate of failing pregnancy was 27%, and that of intrauterine pregnancy (IUP) was 25%. Overall, in PUL patients diagnosed with ectopic pregnancy, 9% behaved like IUP, and 4% had an atypical trend in their ß-HCG. Those who had an IUP, 11% had a suboptimal increase in ß-HCG. Conclusion: PUL rate in our unit was 6%. Majority of the outcome of PUL was ectopic in our study. Every case of PUL should be managed based on the initial ß-HCG values, clinical assessments and upon the consent of the patient.

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P16.19: Intrauterine pregnancy of uncertain viability: what influences outcome of the first trimester?

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.8537 ◽

2010 ◽

Vol 36 (S1) ◽

pp. 233-233

Author(s):

J. Riemke ◽

C. Lu ◽

T. Bignardi ◽

I. V. Casikar ◽

D. Alhamdan ◽

...

Keyword(s):

First Trimester ◽

Intrauterine Pregnancy

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P27.07: Intrauterine pregnancy of uncertain viability: what influences outcome of the first trimester?

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.9933 ◽

2011 ◽

Vol 38 (S1) ◽

pp. 257-257

Author(s):

S. Reid ◽

A. Model ◽

J. Riemke ◽

I. V. Casikar ◽

C. Lu ◽

...

Keyword(s):

First Trimester ◽

Intrauterine Pregnancy

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Ectopic Pregnancy Versus Corpus Luteum Cyst Revisited

Journal of Ultrasound in Medicine ◽

10.7863/jum.2003.22.11.1181 ◽

2003 ◽

Vol 22 (11) ◽

pp. 1181-1184 ◽

Cited By ~ 35

Author(s):

Mostafa Atri

Keyword(s):

Ectopic Pregnancy ◽

Corpus Luteum ◽

Corpus Luteum Cyst

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Ultrasound Evaluation of Pregnancy in the First Trimester

Donald School Journal of Ultrasound in Obstetrics & Gynecology ◽

10.5005/jp-journals-10009-1125 ◽

2010 ◽

Vol 4 (1) ◽

pp. 17-28 ◽

Cited By ~ 3

Author(s):

George M Graham

Keyword(s):

Early Pregnancy ◽

First Trimester ◽

Transvaginal Sonography ◽

List Type ◽

Intrauterine Pregnancy ◽

Ultrasound Evaluation ◽

Early Pregnancy Failure ◽

Ultrasound Findings ◽

Ultrasound Technology ◽

First Trimester Ultrasound

Abstract Improvements in ultrasound technology, including transvaginal sonography and higher frequency probes, have led to a better understanding of early pregnancy development. These advances and the increasing availability of ultrasound allow women to have an earlier and more accurate assessment of their pregnancy. First trimester sonographic signs have been identified that can be used to reassure women that their pregnancy is progressing normally or counsel them that their pregnancy will fail. In addition, first trimester ultrasound can accurately predict the type of twinning in multiple gestations, allowing for appropriate counseling and management. Objectives Know the first trimester ultrasound findings of a normal intrauterine pregnancy Understand the ultrasound findings that diagnose an early pregnancy failure Know the ultrasound criteria used to diagnose a multifetal gestation

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Effect of some Nigerian traditional alcoholic beverages on the estrous cycle and histological assessment of the ovaries and uterus of albino rats

GSC Biological and Pharmaceutical Sciences ◽

10.30574/gscbps.2021.14.1.0001 ◽

2021 ◽

Vol 14 (1) ◽

pp. 027-036

Author(s):

Olusayo Moritiwon ◽

Timothy Olugbenga Ogundeko ◽

James Bitrus ◽

David Oyebode ◽

Olufunmilayo Ibiyemi Abobarin

Keyword(s):

Corpus Luteum ◽

Estrous Cycle ◽

Ovarian Follicle ◽

Alcoholic Beverages ◽

Albino Rats ◽

Histological Image ◽

Follicular Cyst ◽

Regular Consumption ◽

Alcoholic Drinks ◽

Corpus Luteum Cyst

Alcohol related health challenges have lingered over the years. Such associated with locally brewed alcoholic beverages have received little attention. The urgency to explore this becomes imperative. This study aimed at evaluating the effect of regular consumption of local alcoholic beverages on the estrous cycle and histological image of the ovaries and uterus thus fertility of female albino rats. Thirty screened female albino rats weighing 180-220g were divided into five groups and daily administered each with 10ml/kg of pito, burukutu, ogogoro, goskolo and 0.5ml/kg normal saline respectively for 21 days. Effect of the beverages on the estrous cycle as well as histopathological evaluation was carried out on the isolated ovaries and uterus. Results showed significant increase proestrous phase of the estrous cycle with ingestion of pito, burukutu, ogogorogo and goskolo. Also the histology of the ovary was basically without obvious pathological changes with pito, while there was alteration of histological parameters by burukutu, marked with formation of fibrosis, corpus luteum cyst resulting immature ovarian follicle, ogogoro marked with formation of fibrosis, corpus luteum cyst resulting immature ovarian follicle and goskolo marked with formation of multiple follicular cyst resulting in complete collapse of the ovarian section. The effect of traditional alcoholic beverages revealed the classical effects of alcoholic drinks by way of significant alteration in the estrous cycle of albino rats with marked alteration of the histological architecture of ovarian tissues. Pito, burukutu, ogogoro, and goskolo have a reprotoxic effect on the ovaries and uterus thus a deleterious effect on fertility of female albino rats.

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Role of Maternal Serum Glycodelin as Predictor of Ectopic Pregnancy in First Trimester

International Journal of Women s Health and Reproduction Sciences ◽

10.15296/ijwhr.2019.77 ◽

2018 ◽

Vol 7 (4) ◽

pp. 467-470

Author(s):

Wasan Wajdi Ibrahim ◽

Afraa Mahjoob Al-Naddawi ◽

Hayder A. Fawzi

Keyword(s):

Ectopic Pregnancy ◽

Predictive Value ◽

First Trimester ◽

Maternal Serum ◽

Intrauterine Pregnancy ◽

Receiver Operator Curve Analysis ◽

Medical City ◽

First Trimester Of Pregnancy ◽

Control Study

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.

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