scholarly journals Negative Urine B-hCG Pregnancy Test in Chronic Ectopic Pregnancy – a Case Report

2018 ◽  
Vol 1 (1) ◽  
pp. 49-50
Author(s):  
Shyam Sundar Parajuly ◽  
Ananda Bahadur Shrestha ◽  
Dela Singh ◽  
Rabi Prasad Regmi ◽  
Rajesh Adhikari
Keyword(s):  
Ectopic Pregnancy ◽  
Histopathological Examination ◽  
Lower Abdominal Pain ◽  
Tubal Pregnancy ◽  
Rare Type ◽  
Chorionic Villi ◽  
Pregnancy Test ◽  
Beta Human Chorionic Gonadotropin ◽  
History Of ◽  
Hcg Test

Ectopic pregnancy (EP) is a gynecological emergency that can bring catastrophic condition leading tubal rupture and hemorrhagic shock. Chronic ectopic pregnancy is a very rare type of tubal pregnancy presenting with a tubal mass with negative B hCG (beta human chorionic gonadotropin test. We present a case in twenty seven years old female with a history of six weeks of amenorrhea with complain of acute lower abdominal pain and per-vaginal bleeding. Urine pregnancy test (UPT) was negative. A total left salpingoectomy was undertaken and the histopathological examination revealed the presence of chorionic villi, suggesting the diagnosis of chronic ectopic tubal pregnancy. It is obvious that ectopic pregnancy could not be excluded with negative urine B-hCG test.

Ruptured salpingitis isthmica nodosa: a rare cause for spontaneous haemoperitoneum

2021 ◽  
Vol 14 (1) ◽  
pp. e237860
Author(s):  
Dora Huang ◽  
Sandon Lowe ◽  
Pravena Kumaran ◽  
Kay Tai Choy
Keyword(s):  
Ectopic Pregnancy ◽  
Fallopian Tube ◽  
Diagnostic Laparoscopy ◽  
Lower Abdominal Pain ◽  
Atypical Presentation ◽  
Pelvic Ultrasound ◽  
Beta Human Chorionic Gonadotropin ◽  
History Of ◽  
Ectopic Pregnancies ◽  
The Right

Salpingitis isthmica nodosa (SIN) is the nodular swelling or diverticulum of the isthmus of the fallopian tube. It is most commonly identified when investigating female infertility or in association with ruptured ectopic pregnancies. We experienced a rare and atypical presentation of SIN. A 33-year-old woman presented with a 1-hour history of acute lower abdominal pain associated with nausea and vomiting. CT and pelvic ultrasound revealed haemoperitoneum with no radiological evidence for its aetiology. Initial beta-human chorionic gonadotropin excluded ectopic pregnancy. A diagnostic laparoscopy was performed following clinical deterioration of the patient. Active bleeding of the right fallopian tube was identified and managed with a right partial salpingectomy, with subsequent histopathology revealing ruptured SIN. There have been no reported cases of SIN being a primary cause for an acute abdomen or haemoperitoneum in the absence of an ectopic pregnancy, making this case a surgical novelty.

scholarly journals Ectopic pregnancy in the ampulla of the fallopian tube at 16 gestational weeks: lessons from a case report

2020 ◽  
Vol 20 (4) ◽  
pp. 1895-7
Author(s):  
Nnabuike Chibuoke Ngene ◽  
Ongombe Lunda
Keyword(s):  
Abdominal Pain ◽  
Ectopic Pregnancy ◽  
Fallopian Tube ◽  
Haemoglobin Concentration ◽  
Lower Abdominal Pain ◽  
First Trimester ◽  
Tubal Pregnancy ◽  
Emergency Laparotomy ◽  
History Of ◽  
The Right

Background: It is uncommon to find ampullary tubal pregnancy in the second trimester. Methods: A 35-year-old G4P3 at 16 gestational weeks presented with a day history of sudden severe lower abdominal pain and no vaginal bleeding. The patient had a normal pulse of 82/minutes, haemoglobin concentration of 6.3 g/dl and ultrasonography showed an empty uterus with an alive fetus in the right adnexa. She was provisionally diagnosed to have an abdominal pregnancy. Results: The patient had an emergency laparotomy where 2.2 L of haemoperitoneum and a slow-leaking right ampullary tubal pregnancy were found. Right total salpingectomy was performed and she had an uncomplicated post-operative fol- low-up. Histology of the lesion confirmed tubal pregnancy. Conclusion: The growth of a pregnancy in the ampulla beyond the first trimester is possibly due to increased thickness and or distensibility of the fallopian tube. A tubal pregnancy may present with a normal pulse despite significant haemorrhage. Keywords: Abdominal pain; ampullary tubal ectopic pregnancy; Bezold–Jarish-like reflex.

scholarly journals Primary ovarian pregnancy: histopathology remains the key to confirming diagnosis setting

2017 ◽  
Vol 6 (4) ◽  
pp. 1649
Author(s):  
Priyanka Anand ◽  
Namrata Nargotra
Keyword(s):  
Abdominal Pain ◽  
Ectopic Pregnancy ◽  
Histopathological Examination ◽  
First Trimester ◽  
Accurate Diagnosis ◽  
Rare Entity ◽  
Chorionic Villi ◽  
Ovarian Pregnancy ◽  
Ovarian Stroma ◽  
History Of

Ectopic pregnancy occurs in 2% of all pregnancies. Primary ovarian pregnancy is a rare entity and accounts for only 0.15-3% of all ectopic gestations. It usually ends with rupture before the end of first trimester. The diagnosis is often made intraoperatively and confirmed histopathologically. A 23 year old female presented with severe hypogastric abdominal pain with no history of amenorrhea. She underwent a laprotomy and a right sided salpingo-oopherectomy and the excised material was sent for histopathological examination. Chorionic villi were seen within the ovarian stroma suggesting the likely possibility of an ovarian pregnancy. Ovarian pregnancy is rare; although awareness of this condition is important for reducing its associated morbidity and mortality. This highlights the importance of histopathology for the accurate diagnosis of this condition.

scholarly journals Primary tubal choriocarcinoma

2018 ◽  
Vol 7 (6) ◽  
pp. 2509
Author(s):  
Neetha Nandan ◽  
Kishan Prasad ◽  
Mubeena Begum ◽  
Supriya Rai
Keyword(s):  
Adjuvant Chemotherapy ◽  
Ectopic Pregnancy ◽  
Malignant Transformation ◽  
Histopathological Examination ◽  
Gestational Trophoblastic Disease ◽  
Common Site ◽  
Chorionic Villi ◽  
Trophoblastic Disease ◽  
Aggressive Form ◽  
Β Hcg

Choriocarcinoma is extremely aggressive form of gestational trophoblastic disease. It occurs due to neoplastic changes in the chorionic villi. The most common site of origin is uterus but rarely can occur in tube, cervix or ovary. Tubal choriocarcinoma may develop either by malignant transformation of a tubal pregnancy or can arise denovo without an ectopic pregnancy. The reported incidence of tubal choriocarcinoma is approximately 1.5/1,000,000 births. Here, we report a case in which salphingectomy was done thinking it was an acute ectopic pregnancy, but histopathological examination showed tubal choriocarcinoma. This tubal choriocarcinoma occurred denovo and was not secondary to an ectopic pregnancy. Patient did not need adjuvant chemotherapy as it was detected early and is being followed up by β-hcg monitoring.

scholarly journals The Largest Tubal Pregnancy: 14th Week

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Amr Elmoheen ◽  
Waleed Salem ◽  
Mahmoud Eltawagny ◽  
Rehab Elmoheen ◽  
Khalid Bashir
Keyword(s):  
Ectopic Pregnancy ◽  
Inflammatory Diseases ◽  
Lower Abdominal Pain ◽  
Subsequent Development ◽  
Tubal Pregnancy ◽  
Free Fluid ◽  
Pathology Report ◽  
Point Of Care Ultrasound ◽  
Wide Range ◽  
Gestational Sac

Subsequent development and implantation of embryo outside the uterine lining are defined as an ectopic pregnancy. Ectopic pregnancies have a wide range of presentations, for example, acute hemoperitoneum to chronic ectopic pregnancy. The case presented is an unusual case of ectopic pregnancy with large hematosalpinx with classic symptoms. To the best of the authors’ knowledge, this case is the largest intact tubal ectopic pregnancy reported ever in the 14th week of gestation. A 40-year-old patient presented to the emergency department with lower abdominal pain, mild dysuria, and loose motion. The patient’s previous menstrual cycles were regular till four months ago, then started to be irregular, and she had no history of chronic diseases except repeated pelvic inflammatory diseases (PID). Clinically, the patient was hemodynamically stable. On palpation, the abdomen was tender, and cervical movements were not tender. BHCG in the blood came very high. The bedside point-of-care ultrasound (POCUS) showed free fluid in the abdomen and a sac in the left adnexa with a living fetus (visible heartbeats). The conventional ultrasound showed 14 weeks of an extrauterine gestational sac with visible early pregnancy. Differential diagnosis was either an abdominal pregnancy versus a complicated tubal pregnancy. The surgical pathology report confirmed the diagnosis of ectopic tubal pregnancy as the tube was dilated in the middle portion containing chorionic villi, decidual reaction, and the whole gestational sac consistent with the ectopic tubal pregnancy. The patient had a successful laparotomy with salpingectomy and hemostasis and did well after the operation. So, an intact ectopic tubal pregnancy may last until the 14th week of gestation.

scholarly journals Total Laparoscopic Conservative Surgery for an Intramural Ectopic Pregnancy

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Hiroshi Nabeshima ◽  
Mitsuo Nishimoto ◽  
Hiroki Utsunomiya ◽  
Maiko Arai ◽  
Tomohisa Ugajin ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Conservative Surgery ◽  
Cystic Mass ◽  
Heart Beat ◽  
Transvaginal Sonography ◽  
Chorionic Villi ◽  
Pathologic Evaluation ◽  
History Of ◽  
Gestational Sac ◽  
Laparoscopic Removal

A 38-year-old woman, gravida 3, para 1 with a history of a left salpingectomy for an ectopic pregnancy was admitted for treatment of a presumed ectopic pregnancy. Transvaginal sonography revealed an ill-defined gestational sac and fetal heart beat within the fundal myometrium adjacent to the left cornua. Laparoscopy was performed for a suspected left cornual pregnancy or intramural pregnancy. A cystic mass 3 cm in diameter was visible within the fundal myometrium. Total laparoscopic removal of the gestational sac was performed, and the uterus was preserved. Pathologic evaluation of the excised mass demonstrated chorionic villi involving the myometrium. In the literature, only one other case describing the laparoscopic removal of an intramural pregnancy has been reported. However, in the prior report, the patient still required hysterectomy after conservative surgery. Therefore, this is the first report of the successful treatment of an intramural pregnancy exclusively with laparoscopy.

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 Unilateral Twin Ectopic Pregnancy in a Patient With a History of Multiple Sexually Transmitted Infections

2006 ◽  
Vol 2006 ◽  
pp. 1-3 ◽  
Author(s):  
Charles J. Rolle ◽  
Clifford Y. Wai ◽  
Roger Bawdon ◽  
Rigoberto Santos-Ramos ◽  
Barbara Hoffman
Keyword(s):  
Ectopic Pregnancy ◽  
Sexually Transmitted Infections ◽  
Fallopian Tube ◽  
Lower Abdominal Pain ◽  
Rare Condition ◽  
Operative Trauma ◽  
Sexually Transmitted ◽  
Uncommon Presentation ◽  
Increased Risk ◽  
History Of

Background. The incidence of unilateral twin ectopic pregnancy is a rare condition. Several factors increase the risk of ectopic pregnancy, the most important of which is pelvic inflammatory disease, followed by operative trauma, congenital anomalies, tumors, and adhesions resulting in anatomically distorted fallopian tubes. We present a case of a woman with a history of four confirmed sexually transmitted infections (STIs) including Chlamydia trachomatis, Neisseria gonorrhoeae, herpes simplex virus 2, and Treponema pallidum. The case illustrates the potential impact of sexually transmitted infections (STIs) on the risk of a twin ectopic pregnancy. Case. A 24-year-old primigravida, presented with an unknown last menstrual period, lower abdominal pain, watery vaginal discharge, and vaginal spotting. During this hospitalization, serumβ-HCG testing was 263 mIU/mL and transvaginal ultrasonographic examination suggested a nonviable unilateral twin ectopic pregnancy. At exploratory laparotomy, a 10 cm mass involving the right fallopian tube and ovary was excised. Pathological evaluation of the specimen identified a monochorionic, diamnionic twin ectopic pregnancy within the fallopian tube. Conclusions Patients with a history of multiple (STIs) are known to be at risk for the development of chronic pelvic infection and postinflammatory scarring. The resulting distortion of the normal tubal anatomy leads to an increased risk of an uncommon presentation of ectopic pregnancy.

scholarly journals Placenta Increta Complicating Persistent Cesarean Scar Ectopic Pregnancy following Failed Excision with Subsequent Preterm Cesarean Hysterectomy

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
M. F. Malik ◽  
L. R. Hoyos ◽  
J. Rodriguez-Kovacs ◽  
J. Gillum ◽  
S. C. Johnson
Keyword(s):  
Ectopic Pregnancy ◽  
Placenta Increta ◽  
Pelvic Mri ◽  
Chorionic Villi ◽  
Thin Endometrium ◽  
Cesarean Scar ◽  
Cesarean Hysterectomy ◽  
Cesarean Deliveries ◽  
History Of ◽  
Gestational Sac

Introduction.Cesarean scar pregnancies (CSPs) are one of the rarest forms of ectopic pregnancy. Given their rarity, there is lack of consensus regarding the management and natural course of CSPs.Case.A 37-year-old G10 P3063 female with a history of two prior cesarean deliveries was diagnosed with her second CSP at 6 weeks and 5 days in her tenth pregnancy. The patient underwent vertical hysterotomy, excision of a gestational sac implanted in the cesarean sac, and bilateral salpingectomy via a laparotomy incision. The histopathology report confirmed immature chorionic villi. The patient returned 10 weeks later and was found to be still pregnant. Obstetric ultrasound confirmed a viable fetus of 19 weeks and 4 days of gestational age with a thin endometrium and an anteroposterior and right lateral placenta with multiple placental lakes. The patient ruptured her membranes at 31 weeks of gestation and pelvic MRI revealed an anterior placenta invading the myometrium and extending to the external serosal surface consistent with placenta increta. Following obstetric interventions, a live female infant was delivered by cesarean hysterectomy (because of placenta increta) at 32 weeks of gestation.Conclusion.Development of standardized guidelines for management of CSPs, as well as heightened vigilance for possible complications, is required for proper care and avoidance of potential morbidity and mortality.

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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