scholarly journals Recurent Ectopic Pregnancy Score As Predictor To Fertility Outcome Following Tubal Ectopic Pregnancy

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Nurul Yaqin Mohd Nor
Keyword(s):  
Multivariate Analysis ◽  
Ectopic Pregnancy ◽  
Human Resources Management ◽  
Abdominal Cavity ◽  
Study Data ◽  
Fertility Treatment ◽  
Intrauterine Pregnancy ◽  
Tubal Ectopic Pregnancy ◽  
Operative Removal ◽  
Laparoscopic Salpingectomy

Introduction: Ectopic pregnancy may occur in fallopian tube, ovary or abdominal cavity. This study focused on tubal pregnancy outcome. The return of fertility after operative removal of tubal ectopic pregnancy was examined in 237 women who were admitted to Hospital Sultanah Nur Zahirah (HSNZ) for ectopic pregnancy between 2012 and 2016. The follow-up period averaged six months to four years. Materials and Methods: This was a case control, retrospective non-comparative study. Data collected from HSNZ Human Resources Management Information System (HRMIS). Patient who has no pregnancy or delivery record after six months of ectopic event were contacted via phone. Multivariate analysis was done to identify score for patients who were at risk of recurrence, and who require fertility help. Results: One hundred forty eight women (64%) aged 20-35 years old able to conceive spontaneously after ectopic pregnancy, with the mean-time of 8 months if one tube is patent. Ninety three percents of those who conceived had intrauterine pregnancy, 5% had recurrent ectopic pregnancy. Conclusion: From a multivariate analysis, a scoring system, Recurrent Ectopic Pregnancy (REP) score was made to choose most suitable patient for laparoscopic intervention, preserve fertility or facilitate fertility. Significant REP score of 4/5 suggest laparoscopic salpingectomy with contralateral sterilization to prevent recurrence of ectopic. Patient with REP score 2-3 may have spontaneous conception and REP score less than 1/5 will require further fertility treatment.

HETEROTOPIC PREGNANCY WITH INEVITABLE ABORTION (RIGHT ADNEXAL LIVE ECTOPIC AND COEXISTING INTRAUTERINE TRIPLETS WITH ABSENT FETAL CARDIAC ACTIVITY)

2021 ◽  
pp. 58-59
Author(s):  
Jayanta Sarkar ◽  
Mini Sengupta
Keyword(s):  
Ectopic Pregnancy ◽  
Abdominal Cavity ◽  
Lower Abdominal Pain ◽  
Cardiac Activity ◽  
Exploratory Laparotomy ◽  
Sudden Onset ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Short Period ◽  
The Right

Heterotopic pregnancy describes the occurrence of two or more pregnancies in different implantation sites simultaneously, intrauterine pregnancy coexists withectopic pregnancies (ampullary in 80%). A 27-year-old women (P ,L1) presented to the emergency department with a complaint of sudden onset of right-sided lower abdominal pain with 1+1 vaginal bleeding and had a short period of Amenorrhea. Ultrasonography demonstrated three intrauterine gestational sacwith foetal pole noted but Cardiac activity was absent . The right adnexa showed a heteroechoic area andmoderate amount of free uid was present in the lower abdominal cavity. Ectopic pregnancy was disturbed. An emergency exploratory laparotomy was performed under general anesthesia. Haemoperitoneum was found with a ruptured righttubal ectopic pregnancy as well. Both the ovaries appeared normaland a corpus luteal cyst was presentin right ovary. Right sided salpingectomy was performed with removal of the ectopic mass,heamostasis secured ,on table blood transfusion had been given.Suction evacuation had also been performed by manual vacuum aspirationon same sitting.Both the specimen send for histopathology. Histology conrmedGestational sac suggestive of an intra uterine pregnancy coexists with ectopic pregnancy. Left tube and both ovaries were found healthy. Episodes of PID also have a strong correlation with occurrence of ectopic gestation. Once diagnosis of heterotrophic pregnancy has been made the management is essentially surgical.

scholarly journals Medical Management of Ectopic Pregnancy: An Observational Study

2016 ◽  
Vol 29 (1) ◽  
pp. 32-36
Author(s):  
Shahana Begum ◽  
Rowshan Akhtar
Keyword(s):  
Single Dose ◽  
Observational Study ◽  
Medical Treatment ◽  
Ectopic Pregnancy ◽  
Medical Management ◽  
Progesterone Level ◽  
Fertility Treatment ◽  
Intrauterine Pregnancy ◽  
College Hospital ◽  
Serum Progesterone

Objectives: The aim of this study was to explore the safety and efficacy of medical management of ectopic pregnancy.Materials and methods: This prospective observational study was conducted between February 2011 to August 2013 in Chittagong Medical College Hospital (CMCH) and in different private clinics of Chittagong city. Twenty-seven patients of ectopic pregnancy conceived by fertility treatment were recruited for medical treatment after proper evaluation. Ectopic pregnancy was diagnosed by serum ?-hCG and progesterone level but missing intrauterine pregnancy by transabdominal sonography (TAS). Serum ?-hCG was repeated after 48 hours to observe doubling of the level. If level was not doubled or increment was not at least 66% and serum progesterone level was less than 15ng/ml then it was considered as ectopic pregnancy. Patients were treated with Injection methotrexate 50 mg intramuscularly either by single dose or two doses. After 4 days of 1st injection ?-hCG was repeated and if level decreased > 15% then patients were assessed weekly till ?-hCG fell to <5lU/L. If drop was <15% after 4 days a second dose of methotrexate was given.Results: Overall success rate was 66.66% . Surgical intervention was needed in 22.22% patients. All patients were treated after hospitalization in CMCH and different private clinics of Chittagong. They got injection methotrexate, antibiotic, antispasmodic and analgesics for abdominal pain. Single dose cured 55.55% patients and 11.11% patients needed second dose, another 11.11% patients were misdiagnosed –later on they were diagnosed as intrauterine pregnancy and medical termination was done. Within one year of treatment 33.33% patients conceived again. There was no side effect or complications of the treatment.Conclusion: This small trial gave a good impression about medical treatment in selective cases. The efficacy should be assessed in a randomized clinical trial with a different set of populationBangladesh J Obstet Gynaecol, 2014; Vol. 29(1) : 32-36

scholarly journals Ruptured Tubal Ectopic Pregnancy at Fifteen Weeks Gestational Age

2019 ◽  
Vol 3 (1) ◽  
pp. 62-64 ◽  
Author(s):  
Justine Stremick ◽  
Kyle Couperus ◽  
Simeon Ashworth
Keyword(s):  
Abdominal Pain ◽  
Ectopic Pregnancy ◽  
Gestational Age ◽  
Vaginal Bleeding ◽  
First Trimester ◽  
Second Trimester ◽  
Intrauterine Pregnancy ◽  
Tubal Ectopic Pregnancy ◽  
Ectopic Pregnancies ◽  
First Trimester Ultrasound

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.

scholarly journals Use of FloSeal Sealant in the Surgical Management of Tubal Ectopic Pregnancy

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Mara Clapp ◽  
Jaou-Chen Huang
Keyword(s):  
Ectopic Pregnancy ◽  
Surgical Management ◽  
Thermal Injury ◽  
Tubal Pregnancy ◽  
Effective Alternative ◽  
Intrauterine Pregnancy ◽  
Tubal Ectopic Pregnancy ◽  
Tubal Patency ◽  
Ectopic Pregnancies

Background. Surgery is sometimes required for the management of tubal ectopic pregnancies. Historically, surgeons used electrosurgery to obtain hemostasis. Topical hemostatic sealants, such as FloSeal, may decrease the reliance on electrosurgery and reduce thermal injury to the tissue.Case. A 33-year-old G1 P0 received methotrexate for a right tubal pregnancy. The patient became symptomatic six days later and underwent a laparoscopic right salpingotomy. After multiple unsuccessful attempts to obtain hemostasis with electrocoagulation, FloSeal was used and hemostasis was obtained. Six weeks later, a hysterosalpingogram (HSG) confirmed tubal patency. The patient subsequently had an intrauterine pregnancy.Conclusion. FloSeal helped to achieve hemostasis during a laparoscopic salpingotomy and preserve tubal patency. FloSeal is an effective alternative and adjunct to electrosurgery in the surgical management of tubal pregnancy.

scholarly journals Levonorgestrel intrauterine system embedded within tubal ectopic pregnancy: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Dorothy Makena ◽  
Ingrid Gichere ◽  
Khadija Warfa
Keyword(s):  
Case Report ◽  
Ectopic Pregnancy ◽  
Fallopian Tube ◽  
Intrauterine Device ◽  
African Woman ◽  
Rare Occurrence ◽  
Intrauterine Pregnancy ◽  
Case Presentation ◽  
Tubal Ectopic Pregnancy ◽  
Left Fallopian Tube

Abstract Background The presence of the levonorgestrel-releasing intrauterine system embedded within an ectopic pregnancy is a rare occurrence. Tubal migration of an intrauterine device is not well understood and has not been extensively studied in literature. Case presentation A 34-year-old African woman, para 1, gravida 2, presented with symptoms of ruptured ectopic pregnancy. She underwent a laparoscopy where a ruptured left ectopic pregnancy was found with a levonorgestrel-releasing intrauterine system inserted 2 years prior embedded within the tube. A left salpingectomy was performed with removal of the levonorgestrel-releasing intrauterine system. The patient recovered well and proceeded to have an intrauterine pregnancy 3 months later. Conclusion Migration of the levonorgestrel-releasing intrauterine system into the fallopian tube is a rare occurrence that is not well understood. In the case presented, levonorgestrel-releasing intrauterine system was found embedded within the fimbrial end of the left fallopian tube, which had a ruptured ectopic pregnancy. Surgical treatment with laparoscopy is recommended for intraabdominal intrauterine device to prevent complications.

scholarly journals Cornual Ectopic Pregnancy: Case Series

2015 ◽  
Vol 10 (1) ◽  
pp. 62-65
Author(s):  
G Baral ◽  
B Shakya ◽  
J Silwal
Keyword(s):  
Ectopic Pregnancy ◽  
Surgical Management ◽  
Case Series ◽  
Cornual Pregnancy ◽  
Intrauterine Pregnancy ◽  
Tubal Ectopic Pregnancy ◽  
Pregnancy Diagnosis ◽  
Potential Loss

Three cases of cornual pregnancies encountered within three weeks at Paropakar Maternity and Women’s Hospital had diverse presentations. Fortunately, in all three case series, cornual resection was performed successfully. Cornual pregnancy is difficult to diagnose preoperatively with low ultrasonographic sensitivity and is easily confused with tubal ectopic pregnancy or a normal intrauterine pregnancy. Diagnosis before rupture is essential to prevent mortality and potential loss of fertility. The surgical management of diagnosed cornual pregnancy consists of hemostasis, resection, repair and reconstruction. 

scholarly journals Acute pelvic pain following miscarriage heterotopic pregnancy must be excluded: case report

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Udit Thakur ◽  
Kiran Atmuri ◽  
Angelika Borozdina
Keyword(s):  
Ectopic Pregnancy ◽  
Pelvic Pain ◽  
Point Of Care ◽  
Transvaginal Ultrasound ◽  
Heterotopic Pregnancy ◽  
Point Of Care Ultrasound ◽  
Pelvic Ultrasound ◽  
Intrauterine Pregnancy ◽  
Tubal Ectopic Pregnancy ◽  
Acute Pelvic Pain

Abstract Background Heterotopic pregnancies are increasing in prevalence and this case highlights the importance of excluding the diagnosis in patients with pelvic pain following miscarriage. A known pre-existing intrauterine pregnancy can be falsely reassuring and delay the diagnosis of a potentially life-threatening concurrent ectopic pregnancy. Case presentation In this report, we describe a case of spontaneous heterotopic pregnancy in a woman who had initially presented with pelvic pain and vaginal bleeding, and was diagnosed on pelvic ultrasound with a missed miscarriage; a non-viable intrauterine pregnancy. She re-presented 7 days later with worsening pelvic pain and bleeding, and a repeat pelvic ultrasound identified a ruptured tubal ectopic pregnancy in addition to an incomplete miscarriage of the previously identified intrauterine pregnancy. She underwent an emergency laparoscopy where a ruptured tubal ectopic pregnancy was confirmed. Conclusion Being a time critical diagnosis with the potential for an adverse outcome, it is important that the emergency physician considers heterotopic pregnancy as a differential diagnosis in patients presenting with pelvic pain following a recent miscarriage. The same principle should apply to pelvic pain in the context of a known viable intrauterine pregnancy or recent termination of pregnancy. A combination of clinical assessment, beta human chorionic gonadotropin levels, point of care ultrasound and formal transvaginal ultrasound must be utilized together in these situations to explicitly exclude heterotopic pregnancy.

scholarly journals An Intrauterine Pregnancy with Tubo-ovarian Torsion mimicking Ruptured Tubal Ectopic Pregnancy

2017 ◽  
Vol 9 (1) ◽  
pp. 56-59
Author(s):  
Khushpreet Kaur ◽  
Navneet Kaur ◽  
Surbhi Saini
Keyword(s):  
Pregnant Woman ◽  
Ectopic Pregnancy ◽  
Surgical Intervention ◽  
Imaging Modality ◽  
Tertiary Care ◽  
Ovarian Torsion ◽  
Adnexal Torsion ◽  
Intrauterine Pregnancy ◽  
Tubal Ectopic Pregnancy ◽  
Early Surgical Intervention

ABSTRACT Aims and objectives Adnexal torsion is a rare gynecological emergency that requires an early surgical intervention to save the adnexa from irreversible damage. Our study is about the clinical presentation and management of adnexal torsion in a pregnant woman in a tertiary care center. Materials and methods This case study was done in a pregnant woman who came with adnexal torsion in the first trimester in the labor room of Government Medical College and Patiala, Punjab, India. Results Torsion ovarian cyst is found in 5 per 10,000 women in pregnancy. The woman was suspected of having heterotopic pregnancy (an intrauterine pregnancy with ruptured tubal ectopic pregnancy). However, she was diagnosed as intrauterine pregnancy with adnexal torsion during laparotomy. Conclusion Adnexal torsion is a rare emergency, which requires a high index of clinical suspicion for diagnosis as the symptoms are nonspecific. Imaging helps in diagnosis, but most of them are diagnosed intraoperatively. Diagnosis is made clinically along with imaging modalities. Ultrasound with color Doppler is the most commonly used imaging modality. An early surgical intervention helps in salvaging the adnexa and prevents further complications. How to cite this article Kaur N, Kaur K, Saini S. An Intrauterine Pregnancy with Tubo-ovarian Torsion mimicking Ruptured Tubal Ectopic Pregnancy. J South Asian Feder Obst Gynae 2017;9(1):56-59.

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