scholarly journals Heterotopic Pregnancy: A Clinical Case Report

1970 ◽  
Vol 39 (3) ◽  
Author(s):  
S Chowdhury ◽  
T Chowdhury
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Ectopic Pregnancy ◽  
Clinical Examination ◽  
Clinical Case ◽  
Lower Abdominal Pain ◽  
Tubal Pregnancy ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Ectopic Pregnancies

Heterotopic pregnancy is coexistence of intrauterine and extrauterine pregnancies that is ectopic pregnancies. It is said to be rare. Here we report a case of 27 years old woman with heterotopic pregnancy. Patient had a typical presentation of severe lower abdominal pain following amenorrhoea for 2½ months. On clinical examination, there was suspicion of ectopic pregnancy but ultrasonography revealed early intrauterine pregnancy along with right tubal pregnancy with huge collection in abdomen . Immediate laparotomy was done and diagnosis was confirmed as a case of heterotopic pregnancy.DOI: http://dx.doi.org/10.3329/bmj.v39i3.9950 BMJ 2010; 39(3)

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 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 HETEROTOPIC PREGNANCY

2006 ◽  
Vol 13 (01) ◽  
pp. 162-164
Author(s):  
FARKHUNDA AKTHAR
Keyword(s):  
Abdominal Pain ◽  
Rare Case ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Tubal Pregnancy ◽  
Heterotopic Pregnancy ◽  
Atypical Presentation ◽  
Intrauterine Pregnancy ◽  
Ectopic Gestation

A rare case of simultaneous tubal pregnancy and intrauterine pregnancy is discussed. Patient hadan atypical presentation of abdominal pain and a abnormal uterine bleeding but no period of amenorrhea. On clinicalexamination there was suspicion of ectopic gestation but ultrasonography revealed early intrauterine pregnancy alongwith luteal cyst. Because of increase severity of pain she was reviewed again. Repeat sonography findings wereconsistent with heterotopic which was confirmed by laparotomy and histopathology.

scholarly journals The Value of Color and Power Doppler in the Diagnosis of Ectopic Pregnancy

2013 ◽  
Vol 7 (4) ◽  
pp. 429-439 ◽  
Author(s):  
Ulrich Honemeyer ◽  
Sanja Kupesic-Plavsic ◽  
Afshin Pour-Mirza
Keyword(s):  
Ectopic Pregnancy ◽  
Obstet Gynecol ◽  
Power Doppler ◽  
Three Dimensional ◽  
Uterine Cavity ◽  
Lower Abdominal Pain ◽  
First Trimester ◽  
Tubal Pregnancy ◽  
Ectopic Pregnancies ◽  
Color And Power Doppler

ABSTRACT Implantation of the zygote outside the uterine cavity occurs in 2% of all pregnancies. The rate of ectopic pregnancies has increased from 0.5% in 1970 to 2% today. The prevalence of ectopic pregnancy in all women presenting to an emergency department with first-trimester bleeding, lower abdominal pain or a combination of the two is between 6 and 16%. When diagnosis is made early, the product of conception can be removed safely by laparoscopic surgery and be submitted for histological examination. Tubal rupture is a complication of late diagnosed tubal pregnancy which is more difficult to treat conservatively and often indicates tubectomy or segmental resection. In 5 to 15% of treated ectopic pregnancy cases, remnant conception product parts are diagnosed and may require a final methotrexate (MTX) injection. Rare sites of ectopic pregnancy include interstitial, cervical, abdominal and cesarean scar pregnancies. Our manuscript reviews and illustrates the use of novel sonographic methods such as three-dimensional ultrasound, multiplanar view, in combination with color and power Doppler ultrasound, for early detection of ectopic tubal pregnancy and of other, rare locations of ectopic pregnancy. How to cite this article Honemeyer U, Alkatout I, Plavsic SK, Pour-Mirza A, Kurjak A. The Value of Color and Power Doppler in the Diagnosis of Ectopic Pregnancy. Donald School J Ultrasound Obstet Gynecol 2013;7(4):429-439.

scholarly journals Heterotopic pregnancy: a case report

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Tamer Ali ◽  
Mohamed A. Tawab ◽  
Mona Abdel Ghaffar ElHariri ◽  
Alaa A. Ayad
Keyword(s):  
Abdominal Pain ◽  
Adnexal Mass ◽  
Stable Condition ◽  
Lower Abdominal Pain ◽  
Rare Condition ◽  
First Trimester ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Laboratory Findings ◽  
The Right

Abstract Background Heterotopic pregnancy describes the occurrence of two pregnancies in different implantation sites simultaneously, which is rare, yet it is a challenge to diagnose such a problem due to complex clinical and laboratory findings. In the current study, we present a case of first trimester heterotopic pregnancy diagnosed by ultrasound (US) and magnetic resonance imaging (MRI) and was managed successfully. Case presentation A 22-year-old primigravida lady with spontaneous pregnancy was presented by increasing lower abdominal pain for 5 days with brownish vaginal discharge, nausea, and vomiting episodes. Trans-abdominal and endovaginal ultrasound was performed and revealed a viable intrauterine pregnancy of 8 weeks and 1 day, associated with a heterogeneous complex right adnexal mass. MR imaging revealed a right adnexal mass intimately anterior to the normal right ovary. Laparascopy was done; it revealed a distended right fallopian tube with pregnancy while the right ovary was not seen (impeded in the pouch of Douglas), and right salpingectomy was done. The specimen was sent for histopathology. The patient tolerated the procedure well and was then taken to the recovery room in stable condition. The histopathological report confirmed the diagnosis of ectopic pregnancy. Conclusion However, heterotopic is a rare condition, any pregnant woman presenting with alarming abdominal pain and adnexal abnormality; heterotopic pregnancy should be among the differential diagnosis possibilities. The patient should be thoroughly investigated using ultrasound and MRI if needed, to exclude this rare diagnosis and allow on-time proper management.

scholarly journals Vaginal Delivery at Term in a Woman with a Spontaneous Heterotopic Pregnancy Treated with Laparoscopic Salpingectomy

2020 ◽  
Vol 2020 ◽  
pp. 1-5 ◽  
Author(s):  
Michail Diakosavvas ◽  
Nikolaos Blontzos ◽  
Georgios Daskalakis ◽  
Athanasios Protopapas ◽  
Nikolaos Kathopoulis ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Vaginal Delivery ◽  
Clinical Symptoms ◽  
Lower Abdominal Pain ◽  
Major Complication ◽  
Heterotopic Pregnancy ◽  
Clinical Image ◽  
Intrauterine Pregnancy ◽  
Beta Hcg ◽  
Laparoscopic Salpingectomy

Background. The coexistence of an intrauterine pregnancy and an ectopic pregnancy (heterotopic pregnancy) is an extremely rare, yet major, complication during pregnancy. The early diagnosis of a heterotopic pregnancy is of great importance for fetal viability, maternal safety, and the progression of an uncomplicated intrauterine pregnancy. Case Presentation. We report a case of a naturally conceived heterotopic tubal pregnancy in a 37-year-old primigravida. The patient presented with continuous, dull, lower abdominal pain and a positive urine pregnancy test which was conducted a week prior to the start of the pain. The patient was hospitalized, and based on the clinical image and after strict monitoring, she was diagnosed with a heterotopic pregnancy. She was treated with laparoscopic salpingectomy after the rupture of the ectopic pregnancy while the desired intrauterine gestation continued without any complications. The pregnancy resulted in the birth of a healthy infant through vaginal delivery. Discussion. Strict monitoring with multiple sonographic evaluations should always be conducted in women with abnormal serum beta-hCG, adnexal abnormalities, or clinical symptoms, while heterotopic pregnancy should be in differential diagnosis and treatment should not be delayed since emerge management is important for the progression of the intrauterine pregnancy.

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 A Ruptured Spontaneous Heterotopic Tubal Pregnancy With a Viable Intrauterine Pregnancy

2017 ◽  
Vol 2 (2) ◽  
Keyword(s):  
United States ◽  
Cesarean Section ◽  
Ectopic Pregnancy ◽  
Fallopian Tube ◽  
Peritoneal Cavity ◽  
First Trimester ◽  
The United States ◽  
Tubal Pregnancy ◽  
Intrauterine Pregnancy ◽  
Ectopic Pregnancies

An ectopic pregnancy is a pregnancy located outside of the intrauterine cavity.They comprise 1-2% of all first trimester pregnancies and 6% of pregnancy related deaths in the United States [1]. Ectopic pregnancies most commonly occur in the fallopian tube but can also implant in other locations, including the ovaries, peritoneal cavity, cesarean section scars and the cervix [2].

scholarly journals Heterotopic in spontaneous ruptured pregnancy with a living birth term: a case report in Madagascar

2018 ◽  
Vol 7 (7) ◽  
pp. 2942
Author(s):  
Ibrahim Housni ◽  
Romuald Randriamahavonjy ◽  
Tanjona Andriamanetsiarivo Ratsiatosika ◽  
Rasoanandrianina Bienvenue Solange ◽  
Abasse Baco Abdallah ◽  
...  
Keyword(s):  
Case Report ◽  
Pregnant Woman ◽  
Ectopic Pregnancy ◽  
Live Birth ◽  
Pelvic Pain ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Therapeutic Alternative ◽  
Spontaneous Pregnancy ◽  
Acute Pelvic Pain

Heterotopic pregnancy is defined as the coexistence of an intrauterine pregnancy (UGI) and an ectopic pregnancy (EUS), regardless of its location. It is a rare pathology. Here, we report the case of a 29-year-old patient who had a heterotopic in spontaneous pregnancy complicated by hemoperitoneum at 7 weeks of amenorrhea. A laparotomy with salpingectomy was performed. The result was favourable with a live birth with 37 SA of the GIU. A heterotopic pregnancy must always be eliminated in the presence of acute pelvic pain in the pregnant woman. Laparotomy is a therapeutic alternative if laparoscopy is not available.

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