Ectopic Pregnancy at 13-week Period of Gestation with Live Fetus

Ectopic pregnancy will unavoidably result in abortion or rupture. Ultrasound examination and β-hcg measurement are required, regarding symptomatic women with positive pregnancy test, in order to early detect cases of ectopic pregnancy. Here we report a case of a woman presented to the emergency depart- ment with acute abdomen and hemodynamic instability. History revealed a period of amenorrhea of 13 weeks and pregnancy test was found positive. Sonographic examination showed left adnexal swelling with viable fetus inside, hemoperitoneum and thus immediate laparotomy was decided. Left salpingo-oophorec- tomy was performed and post-operative course of the patient was uneventful. According to this case, ec- topic pregnancy should not be eliminated from differential diagnosis when it comes to pregnant women with relevant clinical presentation, even in advanced gestational age.

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Lung neoplasm mimicking as ectopic pregnancy due to paraneoplastic secretion of human chorionic gonadotropin: a case report and literature review

Archives of Gynecology and Obstetrics ◽

10.1007/s00404-020-05927-2 ◽

2021 ◽

Author(s):

Jin Peng ◽

Shangge lv ◽

Lin Liu ◽

Shuai Feng ◽

Naidong Xing

Keyword(s):

Systematic Review ◽

Ectopic Pregnancy ◽

Chorionic Gonadotropin ◽

Human Chorionic Gonadotropin ◽

Lung Neoplasm ◽

High Serum ◽

Pregnancy Test ◽

Positive Pregnancy Test ◽

Β Hcg ◽

Present Systematic Review

Abstract Purpose The present systematic review aimed to examine the relationship between lung neoplasm and human chorionic gonadotropin (HCG). Especially, women with lung neoplasm mimicking as ectopic pregnancy were explored. Methods A rare case of lung neoplasm with high serum β-HCG, which was initially thought to be ectopic pregnancy, was reported. A literature search was performed of the US National Library of Medicine (MEDLINE), EMBASE, PubMed, and the Cochrane Database of Systematic Reviews using appropriate keywords and subject headings to February 2020. Results Studies assessed lung neoplasm patients with positive HCG were included. Twenty studies, including 24 patients, were included. These cases illustrate the importance of considering the possibility of paraneoplastic secretion of β-HCG in patients who have a positive pregnancy test. This may prevent a delay in the diagnosis and treatment of malignancy in young women. Of the 24 cases, only 7 (29.17%) were managed surgically; others were managed conservatively or with chemotherapy or radiation. Conclusion The present systematic review shows the need to re-awaken awareness and high index of suspicion to lung neoplasm diagnosis in patients with positive pregnancy test.

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Ectopic pregnancy in a tertiary care centre of Jharkhand, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20193505 ◽

2019 ◽

Vol 8 (8) ◽

pp. 2969

Author(s):

Meetali Parashar ◽

Meena Mehta

Keyword(s):

Ectopic Pregnancy ◽

Clinical Presentation ◽

Previous History ◽

First Trimester ◽

Near Miss ◽

Obstetrics And Gynaecology ◽

Maternal Morbidity And Mortality ◽

History Of ◽

Β Hcg ◽

A Prospective Study

Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions:Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions: Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.

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Medical management of ectopic pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20203861 ◽

2020 ◽

Vol 9 (9) ◽

pp. 3809

Author(s):

Tseten Zangmu Bhutia ◽

Zigmee Dorjee Tamang ◽

Goutam Giri

Keyword(s):

Medical Treatment ◽

Ectopic Pregnancy ◽

Failure Rate ◽

Medical Management ◽

Treatment Options ◽

First Trimester ◽

Benign Condition ◽

Β Hcg ◽

Ectopic Pregnancies ◽

Period Of Gestation

Background: Ectopic pregnancy is a commonest cause of maternal morbidity and mortality in the first trimester of pregnancy. Clinical presentation of ectopic pregnancy has changed from life threatening disease to a more benign condition for which nonsurgical treatment options are available with methotrexate administered systemically or locally. The study was done to evaluate the outcome of medical management of ectopic pregnancy with single regimen methotrexate.Methods: A cohort study was conducted over 18 months on 60 unruptured ectopic pregnancies who were treated with methotrexate injection.Results: Out of 60 unruptured ectopic pregnancies, 53 (88.3%) were successfully treated with methotrexate. Failure rate was 11.7% (7/60) patients who underwent laparotomy. Success of medical treatment was dependent on pretreatment β-hCG (≤4102.5 mIU/mL), period of gestation (≤5 weeks), size of gestational sac (≤3 cm) above which the failure rate increases. No correlation was seen between fall of β-hCG from day 4 to 7 and the success rate. Mean time to resolution of β-hCG seen was 4.3±1.25 weeks. Mean duration of hospital stay was 8.85±1.603 days. Single dose regimen of methotrexate was given to all patients and only 1/60 patients required second dose of methotrexate for suboptimal decrease of β-hCG.Conclusions: The result showed that pretreatment β-hCG level and period of gestation were good predictors for success of medical treatment.

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Unruptured Ampullary Ectopic Pregnancy at 16-week Period of Gestation with Live Fetus

The Journal of Obstetrics and Gynecology of India ◽

10.1007/s13224-012-0228-7 ◽

2012 ◽

Vol 64 (1) ◽

pp. 73-74

Author(s):

Rita Mhaskar ◽

Manjula Harish ◽

Tejaswini Jaiprakash

Keyword(s):

Ectopic Pregnancy ◽

Live Fetus ◽

Period Of Gestation

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Interstitial ectopic pregnancy diagnosis by three-dimensional ultrasound and its laparoscopic management: A case report

International Journal of Reproductive BioMedicine ◽

10.18502/ijrm.v17i12.5801 ◽

2019 ◽

Author(s):

Firoozeh Ahmadi ◽

Fattaneh Pahlavan ◽

Fariba Ramezanali ◽

Farnaz Akhbari

Keyword(s):

Ectopic Pregnancy ◽

Three Dimensional ◽

Sudden Onset ◽

Vitro Fertilization ◽

Live Embryo ◽

Positive Pregnancy Test ◽

Β Hcg ◽

Interstitial Ectopic Pregnancy ◽

Laparoscopic Assisted

Background: Interstitial Ectopic Pregnancy (IEP) is an uncommon type of ectopic pregnancy with the risk of rupturing and bleeding. The incidence of IEP is about 2-4% of all EPs. The diagnosis and management are challenging. We present a well-timed and managed case of IEP. Case: The case was a 37-yr-old woman presented at the Royan Institute with a chief complain of sudden onset of pelvic pain and moderate vaginal bleeding, three weeks after her positive pregnancy test. She had got pregnant with in-vitro fertilization procedure. She was admitted for a two-dimensional ultrasound (2DUS). The 2DUS findings showed a gestational sac with live embryo and yolk sac which was located high in the fundus and eccentric to the endometrium. The suspicion of IEP rose after the 2DUS findings, the confirmation of further diagnosis was then done by three-dimensional ultrasound, and the treatment was done by laparoscopy. The patient underwent laparoscopic left corneal resection. She was discharged after two days and her β-hCG achieved complete resolution (< 5 mIU/mL) after two weeks’ follow-up. Conclusion: According to the life-threatening complications that are associated with IEP, acquaintance and suspicion about IEP is important. Specified information that obtained by three-dimensional ultrasound could be useful for exact locating and detection. Key words: Pregnancy, Ectopic, Diagnostic, Ultrasound, Laparoscopic assisted surgery.

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Cervical Ectopic Pregnancy: Diagnosis With Endovaginal Ultrasound Examination and Successful Treatment With Methotrexate

Archives of Family Medicine ◽

10.1001/archfami.9.1.72 ◽

2000 ◽

Vol 9 (1) ◽

pp. 72-77 ◽

Cited By ~ 54

Author(s):

L. M. Leeman

Keyword(s):

Ectopic Pregnancy ◽

Successful Treatment ◽

Ultrasound Examination ◽

Pregnancy Diagnosis ◽

Endovaginal Ultrasound ◽

Cervical Ectopic Pregnancy

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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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