scholarly journals Ruptured Unilateral Twin Tubal Ectopic Pregnancy. Case Report of an oddity & Literature Review

2020 ◽  
Vol 1 (1) ◽  
pp. 60-63
Author(s):  
Palwasha Gul ◽  
Khanda Gul ◽  
Pari Gul ◽  
Tanzila Parveen
Keyword(s):  
Ectopic Pregnancy ◽  
Transvaginal Ultrasound ◽  
Uterine Cavity ◽  
Lower Abdominal Pain ◽  
Exploratory Laparotomy ◽  
First Trimester ◽  
Maternal Deaths ◽  
Tubal Ectopic Pregnancy ◽  
Beta Hcg ◽  
Ectopic Pregnancies

Background: An ectopic pregnancy (EP) is a type of conception in which, the fertilized egg is lodged outside the uterine cavity. Twin ectopic pregnancies are a rarity, and the reported cases of twin tubal pregnancies are a handful to date.Case Report: We report a case of a 35 years old patient who presented to the emergency with the complaint of lower abdominal pain and intermittent vaginal discharge. She was diagnosed with twin tubal alive gestation, underwent exploratory laparotomy and right salpingectomy.Conclusion: Ectopic pregnancy can occur even in the absence of known risk factors. Its incidence is on the rise. It is a leading cause of first-trimester maternal deaths and can be easily diagnosed with Beta HCG levels and transvaginal ultrasound.

scholarly journals Non-surgical management of unruptured tubal ectopic pregnancy

2017 ◽  
Vol 6 (7) ◽  
pp. 3041
Author(s):  
Anjali Choudhary ◽  
Priyanka Chaudhari ◽  
Neeta Bansal
Keyword(s):  
Ectopic Pregnancy ◽  
Medical Management ◽  
Expectant Management ◽  
First Trimester ◽  
Response To Treatment ◽  
Surgical Trauma ◽  
Tubal Ectopic Pregnancy ◽  
Beta Hcg ◽  
Surgical Options ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is still the leading cause of pregnancy related morbidity in the first trimester. Since majority of the women who present with ectopic pregnancies are sub fertile and young, there is a role for non-surgical options of managing these pregnancies. Expectant and medical management not only serves to conserve the fallopian tubes but also saves women from surgical trauma and morbidity. The objective of this retrospective study was to share our experience of treating un-ruptured tubal ectopic pregnancies conservatively.Methods: Women diagnosed with un-ruptured tubal ectopic pregnancy, fit for conservative /medical management were included. Women with serum beta HCG levels less than 1000 mIU/L were treated expectantly and women with Bet HCG levels >1000 but <10,000 mIU /L were given Injectable methotrixate. Response to treatment was monitored by serial beta HCG levels.Results: Total 37 women included in the study.12% women showed complete resolution with expectant treatment alone and 88% resolved after a single dose methotrixate.Conclusions: Many women with un-ruptured tubal ectopic pregnancies would benefit from expectant management, or methotrixate therapy. Methotrixate used in carefully selected women is safe and effective in resolving these cases with good post treatment reproductive outcome.

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 Advanced tubal ectopic pregnancy of 19 weeks gestation: case report and review of the literature

2018 ◽  
Vol 7 (11) ◽  
pp. 4794
Author(s):  
Ángel Lemus Huerta ◽  
Junior Joel Araiza Navarro ◽  
Araceli Román Pompa ◽  
Oyuki Aricet Morales Uscanga ◽  
Margarita Eugenia Pérez Chavura ◽  
...  
Keyword(s):  
Case Report ◽  
Ectopic Pregnancy ◽  
Uterine Cavity ◽  
Pain Syndrome ◽  
Exploratory Laparotomy ◽  
First Trimester ◽  
Tubal Ectopic Pregnancy ◽  
Surgical Interventions ◽  
Abdominal Organs ◽  
History Of

Ectopic pregnancy is a condition in which the fertilized ovum is impacted anywhere other than the uterine cavity, these sites may be uterine tubes, cervix, ovary and abdomen. Ectopic implantation in the uterine tubes occurs up to 98%. The distribution according to its location is: 78% ampullary, 12% isthmic, 5% fibrous, 2-3% interstitial, 1% ovarian, 1-2% abdominal, and more rare in cervix with 0.5%. Ectopic pregnancy occurs 1.2 to 2% of pregnancies, with an associated mortality of 0.5 deaths per 1000 pregnancies. There are multiple risk factors for an ectopic pregnancy, among the most frequent are: women with pelvic inflammatory disease (salpingitis) conditioned mainly by Chlamydia trachomatis and Neisseria gonorrhea, anatomical abnormalities of the tubes, previous surgery in them (including sterilization), masses extrinsic tumors that compress them, endometriosis, zygote anomalies, endocrinopathies (corpus luteum deficiency in late ovulation), use of intrauterine devices, previous ectopic pregnancy (as a result of surgical treatment or due to persistence of the original risk factor), contraceptive users with gestagens in low doses, assisted reproduction techniques, smokers, secondary adhesions to surgical interventions on the uterus, ovaries, and other pelvic or abdominal organs, exposure of the uterus to diethylstilbestrol, among others. The objective of this case is to describe an advanced tubal ectopic pregnancy. The following case report is about a 24-year-old patient with a pregnancy of 19 weeks of gestation by first-trimester ultrasound and a history of recent laparoscopic cholecystectomy secondary to biliary lithiasis. He is in the first trimester of normo-evolutive and without symptoms. Authors present to the emergency department with a 24-hour abdominal pain syndrome that requires exploratory laparotomy and right salpingo-oophorectomy due to the presence of ruptured tubal ectopic pregnancy with average fetometry of 19 weeks of gestation. The patient is discharged after an adequate clinical evolution.

scholarly journals Spontaneous Unilateral Tubal Twin Ectopic Pregnancy: A Case-Based Discussion and Assessment

2011 ◽  
Vol 5 (4) ◽  
pp. 416-420
Author(s):  
Vaneesha Vallabh-Patel ◽  
Robert Vera ◽  
Gustavo Martell
Keyword(s):  
Ectopic Pregnancy ◽  
Color Doppler ◽  
Transvaginal Ultrasound ◽  
Power Doppler ◽  
Lower Abdominal Pain ◽  
Color Doppler Ultrasound ◽  
The United States ◽  
Beta Hcg ◽  
Ectopic Pregnancies ◽  
The Right

ABSTRACT Introduction Two percent of all 1st trimester pregnancies in the United States are ectopic. Transvaginal ultrasound is considered the mainstay in diagnosis. Color Doppler ultrasound can prove to be an added helpful modality in identifying ectopic pregnancies. Case report An 18-year-old nulliparous female presented with vaginal bleeding and lower abdominal pain. Pelvic exam revealed tenderness in the right adnexal region with elevated quantitative serum beta-hCG. A transvaginal ultrasound showed an echogenic ring adjacent to the right ovary and M-mode and color Doppler revealed two fetal heart tones. Color Doppler enabled visualization of randomly dispersed tubal arteries and heart activity of both embryos. A right salpingectomy was performed without complications and beta hCG levels returned to undetectable levels. Conclusion B mode ultrasound is a vital diagnostic tool in the detection of ectopic pregnancy. Color Doppler provides both morphologic and functional information essential for determining the optimal therapeutic strategy. Three-dimensional ultrasound with color and/or power Doppler has proven useful in both the initial diagnosis and follow-up of ectopic pregnancies especially in patients following assisted reproduction treatment.

scholarly journals Clinical presentation of tubal ectopic pregnancy

2020 ◽  
Vol 9 (3) ◽  
pp. 1148
Author(s):  
Kavitha Garikapati ◽  
M. Parvathi Devi ◽  
N. Alekya Goud
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Uterine Cavity ◽  
Expectant Management ◽  
Signs And Symptoms ◽  
First Trimester ◽  
Child Bearing ◽  
Incidence Risk ◽  
Ectopic Pregnancies

Background: When the fertilized ovum gets implanted at site other than normal position of uterine cavity, it is known as ectopic pregnancy. Incidence of ectopic pregnancy is 1-2% of all reported pregnancies. It is an unmitigated disaster of human production and the most important cause of morbidity and mortality in first trimester with major cause of reduced child bearing potential. It is notorious in its clinical presentation, challenging the attending physician.Methods: women with risk factors, signs and symptoms and with confirmed diagnosis. Women discharged against medical advice. Study population is 50. Retrospective analysis for 3 years (2016-2019). Objectives of this study were to study the incidence, risk factors, clinical presentation, diagnosis and changing trends of modern management. Results analysed after entering the information in the excel sheets using descriptive analysisResults: Out of 4940 deliveries, 50 were tubal ectopic pregnancies 1.012%. Women aged 20-25 years were 52%. In our study, multiparous were 68%. Common symptoms were abdominal pain 80.2%, amenorrhea 72%, urine gravindex test positive 92.8%. Etiology was PID 20%, previous ectopic pregnancy 4%, IUCD 4%, LSCS with tubectomy 16%, most common site is ampulla 82%. About 78% were ruptured. Tubal abortions 4%, salpingectomy done in 82%. Laparotomy in 2.43% in hemodynamically unstable. Medical management 8%. Salpingostomy in 4% and expectant management 2%. Morbidity in the form of blood transfusion 23.48%, DIC with ICU admission 2%. No mortality.Conclusions: A high index of clinical suspicion with underlying risk factors may get us early diagnosis for timely intervention.

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 Chronic Tubal Ectopic Pregnancy with Diagnostic Conundrum: A Case Report

2021 ◽  
Vol 6 (2) ◽  
pp. 192-194
Author(s):  
Vishal Sharma ◽  
Ravi Dutt Wadhwa
Keyword(s):  
Case Report ◽  
Ectopic Pregnancy ◽  
Gestational Age ◽  
First Trimester ◽  
Present Case Report ◽  
Tubal Ectopic Pregnancy ◽  
Threatening Condition ◽  
Life Threatening ◽  
First Trimester Of Pregnancy ◽  
Ectopic Pregnancies

Ectopic pregnancy is a life threatening condition and mostly ectopic pregnancies occurs in fallopian tube. The most common site of ectopic tubal pregnancy is ampulla. Ectopic pregnancy is a complication of pregnancy and usually easy to diagnose by ultrasonography during the first trimester of pregnancy. Due to limited healthcare resources in developing countries, women do not undergo for ultrasound examination during pregnancy which leads to late diagnosis. In most of cases women with ectopic pregnancy are asymptomatic, unless ruptured. The mean gestational age for clinical presentation of ectopic pregnancy is 7.2 weeks after the last normal menstrual period. In rural population, late presentations of ectopic pregnancies are more commonly seen because of lack of modern diagnostic ability. Present case report is a rare case of non-viable, unruptured, tubal ampullary chronic ectopic pregnancy of 12 weeks gestational age. Keywords: Ectopic pregnancy, Unruptured, gestational age, ultrasonography.

scholarly journals Cervical Twin Heterotopic Pregnancy: Overview of Ectopic Pregnancies and Scanning Detection Algorithm

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 969
Author(s):  
Antonios Koutras ◽  
Zacharias Fasoulakis ◽  
Michail Diakosavvas ◽  
Athanasios Syllaios ◽  
Athanasios Pagkalos ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Uterine Cavity ◽  
Medical Abortion ◽  
First Trimester ◽  
Detection Algorithm ◽  
Heterotopic Pregnancy ◽  
Cervical Canal ◽  
Mortality And Morbidity ◽  
Gestational Sac ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is the leading cause of gestation-related deaths during the first trimester. Cervical twin heterotopic pregnancies, when ectopic, constitute a small and rare part of gynecological surgery. Case Presentation: A 30-year-old pregnant woman (gravida 3, para 2) presented with mild pain in the lower abdomen and traces of bleeding per vaginum for three days. Transvaginal ultrasonography revealed a balloon-shaped cervical canal with a visible gestational sac measuring 3.5 × 3.9 cm. A second gestational sac was seen in the uterine cavity. The measurements of the gestational sacs corresponded to 7 + 4 weeks’ pregnancy. A decision for medical abortion with mifepristone and misoprostol was made. However, due to an incomplete abortion and continuous bleeding, a curettage was performed. Conclusions: Spontaneous heterotopic pregnancy with the ectopic pregnancy located in the cervix is an extremely rare clinical condition requiring urgent treatment in order to reduce maternal mortality and morbidity and preserve fertility.

scholarly journals LETROZOLE - NOVEL DRUG FOR MEDICAL MANAGEMENT FOR TUBAL ECTOPIC PREGNANCY

2020 ◽  
pp. 1-2
Author(s):  
Rana Choudhary ◽  
Seema Pandey ◽  
Priyanka Vora
Keyword(s):  
Ectopic Pregnancy ◽  
Medical Management ◽  
Maternal Morbidity ◽  
First Trimester ◽  
Tubal Ectopic Pregnancy ◽  
Future Fertility ◽  
Life Threatening ◽  
Diagnostic Modalities ◽  
Ectopic Pregnancies ◽  
Novel Drug

Ectopic pregnancy is one of the most common life-threatening conditions leading to increased maternal morbidity and mortality in the first trimester. With advances in diagnostic modalities, one can now diagnose most ectopic pregnancies before their rupture and other catastrophic events. Methotrexate is the most common drug used for medical management but has adverse effects and needs strict monitoring. We report a case of tubal ectopic pregnancy which was successfully managed with letrozole. We were able to prevent maternal morbidity, reduce cost of therapy and preserve future fertility in our patient.

scholarly journals A Case of Cervical Ectopic Pregnancy

2016 ◽  
Vol 27 (1) ◽  
pp. 31-35
Author(s):  
Jahanara Begum ◽  
Shamsun Nahar Begum ◽  
Rowshan Ara ◽  
Shamim Fatema Nargis
Keyword(s):  
Ectopic Pregnancy ◽  
Uterine Cavity ◽  
First Trimester ◽  
Conservative Approach ◽  
Artery Ligation ◽  
Severe Hemorrhage ◽  
Threatening Condition ◽  
Life Threatening ◽  
Ectopic Pregnancies ◽  
Cervical Ectopic Pregnancy

Cervical ectopic pregnancy is the implantation of a pregnancy in the endocervix1. Such pregnancy typically aborts within the first trimester, if it is implanted closer to the uterine cavity called cervico isthmic pregnancy it may continue longer2. Cervical pregnancy accounts for less than 1% of all ectopic pregnancies, with an estimated incidence of one in 2500 to one in 180003-5. Though the pregnancy in this area is uncommon but possibly life threatening condition due to risk of severe hemorrhage and may need hysterectomy. Early detection and conservative approach of treatment limit the morbidity and preserve fertility. A 26 years lady diagnosed as a case of cervical ectopic pregnancy and managed conservatively successfully with adjunctive techniques like cervical artery ligation and cervical temponade to control haemorrhage. The case is reported here for its relative rarity.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(1) : 31-35

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