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

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.

2019 ◽  
Vol 3 (1) ◽  
pp. 62-64 ◽  
Author(s):  
Justine Stremick ◽  
Kyle Couperus ◽  
Simeon Ashworth

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.


2020 ◽  
pp. 1-2
Author(s):  
Rana Choudhary ◽  
Seema Pandey ◽  
Priyanka Vora

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.


2016 ◽  
Vol 27 (1) ◽  
pp. 31-35
Author(s):  
Jahanara Begum ◽  
Shamsun Nahar Begum ◽  
Rowshan Ara ◽  
Shamim Fatema Nargis

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


2014 ◽  
Vol 13 (2) ◽  
pp. 63-66
Author(s):  
Shahana Begum ◽  
Afroza Ferdous ◽  
Munawar Sultana ◽  
Rowshan Ara Begum

Cervical ectopic pregnancy is the implantation of the conceptus within the cervix below the level of internal os1. 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 1 in 2500 to 1 in 18000. Though the pregnancy in this area is uncommon but possibly life threatening condition due to risk of severe hemorrhage and may need hysterectomy2,3. Early detection and conservative approach of treatment limit the morbidity and preserve fertility. A 37 year old lady para 4+0 diagnosed as a case of cervical ectopic pregnancy with intractable bleeding and save the patient by emergency hysterectomy to control hemorrhage. The case is reported here for its relative rarity.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21072


Author(s):  
Vipul R. Khandagale

Heterotopic pregnancy is a rare clinical condition in which intrauterine and extrauterine pregnancies occur at the same time. It can be a life threatening condition and easily missed with the diagnosis. We present the case of a 37 year old patient who was treated for a heterotopic pregnancy with live intrauterine gestation and ruptured left adnexal gestation.The ectopic pregnancy was not suspected at her initial presentation. A high index of suspicion is needed in women with risk factors for an ectopic pregnancy and in low risk women who have free fluid with or without an adnexal mass with an intrauterine gestation.It is difficult to estimate exactly the incidence of ectopic pregnancies, but on an average it is approximately 1:300 normal pregnancies worldwide.


Author(s):  
Anjali Choudhary ◽  
Priyanka Chaudhari ◽  
Neeta Bansal

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.


Author(s):  
Tanjona Andriamanetsiarivo Ratsiatosika ◽  
Romuald Randriamahavonjy ◽  
Baco Abdallah Abasse ◽  
Mahefarisoa Fnat ◽  
Ibrahim Housni ◽  
...  

Ectopic pregnancy is a life-threatening condition occurring in 1-2% of all pregnancies. The most common site of implantation for an ectopic pregnancy is the fallopian tube. Authors report a case of recurrent ipsilateral ectopic pregnancy following right partial salpingectomy of a 29-Year-Old woman that led to tubal rupture. The pregnancy was conceived spontaneously. Diagnostic of ruptured ectopic pregnancy was done after clinical and ultrasonography examination. The presence of a massive hemoperitoneum with a positive pregnancy urinary test that lead us to the diagnosis of ectopic pregnancy. She underwent a laparotomy for a suspicion of ruptured ectopic pregnancy. The ectopic pregnancy was identified in the left remnant fallopian tube. Partial salpingectomy, removal of tubal stump, and resection of the uterine cornua, was performed. The postoperative recovery was uneventful. She has stayed for five days at the Hospital. All patients, even though they have already received a definitive contraception by tubal section and ligature or unilateral or by bilateral salpingectomy for any reason, must seek an ectopic pregnancy in case of pelvic pain, vaginal bleeding and/ or amenorrhea. Authors propose to carry a total salpingectomy after a chosen surgical treatment.


2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Salma Ouassour ◽  
Abdelhai Adib Filali ◽  
Mohamed Raiss ◽  
Rachid Bezad ◽  
Zakia Tazi ◽  
...  

Background. Retroperitoneal ectopic pregnancy is extremely rare. This unusual location represents a great challenge for clinicians due to the difficulties of diagnosis and high risk of life-threatening complications. Case Report. We report the case of a spontaneous early pregnancy of undetermined location in a patient with a history of previous laparoscopic surgery. Diagnosis steps using clinical examination, ultrasound, and magnetic resonance imaging led to the localization of the pregnancy, in the left side of the para-aortic region, in the retroperitoneal space. Conclusion. Retroperitoneal ectopic pregnancy is an uncommon entity with rather complex pathogenesis. Clinicians should carefully interpret clinical signs, biological findings, and imaging features and be aware of unusual locations such as the retroperitoneum for ectopic pregnancies. Early diagnosis and appropriate management strategy are conditio sine qua non for successful treatment outcomes.


Author(s):  
Alfiya R ◽  
Sowparnika Treasa Sabu ◽  
Shaiju S Dharan

Methotrexate is a folic acid antagonist, it works by inhibiting the dihydrofolate by interfering with the DNA synthesis. Ectopic pregnancy is a life threatening condition that may cause maternal mortality. The main aim of this review to show the efficacy of systemic methotrexate and shows the importance of methotrexate treatment in management of ectopic pregnancy with surgical treatment and dosage regimen with protocol treatment. The selection criteria of candidates in this review is pregnant women with <5000miu/ml, adrenal mass <4cm, presence of peritoneum <100mland no sign of cardiac activity. Data collections are made from most relevant article between the periods of 1987-2020. Ectopic pregnancy is an emergency condition if not timely diagnosed and most of the cases where identified in first trimester.


2019 ◽  
Vol 3 (2) ◽  
pp. 142-150
Author(s):  
Widayat Widayat ◽  
Ariadi Ariadi

Objective: To report cases of ovarian pregnancyMaterials and Methods: This article describes a case report of a 33 year old woman, with a diagnosis of Ovarian Pregnancy at 6-7 weeks gravid G2P0A1H0. The patient came to the emergency room Dr. M. Djamil Padang. The ultrasound examination gives the impression of an ectopic pregnancy in the right ampulla tube. After laparoscopy, an ectopic pregnancy was seen in the right ovary without bleeding. Right ovarian pregnancy impression. Partial Oophorectomy was performed and tissue evacuation with bleeding during the procedure ± 30 cc.Results: Patients receiving laparoscopic intervention showed an ectopic pregnancy in the right ovary without bleeding, the left ovary was within normal limits. Right ovarian pregnancy impression. Partial Oophorectomy was performed and tissue evacuation with bleeding during the procedure ± 30 cc. The tissue was examined for histology of anatomic pathology.Conclusion: Ovarian pregnancy is one of the rarest forms of ectopic pregnancy, it is sometimes difficult to diagnose because it can be confused with tubal ectopic pregnancy or hemorrhagic ovarian cyst. Pregnancy ovaries can rupture in the first trimester of pregnancy.Keywords: Ovarian Pregnancy, Laparoscopy, Partial Oophorectomy


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