Heterotopic pregnancy; case report

2019 ◽  
Vol 7 (05) ◽  
Author(s):  
Vipul R. Khandagale
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Adnexal Mass ◽  
Heterotopic Pregnancy ◽  
Free Fluid ◽  
Threatening Condition ◽  
Life Threatening ◽  
Ectopic Pregnancies ◽  
High Index Of Suspicion ◽  
Low Risk Women

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.

scholarly journals Clinical study on presentation and management of ectopic pregnancies in a tertiary care centre

2019 ◽  
Vol 9 (1) ◽  
pp. 173
Author(s):  
Anjum Ara ◽  
Indu Chawla ◽  
Rasika Agarwal ◽  
Bangali Manjhi
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Treatment Modality ◽  
Adnexal Mass ◽  
Care Center ◽  
Tertiary Care ◽  
Uterine Cavity ◽  
Free Fluid ◽  
Tertiary Care Centre ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy means pregnancy outside the normal uterine cavity. It is the leading cause of maternal morbidity and mortality in first trimester. Early diagnosis and timely intervention can significantly improve the outcomes.Methods: Retrospective observational study done in the department of obstetrics and gynecology ABVIMS and Dr. RML hospital, New Delhi from January 2016 to March 2019. Case records of 76 patients of confirmed ectopic pregnancy were retrieved and studied from the medical record section. The main aims were to see the clinical presentation, mode of diagnosis, predisposing risk factors; treatments offered and associated morbidity and mortality.Results: The incidence of ectopic pregnancy in present study was 1.7%, highest in 21 to 30 years age multiparous patients. 85.1% presented as acute emergencies, 75% patients had classic triad of amenorrhea, pain and bleeding. Pain was the commonest symptom in 96.1%. The commonest clinical sign was adnexal mass and tenderness. Ultrasound findings had adnexal mass in 98.7% and free fluid in 84.7% cases with empty uterus in 100%. 90.7 % case were tubal ectopic and 69.73 % were ruptured. Surgery was the main treatment modality in 96.0% cases. Salpingectomy was the commonest surgery in 80.25%. There was 0% mortality and 78.9% cases required blood transfusions, 44.7% patients had no known risk factors whereas some of the common identifiable risk factors were history of previous abortion, previous pelvic surgeries and pelvic inflammatory disease.Conclusions: ABVIMS and Dr. RML hospital is a tertiary care center so majority of patients with ectopic pregnancies presented late, as such surgery was the main treatment modality but there was 0% mortality in our study. Conservative treatments such as laparoscopy and medical management can also be offered to hemodynamically stable patients.

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 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

scholarly journals Spontaneous Heterotopic Pregnancy: Dual Case Report and Review of Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Annika Chadee ◽  
Shadi Rezai ◽  
Catherine Kirby ◽  
Ekaterina Chadwick ◽  
Sri Gottimukkala ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Rare Complication ◽  
Heterotopic Pregnancy ◽  
Pelvic Surgery ◽  
Intrauterine Pregnancy ◽  
Fertility Treatments ◽  
Populations At Risk ◽  
History Of ◽  
High Index Of Suspicion

Introduction.Heterotopic pregnancy is a rare complication usually seen in populations at risk for ectopic pregnancy or those undergoing fertility treatments. It is a potentially dangerous condition occurring in only 1 in 30,000 spontaneous pregnancies. With the advent of Assisted Reproduction Techniques (ART) and ovulation induction, the overall incidence of heterotopic pregnancy has risen to approximately 1 in 3,900 pregnancies. Other risk factors include a history of pelvic inflammatory disease (PID), tubal damage, pelvic surgery, uterine Mullerian abnormalities, and prior tubal surgery. Heterotopic pregnancy is a potentially fatal condition, rarely occurring in natural conception cycles. Most commonly, heterotopic pregnancy is diagnosed at the time of rupture when surgical management is required.Case.This paper represents two cases of heterotopic pregnancies as well as a literature review.Conclusion.Heterotopic pregnancy should be suspected in patients with an adnexal mass, even in the absence of risk factors. Clinicians must be alert to the fact that confirming an intrauterine pregnancy clinically or by ultrasound does not exclude the coexistence of an ectopic pregnancy. A high index of suspicion in women is needed for early and timely diagnosis, and management with laparotomy or laparoscopy can result in a favorable and successful obstetrical outcome.

scholarly journals A rare case of lower segment scar pregnancy

2020 ◽  
Vol 9 (6) ◽  
pp. 2610
Author(s):  
Jaydeep Bhatu ◽  
Nikhil A. Anand ◽  
Ankita B. Chaudhari
Keyword(s):  
Ectopic Pregnancy ◽  
Histopathological Examination ◽  
False Negative ◽  
Lower Uterine Segment ◽  
Caesarean Scar ◽  
Anterior Position ◽  
Threatening Condition ◽  
Life Threatening ◽  
Gestational Sac ◽  
Ectopic Pregnancies

Caesarean scar ectopic is one of the rarest of all ectopic pregnancies. The incidence of caesarean scar ectopic has increased due to increase in number of caesarean deliveries. A 31-year-old woman (G4P3003) presented from an outside facility to Sola Civil Hospital with vaginal bleeding and discharge with no abdominal pain or any discomfort. The gestational sac was located in an anterior position toward the anterior lower uterine segment at the level of prior caesarean scar with little visible myometrium noted anterior to the gestational sac in the lower uterine segment and Tissue was sent for histopathological examination and diagnosis of caesarean scar ectopic pregnancy was confirmed. Reports found that It is life threatening condition, causes excessive hemorrhage and risk of uterine rupture. The diagnosis of this type of ectopic pregnancy is very difficult and false negative diagnosis can lead to major complications.

Ruptured ectopic pregnancy: risk factors for a life-threatening condition

2008 ◽  
Vol 279 (5) ◽  
pp. 621-623 ◽  
Author(s):  
Michael Sindos ◽  
Athanasia Togia ◽  
Theodoros N. Sergentanis ◽  
Apostolos Kabagiannis ◽  
Fotodotis Malamas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Pregnancy Risk ◽  
Threatening Condition ◽  
Life Threatening

scholarly journals Trends in ectopic pregnancy: a retrospective clinical study of 79 cases

2017 ◽  
Vol 6 (7) ◽  
pp. 3009
Author(s):  
Sindhura M. ◽  
Sailatha R. ◽  
Famida A. M. ◽  
Vijayalakshmi K. ◽  
Sathiya S. ◽  
...  
Keyword(s):  
Risk Factors ◽  
Early Diagnosis ◽  
Ectopic Pregnancy ◽  
Conservative Management ◽  
Sexual Practices ◽  
Age Group ◽  
Future Fertility ◽  
Retrospective Clinical Study ◽  
Ectopic Pregnancies ◽  
High Index Of Suspicion

Background: To know the age group, parity, risk factors, clinical features, modalities of treatment employed and their efficacies, morbidity and mortality associated with ectopic pregnancy.Methods: This is a retrospective study conducted in the department of Obstetrics and Gynaecology at Chettinad Hospital and Research Institute; Chennai over a period of 3 years from January 2014 to December 2016. A total number of 79 cases of ectopic pregnancies were reported during this period. Data were collected, tabulated and analyzed.Results: 79 cases were diagnosed as ectopic pregnancies during the study period giving an incidence of 3.49%. Incidence of cases was maximum in women between the age group of 26-30 years (40.50%), in multiparous women (72.15%) and also in women of gestational age between 6 to 10 weeks (81.01%).72% of the cases had one or more identifiable risk factors. Ruptured ectopic was observed in 45 (56.96%)cases while unruptured in 31 (39.24%) cases. Tubal abortion was found in 3 (3.74%) cases. 2.53% cases were expectantly managed. 34.17% cases were medically managed. 63.29% cases were managed surgically. Morbidity due to ectopic pregnancy included anaemia, wound infection, SICU admission. No mortality observed.Conclusions: A high index of suspicion is needed in the diagnosis of ectopic pregnancy especially in women with high risk factors to arrive at early diagnosis, followed with conservative management, thus reducing the morbidity. We can reduce the incidence of ectopic pregnancy by awareness on safe sexual practices and contraception. The lady’s future fertility can be improved by focusing on prevention, early diagnosis and conservative management of ectopic pregnancy.

scholarly journals Ectopic pregnancy at Soavinandriana hospital center, Antananarivo, Madagascar

2018 ◽  
Vol 6 (8) ◽  
pp. 2596
Author(s):  
Romuald Randriamahavonjy ◽  
Hary F. Rabarikoto ◽  
Fy N. A. T. Mahefarisoa ◽  
Tanjona A. Ratsiatosika ◽  
Hery R. Andrianampanalinarivo
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Reproductive Potential ◽  
First Trimester ◽  
Early Presentation ◽  
Induced Abortions ◽  
Life Threatening ◽  
Β Hcg ◽  
Ectopic Pregnancies ◽  
A Prospective Study

Background: In the first trimester pregnancy, ectopic pregnancy is the most life-threatening gynecological emergency. The aim of this study was to estimate the epidemiological, diagnostic and therapeutic aspects of ectopic pregnancy in Antananarivo, Soavinandriana Hospital Center.Methods: This was a prospective study carried out among consecutive patients of ectopic pregnancy admitted from January 2014 to February 2016. All cases of diagnosed ectopic pregnancy admitted and managed in the gynecological ward were included in the study. These were reviewed and information was extracted regarding women characteristics, clinical features, diagnosis, management and post-operative complications.Results: During this period, there were 41 ectopic pregnancies. The incidence was therefore 20/1000 births. The mean age was 32,26years. The peak age of incidence was the 30-39 years age group. Nulliparous were the most sufferers. The commonest risk factors identified were previous genital infection. (n=17; 41,46%) previous induced abortions (n=15; 36,58%) and the age ≥35 years old (n =16; 39,02%). Twenty seven patients (n=11) did not have a quantitative measurement of the β subunit of human chorionic gonadotropin (β-hCG). Pelvic ultrasound (transabdominal) was performed on all patients. The majority of patients had a laparotomy (n=35, 85,36%). Tubal pregnancies were noted in 90% (n=37) cases.Conclusions: Health educations on early presentation in hospitals are expected to reduce the incidence of EP and the consequent loss of reproductive potential. The majority of risk factors we identified can be early detected and treated.

scholarly journals Study of demography and clinical profile of ectopic pregnancies in a tertiary level hospital in Uttarakhand: a five year review

2020 ◽  
Vol 9 (5) ◽  
pp. 2127
Author(s):  
Shweta Nimonkar ◽  
Priyanka Chaudhari ◽  
Namrata Saxena ◽  
Vineeta Gupta ◽  
Archna Tandon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Maternal Mortality ◽  
Ectopic Pregnancy ◽  
Clinical Signs ◽  
Clinical Profile ◽  
Hilly Region ◽  
Risk Of Rupture ◽  
Life Threatening ◽  
Ectopic Pregnancies ◽  
Associated Risk Factors

Background: Ectopic pregnancy is a condition when a fertilized ovum is implanted outside the uterine cavity. Life threatening risk of rupture of ectopic pregnancy remains one of the important causes of maternal mortality in India. The aim of study is to analyse the clinical profile, associated risk factors, complications, treatment outcomes to improve maternal mortality and morbidity associated with ectopic pregnancy.Methods: It is a retrospective study conducted at Shri Guru Ram Rai Institute of Medical and Health Sciences from January 2015 to January 2020. A total of 182 patients diagnosed of Ectopic Pregnancy were analysed for clinical profile, risk factors, serology, ultrasound findings, complications, treatment offered and outcome.Results: During the study period of 5 years there were total 182 patients who were diagnosed of ectopic pregnancy showing the incidence of ectopic pregnancy in our hospital 1.4% of total number of deliveries. Majority of patients were in the age group of 25 to 30 years (43.95%). Mostly multiparous women (80.1%) had ectopic pregnancy. Majority of patients (56.1%) had no associated risk factors for ectopic pregnancy. Main presenting complain was abdominal pain in 58.8% of patients. Majority of patients (63.2%) had surgery as primary care which indicates delay in diagnosis and arrival at hospital especially in hilly region of Uttarakhand.Conclusions: Ectopic pregnancies need to be diagnosed timely to decrease maternal morbidities and mortalities.  Clinical signs and symptoms with serology (Serum beta hCG) and radiological findings helps to optimize treatment for potentially life-threatening condition.

scholarly journals Cervical Ectopic Pregnancy: A Puzzling Event

2014 ◽  
Vol 13 (2) ◽  
pp. 63-66
Author(s):  
Shahana Begum ◽  
Afroza Ferdous ◽  
Munawar Sultana ◽  
Rowshan Ara Begum
Keyword(s):  
Ectopic Pregnancy ◽  
Uterine Cavity ◽  
First Trimester ◽  
Conservative Approach ◽  
Severe Hemorrhage ◽  
Threatening Condition ◽  
Life Threatening ◽  
Emergency Hysterectomy ◽  
Ectopic Pregnancies ◽  
Cervical Ectopic Pregnancy

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

Sign in / Sign up

Export Citation Format

Share Document