scholarly journals P27.01: Why are some ectopic pregnancies characterized as pregnancies of unknown location at the initial transvaginal ultrasound examination? 3-D volumetric transvaginal evaluation of the ectopic pregnancy mass

2011 ◽  
Vol 38 (S1) ◽  
pp. 255-255
Author(s):  
S. Winder ◽  
S. Pixton ◽  
M. Mongelli ◽  
S. Reid ◽  
I. V. Casikar ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Ultrasound Examination ◽  
Transvaginal Ultrasound ◽  
Ectopic Pregnancies

Ectopic pregnancy outcomes in patients discharged from the emergency department

CJEM ◽  
2018 ◽  
Vol 21 (1) ◽  
pp. 71-74
Author(s):  
Krista Hawrylyshyn ◽  
Shelley L. McLeod ◽  
Jackie Thomas ◽  
Catherine Varner
Keyword(s):  
Emergency Department ◽  
Ectopic Pregnancy ◽  
Chart Review ◽  
Transvaginal Ultrasound ◽  
Tertiary Care ◽  
Expectant Management ◽  
Retrospective Chart Review ◽  
Missed Abortion ◽  
Ectopic Pregnancies ◽  
Rule Out

AbstractObjectiveThe objective of this study was to determine the proportion of women who had a ruptured ectopic pregnancy after being discharged from the emergency department (ED) where ectopic pregnancy had not yet been excluded.MethodsThis was a retrospective chart review of pregnant (<12-week gestational age) women discharged home from an academic tertiary care ED with a diagnosis of ectopic pregnancy, rule-out ectopic pregnancy, or pregnancy of unknown location over a 7-year period.ResultsOf the 550 included patients, 83 (15.1%) had a viable pregnancy, 94 (17.1%) had a spontaneous or missed abortion, 230 (41.8%) had an ectopic pregnancy, 72 (13.1%) had unknown outcomes, and 71 (12.9%) had other outcomes that included therapeutic abortion, molar pregnancy, or resolution of βHCG with no location documented. Of the 230 ectopic pregnancies, 42 (7.6%) underwent expectant management, 131 (23.8%) were managed medically with methotrexate, 29 (5.3%) were managed with surgical intervention, and 28 (5.1%) patients had a ruptured ectopic pregnancy after their index ED visit. Of the 550 included patients, 221 (40.2%) did not have a transvaginal ultrasound during their index ED visit, and 73 (33.0%) were subsequently diagnosed with an ectopic pregnancy.ConclusionThese results may be useful for ED physicians counselling women with symptomatic early pregnancies about the risk of ectopic pregnancy after they are discharged from the ED.

scholarly journals OC59: A single transvaginal ultrasound examination as a test for ectopic pregnancy

2007 ◽  
Vol 30 (4) ◽  
pp. 385-385
Author(s):  
E. Kirk ◽  
A. T. Papageorghiou ◽  
G. Condous ◽  
L. Tan ◽  
S. Bora ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Ultrasound Examination ◽  
Transvaginal Ultrasound

scholarly journals Twin cervical pregnancy: a unique case report

2018 ◽  
Vol 7 (8) ◽  
pp. 3407
Author(s):  
Karthik Chandra Bassetty ◽  
Rina Dutta Ahmed ◽  
Mukesh Fogla
Keyword(s):  
Medical Treatment ◽  
Ectopic Pregnancy ◽  
Transvaginal Ultrasound ◽  
Late Gestation ◽  
Management Options ◽  
Unique Case ◽  
Cervical Pregnancy ◽  
Ectopic Gestation ◽  
Ectopic Pregnancies ◽  
Cervical Ectopic Pregnancy

Cervical ectopic pregnancy is implantation of an embryo into the cervical mucosa below the level of the internal os. Cervical pregnancy is an infrequent form of ectopic gestation both in naturally conceived pregnancies and even after assisted reproductive technology (ART). It accounts for less than 1% of all ectopic pregnancies. The diagnosis can be missed as a case of incomplete abortion unless an experienced sonologist performs a transvaginal ultrasound. Management options vary and depend on the gestational age at diagnosis, general condition of the patient and woman’s desire to maintain fertility. Medical treatment with methotrexate is the therapy of choice in early gestation with hemodynamically stable patient. Surgical intervention is indicated in late gestation, unstable cases or failed medical treatment. At times hysterectomy is elected as the final path when bleeding does not subside. We present an unique case of twin cervical ectopic pregnancy managed initially conservatively later surgical management was undertaken in view of bleeding.

scholarly journals Atypical ectopic pregnancy: a nightmare for the gynaecologist

2021 ◽  
Vol 10 (11) ◽  
pp. 4304
Author(s):  
Bikram Bhardwaj ◽  
Aruna Menon ◽  
Souvik Nandy ◽  
Santosh .
Keyword(s):  
Ectopic Pregnancy ◽  
Transvaginal Ultrasound ◽  
Armed Forces ◽  
Pain Abdomen ◽  
Beta Hcg ◽  
Surgical Methods ◽  
Maternal Morbidity And Mortality ◽  
Ectopic Pregnancies ◽  
Classical Triad ◽  
Atypical Presentations

Ectopic pregnancy is one of the leading causes of maternal morbidity and mortality in early pregnancy. Incidence of ectopic pregnancy is 2% of total reported pregnancies and is rising in the recent past due to increase in RTIs and STIs and even early diagnosis due to advancing technology. Classical triad of pain abdomen, bleeding p/v and amenorrhea is not present in all the cases which add to confusion in diagnosing these atypical presentations. A meticulous history and clinical examination along with combination of transvaginal ultrasound (TVS) and serum beta HCG levels (discriminatory zone) can aid in picking up these atypical cases as depicted in our study. Here, we discussed 7 cases of atypical presentations of ectopic pregnancy which reported to gynaecology OPD of a service hospital of armed forces in a span of 3 months. One patient had pregnancy test negative, one patient was repeatedly treated as a case of AUB, 2 cases of heterotopic pregnancies, 1 case of elderly cornual ectopic and 2 young cases reporting one with repeated episodes of gastritis and other with post tubectomy status. The cases were managed accordingly using surgical methods. Ectopic pregnancy is like a tornado which if not diagnosed in time may prove fatal. Atypical presentation of ectopic pregnancies not fitting into the well-known triad of ectopic pregnancies these days add to confusion. One really needs to be ectopic minded if we actually want to avoid this catastrophe & save these young mothers.

scholarly journals Cervical ectopic pregnancy: a rare case report

2018 ◽  
Vol 7 (6) ◽  
pp. 2506
Author(s):  
Indu Verma ◽  
Charvi Chugh ◽  
Unmesh Santpur ◽  
Pratibha Pundhir
Keyword(s):  
Ectopic Pregnancy ◽  
Ultrasound Examination ◽  
Delayed Diagnosis ◽  
Lower Abdominal Pain ◽  
Rare Condition ◽  
Successful Management ◽  
Tubal Ectopic Pregnancy ◽  
Rare Case Report ◽  
Ectopic Pregnancies ◽  
Cervical Ectopic Pregnancy

Cervical ectopic pregnancy is rare condition which occurs in less than 1% of all ectopic pregnancies. Early diagnosis is a key to successful management; delayed diagnosis can lead to significant morbidity and fertility loss of the mother. We present a case of woman who presented with vaginal bleeding and lower abdominal pain for 3 days following amenorrhea of 3 ½ months. Ultrasound examination done outside was suggestive of left tubal ectopic pregnancy whereas scan done at our hospital indicated either uterine rupture within intraperitoneal sac or a cervical ectopic pregnancy. She was taken up for laparotomy and hysterectomy since she was bleeding profusely, and it was lifesaving.

scholarly journals Cesarean Scar Ectopic Pregnancy: Treatment Decision Algorithm and Success With Medical Treatment

2021 ◽  
Author(s):  
Lorena Sabonet Lorente ◽  
Ana I. Guzman Leon ◽  
Pilar Espejo Reina ◽  
José Ramón Anderica Herrero ◽  
Ernesto Gonzalez Mesa ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Transvaginal Ultrasound ◽  
Treatment Options ◽  
Expectant Management ◽  
Treatment Decision ◽  
Maternal Condition ◽  
Decision Algorithm ◽  
Cesarean Scar ◽  
Future Fertility ◽  
Ectopic Pregnancies

Background Cesarean scar ectopic pregnancies are a rare form of extrauterine pregnancies, yet their incidence has increased along with the rise in the number of cesarean deliveries. As with other ectopic pregnancies, cesarean scar ectopic pregnancies pose a greater risk for maternal hemorrhage and ultimately maternal mortality. Case presentation We present a series of clinical cases of cesarean scar ectopic pregnancy diagnosed by transvaginal ultrasonography. Each patient received an individualized treatment: the rate of success depended on the particular maternal condition in each case. Due to the low frequency of this entity, there are no clear protocols for its treatment and thus there are numerous options for treatment and follow up: expectant management, medical therapy, surgical intervention, uterine artery embolization or a combined approach. Each method has different levels of success and is dependent on the surgeon&rsquo;s skill and patient presentation. The transvaginal ultrasound is necessary to obtain the fine details of the gestation sac and its relation to the scar and must be followed by a meticulous abdominal scan with a full bladder. Conclusion Herein, we present a rare pathological phenomenon whose frequency is on the rise, and for which transvaginal ultrasound and flow doppler provide high diagnostic accuracy. Early diagnosis of cesarean scar ectopic pregnancies offers treatment options to that may help avoid uterine rupture and bleeding, thus preserving the uterus and future fertility.

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 Kehamilan Pada Jejas Luka Sesar: Diagnosis Yang Akurat Dan Keberhasilan Dalam Tatalaksana Secara Konservatif

2020 ◽  
Vol 4 (1) ◽  
pp. 114-119
Author(s):  
Satrio Budhi Purnomo ◽  
Dovy Djanas
Keyword(s):  
Ectopic Pregnancy ◽  
Conservative Therapy ◽  
Ultrasound Examination ◽  
Transvaginal Ultrasound ◽  
Bladder Wall ◽  
Cervical Canal ◽  
Intrauterine Pregnancy ◽  
Cesarean Scar ◽  
Life Threatening ◽  
History Of

Reported case in a woman aged 30 years, with a history of cesarean scar four years ago, diagnosed with gravid two by one gravid 7-8 weeks with gestation on cesarean scar. The patient had a history of accidental trauma two days prior to the complaint of bleeding from the genitals. Several obstetricians have examined but still obtained different results (intrauterine pregnancy and ectopic pregnancy). An accurate diagnosis is critical to the success of the management of a patient with a pregnancy with this life-threatening cesarean scar. With a precise and accurate transvaginal ultrasound examination, the diagnostic criteria with ultrasound on previous surgical scars have been fulfilled in this patient, including an empty uterus, an empty cervical canal image, growth of a gestational pouch in the anterior lower segment of the uterus, and the absence of myometral image between the bladder wall and the gestational pocket. On B-HCG examination, the result was 58,808.70 mlU / mL. Conservative therapy with metrotrexate (MTX) 50 mg / m2 intramuscularly. After giving metrotrexate (MTX) therapy for four times, the results of B-HCG decreased significantly with 21.530, 12 mlU / mL, 2,949.47 mlU / mL, and 593.61 mlU / mL, respectively. After administration of metrotrexate (MTX) therapy, there was a decrease in the size of the gestational bag. Keywords: Ectopic, Pregnancy, Methotrexate, Cesarean Section

scholarly journals Ectopic Twin Pregnancy : About A Case

2020 ◽  
Vol 4 (4) ◽  
Keyword(s):  
Emergency Room ◽  
Ectopic Pregnancy ◽  
Health Care Providers ◽  
Twin Pregnancy ◽  
Transvaginal Ultrasound ◽  
Cardiac Activity ◽  
Care Providers ◽  
Ectopic Pregnancies ◽  
Laparoscopic Salpingectomy ◽  
The Right

Unilateral tubal twin pregnancies occur in approximately 1 in 125,000 spontaneous pregnancies. Due to the lack of data, there are few recommendations on the appropriate management of a twin tubal ectopic pregnancy. We report a CLINICAL CASE of A 28-year-old woman, with type 1 diabetes on insulin and with no significant surgical or gynaecological history, the patient presented to the emergency room for metrorragia evolving for two days in a context of 6sa-2j amenorrhea. Clinical examination finds a hemodynamically stable patient, a depressible flexible abdomen with sensitivity to the right iliac pit and a slightly painful reversed uterus has mobilization with a moderate bleeding abundance of endo uterine origin. The emergency room urine pregnancy test was positive. Beta Hcg serum was 3,966 mUI/ml. Transvaginal ultrasound showed a reversed empty uterus, a fine and homogeneous endometrium of 7.8 mm with the presence at the right tubal level of two gestational bags measuring (7.2mm5.8mm) and (7mm-5.6 mm) with two embryos of 3.8mm and 3.6mm respectively, both had positive cardiac activity. at the douglas bag cul level, the presence of an effusion blade. the diagnosis of bi-amniotic bi-horoial bi-chorial ectopic pregnancy was made.a laparoscopy was performed with a right salpingectomy. postoperative evolution was favourable. Health care providers should have a high index of clinical suspicion for ectopic pregnancies. Unilateral tubal twin ectopic pregnancies, although rare, can be correctly diagnosed by transvaginal ultrasound. Laparoscopic salpingectomy provides an effective treatment for unilateral tubal twin gestation with a short recovery time. Due to the lack of data in the literature, there are few recommendations on the appropriate management of an ectuous ectopic twin pregnancy.

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