Twelve Week Ruptured Interstitial Ectopic Pregnancy

2020 ◽  
Vol 1 (1) ◽  
pp. 23-26
Author(s):  
Sadık Kükrer ◽  
Ayfer Pepekal Kukrer ◽  
Eren Haytoğlu ◽  
Erdal Yılmaz
Keyword(s):  
Maternal Mortality ◽  
Ectopic Pregnancy ◽  
Reproductive Age ◽  
Tubal Ectopic Pregnancy ◽  
Mortality And Morbidity ◽  
Life Threatening ◽  
Gestational Sac ◽  
Interstitial Ectopic Pregnancy ◽  
Ectopic Pregnancies ◽  
Related Mortality

Despite advancements in management and diagnosis, ruptured ectopic pregnancy is still a major reason for pregnancy-related mortality and morbidity. 2% of all pregnancies are ectopic pregnancy and interstitial ectopic pregnancy rate is 2-4% among all ectopic pregnancies. We should consider about it as an essential characteristic in each female of reproductive age that presents with the triad of amenorrhoea, unusual vaginal bleeding and abdominal irritation. It ruptures at a more sophisticated stage of gestation when compared with tubal ectopic pregnancy. Bleeding in interstitial ectopic pregnancy rupture is above that other ectopic pregnancies, also its life-threatening. Interstitial ectopic pregnancy rupture is two to five times greater compared to maternal mortality rate than tubal ectopic pregnancy rupture. Developing gestational sac causes uterine disruption and following hemorrhagic shock, resulting in morbidity and mortality. Clinics that aim to reduce maternal mortality should be much more concerned about convenient disclosure of this abnormal pregnancy condition.

scholarly journals Caesarean scar ectopic pregnancy

2018 ◽  
Vol 7 (5) ◽  
pp. 2038
Author(s):  
T. Ramani Devi ◽  
T. Sweta ◽  
C. Archana Devi
Keyword(s):  
Ectopic Pregnancy ◽  
Conservative Management ◽  
Abdominal Cavity ◽  
Delayed Diagnosis ◽  
Reproductive Age ◽  
Mortality And Morbidity ◽  
Caesarean Scar ◽  
Future Fertility ◽  
Laparoscopic Excision ◽  
Life Threatening

Ectopic pregnancy is a common cause of mortality and morbidity among the women of reproductive age group. Tubal pregnancy is the commonest.  It can occur in cervix, ovaries, previous caesarean scar, interstitial portion of the tube and abdominal cavity. Here we report a case of caesarean scar ectopic pregnancy which was managed conservatively. 31 yrs old gravid 3 previous 1 LSCS and 1 tubal ectopic come for antenatal consultation at 35 days of gestation. UPT was Positive. USG showed no evidence of intra uterine sac. Repeat scan after 10 days showed a gestational sac at the lower uterine segment scar. Hence it was decided for conservative management, injection methotrexate 50 mgm X 2 doses given. This was followed by misoprost vaginal insertion. Since patient did not expel the sac, injection PG F2 alpha 125 mg x 2 doses were given. Patient expelled the products of conception partially. This was followed by hysteroscopic guided evacuation.Caesarean scar ectopic was reported in 1978. Early diagnosis is by TV USG / MRI. Early ectopic can be treated medically. In delayed diagnosis, laparoscopic excision of the scar has to be done. In rupture of the scar site ectopic pregnancy laparotomy is indicated. In the event of heavy bleeding, hysterectomy has to be done. After conservative management and excision of the scar, fertility is not altered. Caesarean section scar pregnancy is a rare form of ectopic pregnancy which can lead to life threatening complications leading to mortality and morbidity. Treatment has to be individualized according to the gestational age, haemodynamic stability and desire for future fertility.

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 ASUHAN KEBIDANAN PADA NY. T USIA 28 TAHUN P1A2 POST CURETTAGE ATAS INDIKASI KEHAMILAN EKTOPIK TERGANGGU DENGAN TINDAKAN LAPAROTOMI DI RUMAH SAKIT SANTA ELIS

2018 ◽  
Vol 3 (1) ◽  
pp. 28-37
Author(s):  
Lismawati . ◽  
Ria Oktaviance
Keyword(s):  
Maternal Mortality ◽  
Pregnant Women ◽  
Ectopic Pregnancy ◽  
Final Report ◽  
Midwifery Care ◽  
Study Approach ◽  
High Prevalence ◽  
Life Threatening ◽  
Ectopic Pregnancies

Ectopic pregnancies are impaired including high-risk pregnancies that can be marked by either spotting or moderate bleeding that can be life-threatening to the mother. Based on worldwide WHO research, there is a maternal mortality of 500,000 lives per year and infant mortality in particular 10 million neonates per year. More than 60% of ectopic pregnancies occur in women aged 20-30 with low socio-economic and live in areas with high prevalence ofgonorrhea and tuberculosis prevalence. In Indonesia the maternal mortality rate is 330/100,000 live births. Maternal mortality is estimated at about 16,500-17,500 per year. One-third of them are due to falling-out services.Goals : Performing a Craving Care in Pregnant Women Mrs.T Age 28 years old G3P1A1 with Disturbed Ectopic Pregnancy using a seven step Varney approachMethods:Using descriptive method with case study approach implemented by author through approach of midwifery management. The case observed by the author in this Final Report is Mrs. T Age 28 years G3P1A1 with Disturbed Ectopic Pregnancy at Saint Elizabeth Hospital Medan Year 2018.Results: Gain real experience on the implementation of Midwifery care in pregnant women with Disturbed Ectopic Pregnancy at Saint Elizabeth Hospital Medan. Implementation of midwifery care in pregnant women with Disturbed Ectopic Pregnancy at Saint Elizabeth Hospital Medan is in accordance with the existing theory and hope can be used as input by students so as to provide broad insight into the quality of midwifery services according to midwifery care.Conclution : Standards through the approach of midwifery care management in pregnant women with Disturbed Ectopic Pregnancy.

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.

scholarly journals A rare case of unruptured tubal ectopic pregnancy at 14 weeks gestation with live foetus in situ and review of literature

2020 ◽  
Vol 10 (1) ◽  
pp. 422
Author(s):  
Jayanta K. Biswas ◽  
Vivek Tewari
Keyword(s):  
Ectopic Pregnancy ◽  
Rare Case ◽  
Average Duration ◽  
Uterine Cavity ◽  
Limited Resources ◽  
Review Of Literature ◽  
Tubal Ectopic Pregnancy ◽  
Life Threatening ◽  
Ectopic Pregnancies

Ectopic pregnancy is a condition, where the fertilized ovum implants anywhere other than normal uterine cavity. It is life threatening emergency condition and it can present in diverse ways. More than 95% of ectopic pregnancies usually occur in fallopian tube, ampulla being commonest site of tubal ectopic pregnancy. Diagnosis with location of pregnancy is usually possible by ultrasonography in 1st trimester. However, in most of the developing countries with limited resources, many women do not undergo ultrasonography and medical examination in early pregnancy, leading to late diagnosis. It may lead to life threatening presentation of ectopic pregnancy. Reported average duration of diagnosis of unruptured tubal ectopic pregnancy is usually between 5 to 9 weeks of gestation. Very rarely tubal ectopic pregnancy can remain asymptomatic and unruptured for longer than this usual period of gestation. The reported case is a rare case of viable, unruptured tubal ampullary ectopic pregnancy of 14 weeks of gestational age.

scholarly journals CPK: The new tool in the diagnosis of ectopic pregnancy

2017 ◽  
Vol 6 (6) ◽  
pp. 2507
Author(s):  
Suvarna Jyothi Ganta ◽  
Sunanda R. Kulkarni ◽  
Vidya Muralidhar
Keyword(s):  
Maternal Mortality ◽  
Ectopic Pregnancy ◽  
Diagnostic Dilemma ◽  
Diagnostic Efficacy ◽  
Mortality And Morbidity ◽  
Appropriate Treatment ◽  
Future Fertility ◽  
Maternal Mortality And Morbidity ◽  
The Mean ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is still a diagnostic dilemma presenting with various complaints. The classic triad of amenorrhea, abdominal pain, vaginal bleeding and /or syncope is not always seen. Misdiagnosis can lead to delay in treatment, blood loss is found to be the major cause of death. Early and accurate diagnosis is critical in bringing down the maternal mortality and morbidity. Prompt and effective treatment of an ectopic pregnancy can help preserve the chances of future healthy pregnancies. Aim of present study was to investigate whether creatinine phosphokinase (cpk) can be used as an effective diagnostic tool in the early diagnosis of ectopic pregnancy which can help in decreasing the maternal mortality and morbidityMethods: This observational comparative three group clinical study was conducted at Chinmaya Mission Hospital, Bangalore, between May 2016 to January 2017.120 women in their early trimester were studied of which 40 were diagnosed cases of ectopic pregnancies, 40 women presented with intrauterine abortive pregnancies and 40 women had normal healthy pregnancies. Serum CPK, serum B-HCG, vaginal scans were done in all, along with routine investigations.Results: The mean CPK values in normal, abortive and ectopic pregnancies were 36.92±6.44, 43.95±11.96 and 91.55±30.43 respectively. It was found to be significantly higher in ectopic Pregnancies. Also, the mean CPK in ruptured and unruptured ectopic pregnancy were 97.26±25.97 and 63.82±34.92 respectively.Conclusions: Present study shows that maternal CPK levels are significantly higher in women with ectopic pregnancies. CPK can serve as the reliable biochemical marker to diagnose ectopic pregnancy particularly ruptured. CPK can be used to increase the diagnostic efficacy in ectopic pregnancy, which followed by rapid and appropriate treatment can reduce the mortality, morbidity and preserve future fertility.

scholarly journals Transvaginal Aspiration of Ectopic Gestational Sac: A Novel Treatment Option in Tubal Ectopic Pregnancies

2015 ◽  
Vol 7 (1) ◽  
pp. 1-4
Author(s):  
Vineet V Mishra ◽  
Urmila Sharma ◽  
Ritu Agarwal
Keyword(s):  
Ectopic Pregnancy ◽  
Treatment Option ◽  
Transvaginal Ultrasound ◽  
Case Series ◽  
Ultrasound Guided ◽  
Tubal Ectopic Pregnancy ◽  
Novel Treatment ◽  
Transvaginal Aspiration ◽  
Gestational Sac ◽  
Ectopic Pregnancies

ABSTRACT Objective To present five cases of unruptured tubal ectopic pregnancies treated with ultrasound-guided aspiration with local potassium chloride (KCl) or systemic methotrexate (MTX) administration. Design Case series. Setting A hospital-based prospective study. Patients Five women with unruptured tubal ectopic pregnancy. Interventions Transvaginal ultrasound-guided aspiration of tubal ectopic pregnancy followed by local KCl or intramuscular injection of MTX (50 mg/m2). Main outcome measures Successful conservative treatment of tubal ectopic pregnancies with preservation of fallopian tubes. Results Four (80%) out of five women weres uccessfully treated, without the need for operative intervention. One patient required salpingectomy for ruptured ectopic pregnancy during the course of treatment. Conclusion Transvaginal ultrasound-guided aspiration of ectopic gestational sac along with either local KCl or systemic methotrexate administration can be safely used to treat unruptured tubal ectopic pregnancies in selected patient population. How to cite this article Mishra VV, Choudhary S, Sharma U, Agarwal R. Transvaginal Aspiration of Ectopic Gestational Sac: A Novel Treatment Option in Tubal Ectopic Pregnancies. J South Asian Feder Obst Gynae 2015;7(1):1-4.

Diagnosis of An Interstitial Ectopic Pregnancy with Two-Dimensional Transvaginal Sonography

Ultrasound ◽  
2009 ◽  
Vol 17 (2) ◽  
pp. 93-95
Author(s):  
Alison Peel
Keyword(s):  
Ectopic Pregnancy ◽  
Treatment Options ◽  
Expectant Management ◽  
Reproductive Age ◽  
Medical Emergency ◽  
Transvaginal Sonography ◽  
Threatening Condition ◽  
Life Threatening ◽  
Preservation Of Fertility ◽  
Interstitial Ectopic Pregnancy

Interstitial ectopic pregnancy is a medical emergency affecting women of reproductive age. Its presentation is late and is often misinterpreted as early miscarriage. If undiagnosed and allowed to progress to a significant gestation, rupture will occur with devastating maternal consequences. There are several treatment options available depending on a number of clinical factors; surgical, medical and expectant management. The most significant outcome is from early treatment, resulting in reduced maternal morbidity and preservation of fertility. The key to successful treatment is early detection. Ultrasound plays a major role in detection of this life threatening condition.

Sign in / Sign up

Export Citation Format

Share Document