Ruptured ectopic pregnancy following a cycle of freeze-all in vitro fertilization: A case report

We report the case of a 28-year-old nulliparous female with unexplained infertility who underwent freeze-all vaginal oocyte retrieval. Twenty-one days later she presented with vaginal bleeding (similar to menstruation) and right lower-quadrant pain. The results of ultrasound scanning and a laboratory work-up were consistent with an ectopic pregnancy. She underwent laparoscopic right salpingectomy for a tubal ectopic pregnancy. We recommend sexual abstinence during assisted reproduction to lower the risk of multiple pregnancy and especially of heterotopic pregnancy.
Source: Case Reports in Womens Health - Category: OBGYN Source Type: research

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Conclusion: We identified a subgroup of patients at higher risk of being infertile after the diagnosis of isthmocele and a subgroup of patients who could benefit the most in terms of fertility after minimally invasive hysteroscopic surgery. PMID: 31528130 [PubMed]
Source: Ochsner Journal - Category: General Medicine Tags: Ochsner J Source Type: research
SUMMARY An isthmocele, a cesarean scar defect or uterine niche, is any indentation representing myometrial discontinuity or a triangular anechoic defect in the anterior uterine wall, with the base communicating to the uterine cavity, at the site of a previous cesarean section scar. It can be classified as a small or large defect, depending on the wall thickness of the myometrial deficiency. Although usually asymptomatic, its primary symptom is abnormal or postmenstrual bleeding, and chronic pelvic pain may also occur. Infertility, placenta accrete or praevia, scar dehiscence, uterine rupture, and cesarean scar ectopic preg...
Source: Revista da Associacao Medica Brasileira - Category: General Medicine Source Type: research
This article provides an overview of the latest techniques and devices used for uterine-sparing surgical treatment of fibroids. While laparoscopic myomectomy is still the gold standard, novel laparoscopic and transcervical radiofrequency ablation techniques use low-voltage and alternating current to induce heat in the uterine tissue, which triggers necrosis in fibroids. This enables the removal of multiple fibroids without the need for large incisions in the uterine wall. In addition, we address the benefits and potential risks, as well as the impact on fertility and pregnancy, of the different surgical approaches used for...
Source: Surgical Technology International - Category: Surgery Tags: Surg Technol Int Source Type: research
Publication date: Available online 10 February 2019Source: Best Practice &Research Clinical Obstetrics &GynaecologyAuthor(s): Vasilios Tanos, Zara Abigail ToneyAbstractThe increasing rate of elective and indicated caesarean sections worldwide has led to new pathologies and management challenges. The number of patients undergoing trial of labor after caesarean section (TOLAC) is also increasing. Three professional societies provide detailed guidelines based on scientific evidence for the management of patients attempting vaginal birth after caesarean section (VBAC). However, they do not provide any recommendations f...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - Category: OBGYN Source Type: research
Publication date: Available online 10 February 2019Source: Best Practice &Research Clinical Obstetrics &GynaecologyAuthor(s): Vasilios Tanos, Zara Abigail ToneyAbstractThe increasing rate of elective and indicated caesarean sections worldwide has led to new pathologies and management challenges. The number of patients undergoing trial of labour after caesarean section (TOLAC) is also increasing. Three professional societies provide detailed guidelines based on scientific evidence for the management of patients attempting vaginal birth after caesarean section (VBAC). However, they do not provide any recommendations ...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - Category: OBGYN Source Type: research
ConclusionWhile pre-procedural pregnancy test should not be performed for all, a high index of suspicion for early pregnancy should be maintained as undetected ectopic and heterotopic pregnancies could lead to serious complications once the HSG is done.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
ConclusionWhile pre-procedural pregnancy test should not be performed for all, a high index of suspicion for early pregnancy should be maintained as undetected ectopic and heterotopic pregnancies could lead to serious complications once the HSG is done.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
The objective of this study was to demonstrate a markedly enlarged isthmocele, that resulted in the miscarriage of a 12-week IVF twin pregnancy.
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Source Type: research
Objective: Caesarean scar defect, or isthmocele, is a reservoir type pouch on the anterior wall of the uterine isthmus caused by inappropriate healing of the lower segment incision after caesarean section. The incidence of caesarean scar defects is reported to be as high as 84%, and is increasing due to the rising rates of caesarean sections worldwide. Caesarean scar defects may be asymptomatic, or cause a number of gynaecologic and obstetric sequealae, including abnormal bleeding, pelvic pain, infertility and ectopic scar pregnancy.
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Source Type: research
Uterine myomas are common benign monoclonal tumors with extremely low potential for malignancy. They are estimated to be present in up to 70% of women of reproductive age [1], with a higher incidence in obese women and those of African American descent, and when symptomatic, a frequent indication for gynecologic surgery. Although the presence of myomas may be associated with a plethora of symptoms including pelvic pain, abnormal uterine bleeding, infertility/subfertility, and adverse pregnancy outcomes [2], the vast majority of women with uterine fibroids are asymptomatic.
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Tags: Perspective Source Type: research
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