Live birth after treatment of a spontaneous ovarian heterotopic pregnancy: a case report

We report the case of a healthy 32-year-old woman, gravida 4, para 3, who presented to the emergency room with severe abdominal pain. Two weeks earlier, pelvic ultrasound had revealed a 6-week intrauterine pregnancy. She was hemodynamically stable, but had rebound tenderness on the right iliac fossa. Transvaginal ultrasound revealed an evolutive intrauterine pregnancy with a gestational age (GA) of 8 weeks, with a synchronous evolutive adnexal pregnancy of the same GA and some free fluid in the pouch of Douglas. She underwent an urgent laparoscopy which showed an intact gestational sac containing an embryo on the right ovary associated with mild hemoperitoneum. An ovarian wedge resection was performed to preserve ovarian tissue. The intrauterine pregnancy had no complications and the patient delivered vaginally at term.Heterotopic pregnancy is potentially life-threatening. Despite being extremely rare after natural conception, and even more so in the absence of major risk factors, it should be considered in any pregnant woman with abdominal pain. A high index of suspicion is important for a prompt diagnosis, selection of the appropriate surgical treatment and successful obstetric outcomes.
Source: Case Reports in Womens Health - Category: OBGYN Source Type: research

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Prediction of Adnexal Torsion by Ultrasound in Women with Acute Abdominal Pain. Ultraschall Med. 2019 Nov 08;: Authors: Bardin R, Perl N, Mashiach R, Ram E, Orbach-Zinger S, Shmueli A, Wiznitzer A, Hadar E Abstract PURPOSE:  To investigate the accuracy of ultrasound in the diagnosis of adnexal torsion. MATERIALS AND METHODS:  Retrospective cohort analysis of 322 women, presenting to a tertiary medical center with acute abdominal pain, who underwent gynecological examination, sonographic evaluation and laparoscopic surgery, between 2010 and 2016. Findings for adnexal torsi...
Source: Ultraschall in der Medizin - Category: Radiology Authors: Tags: Ultraschall Med Source Type: research
AbstractBackgroundEndometriosis can exert obvious negative effects on women ’s quality of life.Excisional surgery is among the most effective treatments for severe pelvic endometriosis. The prevalence of severe pelvic adhesions following a laparoscopic examination of severe endometriosis varies between 50 and 100%. Temporary intraoperative ovarian suspension is a method for the reduction of adhesions is in the treatment of severe pelvic endometriosis. Given the importance and the prevalence of endometriosis and its complications, we conducted the present study to determine more effective adhesion-reducing methods wit...
Source: Gynecological Surgery - Category: OBGYN Source Type: research
ConclusionCEP is a variant of EP with low or absent trophoblast activity. A prolonged clinical course is typical and surgery is the mainstay of treatment.
Source: Archives of Gynecology and Obstetrics - Category: OBGYN Source Type: research
Conclusion: Healthcare providers should have a high index of clinical suspicion for ectopic pregnancies. Unilateral tubal twin ectopic pregnancies, while rare, can be adequately diagnosed with transvaginal ultrasound. Laparoscopic salpingostomy provides conservative and successful treatment of unilateral tubal twin gestation with short recovery time. Medical treatment with methotrexate has not been adequately studied in this clinical scenario, but further exploration of this management modality should be considered. PMID: 31258432 [PubMed]
Source: Ochsner Journal - Category: General Medicine Tags: Ochsner J Source Type: research
We present a patient that was admitted to our department with amenorrhea, positive ßhCG and acute abdomen. Emergency laparoscopy was performed but no ectopic pregnancy was found, just blood, coagula and a ruptured corpus luteum. The day after the surgery, intrauterine pregnancy was found on ultrasound and the pregnancy ended with term delivery. PMID: 31168219 [PubMed - in process]
Source: Acta Clinica Croatica - Category: General Medicine Tags: Acta Clin Croat 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
CONCLUSIONImmediate explorative laparoscopic surgery is a potentially safe and useful strategy for treating ovarian torsion during the early first trimester of pregnancy.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
ConclusionLaparoscopic removal of perforated IUD during pregnancy under regional anesthesia is a feasible and safe option that should be considered when needed.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Conclusion Four types of USL endometriosis were summarized according to the ultrasound characteristics and the distribution of USL involvement was also concluded according to the results of surgery. TVS has significant value in diagnosis of USL endometriosis and can be used as a first-line tool for diagnosis. Ethics Statement The Medical Science Ethics Committee of Shenzhen People’s Hospital approved this study (No. 2018100). Each patient or an appropriate family member provided informed written consent to obtain clinical materials. Author Contributions YZ and BD conceived and designed the whole experiments and ...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
CONCLUSIONS: The accuracy of pre-operative ultrasound diagnosis of EUEP is high. The morphological type of EUEP on TVS had no significant effect on the accuracy of pre-operative diagnosis. This article is protected by copyright. All rights reserved. PMID: 30937982 [PubMed - as supplied by publisher]
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research
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