1/15. broad ligament twin pregnancy following in-vitro fertilization.We report the first case of an ectopic twin pregnancy in the broad ligament following in-vitro fertilization and embryo transfer in a patient with a previous ipsilateral (left) salpingo-oophorectomy. The previous surgery was for endometriosis. We discuss the possible contribution of the embryo transfer technique, limitations of preventive measures and importance of transvaginal ultrasound in establishing the diagnosis.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
2/15. Extrauterine abdominal pregnancy: report of a case.A healthy, 34-year-old, gravida 3, para 1,011, patient presented for cesarean delivery in her 35th week of gestation with a diagnosis of complete placenta previa. During her 26th week of gestation, the patient was admitted to a high-risk obstetric unit with the diagnosis of premature rupture of membranes. Numerous ultrasonographic studies were conducted throughout her 10-week hospital stay, confirming the admitting diagnosis. A routine cesarean section was planned, and preparations were made for a potential increase in blood loss related to the placenta previa. The procedure began under spinal anesthesia and, upon incision of the abdomen, an extrauterine pregnancy was identified. The patient was immediately anesthetized and intubated at the request of the surgeon. During the 3-hour surgical procedure, the patient sustained massive blood loss, transfusions, central line placement, and aggressive pharmacological therapy. The patient was extubated the day after surgery, and was discharged approximately 1 week later. The only major complication was compartment syndrome of the left upper extremity related to the infiltration of vasopressors requiring fasciotomy and closure 2 days later. The incidence, morbidity/mortality, and anesthetic implications of abdominal pregnancy are reviewed.- - - - - - - - - - ranking = 0.00036028003354798keywords = membrane (Clic here for more details about this article) |
3/15. Primary peritoneal pregnancy: a case report.A 22-year-old primipara using intrauterine contraceptive device was diagnosed to be in haemorrhagic shock due to acute ruptured ectopic pregnancy. At laparotomy, both tubes and ovaries were normal and products of conception were found to be implanted on the posterior surface of uterus near the attachment of right uterosacral ligament producing a haemoperitoneum of more than 2 l. This is the fourth case report of primary abdominal pregnancy associated with intrauterine contraceptive device (IUCD).- - - - - - - - - - ranking = 0.2keywords = ligament (Clic here for more details about this article) |
4/15. Primary peritoneal pregnancy implanted on the uterosacral ligament: a case report.Peritoneal pregnancies are classified as primary and secondary. Primary implantation on the peritoneum is extremely rare in extrauterine pregnancy and is a potentially life-threatening variation of ectopic pregnancy within the peritoneal cavity, representing a grave risk to maternal health. Secondary abdominal pregnancies are by far the most common and result from tubal abortion or rupture, or less often, after uterine rupture with subsequent implantation within abdomen. early diagnosis and appropriate surgical management, regardless of stage of gestation, appear to be important in achieving good results. We report a case of primary peritoneal pregnancy in a 28-year-old woman, who had severe lower abdominal pain one day before laparotomy for a preoperative diagnosis of ectopic pregnancy. The conceptus was implanted on the left uterosacral ligament. A fresh embryo of approximately 8 weeks' gestation was found in the conceptus.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
5/15. Successful laparoscopic treatment of an abdominal pregnancy in the posterior cul-de-sac.PURPOSE: To describe the laparoscopic treatment of a first trimester abdominal pregnancy found in the cul-de-sac between the right uterosacral ligament and the rectum. CASE REPORT: A 32-year-old female presented to the emergency department with abdominal pain beginning a few hours prior to presentation. The serum betahCG level was 543 mIU/ml. An ultrasound examination revealed an empty uterus, bilateral normal fallopian tubes, and a large quantity of fluid in the pelvis. Secondary to patient symptoms, laparoscopy was performed. After the pelvis was irrigated to remove blood and clot, bilaterally normal fallopian tubes and ovaries were found. Further laparoscopic examination revealed an abdominal pregnancy implanted on the peritoneum between the right uterosacral ligament and the rectum. Hydrodissection was used to help elevate the peritoneum away from adjacent structures, and the products of conception were removed laparoscopically. CONCLUSION: In select first trimester patients with abdominal pregnancies, laparoscopic management can be performed.- - - - - - - - - - ranking = 0.4keywords = ligament (Clic here for more details about this article) |
6/15. Calcified abdominal pregnancy with eighteen years of evolution: case report.CONTEXT: The lithopedion (calcified abdominal pregnancy) is a rare phenomenon and there are less than 300 cases reported in the medical literature. CASE REPORT: In this case, a 40 year-old patient had had her only pregnancy 18 years earlier, without medical assistance since then. She came to our hospital with pain and tumoral mass of approximately 20 centimeters in diameter. Complementary examinations (abdominal X-ray, ultrasonography and computerized tomography) demonstrated an extra-uterine abdominal 31-week pregnancy with calcification areas. Exploratory laparotomy was performed, with extirpation of a well-conserved fetus with partially calcified ovular membranes.- - - - - - - - - - ranking = 0.00036028003354798keywords = membrane (Clic here for more details about this article) |
7/15. Five-year follow-up of placental involution after abdominal pregnancy.A 29-year-old woman with an abdominal pregnancy was admitted to the hospital at 29 weeks' menstrual age. At 30 weeks, laparotomy was performed, and a live fetus, wrapped in membrane remnants, was taken from the abdominal cavity. The placenta, inserted in the right hemipelvis, was left in situ. The patient's postoperative recovery was uneventful, and she was monitored periodically as follow-up. At her 5-year follow-up visit, we assessed placental involution by measuring serum beta human chorionic gonadotropin and by using color and pulsed Doppler sonography. The dynamics of the regression of placental volume yielded a bimodal curve: a phase of decrease over the first 2 months, coincident with a reduction in vascularization, followed by stability that lasted 6-8 months, and a second phase of gradual volume reduction. At 5 years, the placenta appeared as a small residual echogenic mass with no vascularity. The use of MRI in this case provided no additional information to what we found using sonography.- - - - - - - - - - ranking = 0.00036028003354798keywords = membrane (Clic here for more details about this article) |
8/15. pregnancy in the broad ligament.pregnancy in the broad ligament is a rare form of ectopic pregnancy, and one type of abdominal pregnancy. The diagnosis is seldom established before surgery. A 38-year-old, 11-week pregnant woman, gravida 3, para 2, presented with vaginal bleeding. She had undergone two cesarean sections 10 and 6 years earlier. pregnancy in the right broad ligament was diagnosed from clinical and transvaginal ultrasonographic findings. Emergency laparotomy and excision of a pregnancy in the right broad ligament and right salpingectomy were performed. She was well at discharge and at the 6-week follow up. We suggest the use of clinical and ultrasonographic findings for the suspicion of pregnancy in the broad ligament.- - - - - - - - - - ranking = 1.6keywords = ligament (Clic here for more details about this article) |
9/15. Term abdominal pregnancy misdiagnosed as abruptio placenta.A 37 year old multiparous woman at 37th week gestation presented with an undiagnosed abdominal pregnancy and acute abdomen following forceful reduction of an associated utero-vaginal prolapse. She had an urgent laparotomy with delivery of a live female baby lying in the left broad ligament. The baby weighed 2.6 kg with Apgar scores of 2 and 6 at first and fifth minutes respectively. The partially detached placenta was easily delivered complete with membranes. Haemostasis was secured by ligation and excision of the left adnexum (broad ligament with the pregnancy sac and uterine appendages). She was transfused with two units of whole blood. This case highlights the importance of excluding pregnancy in any woman of reproductive age with undiagnosed abdominal mass and utero-vaginal prolapse before any manipulation. It also underscores the importance of ultrasound scan in early pregnancy by a competent sonologist.- - - - - - - - - - ranking = 0.40036028003355keywords = ligament, membrane (Clic here for more details about this article) |
10/15. Term abdominal pregnancy misdiagnosed as abruptio placenta.A 37 year old multiparous woman at 37th week gestation presented with an undiagnosed abdominal pregnancy and acute abdomen following forceful reduction of an associated utero-vaginal prolapse. She had an urgent laparotomy with delivery of a live female baby lying in the left broad ligament. The baby weighed 2.6kg with Apgar scores of 2 and 6 at first and fifth minutes respectively. The partially detached placenta was easily delivered complete with membranes. Haemostasis was secured by ligation and excision of the left adnexum (broad ligament with the pregnancy sac and uterine appendages). She was transfused with two units of whole blood. This case highlights the importance of excluding pregnancy in any woman of reproductive age with undiagnosed abdominal mass and utero-vaginal prolapse before any manipulation. It also underscores the importance of ultrasound scan in early pregnancy by a competent sonologist.- - - - - - - - - - ranking = 0.40036028003355keywords = ligament, membrane (Clic here for more details about this article) |
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