1/12. 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 = fertilization (Clic here for more details about this article) |
2/12. 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 = 0.0031949139376278keywords = conception (Clic here for more details about this article) |
3/12. 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 = 0.0031949139376278keywords = conception (Clic here for more details about this article) |
4/12. Undiagnosed abdominal pregnancy masquerading as faecal fistula in a simultaneous intra uterine and abdominal pregnancies--a case report.A rare case of faecal fistula resulting from undiagnosed abdominal pregnancy that had earlier co-existed with intrauterine conception. Both the extrauterine and intrauterine foetuses were well developed. Normal baby was delivered by emergency lower segment caesarian section 9 months before presentation with enterocutaneous fistula and sepsis.- - - - - - - - - - ranking = 0.0031949139376278keywords = conception (Clic here for more details about this article) |
5/12. Minimally invasive management of 14.5-week abdominal pregnancy without laparotomy: a novel approach using percutaneous sonographically guided feticide and systemic methotrexate.OBJECTIVE: To evaluate the possible role of a novel, minimally invasive approach to the management of abdominal pregnancy. methods: We hypothesized that sonographically guided feticide without subsequent laparotomy for removal of the fetus and placenta could minimize potential blood loss and would be a reasonable approach in the care of a patient who had a viable 14.5-week abdominal pregnancy with placental implantation directly over the bifurcation of the left common iliac artery. An extensive medline literature review revealed 1 case of sonographically guided feticide followed 10 days later by uneventful laparotomy for removal of the fetus and placenta. Thus, we used sonographically guided feticide without subsequent laparotomy for removal of the products of conception. RESULTS: The sonographically guided feticide was uneventful, and the patient had no major postprocedure morbidity; a mild ileus was treated conservatively without the need for nasogastric suctioning. No major postprocedure bleeding was encountered. Human chorionic gonadotropin levels dropped precipitously. During the 1.5 years of postprocedure follow-up, the patient reported no major complications. The gestational sac involuted very slowly; amniotic fluid volume appeared normal at 6 months after the procedure but was diminished at the 9-month postprocedure examination. CONCLUSIONS: In cases of previable intra-abdominal pregnancy, sonographically guided feticide may lessen the risk of extensive hemorrhage that can be associated with exploratory laparotomy. Sonographically guided feticide without subsequent exploratory laparotomy can result in a gradual resorption of the products of conception and an uncomplicated recovery. This treatment option should be considered in the management of this potentially life-threatening condition.- - - - - - - - - - ranking = 0.0063898278752556keywords = conception (Clic here for more details about this article) |
6/12. Concomitant abdominal and intrauterine pregnancy after in vitro fertilization in a woman with bilateral salpingectomy. A case report.BACKGROUND: Abdominal pregnancy is a rare event, and the concomitant presence of an intrauterine pregnancy is very exceptional. CASE: A case of concomitant abdominal and intrauterine pregnancy following in vitro fertilization and embryo transfer (IVF-ET) occurred in a woman with bilateral salpingectomy. The abdominal pregnancy was successfully treated surgically, with preservation of the intrauterine pregnancy. CONCLUSION: A careful ultrasound examination should be performed on women who have undergone IVF-ET, and the possibility of abdominal pregnancy should be kept in mind in the differential diagnosis of acute abdomen.- - - - - - - - - - ranking = 1keywords = fertilization (Clic here for more details about this article) |
7/12. Minimally invasive management of an advanced abdominal pregnancy.BACKGROUND: Advanced abdominal pregnancy is a rare, life-threatening condition that presents a number of challenges. CASE: A 29-year-old primigravida with 10 years of secondary infertility and a previous tuboplasty had a 21-week abdominal pregnancy treated with preoperative arterial embolization before laparoscopically assisted fetal delivery. Postoperatively, 4 cycles of methotrexate were administered at 50 mg/m2 intramuscularly every 3 weeks for the retained abdominal placenta. Subsequent spontaneous conception occurred, and a live, full-term infant was delivered by cesarean delivery 17 months later. No adverse sequelae were found during long-term follow-up. CONCLUSION: This report demonstrates successful minimally invasive management of an advanced abdominal pregnancy with a multimodal approach that included preoperative arterial embolization, laparoscopically assisted delivery, and judicious use of postoperative methotrexate.- - - - - - - - - - ranking = 0.0031949139376278keywords = conception (Clic here for more details about this article) |
8/12. A case of simultaneous tubal-splenic pregnancy after assisted reproductive technology.OBJECTIVE: To present a case of simultaneous splenic and tubal pregnancy following in vitro fertilization. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 37-year-old woman who had undergone in vitro fertilization and embryo transfer for unexplained infertility at another clinic. INTERVENTION(S): laparoscopy and laparotomy. MAIN OUTCOME MEASURE(S): serum concentration of human chorionic gonadotropin (hCG) after salpingosplenectomy. RESULT(S): After transfer of three embryos following fertilization by intracytoplasmic sperm injection (ICSI) at another clinic, the patient was referred to our hospital with suspicion of ectopic pregnancy. Because tubal pregnancy was suspected, laparoscopic right salpingectomy was performed. Although villi were detected in the resected fallopian tube, the serum hCG concentration did not decrease after the operation and a new intraabdominal hemorrhage was detected. We then suspected abdominal pregnancy in the epigastric region, and performed magnetic resonance imaging, computed tomography, and ultrasound examinations, which revealed implantation at the inferior pole of the spleen. splenectomy was performed, with the resulting disappearance of intraabdominal hemorrhage and rapid fall of the serum concentration of hCG. CONCLUSION(S): Assisted reproduction sometimes results in heterotopic pregnancy, but an abdominal pregnancy involving the upper abdominal organs is considered extremely rare. Particularly, splenic pregnancy is usually overlooked and may only be discovered after a sudden intraabdominal hemorrhage. If hemorrhaging is present in the abdominal cavity but pregnancy is not detected within the pelvis, it is advisable to examine patients using imaging techniques to detect any upper abdominal pregnancies.- - - - - - - - - - ranking = 0.6keywords = fertilization (Clic here for more details about this article) |
9/12. Advanced heterotopic pregnancy after in-vitro fertilization and embryo transfer, with survival of both the babies and the mother.A combination of an extra-uterine and an intra-uterine pregnancy is defined as heterotopic pregnancy. An infertile patient, pregnant at her fourth in-vitro fertilization/embryo transfer attempt, was diagnosed at 21 weeks' gestation as having simultaneous abdominal and intra-uterine pregnancy. Expectant management under strict hospitalization was proposed and accepted by the couple, fetal assessment was by serial ultrasound evaluation of growth and amniotic fluid volume and by non-stress tests. Planned operative delivery was accomplished at 34 weeks' gestation. Both the mother and infants are alive and well.- - - - - - - - - - ranking = 1keywords = fertilization (Clic here for more details about this article) |
10/12. An ectopic pregnancy in the upper retroperitoneum following in vitro fertilization and embryo transfer.Thirty-seven days after successful embryo transfer, a chorionic vesicle was recovered from the upper abdominal retroperitoneal space in a patient presenting with an acute life-threatening hemorrhage. This is the first case report of a retroperitoneal ectopic pregnancy which, although uncommon, is a potentially fatal complication of in vitro fertilization-embryo transfer.- - - - - - - - - - ranking = 1keywords = fertilization (Clic here for more details about this article) |
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