Cases reported "Pregnancy, Ectopic"

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1/99. Conservative treatment by angiographic uterine artery embolization of a 12 week cervical ectopic pregnancy.

    A 32 year old woman, gravid 1, nulliparous, was admitted to our department at 11 weeks and 2 days of gestation after being diagnosed with cervical pregnancy. She was unsuccessfully treated with methotrexate for 5 days. On the fifth day after admission she underwent bilateral uterine artery angiographic embolization followed by vacuum evacuation and curettage of the cervical canal. A Foley catheter was also inserted in the cervical canal and left in place for 4 days. The patient was discharged in good condition on the seventh postoperative day.
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ranking = 1
keywords = operative
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2/99. Laparoscopic management of an ectopic pregnancy in a previous Caesarean section scar.

    A case of laparoscopic management of an ectopic pregnancy in a previous Caesarean section scar is reported. A 30 year old woman was admitted to our hospital for profuse vaginal bleeding 2 weeks after an abortion had been performed. A urine pregnancy test was positive. Abdominal ultrasound revealed a well-encapsulated bulging mass over the lower anterior uterine wall measuring 7x5 cm. hysteroscopy revealed retained gestational tissue in the lower corpus despite a normal uterine cavity. An incision was made over the most prominent area of the mass by operative laparoscopy. Dark reddish tissue suggestive of the products of conception was removed using grasping forceps. One-layer of continuous endoscopic sutures along the affected uterine wall was made with 1-0 Prolene. laparoscopy enabled the successful treatment of an unruptured ectopic pregnancy in a previous Caesarean scar and made it possible to preserve the patient's reproductive capability.
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ranking = 1
keywords = operative
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3/99. Extrauterine pregnancy resulting from early uterine rupture.

    BACKGROUND: Cesarean scar rupture of a gravid uterus in early gestation is rare. CASE: A 38-year-old woman, gravida 4, para 2-0-1-1, presented at 13 weeks' gestation with cramping and spotting. She had a history of two cesareans. Ultrasound and magnetic resonance imaging indicated probable uterine dehiscence and a viable extrauterine pregnancy. After embolization of the uterine arteries with subsequent fetal death, the subject had a hysterectomy. Intraoperatively, she had complete rupture of the lower uterine segment, but the pregnancy was enclosed within scar tissue between the uterus and bladder. placenta percreta was found by histologic examination. CONCLUSION: women with histories of cesareans might be at risk of early uterine rupture.
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ranking = 1
keywords = operative
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4/99. Cervical pregnancy: assessment with three-dimensional power Doppler imaging and successful management with selective uterine artery embolization.

    Cervical pregnancy is frequently associated with extensive hemorrhage which, in severe cases, may be stopped only by hysterectomy. We report a case of an anembryonic cervical pregnancy diagnosed at 10 weeks, and associated with a large arteriovenous malformation. The patient was conservatively managed with simple selective uterine artery embolization. After embolization, her vaginal bleeding ceased and the level of serum beta-human chorionic gonadotropin decreased rapidly. No additional treatment was given. The patient's postoperative course was uneventful and the cervical mass had disappeared at the follow-up 4 months later. To the best of our knowledge, this is the first report of conservative management of cervical pregnancy simply by uterine artery embolization. The role of three-dimensional power Doppler ultrasonography in the assessment of cervical pregnancy and in monitoring the therapeutic response is discussed.
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ranking = 1
keywords = operative
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5/99. A cervical ectopic masquerading as a molar pregnancy.

    We report a case of cervical pregnancy complicated by life threatening hemorrhage. An initial diagnosis of molar pregnancy was made preoperatively. During uterine evacuation she developed profuse hemorrhage which required an emergency hysterectomy for uncontrolled bleeding. Histopathological examination confirmed a cervical pregnancy. The clinical and pathological criteria for the diagnosis and the etiology of cervical pregnancy are discussed.
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ranking = 1
keywords = operative
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6/99. Laparoscopic removal of a rudimentary uterine horn during pregnancy. A case report.

    BACKGROUND: A unicornuate uterus with a rudimentary horn is a mullerian anomaly associated with endometriosis and pregnancy complications, including miscarriage, ectopic pregnancy, uterine rupture, preterm labor and malpresentation. Therefore, the horn is removed if it is thought to contain functional endometrium. This is usually done by laparotomy in the nonpregnant state. CASE: A woman presented during pregnancy with symptoms, examination and ultrasonogram suspicious for an ectopic pregnancy. Intraoperative findings and final pathology, however, showed a rudimentary uterine horn, which was laparoscopically removed, and a concomitant intrauterine pregnancy. CONCLUSION: A rudimentary uterine horn may present during pregnancy and mimic an ectopic pregnancy. In this case, the horn was removed laparoscopically.
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ranking = 1
keywords = operative
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7/99. Laparoscopic therapy of an intact primary ovarian pregnancy with ovarian hyperstimulation syndrome: case report.

    A case of an intact primary ovarian pregnancy with ultrasonographic demonstration of heart motion following ovarian stimulation is presented. After preoperative ultrasonographic confirmation of an extrauterine pregnancy, proof of the ovarian localization was achieved by intra-operative ultrasonographic visualization during a diagnostic laparoscopy on post-menstrual day 48. A moderate ovarian hyperstimulation syndrome with a concomitant increase in size, vulnerability and vascularity of the ovaries presented an additional challenge for the surgical approach. However, thanks to the early diagnosis of the ectopic pregnancy localization, a laparoscopic organ-preserving removal of the intact ovarian pregnancy was successfully performed. In this way, the fertility of the patient, who had previously undergone contralateral ovariectomy, was preserved. To our knowledge, this represents the first such treatment to be reported in the medical literature. Improvements in diagnosis and therapy of ovarian pregnancy are reviewed.
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ranking = 2
keywords = operative
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8/99. A cervical ectopic masquerading as a molar pregnancy.

    We report a case of cervical pregnancy complicated by life threatening hemorrhage. An initial diagnosis of molar pregnancy was made preoperatively. During uterine evacuation she developed profuse hemorrhage which required an emergency hysterectomy for uncontrolled bleeding. Histopathological examination confirmed a cervical pregnancy. The clinical and pathological criteria for the diagnosis and the etiology of cervical pregnancy are discussed.
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ranking = 1
keywords = operative
(Clic here for more details about this article)

9/99. uterine artery embolization in a 10-week cervical pregnancy with coexisting fibroids.

    A 36-year-old woman, gravid 3, para 1, abortus 1, was admitted to our department at 10 weeks and 4 days of gestation with the diagnosis of cervical pregnancy and multiple uterine fibroids. After admission she underwent angiographic embolization of bilateral uterine arteries followed by intraamniotic 70-mg methotrexate injection. Despite being given a second dose of methotrexate injection 1 week later, the gestational sac did not resolve spontaneously, thus vacuum evacuation and curettage of the cervical canal was required on the 15th day of embolization. The patient was discharged in good condition. She had no complaints by post-operative at month 11, except amenorrhea. Her uterine fibroids markedly decreased in size after the procedure. As a result, embolization of uterine arteries provided surgical evacuation of cervical pregnancy with minimal hemorrhage, and the patient's potential fertility was preserved, but a long-term amenorrhea was observed.
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ranking = 1
keywords = operative
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10/99. Conservative treatment of ectopic pregnancy in a cesarean section scar with methotrexate: a case report.

    Ectopic pregnancies sited in dehiscent cesarean section scars have a high risk of rupture and bleeding. Attempts at operative therapy frequently end in loss of the uterus. A connection with the cavum uteri justifies an attempt at dilatation and curettage. We describes a patient with combined systemic and local intra-amniotic methotrexate (MTX). The uterus was preserved.
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ranking = 1
keywords = operative
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