Cases reported "Pregnancy, Ectopic"

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11/737. Successful intrauterine term pregnancy after resection of corneal pregnancy.

    A woman with previous bilateral salpingectomia, including wedge-formed corneal resection, became heterotopic pregnant after in-vitro-fertilization. Ultrasound revealed a twin corneal pregnancy and an intrauterine pregnancy. Undergoing laparotomy, the uterine corner with the ectopic pregnancy was resected. The intrauterine pregnancy proceeded uncomplicated. She delivered a healthy girl, at 38 weeks of gestation. ( info)

12/737. survival of cornual (interstitial) pregnancy.

    We report a case of a singleton cornual (interstitial) pregnancy following spontaneous conception in a primigravida with no risk factors for ectopic pregnancy. She presented at 30 weeks gestation with haemoperitoneum, due to a small rupture on the posterior surface of the cornual pregnancy. At laparotomy, an incision was made in the cornu, the baby was delivered and survived after spending 39 days in a special care baby unit. ( info)

13/737. 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. ( info)

14/737. 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. ( info)

15/737. Laparoscopic cornuostomy for interstitial pregnancy. A case report.

    BACKGROUND: With recent advances in laparoscopic surgery, many reports have described laparoscopic cornual resection for interstitial pregnancy as a safe alternative to laparotomy. We report a laparoscopic cornuostomy for unruptured interstitial pregnancy with myometrium reconstruction. CASE: A 32-year-old woman presented with complaints of abdominal cramps and vaginal spotting after 6 weeks of amenorrhea. Ultrasonographic examination revealed a gestational sac 7 mm in diameter in the left uterine corner. There was clear separation between the endometrium and gestational sac. A 3-mm periumbilical trocar for the laparoscope and a 3-mm trocar in the lower abdomen were used, and the left interstitial pregnancy was confirmed. An additional, 5-mm trocar was used in the lower abdomen for the laparoscopic surgery. The patient underwent a laparoscopic cornuostomy. myometrium reconstruction was performed by suturing and tying with a laparoscopic technique. CONCLUSION: In this case, minilaparoscopy was useful in the diagnosis and treatment of interstitial pregnancy. ( info)

16/737. Advanced extra-uterine pregnancy--a case of fimbrial expulsion of the fetus with complete placental development in the fallopian tube.

    A case report is presented of a 30-year-old woman, gravida 3 para 2, presented with an advanced extra-uterine pregnancy with complete development of the placenta in the fallopian tube. ( info)

17/737. A cervical ectopic pregnancy managed by medical treatment and angiographic embolization.

    Medical treatment in the form of systemic methotrexate with or without local methotrexate/potassium chloride is effective for early cervical pregnancy. It should be the treatment of choice in suitable cases. Haemorrhagic complications can be effectively managed by angiographic embolization. A case report illustrating these points is presented. ( info)

18/737. Treatment of heterotopic cervical and intrauterine pregnancy.

    OBJECTIVE: To find a suitable technique to selectively terminate a cervically implanted embryo while maintaining viability of a concomitant intrauterine pregnancy. methods: A 34-year-old patient achieved a twin pregnancy after 4 IVF attempts. Ultrasound revealed a viable intrauterine and cervical pregnancy. Given our experience with KCl injection for fetal reduction, we offered the patient an attempt to reduce the cervical pregnancy. RESULTS: Best visualization in this case was obtained by transabdominal scanning. A 6-inch 20-gauge spinal needle was inserted transcervically and maneuvered into the thorax of the embryo. fetal heart rate ceased even before KCl could be injected. Then 3 cm(3) of saline were injected to provide better visualization of the cervical fetus, and to confirm absence of heart beat. The patient had minor vaginal bleeding for several days. The intrauterine pregnancy progressed uneventfully through 36(1)/(2) weeks with delivery of a healthy, 2, 700-gram newborn. CONCLUSION: Cervical pregnancy is usually considered a life-threatening event. Other factors such as concomitant intrauterine pregnancy and the patient's infertility history generally would be secondary concerns. In this case, we were able to selectively terminate the cervical pregnancy, while preserving the intrauterine one, allowing this couple to have a healthy newborn. Further cases will be necessary to appropriately define risk rates for such an approach. ( info)

19/737. Successful management of a viable cervical pregnancy by single-dose methotrexate.

    Cervical pregnancy is very uncommon and carries a high risk for hysterectomy with surgical treatment. Prior reports of medical treatment included various regimens of high-dose systemic methotrexate (MTX) with citrovorum rescue and local injection. This is the first report of successfully treating a viable cervical pregnancy with single-dose i.m. MTX, followed by a vaginal delivery. ( info)

20/737. The therapeutic dilemma of an ectopic pregnancy in the setting of the severe ovarian hyperstimulation syndrome.

    Severe ovarian hyperstimulation syndrome as a result of assisted reproductive therapy occurs rarely. However, this iatrogenic condition can result in a life threatening illness with difficult management dilemmas for the attending physicians. A patient with severe adult respiratory distress syndrome and septicaemia after in vitro fertilization required prolonged intensive care treatment and subsequently had a probable ectopic pregnancy treated with systemic methotrexate as an alternative to surgical management. A satisfactory outcome was obtained, followed by a spontaneous successful pregnancy some months after these events. ( info)
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