Abdominal pregnancy at a patient after cesarean section, bilateral salpingectomy and embryotransfer
Authors:
E. Suchánková; J. Pavlásek; I. Bydžovská; M. Lubušký
Authors‘ workplace:
Porodnicko-gynekologická klinika LF UP a FN, Olomouc
přednosta prof. MUDr. R. Pilka, Ph. D.
; Gynekologicko-porodnické oddělení, Krajská nemocnice Liberec, a. s.
primář MUDr. P. Černý
Published in:
Ceska Gynekol 2017; 82(2): 122-125
Overview
Objective:
Presentation of rare complication following the assisted reproduction at a patient after cesarean section and bilateral salpingectomy.
Design:
Case report.
Settings:
Department of Obstetrics and Gynaecology, Regional Hospital Liberec, a. s.; Department of Obstetrics and Gynaecology, Palacky University Hospital, Olomouc.
Observation:
Pregnant woman, 26-years old, primiparous, with history of cesarean section and bilateral salpingectomy, was referred from the assisted reproduction centre to solve suspicion of molar intrauterine pregnancy. This diagnosis was settled on the basis of ultrasound scan of uterine cavity and high level of human choriogonadotropine. Instrumental revision of uterine cavity was performed, however there was not consequently demonstrated any histological prove of the pregnancy tissue in uterine cavity and decrease of human choriogonadotropine values. The verifying ultrasound examination was made and then the suspicion of ectopic pregnancy on the right side of the uterus was expressed. Laparoscopy diagnosed ectopic pregnancy localized in the right broad ligament. It was treated by exstirpation of the pregnancy tissue.
Conclusion:
The diagnosis of ectopic pregnancy should be based on personal history, human choriogonadotropine level assessment and pelvic ultrasound examination. Although it´s important to evaluate all the components globally, ultrasound examination is in a majority of cases the most important part for setting the right diagnosis.
Keywords:
abdominal ectopic pregnancy, embryotransfer, salpingectomy, cesarean section, broad ligament
Sources
1. Angelova, MA., Kovachev, EG., Kozovski, I., et al. A case of secondary abdominal pregnancy after in vitro fertilization pre-embryo transfer (IVF-ET). Open Access Maced J Med Sci, 2015, 3, 3, p. 426–428.
2. Apantaku, O., Rana, P., Inglis, T. Broad ligament ectopic pregnancy following in-vitro fertilisation in a patient with previous bilateral salpingectomy. J Obstet Gyn, 2006, 26, 5, p. 474 [cit. 2016-11-30]. DOI: 10.1080/01443610600766595. ISSN 0144-3615. Dostupné z: http://www.tandfonline.com/doi/full/10.1080/01443610600766595
3. Borton, Z., Landon, AG., Singh, S. A painless pelvic wall ectopic pregnancy. BMJ Case Reports [online]., bcr2015211529- [cit. 2016-08-21]. ISSN 1757-790x. Dostupné z: http://casereports.bmj.com/lookup/doi/10.1136/bcr-2015-211529
4. Calda, P., Břešťák, M., Fischerová, D. Doporučení k posouzení komplikací vývoje plodu v I. trimestru (zamlklý potrat, ektopická gravidita, těhotenství neznámé lokalizace). Actual Gyn, 2013, 5, s. 78–80.
5. Champion, PK., Tessitore, NJ. Intraligamentary pregnancy: a survey of all published cases of over 7 calendar months, with the discussion of an additional case. Am J Obstet Gynecol, 1938, 36, 5, p. 281–293.
6. Kalivodová, D. Těhotenství neznámé lokalizace. Postgrad Med, 2014, 5, s. 13–16.
7. Kolařík, D., Halaška, M., Feyereisl, J. Repetitorium gynekologie. Praha: Maxdorf, 2008, 570 s.
8. Kunwar, S., Tamkin, S., Srivastava, K. Abdominal pregnancy: methods of hemorrhage control. Intractable Rare Dis Res [online], 2015, 4(2), p. 105–107 [cit. 2016-08-09]. ISSN 2186-361x. Dostupné z https://www.jstage.jst.go.jp/article/irdr/4/2/4_2015.01006/_article
9. Kutlesic, R., Lukic, B., Kutlesic, M., et al. Unruptured retroperitoneal pregnancy implanted in the left broad ligament: A case report. Vojnosanit. Pregl. [online]. 2016, (00), p. 160–160. [cit. 2016-11-30]. DOI: 10.2298/VSP150723160K. ISSN 0042-8450. Dostupné z: http://www.doiserbia.nb.rs/Article.aspx?ID=0042-84501600160K
10. Nayar, J., Nair, SS. Broad Ligament Pregnancy - success atory of a laparoscopically managed case. J. Clin. Diagn. Res., [online]. 2016, 10(7), p.QD04-QD05, [cit. 2016-10-20]. Dostupné z: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5020297/
11. Richardson, A., Gallos, I., Dobson, S., et al. Accuracy of first-trimester ultrasound in diagnosis of tubal ectopic pregnancy in the absence of an obvious extrauterine embryo: systematic review and meta-analysis. Ultrasound Obstet Gynecol, 2015, 47, 1, p. 28–37. doi:10.1002/uog.14844
12. Santos-Riberio, S., Tournaye, H., Polyzos, NP. Trends in ectopic pregnancy rates following assisted reproductive technologies in the UK: a 12-year nationwide analysis including 160 000 pregnancies. Hum Reprod, 2016, 31, 2, p. 393–402.
13. Smažinka, M. Ektopická gravidita, možnosti diagnostiky a léčby. Moderní babictví. 2006, 11, 9.
14. Yoder, N., Tal, RJ., Martin, R. Abdominal ectopic pregnancy after in vitro fertilization and single embryo transfer: a case report and systematic review. Reprod Biol Endocrinol, 2016, 14, p. 69 [online]. [cit. 2016-11-30]. DOI: 10.1186/s12958-016-0201-x. ISSN 1477-7827. Dostupné z: http://rbej.biomedcentral.com/articles/10.1186/s12958-016-0201-x
15. Zdeňková, A., Fanta, M., Calda, P. Metotrexát v léčbě ektopické gravidity. Actual Gyn 2015, 7, s. 27–32.
Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicineArticle was published in
Czech Gynaecology
![Issue 2](https://www.prolekare.cz/media/cache/resolve/journal_issue/media/image_pdf/4f5051f0edbbb0bfda9ead979a2b6446.jpeg)
2017 Issue 2
Most read in this issue
- Uterine inversion
- Inflammatory bowel disease during pregnancy and childbirth
- Ultrasound diagnosis of fetal inflammatory response syndrome in women with preterm premature rupture of membrane
- Czech linguistic validation of the Pelvic Organ Prolapse/ Urinary Incontinence Sexual Questionnaire – IUGA revised