Marzieh Talebian; Zohreh Talebi Mazreshahi; Elham Khosravi Mashizi; Nafiseh Khalili
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Introduction: Although 1% to 2% of all pregnancies are ectopic, ectopic pregnancy (EP) is the most frequent obstetrical disease leads to maternal mortality and morbidity at first trimester. The basic diagnostic method of EP is the human chorionic gonadotropin (HCG) test and transvaginal ultrasound. There ...
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Introduction: Although 1% to 2% of all pregnancies are ectopic, ectopic pregnancy (EP) is the most frequent obstetrical disease leads to maternal mortality and morbidity at first trimester. The basic diagnostic method of EP is the human chorionic gonadotropin (HCG) test and transvaginal ultrasound. There are some rare EP cases with negative HCG blood test. Case presentation: A 31-years old woman referred to the emergency department with hypogastric, periumbilical, and right upper quadrant intermittent pain and vaginal bleeding and prior history of EP 7-months ago that treated with methotrexate and her intra uterine device had been removed at that time. Her last menstrual period was undetermined. Although HCG blood test-qualitative was negative (2.08 IU /ml),ultrasound examination showed an 43×53 mm echogenic, heterogenic complex solid mass in the left adnexa and a large amount of echogenic fluid demonstrating hemoperitoneum. Taken surgery because of the exceeded abdominal pain revealed active bleeding in the left salpinx due to ruptured EP. Conclusion: Management of patients suspected of EP with negative HCG-blood test is difficult. In this uncommon cases in emergency, computed tomography, ultrasound and diagnostic laparoscopy or laparotomy can improve prognosis of patient.
Obstetrics and Gynecology
Fatemeh Hosseinabadi; Narjes Noori; Marzieh Ghasemi; Motahare Bitaghsir Fadafan; Erfan Ayubi
Volume 9, Issue 1 , January and February 2024, , Pages 83-87
Abstract
Background: Ectopic pregnancy (EP) is one of the important issues in the field of obstetrics and gynecology. Proper assessment of fallopian tube patency following medical treatment of an EP in women who wish to have future children seems reasonable. Therefore, the purpose of this study was to investigate ...
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Background: Ectopic pregnancy (EP) is one of the important issues in the field of obstetrics and gynecology. Proper assessment of fallopian tube patency following medical treatment of an EP in women who wish to have future children seems reasonable. Therefore, the purpose of this study was to investigate the patency of fallopian tubes after clinical and surgical treatment of EP.Methods: In this quasi-experimental study, our research population was 270 people who were referred to Ali-Ibn-Abitaleb hospital in Zahedan with a definite diagnosis of EP in 2020. Patients were divided into three groups: drug treatment (90 people), surgical treatment (90 people) and expectant treatment (90 people). For each patient, the patency of the left and right fallopian tubes was investigated and the obtained data were statistically analyzed by t-test and chi-square test methods using SPSS software version 22 (IBM, USA).Results: A total of 270 patients were examined. The mean age of the patients in the drug treatment, surgical therapy and expectant treatment groups were 32.34 ± 6.17, 32.02 ± 6.12 and 32.12 ± 6.40 years, (P=0.389). Moreover, there was no statistically significant difference between the right fallopian tubes (P=1.00), and the left fallopian tubes in the investigated groups (P=0.08).Conclusion: Based on the results of this study, there was no statistically significant difference between the drug treatment and the surgery treatment groups. The findings of this study revealed that the uterine tube opening was similar on both sides after drug treatment, surgical treatment and expectant treatment.
Obstetrics and Gynecology
Somayeh Khanjani; Shamin Ghobadi; Farahnaz Mardanian; Leila Mousavi Seresht
Volume 8, Issue 6 , November and December 2023, , Pages 629-632
Abstract
Cesarean scars in pregnancy have become a worrisome obstetric problem. Furthermore, given the challenge of diagnosis in cases of low suspicion in the initial prenatal sonographic screening, there is still debate over the standard of management. According to rare reported cases, the most acceptable recommendation ...
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Cesarean scars in pregnancy have become a worrisome obstetric problem. Furthermore, given the challenge of diagnosis in cases of low suspicion in the initial prenatal sonographic screening, there is still debate over the standard of management. According to rare reported cases, the most acceptable recommendation is still termination of pregnancy to decrease the chance of further maternal dreadful complications. A case of twin pregnancy had been terminated at gestational age of 34 weeks with a history of diagnosis of cesarean scar pregnancy. Since pregnancy at the site of a previous cesarean section is very rare, but due to the complications of this type of pregnancy, choosing a suitable clinical approach for these patients is desirable. This type of pregnancy can increase the value of antenatal care if it can be continued until the fetus is viable and its complications, including placenta accreta and bleeding, are managed.
Malihe Hasanzadeh; Mina Baradaran Khalkhale; Akram Behroznia
Volume 2, Issue 2 , May and June 2017
Abstract
Introduction: The prevalence of ectopic pregnancy is 1 to 2% and a previous cesarean section scar ectopic pregnancy or hysterectomy occurs as rare as 1 per 2000 pregnancies. In the current case report, the authors introduced ectopic pregnancy in cesarean scar with unstable hemodynamic condition and surgical ...
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Introduction: The prevalence of ectopic pregnancy is 1 to 2% and a previous cesarean section scar ectopic pregnancy or hysterectomy occurs as rare as 1 per 2000 pregnancies. In the current case report, the authors introduced ectopic pregnancy in cesarean scar with unstable hemodynamic condition and surgical management to preserve uterus.
Case Presentation: A 31-year-old pregnant female in the 9th week of pregnancy was admitted with vaginal bleeding and slight pain in the hypogastrium. The cesarean scar pregnancy was confirmed by sonography. In the course of hospitalization, due to the patient’s hemodynamic instability, the emergency laparotomy was performed. In the previous cesarean section scar, a 3 × 4 cm mass with a massive hematoma was found. It was removed and placental bed was sutured. Since the vaginal bleeding continued, the uterine artery ligation was carried out and due to severe bleeding, Foley catheters were packed inside the uterus. Two days later, the patient was discharged from the hospital in good general condition.
Conclusions: Despite the rarity of ectopic pregnancies in the previous cesarean section scars, paying attention and having this kind of pregnancy in mind can aid its early diagnosis and reduce possible morbidity and mortality including uterine rupture and severe bleeding, which can be considered as its irreversible complications.
