Ectopic Pregnancy and Its Associated Endometrial Changes

Lopez, Hector B.B.; Micheelsen, Ulla; Berendtsen, H; Kock, Kirsten

doi:10.1159/000292459

Cited by 5 publications

(3 citation statements)

References 7 publications

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“…Embryo implantation outside the uterus is always associated with endometrial changes. Proliferation, cystic hyperplasia, secretory transformation, hyper-secretory changes, asynchronous secretory changes between the glands and the stroma, and decidua reaction were histopathologically verified [25,26]. Instrumental curettage of the uterine cavity is not a standard post-surgical line of therapy in ectopic pregnancy management, except in heavy or prolonged uterine bleeding, or in cases of suspected heterotopic pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Unruptured tubal pregnancy in early second trimester

et al. 2018

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Introduction Most ectopic pregnancies are tubal pregnancies. They are potentially life-threatening conditions with a high mortality rate if unrecognized. The diagnosis is established when the first warning symptoms occur, or during the first prenatal visits to a gynecologist. The diagnosis in the second trimester is extremely rare, since clinical presentation resulting either from the expulsion of the fetus into the peritoneal cavity or from the tubal rupture is manifested by that time. If there is no rupture or the expulsion of the fetus, the pregnancy is allowed to continue and ectopic pregnancy diagnosis may be established in the second trimester. Case outline We present a case of a 31-year-old second gravida with a vital intrauterine pregnancy confirmed at the first examination. In the early second trimester, the patient visited her doctor due to vaginal bleeding. After a gynecological examination and ultrasonography, ectopic pregnancy was suspected, so the patient underwent laparotomy. Ectopic pregnancy was confirmed and adnexectomy was performed. Conclusion Early ultrasound examinations have to confirm whether eutopic pregnancy is present. A misdiagnosis and monitoring of ectopic pregnancy as eutopic one is potentially life-threatening for a pregnant woman. Keywords: unruptured pregnancy; tubal pregnancy; early second trimester 2 Клинички центар Ниш, Клиника за гинекологију и акушерство, Ниш, Србија

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Section: Discussionmentioning

confidence: 99%

Unruptured tubal pregnancy in early second trimester

et al. 2018

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“…The most common types of endometrium associated with ectopic pregnancy are decidual reaction (42%), secretory endometrium (22%), and proliferative endometrium (12%). 16 The trilaminar pattern is specific for the diagnosis of ectopic pregnancy, but it is associated with low sensitivity. 17 The endometrial thickness tends to be lesser in patients with an ectopic pregnancy.…”

Section: Anatomy O F T H E Fallopian Tubementioning

confidence: 99%

Ectopic Pregnancy: Laparoscopic Conservative Treatment and Laparoscopic Salpingotomy

Alsadi¹

2018

World Journal of Laparoscopic Surgery With DVD

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Objective: Whether a laparoscopic salpingostomy should be done or a salpingectomy for surgical treatment of ectopic pregnancy. Materials and methods: Literature examining and review the impact of recent advances in the diagnosis and laparoscopic conservative treatment of ectopic tubal pregnancy. Articles published in English language using the following search engines: Medline, Pubmed, Medscape, and Cochrane Database of Systematic Reviews. Results: The choice of salpingostomy or salpingectomy relies upon many factors and includes shared decision-making between the surgeon and patient. Laparoscopic surgery remains the "gold standard" in majority of women. Conclusion:There is some evidence to suggest that future fertility outcomes are slightly improved after tubal conservation at surgery in comparison with salpingectomy. As the incidence of ectopic pregnancy continues to rise in a population that will likely desire future fertility, early diagnosis is key in facilitating safe utilization of more conservative management in the hope of preserving tubal function and reproductive potential.

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“…Several endometrial changes have been described in association with ectopic pregnancy such as decidual reaction, secretory and proliferative endometrium (including trilaminar pattern) 17 but a thin endometrium (Figure 8a) is not compatible with an early ongoing intrauterine pregnancy. 18 The trilaminar appearance is characteristically seen in the late proliferative/periovulatory phase of the menstrual cycle (Figure 8b).…”

Section: Uterine Corpusmentioning

confidence: 99%