Laparoscopic management of a cornual ectopic pregnancy

Buxant, Frédéric; Ansion, M.H.; Noël, Jean Christophe; Anaf, Vincent; Simon, Philippe

doi:10.1007/s10397-005-0098-4

Cited by 3 publications

(4 citation statements)

References 9 publications

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“…Tratamiento quirúrgico. El tratamiento tradicional ha sido la histerectomía o resección cornual por laparotomía (3,6,10,11,13,14,19,(22)(23)(24)(26)(27)(28)(29)31,32), sin embargo, con el advenimiento de la ecografía y la βCG (3,11,19) se realizan diagnósticos más tempranos y ha permitido escoger nuevas alternativas menos agresivas para el tratamiento.…”

Section: Resultsunclassified

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Embarazo ectópico cornual recurrente: caso clínico y revisión de la literatura

2015

Rev. chil. obstet. ginecol.

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Reportar un caso de embarazo ectópico cornual recurrente, al que se le realizó manejo por laparoscopia. Realizar una revisión de la literatura sobre este tema. Caso clínico: Se presenta el caso de una paciente de 34 años, con embarazo cornual recurrente a quien se le realizó manejo exitoso por laparoscopia. Método: Se realizó una búsqueda bibliográfica en las bases de datos con las palabras clave: pregnancy, intersticial y cornual ectopic en Medline, PubMed, Embase, Cochrane Data base, Ovid, Hinari, Scielo y Bireme. Resultados: La búsqueda inicial arrojó 311 artículos, de los cuales se seleccionaron 116 y posteriormente 74 artículos, que estaban relacionados con el tema a revisar, finalmente se escogieron 38 artículos con texto completo. Conclusión: El embarazo ectópico cornual o intersticial tienen los mismos factores de riesgo que el embarazo tubárico. El avance en ecografía y los niveles de βHCG han permitido un diagnóstico precoz, lo que permite realizar tratamientos médico o quirúrgico más conservadores, donde la laparoscopia ha empezado a tener un papel muy importante.

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Section: Resultsunclassified

“…Histeroscopia. La histeroscopia también ha sido reportada para el tratamiento del embarazo ectópico cornual (20,29). Sanz y cols (36), reportan el uso de la histeroscopia para romper un saco persistente después del tratamiento con metotrexato y realizan bajo visión ecográfica la extracción del tejido placentario.…”

Section: Resultsunclassified

Embarazo ectópico cornual recurrente: caso clínico y revisión de la literatura

2015

Rev. chil. obstet. ginecol.

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“…Buxant et al reported using the classical laparoscopic method of incising the cornual area after a transparietal Xylocaine-adrenaline injection, draining the contents and suturing the area [9]. However, they also used a post-operative systemic methotrexate injection [9]. Moon et al described the vasopressin electric cauterisation method, the endoloop before evacuation of conceptus method and the encircling suture before evacuation of conceptus method [8].…”

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Recurrent cornual ectopic pregnancies

et al. 2008

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This report describes the management of a patient who developed two consecutive cornual ectopic pregnancies in a year preceded by two tubal ectopics on the same side. Interstitial pregnancy is a rare form of ectopic pregnancy with a significant mortality rate. It provides a challenge for clinicians both in their diagnosis and management. As yet, the incidence of recurrent cornual ectopic pregnancies is unknown. Currently conservative medical and surgical methods of management are favoured due to good outcomes and fewer risks. However, these methods do not protect against recurrence. In this report, we discuss the various methods of management described in literature.A 28-year-old woman was seen in the acute gynaecology emergency unit with a 3 days history of dysuria and lower abdominal and back pain. She had amenorrhoea for 5 and 1/2 weeks and had a positive pregnancy test. She was gravida 7 para 1+5. Her first pregnancy was an ectopic pregnancy which was managed in South Africa with a right partial salpingectomy. Her following three pregnancies were first trimester miscarriages and her last pregnancy was delivered at full term vaginally.She was haemodynamically stable. On abdominal examination, there was a marked tenderness in the right iliac fossa with guarding. Vaginal examination revealed cervical excitation and right adnexal tenderness but no bleeding. Transvaginal ultrasound showed a 24-mm mass in the right fornix, free fluid with a ground glass appearance in the pouch of Douglas and an empty uterus. An emergency laparoscopy was performed which diagnosed a ruptured ectopic pregnancy in the right tubal stump and a normal left tube and ovary (Fig. 1). A mini laparotomy and excision of the right tubal stump was carried out with good haemostasis. The patient recovered well and was discharged on the third day, post-operatively. Histology confirmed a right ruptured ectopic pregnancy.Three months later, the same patient presented to the acute gynaecology unit with a positive pregnancy test, 5 weeks amenorrhoea and constant dull aching lower abdominal pain. She was haemodynamically stable and on examination her abdomen was soft and non-tender and there was no cervical or adnexal tenderness on vaginal examination. Transvaginal ultrasound scan showed an 18-mm right-sided adenexal mass, free fluid in the pouch of Douglas and an empty uterus. A laparoscopy was performed, which showed that the patient was bleeding from a right cornual ectopic. The right cornual ectopic was removed laparoscopically with an endoloop and diathermy was performed for haemostasis (Fig. 2). The ectopic pregnancy sac was extruded during the procedure and sent for histology which confirmed products of conception. The post-operative BHCG was 2477 IU/L. The patient was followed up over the next 2 weeks with repeat BHCGs that Gynecol Surg (

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