Ruptured tubal ectopic pregnancy with secondary implantation in the pouch of Douglas

Giannopoulos, Theodoros; Katesmark, M

doi:10.1080/01443610410001643489

Cited by 13 publications

(9 citation statements)

References 2 publications

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“…This was the most frequent location for abdominal pregnancies with 55 cases identified [5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48]. The average age of the patient was 31 with a gestational age of 9 weeks for initial treatment and parity of 1.6.…”

Section: Resultsmentioning

confidence: 99%

“…Eight patients were treated with medical therapy as either primary treatment or adjuvants [12,14,19,26,38,46,47,48]. There were 3 cases of successful treatment with methotrexate of abdominal pregnancies which were located in the pouch of Douglas.…”

Section: Resultsmentioning

confidence: 99%

“…There were 3 cases of successful treatment with methotrexate of abdominal pregnancies which were located in the pouch of Douglas. The first case had an HCG of 210, no fetal cardiac activity, and treated with one dose of intramuscular (IM) methotrexate 50 mg/m 2 [19]. The second case had an HCG of 2,619, no fetal cardiac activity, and treated with methotrexate 50 mg/m 2 IM on days 1, 3, 5 and 7 combined with folinic acid 0.1 mg/kg on days 2, 4, 6, and 8 [47].…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Early Abdominal Ectopic Pregnancies: A Systematic Review of the Literature

Poole¹,

Haas

Magann

2012

Gynecol Obstet Invest

135

145

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Objective: To define abdominal ectopic pregnancy outcomes by both location and treatment. Methods: Literature review of abdominal pregnancies from 1965 to August of 2009. Ectopic pregnancy exclusions were interstitial, tubal, cervical, ovarian, or those beyond 20 weeks at diagnosis/treatment. Results: There were 511 cases identified with 225 meeting the inclusion criteria. There were 7 maternal deaths (3.0%) with 18 (8%) of the early abdominal ectopic pregnancies occurring with an intrauterine device in place. Mean gestational age at the time of treatment was 10 weeks 0 days and mean maternal age was 29.7 years. The average blood loss associated with treatment was 1,450 ml. The top three sites of early abdominal ectopic pregnancies were pouches around the uterus (24.3%), serosal surface of the uterus and tubes (23.9%), and multiple sites (12.8%). Primary surgical management was performed in 208 cases (87.8%). Nonsurgical adjuvant or primary therapy included intramuscular methotrexate, intralesional methotrexate, intracardiac KCl, and artery embolization. Conclusion: Abdominal pregnancies should be considered in all patients until an intrauterine location can be confirmed. Understanding treatment options by pregnancy location may be helpful in the management of this potentially life-threatening condition.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Early Abdominal Ectopic Pregnancies: A Systematic Review of the Literature

Poole¹,

Haas

Magann

2012

Gynecol Obstet Invest

135

145

View full text Add to dashboard Cite

show abstract

“…Abdominal pregnancy may be secondary due to tubal abortion or rupture with implantation on any peritoneal or visceral surface or, more rarely primary, due to direct abdominal implantation, with normal fallopian tubes and ovaries and no tubal fistula identified 2 4…”

Section: Discussionmentioning

confidence: 99%

An unusual haemoperitoneum - secondary abdominal pregnancy

Akhtar

Navaratnam²,

Davies³

et al. 2012

Case Reports

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“…Many authors have described pregnancies carried to term with live births, various fetal congenital malformations, poor fetal outcome and high neonatal mortality [4,5] and even minimally invasive surgeries have been tried up to the second trimester of pregnancy [6,14,15]. …”

Section: Discussionmentioning

confidence: 99%

Secondary abdominal pregnancy and its associated diagnostic and operative dilemma: three case reports

et al. 2009

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IntroductionAbdominal pregnancy is extremely rare and has historically been defined as an implantation in the peritoneal cavity, exclusive of tubal, ovarian or intraligamentary pregnancy.Case presentationsThree cases are reported. All came from a lower middle-income group and all of them were subjected to surgery. The first patient was a 30-year-old woman, who was pregnant for the fourth time, who presented at 16 weeks with an abdominal pregnancy. She was admitted with constant abdominal pain and retention of urine. She was hemodynamically stable and was administered a pre-operative intramuscular injection of methotrexate. During laparotomy she had only minor blood loss, the major part of the placenta was removed easily and she did not require any blood transfusion. Serum beta human chorionic gonadotrophin values and ultrasound follow-up revealed a normal study four weeks after surgery. The second patient was a 26-year-old woman, pregnant for the third time, admitted at 14 weeks with an abdominal pregnancy with hemoperitoneum, and the third patient was a 24-year-old woman, pregnant for the first time, who presented at 36 weeks gestation. She was only diagnosed as having an abdominal pregnancy during surgery, experienced excessive blood loss and required a longer hospital stay.ConclusionsWe hypothesize that treatment with pre-operative systemic methotrexate with subsequent laparotomy for removal of the fetus and placenta may minimize potential blood loss, and would be a reasonable approach in the care of a patient with an abdominal pregnancy with placental implantation to the abdominal viscera and blood vessels. This treatment option should be considered in the management of this potentially life-threatening condition. During surgery, if the placenta is attached to vital organs it should be left behind. Early diagnosis can help in reducing associated maternal morbidity and mortality.

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Ruptured tubal ectopic pregnancy with secondary implantation in the pouch of Douglas

Cited by 13 publications

References 2 publications

Early Abdominal Ectopic Pregnancies: A Systematic Review of the Literature

Early Abdominal Ectopic Pregnancies: A Systematic Review of the Literature

An unusual haemoperitoneum - secondary abdominal pregnancy

Secondary abdominal pregnancy and its associated diagnostic and operative dilemma: three case reports

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