Sigmoid Microinvasion by an Ectopic Pregnancy

Paquette, Joalee; Lebœuf, Mathieu; Gorak-Savard, Émilie

doi:10.1016/j.jogc.2016.07.006

Cited by 5 publications

(3 citation statements)

References 9 publications

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“…Until bleeding, the only symptoms showed was an 8 weeks long amenorrhea and abdominal tenderness in lower quadrants at physical examination [21]. Patient with rectal EP can show rectal bleeding while hepatic EP, except for the amenorrhea and vaginal bleeding is hardly ever symptomatic [22][23][24]. Splenic rupture due EP is a very rare event, but it must be recognized considering massive hemoperitoneum [25].…”

Section: Symptoms and Signs Of Ectopic Pregnancymentioning

confidence: 99%

Ectopic Pregnancy: An Overview

Gennaro¹,

Damiani²,

Muzzupapa³

et al. 2022

Clin. Exp. Obstet. Gynecol.

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Objectives: Purpose of this narrative review is to compare, the latest findings about ectopic pregnancy (EP) reporting pathogenetic hypothesis, common and uncommon symptoms, diagnostic work-up, treatment alternatives. EP is a pathological condition characterized by an abnormal blastocyst implant at any site apart from uterine cavity. Dealing with pathogenesis we can recognize many factors: hormonal imbalance, post infective or mechanical induced defects of the tube, assisted reproduction techniques. This condition has aroused interest for its capacity to evolve instantly in a life-threatening condition, needing an early diagnosis and an urgent surgical solution. Mechanism: A comprehensive literature research of recent articles has been performed. Researches for relevant data were conducted utilizing multiple databases, including PubMed, SCOPUS and Ovid. Searches included combinations of the key terms: tubal pregnancy, cervical pregnancy, cesarean scar pregnancy, 'twin and ectopic pregnancy', 'twin and tubal pregnancy', 'twin heterotopic pregnancy', 'laparoscopy and twin pregnancy', 'laparoscopy and tubal pregnancy', 'surgery and pregnancy', 'surgery and ectopic', 'surgery and twin tubal pregnancy', "methotrexate and twin pregnancy 'cornual pregnancy' ". Findings in brief: EP is frequently located in the salpinges but may also occur in many other sites like uterine horns, cervix, ovaries, cesarean scar or in splanchnic organs. Typical signs and symptoms of EP usually consist of pelvic pain, vaginal bleeding or sudden amenorrhea. Beta-human chorionic gonadotropin (b-hCG) dosages are fundamental tools for diagnosis of the early pregnancy whether is normal or not, always considering tubal pregnancy a possible event. Imaging diagnostic tools are described in our review, Ultrasound, Magnetic resonance imaging (MRI), Computed Tomography (CT) are the main options. When the serum b-hCG is positive but at ultrasound examination of pregnancy cannot be found, physician must define this condition as a pregnancy of unknown location (PUL). In this literature-based review we found three therapeutic solutions: expectant, medical or surgical management. Expectant strategy consists of strictly monitoring b-hCG values with no pharmacological or surgical intervention. Methotrexate administration following therapeutic schemes is a cost-effective solution and keeps patient away from surgical risks. Surgery maintains a key role in treatment choice considering that is the only one available in emergency scenario. Conclusions: EP is a diagnostic challenge for the physician, therapy choice is a careful and difficult decision that must be always individualized to ensure patient life uppermost and also future fertility desire.

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Section: Symptoms and Signs Of Ectopic Pregnancymentioning

confidence: 99%

Ectopic Pregnancy: An Overview

Gennaro¹,

Damiani²,

Muzzupapa³

et al. 2022

Clin. Exp. Obstet. Gynecol.

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“…Different from rectal ectopic pregnancies following IVF that have been reported, in this case, the initial serum β-hCG level was 2.31 mIU/mL and neither intrauterine nor ectopic pregnancy was found by TVS. [ 13 , 14 ] And there were 3 similar abdominal pregnancies from 2000 to 2020 (Table 1 ). [ 9 , 15 , 16 ] These cases have common characteristics: the history of IVF failure and the delayed serum β-hCG rise.…”

Section: Discussionmentioning

confidence: 99%

“…It is suspected that a small number of embryos may lead slower proliferative activity of the trophoblast tissue and the abnormal implantation site may cause the poor absorption of β-hCG into the blood circulation. [ 13 ] Although serum β-hCG is most important indicator for the diagnosis of abdominal pregnancy, the possibility of occult abdominal pregnancy should not be excluded when the first serum β-hCG level was < 5 mIU/mL. The best treatment of abdominal pregnancy is surgical removal of gestational tissue as soon as possible, and surgical outcomes are mostly satisfactory.…”

Section: Discussionmentioning

confidence: 99%

Rectal ectopic pregnancy after in vitro fertilization and embryo transfer: A case report

et al. 2022

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Rationale: Rectal ectopic pregnancy is an extremely rare abdominal pregnancy. This article presents a female underwent an unsuccessful in vitro fertilization which was misdiagnosed by serum beta-human chorionic gonadotropin (β-hCG) test and transvaginal ultrasonography. Twenty days later, a ruptured rectal ectopic pregnancy was confirmed by laparoscopy then the gestational tissue removed successfully.Patient concerns: A 32-year-old Chinese female was admitted to our hospital with complaining of symptoms, like gradual worsening of lower abdominal pain and dysuria. The abdominal ultrasonography revealed a sac-like mass in the posterior area to the uterus and a moderate amount of free fluid in the pelvic cavity. Forty days ago, she underwent a frozen embryo transfer. Twenty days ago, her serum β-hCG level was <5 mIU/mL and neither intrauterine nor ectopic pregnancy was detected by transvaginal ultrasonography. Then the procedure was thought to have resulted in biochemical pregnancy failure.

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Rectal Ectopic Pregnancy Managed Successfully by Minimally Invasive Treatment Using Local Methotrexate Injection and Systemic Methotrexate Administration: An Extremely Rare Case at Tu Du Hospital in Vietnam and Literature Review

Nguyen

2023

Journal of Minimally Invasive Gynecology

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Sigmoid Microinvasion by an Ectopic Pregnancy

Cited by 5 publications

References 9 publications

Ectopic Pregnancy: An Overview

Ectopic Pregnancy: An Overview

Rectal ectopic pregnancy after in vitro fertilization and embryo transfer: A case report

Rectal Ectopic Pregnancy Managed Successfully by Minimally Invasive Treatment Using Local Methotrexate Injection and Systemic Methotrexate Administration: An Extremely Rare Case at Tu Du Hospital in Vietnam and Literature Review

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