Simultaneous presentation of tubal and primary abdominal pregnancies following clomiphene citrate treatment

Abstract

Abdominal pregnancy is a rare condition that is potentially life-threatening for the mother. We present a case of simultaneous ectopic pregnancies (EPs) in the right fallopian tube and in the vesicouterine pouch. A 26-yearold woman had undergone prior ovulation induction with clomiphene citrate and human chorionic gonadotropin (hCG) at an outside hospital for unexplained infertility. The patient was referred to our hospital for a suspected ectopic pregnancy at 6 weeks gestation. Transvaginal ultrasonography detected a viable fetus at the anterior left side of the uterus; therefore, we suspected a left tubal pregnancy. However, laparoscopic surgery revealed that EPs were located in both the left vesicouterine pouch and in the right fallopian tube. Resection of the right salpinx and abdominal implant were performed. Histopathological examination confirmed the simultaneous presentation of a primary abdominal pregnancy and a right tubal pregnancy. After surgery, the patient's serum hCG level returned to normal. Concurrent EPs and abdominal pregnancy are very rare. However, it should be noted that reproductive technologies sometimes cause unusual clinical situations. A thorough abdominal inspection is needed.

Factors affecting success of single-dose methotreaxhate treatment in ectopic pregnancy

“…Nulliparous women who do not use any contraceptive method have at least 2.6 times greater risk for tubal pregnancy in a one-year period (21,22). Infertile population have some further risk factors such as history of reversal of tubal sterilization, ovulation induction and in vitro fertilization (23). In many of those women, histerosalphingography does not show any abnormality and one can not detect, intraoperatively any gross tubal pathology.…”

Non-tubal Ectopic Pregnancy: Incidence and Diagnosis

“…Risk factors are similar to tubal ectopic prior history of a medically treated ectopic, previous pelvic inflammatory disease, prior surgery, endometriosis, and assisted conception. Abdominal ectopic pregnancies have been described after ART, specifically after IUI [57], after IVF [58], and after Clomid [59]. Symptoms include abdominal pain, painful fetal movements, vaginal bleeding, nausea, and vomiting.…”

Immunohistochemical Structural Features of the Wall of the Fallopian Tubes of the Fetus at Different Gestation Periods from Mothers with Physiological Pregnancy

“…За даними літератури встановлені і описані в статті особливості будови стінки маткових труб плодів від матерів з фізіологічною вагітністю співпадають з основними етапами закладки і формування органів у внутрішньоутробний період [18][19][20][21][22][23]. А саме: зміни форми і кількості звужень маткових труб відповідно до терміну гестації; формування складок слизової оболонки та становлення її функціональної активності; збільшення показників товщини стінки органу та її основних структурних компонентів; превалювання зрілих колагенів в складі сполучної тканини м'язової оболонки та стінки судин [24][25][26][27][28].…”