Twin tubal pregnancy: A large unruptured ectopic pregnancy

Goswami, Deepti; Agrawal, Nidhi; Arora, Vrinda

doi:10.1111/jog.12771

Cited by 13 publications

(14 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This suggests that tubal distension may not be the main factor causing tubal rupture in ectopic pregnancy. Although a twin pregnancy may be larger, trophoblastic invasion may be less, due to an earlier gestation, compared with an equivalent-sized singleton pregnancy, and is therefore less likely to rupture [13]. Although the present case was a singleton tubal ectopic pregnancy, it grew to 7.3 cm without rupture.…”

Section: Discussionmentioning

confidence: 58%

“…A twin tubal pregnancy mass tends to show marked distension of the Fallopian tube without tubal rupture [12,13]. Krzaniak reported a twin tubal ectopic pregnancy mass measuring 10 cm [12].…”

Section: Discussionmentioning

confidence: 99%

“…Goswami et al reported a twin tubal ectopic pregnancy mass measuring 6 cm [13]. Laparotomy with right salpingectomy was carried out.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Unusually Large, Unruptured Tubal Ectopic Pregnancy Mass in a Woman With Bilateral Tubal Obstruction Treated by Laparoscopy: A Case Report

Kim

2016

J Med Cases

View full text Add to dashboard Cite

A tubal ectopic pregnancy mass usually measures 1.5-3.5 cm, and ruptures if it grows beyond this size. The author encountered a case of an unruptured, tubal ectopic pregnancy mass measuring up to 7.3 cm, containing an embryo with a crown-rump length (CRL) of 2.02 cm, corresponding to 8 weeks, 4 days. To the author's knowledge, this is the largest reported singleton tubal ectopic pregnancy mass. A 36-year-old gravida 0, para 0 woman presented with a history of mild vaginal bleeding, lower abdominal pain, and 8 weeks of amenorrhea. Vaginal bleeding started 3 weeks before, but she mistook this for menstruation. Her menstrual cycle ranged between 28 and 30 days and lasted 6 days. Her last menstrual period was about 8 weeks prior. She had an appendectomy 22 years prior. She was diagnosed with infertility due to tubal obstruction and underwent laparoscopic fimbrioplasty at another general hospital 13 years prior. She was told that her Fallopian tubes were still obstructed on hysterosalpingography after fimbrioplasty. She had not used contraception. On arrival in the emergency room, her serum beta-human chorionic gonadotropin (hCG) level was 15,944 mIU/mL. The transvaginal ultrasound scan (TVUS) demonstrated an ectopic pregnancy mass measuring 7.3 × 4.0 cm in the left adnexa. An embryo with CRL of 2.02 cm corresponding to 8 weeks, 4 days was noted in the ectopic pregnancy mass. Upon entering the pelvic cavity, a dark reddish-colored unruptured tubal ectopic pregnancy mass was noted. Laparoscopic salpingectomy was carried out. The right Fallopian tube was adherent to the right pelvic wall. Even though the Fallopian tubes are obstructed, pregnancy is still possible. Laboratory studies should always include a pregnancy test. A large tubal ectopic pregnancy mass could have developed when a blastocyst was implanted in a fused Fallopian tube that was adherent to the pelvic peritoneum and uterus.

show abstract

Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Unusually Large, Unruptured Tubal Ectopic Pregnancy Mass in a Woman With Bilateral Tubal Obstruction Treated by Laparoscopy: A Case Report

Kim

2016

J Med Cases

View full text Add to dashboard Cite

show abstract

“…In the literature, large tubal ectopic pregnancies, as in our case, have been recognized in twin tubal ectopic pregnancies. Goswami et al (11) defined a twin tubal ectopic pregnancy with a crown-rump length of 2 cm, which is a diameter less than that seen in our case. The accepted treatment option for large tubal ectopic pregnancies is surgical management.…”

Section: Resultsmentioning

confidence: 81%

Unruptured Live Ectopic Pregnancy at 11 Weeks of Gestation

Çelik¹,

Bestel²,

Engin³

et al. 2016

Istanbul Med J

View full text Add to dashboard Cite

Ectopic pregnancy is a complication of pregnancy in which the pregnancy implants outside the uterine cavity. The fallopian tubes are the regions where implantation mostly occurs, but it can also occur in the cervix, ovaries, and abdomen. Ectopic pregnancy can be detected at an earlier stage due to enhanced diagnostic capabilities. As pregnancy progresses, tubal rupture occurs mostly due to the inability of the distention of tubal tissues. Damage to the mother is minimal because of early diagnosis and enhanced surgical techniques. Case ReportA 26-year-old woman was admitted to our clinic with pain in the pelvic region that had developed acutely. She had no pregnancy. Her medical and family histories were unremarkable. Her menstrual cycle was regular, and her last menstrual period was 5 weeks ago. However, her last menstrual bleeding was different from her earlier menses. It was light in amount and short in duration. She did not have vaginal bleeding or pain until that time.She had pain in her lower abdominal quadrants. Apart from this, her vital signs and physical examination results was normal.Her transvaginal ultrasound examination showed a right adnexial mass that was suitable with an unruptured ectopic pregnancy (Figure 1). In the gestational sac located in the ampullary region of the fallopian tube, a fetus was measured as 10 weeks 3 days. The fetal heart beat was positive. Left adnexa was observed normally. The endometrium was 23.2 mm thick and linear. There was no fluid in the Douglas space. A complete blood count showed that the hemoglobin level was normal (hemoglobin: 11.8 g/dL and hematocrit: 35.2%). The serum beta human chorionic gonadotropin level was 32338 mIU/mL. She underwent laparoscopic surgery under general anesthesia. She provided informed consent before surgery. In the abdominal cavity, there were no blood clots. An unruptured ectopic gestational sac was observed; it was located in the right ampullary region of the fallopian tube. This mass was approximately 11 weeks gestation. Salpingectomy was performed with preservation of ovarian tissue. The right ovary, left fallopian tube, and left ovary were observed normally. At the end of laparoscopic surgery, dilatation and curettage was performed. The postoperative course was normal. She was discharged home in a good condition on second day.A histopathological examination of the tissue specimens revealed tubal pregnancy (Figure 2, 3). The tissue from curettage was found to be that of the endometrium with decidual changes, Unruptured Live Ectopic Pregnancy at 11 Weeks of Gestation Ectopic pregnancy is defined as the implantation of a fertilized ovum at a site other than the uterine endometrium. The fallopian tube is the most common site for ectopic implantation. Diagnosis is clinically based on a history of pelvic pain associated with amenorrhea and a positive pregnancy test result with or without slight vaginal bleeding. Ectopic pregnancies account for 10%-15% of all maternal deaths. The prevention of tubal rupture before its occurrence is extremel...

show abstract

“…A report published in 2015 described a non-ruptured twin tubal ectopic pregnancy with fetal crown-rump length of 2 cm [ 10 ]. There was also a report of a bilateral tubal ectopic pregnancy with un-ruptured gestational sacs of over 4 cm [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Previously asymptomatic ruptured tubal ectopic pregnancy at over 10 weeks' gestation: Two case reports

Gauvin

Amberger

Louie

et al. 2019

Case Reports in Women's Health

View full text Add to dashboard Cite

Ectopic pregnancy is a life-threatening condition affecting up to 2% of gestations. Implantation in the fallopian tube is most common, with symptoms typically presenting earlier for gestations in the ampulla and isthmus compared with the cornua and non-tubal sites. In this paper, the cases are described of two patients with advanced ectopic pregnancies that ruptured. One woman aged 36 years presented at 17 1/7 weeks' gestation with a ruptured cornual ectopic pregnancy. The other woman, aged 35 years, presented at 11 1/7′ weeks gestation with a ruptured ectopic pregnancy in the left tubal ampulla. To our knowledge, there are no other reported cases of a tubal ampulla pregnancy presenting at such an advanced gestation with no prior symptoms.

show abstract

Twin tubal pregnancy: A large unruptured ectopic pregnancy

Cited by 13 publications

References 10 publications

Unusually Large, Unruptured Tubal Ectopic Pregnancy Mass in a Woman With Bilateral Tubal Obstruction Treated by Laparoscopy: A Case Report

Unusually Large, Unruptured Tubal Ectopic Pregnancy Mass in a Woman With Bilateral Tubal Obstruction Treated by Laparoscopy: A Case Report

Unruptured Live Ectopic Pregnancy at 11 Weeks of Gestation

Previously asymptomatic ruptured tubal ectopic pregnancy at over 10 weeks' gestation: Two case reports

Contact Info

Product

Resources

About

Twin tubal pregnancy: A large unruptured ectopic pregnancy

Cited by 13 publications

References 10 publications

Unusually Large, Unruptured Tubal Ectopic Pregnancy Mass in a Woman With Bilateral Tubal Obstruction Treated by Laparoscopy: A Case Report

Unusually Large, Unruptured Tubal Ectopic Pregnancy Mass in a Woman With Bilateral Tubal Obstruction Treated by Laparoscopy: A Case Report

Unruptured Live Ectopic Pregnancy at 11 Weeks of Gestation

Previously asymptomatic ruptured tubal ectopic pregnancy at over 10 weeks' gestation: Two case reports

Contact Info

Product

Resources

About

Previously asymptomatic ruptured tubal ectopic pregnancy at over 10 weeks' gestation: Two case reports