1/54. survival of cornual (interstitial) pregnancy.We report a case of a singleton cornual (interstitial) pregnancy following spontaneous conception in a primigravida with no risk factors for ectopic pregnancy. She presented at 30 weeks gestation with haemoperitoneum, due to a small rupture on the posterior surface of the cornual pregnancy. At laparotomy, an incision was made in the cornu, the baby was delivered and survived after spending 39 days in a special care baby unit.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/54. hemoperitoneum from spontaneous bleeding of a uterine leiomyoma: a case report.Bleeding from uterine leiomyoma is a rare cause of hemoperitoneum. In most cases bleeding is a result of trauma or torsion. Spontaneous rupture of a superficial vein is extremely rare. Fewer than 100 cases have been reported. Our patient is a 44-year-old black woman who presented in the emergency room with acute onset of epigastric pain. Past medical and surgical history was not contributory except for a uterine "fibroid." In the emergency room, the patient's abdomen became diffusely tender. Her pregnancy test was negative, and the abdominal ultrasound showed fluid in the peritoneal cavity. The patient became hemodynamically unstable, and there was a significant drop of the hemoglobin/hematocrit. A surgical consultation was requested, and the patient underwent exploratory laparotomy. A subserosal uterine leiomyoma was found, with an actively bleeding vein on its dome. The leiomyoma was excised and 3 liters of blood and blood clots were evacuated from the peritoneal cavity. The patient was premenopausal and had a known leiomyoma. The clinical course was similar to that of previously reported cases. Although extremely rare, when there is no history of trauma, pregnancy, or other findings, spontaneous bleeding from uterine leiomyoma should be in the differential diagnosis. Emergent surgical intervention is recommended to establish the diagnosis and stop the hemorrhage.- - - - - - - - - - ranking = 0.28571428571429keywords = pregnancy (Clic here for more details about this article) |
3/54. Primary peritoneal pregnancy: a case report.A 22-year-old primipara using intrauterine contraceptive device was diagnosed to be in haemorrhagic shock due to acute ruptured ectopic pregnancy. At laparotomy, both tubes and ovaries were normal and products of conception were found to be implanted on the posterior surface of uterus near the attachment of right uterosacral ligament producing a haemoperitoneum of more than 2 l. This is the fourth case report of primary abdominal pregnancy associated with intrauterine contraceptive device (IUCD).- - - - - - - - - - ranking = 0.85714285714286keywords = pregnancy (Clic here for more details about this article) |
4/54. Laparoscopic surgery with intraoperative autologous blood transfusion in patients with heavy hemoperitoneum due to ectopic pregnancy.patients with ectopic pregnancy complicated by heavy hemoperitoneum generally undergo immediate laparotomy, and homologous blood transfusion is sometimes started before the operation. Two women underwent laparoscopic surgery for heavy hemoperitoneum (2600 and 1900 ml) due to ectopic pregnancy. The aspirated blood was reinfused during operation through a leukocyte-reduction filter after lavage with an autologous blood-salvage transfusion apparatus.- - - - - - - - - - ranking = 0.85714285714286keywords = pregnancy (Clic here for more details about this article) |
5/54. Primary peritoneal pregnancy implanted on the uterosacral ligament: a case report.Peritoneal pregnancies are classified as primary and secondary. Primary implantation on the peritoneum is extremely rare in extrauterine pregnancy and is a potentially life-threatening variation of ectopic pregnancy within the peritoneal cavity, representing a grave risk to maternal health. Secondary abdominal pregnancies are by far the most common and result from tubal abortion or rupture, or less often, after uterine rupture with subsequent implantation within abdomen. early diagnosis and appropriate surgical management, regardless of stage of gestation, appear to be important in achieving good results. We report a case of primary peritoneal pregnancy in a 28-year-old woman, who had severe lower abdominal pain one day before laparotomy for a preoperative diagnosis of ectopic pregnancy. The conceptus was implanted on the left uterosacral ligament. A fresh embryo of approximately 8 weeks' gestation was found in the conceptus.- - - - - - - - - - ranking = 1.1428571428571keywords = pregnancy (Clic here for more details about this article) |
6/54. Rupture of splenic artery aneurysm during pregnancy and posterior evolution of gestation.We present a case of splenic artery aneurysm rupture in a 26 weeks pregnant patient. Facing to the maternal collapse and after the ultrasonographical diagnosis of massive hemoperitoneum, the rapid intervention proved to be crucial in controlling the hemorrhage and allowed for the continuation of gestation and successful delivery.- - - - - - - - - - ranking = 0.57142857142857keywords = pregnancy (Clic here for more details about this article) |
7/54. placenta accreta associated with a ruptured pregnant rudimentary uterine horn. Case report and review of the literature.pregnancy in a rudimentary uterine horn is rare and is usually associated with fetal death and serious maternal morbidity and mortality. A case of pregnancy in a rudimentary uterine horn with rupture 14 weeks after last menstrual period and is complicated with placenta accreta is presented. The patient had signs and symptoms of massive hemoperitoneum. An emergency exploratory laparotomy revealed rupture of the gravid rudimentary horn of a bicornuate uterus. Histologic examination of the specimen showed that placenta was accreta. The relative literature is reviewed and the association of placenta accreta in such situations is pointed out.- - - - - - - - - - ranking = 0.14285714285714keywords = pregnancy (Clic here for more details about this article) |
8/54. Primary ruptured ovarian pregnancy in a spontaneous conception cycle: a case report and review of the literature.Ovarian pregnancy is an uncommon presentation of ectopic gestation, where the gestational sac is implanted within the ovary. Usually, it ends with rupture, which occurs before the end of the first trimester. Its presentation often is difficult to distinguish from that of tubal ectopic pregnancy and hemorrhagic ovarian cyst. We describe a case of primary ovarian pregnancy in a 31-year-old patient who presented to the emergency room with symptoms and signs of peritonism and positive urine hCG test. The gestation sac was demonstrated in the right ovary by transvaginal sonography. MSD (mean sac diameter) was 15 mm corresponding to the sixth gestational week. Free fluid was found in the Douglas pouch. Culdocentesis was positive for hemoperitoneum. Henceforth, emergency laparotomy and wedge resection of the ovary was perfomed. Aetiological, clinical and therapeutical aspects of this rare extrauterine pregnancy are described. Also, the problems of its differential diagnosis are discussed.- - - - - - - - - - ranking = 1.1428571428571keywords = pregnancy (Clic here for more details about this article) |
9/54. Heterotopic pregnancy at 16 weeks of gestation after in-vitro fertilization and embryo transfer.We present an heterotopic pregnancy at 16 weeks of gestation following IVF/ET treatment with the ectopic pregnancy located in the left fallopian tube. Intra-abdominal bleeding secondary to an heterotopic pregnancy, causing acute abdominal pain and hemorrhagic shock, should be included in the differential diagnosis even in the second trimester of pregnancy, especially in patients, achieving conception with the use of assisted reproduction techniques.- - - - - - - - - - ranking = 1.1428571428571keywords = pregnancy (Clic here for more details about this article) |
10/54. Omental trophoblastic implants and hemoperitoneum after laparoscopic salpingostomy for ectopic pregnancy. A case report.BACKGROUND: In this era of cost containment, laparoscopic management of ectopic pregnancy has become the mainstay of dealing with this common gynecologic emergency. The aim of surgical intervention remains conservation of the fallopian tube, if possible; salpingectomy is reserved for cases of tubal rupture and/or recurrent ectopic pregnancy, where little hope exists of salvaging tubal function. CASE: A 28-year-old woman, para 2, underwent laparoscopic salpingostomy for ectopic pregnancy. She experienced intraabdominal bleeding within the initial 12 hours of the postoperative period. On exploratory laparotomy, there was active bleeding from the site of the salpingostomy, and a salpingectomy was performed. The patient was lost to follow-up and on postoperative day 21 presented with signs of intraabdominal bleeding; repeat laparotomy revealed active bleeding from trophoblastic implants within the greater omentum. The omentum was adherent to the anterior abdominal wall at the site of umbilical trocar placement. An infracolic omentectomy was performed, with a subsequent uneventful postoperative course; the patient was followed until resolution of the serum beta-hCG. CONCLUSION: Postoperative surveillance is important. Positive intraabdominal pressure during laparoscopic surgery and the Trendelenburg position may be contributory to cephalad migration of trophoblast remnants, with the scavenging action of the omentum and adherence to the site of umbilical trocar placement theoretically providing a mechanism for neovascularization and sustenance of the parasitic trophoblast.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
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