Intramyometrial Pregnancy

Abstract

Study Objective Hysteroscopic management of Extra cavitary ectopic pregnancy. Design Case presentation. Setting Operative Hysteroscopy using 1.8 mm 30degree telescope with operative sheath and hand instruments without electrocautery Patients or Participants single case study. Interventions Operative Hysteroscopy at low pressure of 8 mm Hg under trans abdominal ultrasound guidance. Measurements and Main Results A second para patient was referred to our tertiary center with failed attempt to perform dilatation and evacuation for a missed abortion. They did not find and product of conception in curettage specimen. At our center on 3d transvaginal ultrasound we diagnosed it to be an intra myometrial pregnancy. Under trans abdominal ultrasound guidance with full urinary bladder we decided to remove band of fibrotic adhesion near fundus with cold Scissors to release intra myometrial pregnancy in endometrial cavity. It was followed by suction with disposable cannula under trans abdominal ultrasound guidance for ensure complete evacuation. Integrity of fundal myometrium was checked at the end of the procedure. More than 1 cm myometrial thickness was present above ectopic gestation site. Conclusion Hysteroscopy under sonography guidance is safe management option for such complicated intramyometrial ectopic pregnancy. Hysteroscopic management of Extra cavitary ectopic pregnancy. Case presentation. Operative Hysteroscopy using 1.8 mm 30degree telescope with operative sheath and hand instruments without electrocautery single case study. Operative Hysteroscopy at low pressure of 8 mm Hg under trans abdominal ultrasound guidance. A second para patient was referred to our tertiary center with failed attempt to perform dilatation and evacuation for a missed abortion. They did not find and product of conception in curettage specimen. At our center on 3d transvaginal ultrasound we diagnosed it to be an intra myometrial pregnancy. Under trans abdominal ultrasound guidance with full urinary bladder we decided to remove band of fibrotic adhesion near fundus with cold Scissors to release intra myometrial pregnancy in endometrial cavity. It was followed by suction with disposable cannula under trans abdominal ultrasound guidance for ensure complete evacuation. Integrity of fundal myometrium was checked at the end of the procedure. More than 1 cm myometrial thickness was present above ectopic gestation site. Hysteroscopy under sonography guidance is safe management option for such complicated intramyometrial ectopic pregnancy.