Presence Of Intrauterine Pregnancy Research Articles

Hetero pregnancy. A case report

Background: Heterotopic pregnancy is a rare condition that refers to the simultaneous existence of intrauterine pregnancy (IUP) and ectopic pregnancy. It is a life-threatening condition that requires early diagnosis and prompt management. Case Presentation: A 30-year-old African pregnant woman was presented to the emergency department complaining of severe abdominal pain, especially on the right side. She was checked for history and underwent a physical examination and ultrasound which reveals intrauterine pregnancy with right adnexal mass. While undergoing laparotomy for management of the adnexal mass, a small fetus was found; therefore, a right salpingo- oophorectomy for removal of this ectopic pregnancy was done. She was improved and discharged in good condition with a recommendation to follow up on her pregnancy. Five months later, she was admitted again as she experienced an eclamptic fit with tonic-clonic convulsion lasting for 10 minutes. She experienced a deteriorating condition that required medical termination of pregnancy. She did not improve and she was admitted to the intensive care unit and well-managed, then she improved and was shifted to the ward for observation for 10 days and then discharged in good condition. Conclusion: The presence of IUP does not exclude the presence of ectopic pregnancy. Follow-up during pregnancy is necessary, especially if the patient is known to have previous gestational complications. Examination using transvaginal ultrasound is necessary for early diagnosis of heterotropic pregnancy (HP). Surgical treatment of HP and subsequent follow-up can contribute to maintaining IUP and its successful delivery.

Fertility Outcomes after Surgical Management of Colorectal Endometriosis: A Single-center Retrospective Study

To assess the pregnancy rate after surgery for colorectal endometriosis. A retrospective, single-centre study performed from January 2014 to December 2019. A university tertiary referral centre. Patients with the intention to get pregnant under the age of 43 years, with or without a history of infertility and who were surgically managed for colorectal endometriosis. Complete excision of deeply infiltrating endometriosis (DIE). The postoperative pregnancy rate was assessed. Seventy-seven patients had surgery; their mean age was 32.5 ± 4.4 years. Preoperative documented infertility was present in 77.9% (n = 60) of patients. The mean length of history of infertility was 36.2 ± 24.9 months. The procedure was performed by laparoscopic surgery in 92.2% (n = 71) of patients. Non-conservative, conservative and mixed treatment were performed in 66.2% (n = 51), 29.9% (n = 23) and 3.9% (n = 3) of patients, respectively. According to the Clavien-Dindo classification, the 3B complication rate was 6.5% (n = 5). The mean follow-up was 46.7 ± 20.6 months. Clinical pregnancies were defined by the presence of intra-uterine pregnancy with an embryo with cardiac activity. The postoperative pregnancy rate was 62.3% (n = 48), and 54.2% (n = 26) were spontaneous. The mean number of pregnancies was 1.2 ± 0.4 per patient. In addition, 18.7% (n = 9) of patients got pregnant twice. The mean time from surgery to pregnancy was 13.8 ± 13.1 months. The live birth rate was 89.1% (n = 41). There were no significant differences concerning the prognostic criteria reported in the literature (anti-Müllerian hormone level, age, presence of adenomyosis). There were no predictive criteria for live births. According to this study, surgery for colorectal endometriosis results in a high postoperative pregnancy rate. Studies with a high level of evidence are needed to determine good candidates for this type of surgery.

Laparoscopic Management of Lately Diagnosed Triplet Heterotopic Pregnancy

Ruptured ectopic pregnancy is one of the outcomes of mis or delayed diagnosis and the massive hemorrhage resulting is responsible for more than three quarters of the first trimester maternal death. Simultaneous presence of intrauterine pregnancy adds obstacles for the correct diagnosis to take place. The management of this condition is a real dilemma as life threatening condition could be the only presentation which needs immediate intervention. The high index of suspicion is mandatory to ensure timely diagnosis and management to prevent stormy outcome.

Decidual reactions in the tubal mucosa in the presence of intrauterine pregnancy: Sjovall, A.: Acta obst. et gynec. Scandinav. 15: 68, 1935

Decidual reactions in the tubal mucosa in the presence of intrauterine pregnancy: Sjovall, A.: Acta obst. et gynec. Scandinav. 15: 68, 1935