Live birth after laparoscopic management of a ruptured myomectomy site pregnancy and unruptured tubal gestation in a double ectopic heterotopic gestation

被引:7
|
作者
Kalra, Aradhana [1 ]
Kumar, Prem [2 ]
Parwan, Deepika [3 ]
机构
[1] Milann Fertil, Dept Reprod Med, E 580 GKZ, Delhi 110048, India
[2] Sarvodaya Hosp, Dept Gen Surg, Faridabad, India
[3] Sarvodaya Hosp, Dept Pathol, Faridabad, India
关键词
Pregnancy; heterotopic; Uterine myomectomy; Gynecology; DIAGNOSIS;
D O I
10.23736/S2724-606X.21.04772-9
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Myomectomy scar pregnancy is a rare intramural pregnancy in which gestational sac is implanted in the myometrium, in the previous myomectomy scar separate from endometrial cavity and fallopian tubes. Heterotopic pregnancy is presence of simultaneous gestation at two or more implantation sites. Our patient presented at 7 weeks, in-vitro fertilization (IVF) conception with previous four IVF failures and myomectomy 3 months prior. Transvaginal sonography revealed twin live pregnancies, one intrauterine and another in the posterior wall of the uterus distinctly separate from the endometrial cavity. Laparoscopy revealed a ruptured intramural pregnancy, another unruptured tubal pregnancy which was initially missed by USG. After laparoscopic management, intrauterine pregnancy continued resulting in live birth at 35 weeks. This case adds to the literature and highlights the importance of early diagnosis and timely intervention of a rare form of an ectopic gestation. This is the only reported case in literature with a heterotopic gestation and a coexistent myomectomy scar pregnancy and the only one resulting in successful live birth after laparoscopic management of a ruptured myomectomy scar pregnancy in a heterotopic gestation. Early diagnosis is important for salvaging the intrauterine gestation and one should actively look for them at viability scan especially in assisted reproductive technology (ART) conception and scarred uterus.
引用
收藏
页码:268 / 271
页数:4
相关论文
共 37 条
  • [21] SUCCESSFUL MANAGEMENT AND OUTCOME OF HETEROTOPIC TRIPLET INVITRO FERTILIZATION (IVF) GESTATION - TWIN TUBAL AND SURVIVING INTRAUTERINE PREGNANCY
    GOLDMAN, JA
    DICKER, D
    DEKEL, A
    FELDBERG, D
    ASHKENAZI, J
    JOURNAL OF IN VITRO FERTILIZATION AND EMBRYO TRANSFER, 1991, 8 (05): : 300 - 302
  • [22] Laparoscopic management of a ruptured unilateral live twin ectopic pregnancy in a Jehovah's Witness
    Karanjgaokar, V.
    Shah, P.
    Nicholson, Y.
    Spence-Jones, C.
    JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 2009, 29 (06) : 557 - 558
  • [23] Laparoscopic management of second trimester ruptured cornual heterotopic pregnancy with subsequent live birth delivery: A case report and literature review
    Li, Yi-Ling
    Chuang, Fei-Chi
    Lan, Kuo-Chung
    TAIWANESE JOURNAL OF OBSTETRICS & GYNECOLOGY, 2023, 62 (02): : 363 - 368
  • [24] Laparoscopic management of heterotopic cesarean scar pregnancy with preservation of intrauterine gestation and delivery at term: case report
    Demirel, L. Cem
    Bodur, Harika
    Selam, Belgin
    Lembet, Arda
    Ergin, Tolga
    FERTILITY AND STERILITY, 2009, 91 (04) : 1293.e5 - 1293.e7
  • [25] Persistent ectopic pregnancy after linear salpingotomy: a non-predictable complication to conservative surgery for tubal gestation
    Lund, CO
    Nilas, L
    Bangsgaard, N
    Ottesen, B
    ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, 2002, 81 (11) : 1053 - 1059
  • [26] Laparoscopic management of a second trimester ruptured spontaneous heterotopic tubal pregnancy mimicking ovarian tumour, a case report
    Kathopoulis, N.
    Diakosavvas, M.
    Kypriotis, K.
    Chatzipapas, I.
    Domali, E.
    Protopapas, A.
    FACTS VIEWS AND VISION IN OBGYN, 2023, 15 (02): : 157 - 160
  • [27] Laparoscopic management of short-interval interstitial pregnancy after recent tubal ectopic pregnancy: A case report
    Bernstein, Megan
    Han, Michelle
    CASE REPORTS IN WOMENS HEALTH, 2024, 41
  • [28] Unraveling the "double whammy"dilemma: do concomitant tubal infertility and previous ectopic pregnancy shrink the possibility of live birth?
    Vitale, Salvatore Giovanni
    Riemma, Gaetano
    Cianci, Antonio
    FERTILITY AND STERILITY, 2020, 113 (05) : 934 - 935
  • [29] Live birth of healthy twins after a heterotopic tubal and intrauterine twin pregnancy in a woman who was stimulated with clomiphene citrate
    Sayin, NC
    Yardim, T
    FERTILITY AND STERILITY, 2003, 80 (05) : 1265 - 1267
  • [30] Laparoscopic Management of Short-Interval Interstitial Pregnancy After Recent Tubal Ectopic: A Case Report
    Bernstein, Megan
    Han, Michelle
    OBSTETRICS AND GYNECOLOGY, 2024, 143 (5S): : 22S - 22S