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Diagnostic and management dilemmas of pregnancies at the utero-tubal junction: A case series and management algorithm.
- Source :
-
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2024 Oct; Vol. 167 (1), pp. 413-419. Date of Electronic Publication: 2024 May 17. - Publication Year :
- 2024
-
Abstract
- Objective: A pregnancy at the utero-tubal junction is a rare type of ectopic pregnancy and is associated with high maternal morbidity if it remains undetected. In the present study we discuss four cases of ectopic pregnancies at the utero-tubal junction which caused diagnostic and management dilemmas.<br />Methods: Four cases of early pregnancies with the gestational sac (G-sac) implanted near the utero-tubal junction are described. In case 1 this was suspected after a failed attempt at dilatation and curettage at our hospital, cases 2 and 3 presented with amenorrhea and pain abdomen and case 4 was diagnosed on first pregnancy documentation scan after frozen embryo transfer.<br />Results: As initial two-dimensional (2D) transvaginal scan (TVS) failed to diagnose the exact location of the G-sac, three-dimensional (3D) TVS helped to localize the exact location of pregnancy and subsequent individualized management. Case 1 had a partial intramural ectopic pregnancy managed by laparotomy and removal of the ectopic sac. The second and third cases were eccentric uterine pregnancies. The fourth was an interstitial ectopic pregnancy managed by a laparoscopic loop and stitch technique.<br />Conclusion: This case series describes the role of 3D TVS for the evaluation of pregnancies implanted at the utero-tubal junction and individual management of eccentric intrauterine, interstitial ectopic and intramural ectopic pregnancies. A diagnostic algorithm for such types of cases and management options is discussed.<br /> (© 2024 International Federation of Gynecology and Obstetrics.)
- Subjects :
- Humans
Female
Pregnancy
Adult
Dilatation and Curettage
Laparoscopy methods
Uterus diagnostic imaging
Uterus abnormalities
Gestational Sac diagnostic imaging
Ultrasonography, Prenatal
Embryo Transfer methods
Algorithms
Pregnancy, Ectopic diagnosis
Pregnancy, Ectopic surgery
Pregnancy, Ectopic diagnostic imaging
Pregnancy, Ectopic therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1879-3479
- Volume :
- 167
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
- Publication Type :
- Academic Journal
- Accession number :
- 38757568
- Full Text :
- https://doi.org/10.1002/ijgo.15587