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Live birth after laparoscopic management of a ruptured myomectomy site pregnancy and unruptured tubal gestation in a double ectopic heterotopic gestation
- Source :
- Minerva Obstetrics and Gynecology. 73
- Publication Year :
- 2021
- Publisher :
- Edizioni Minerva Medica, 2021.
-
Abstract
- 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.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
Gestational sac
Uterus
Pregnancy
Uterine Myomectomy
Humans
Medicine
Laparoscopy
Pregnancy, Heterotopic
Assisted reproductive technology
Heterotopic pregnancy
medicine.diagnostic_test
business.industry
Obstetrics
Obstetrics and Gynecology
medicine.disease
medicine.anatomical_structure
Gestation
Female
Pregnancy, Tubal
Live birth
business
Live Birth
Subjects
Details
- ISSN :
- 27246450 and 2724606X
- Volume :
- 73
- Database :
- OpenAIRE
- Journal :
- Minerva Obstetrics and Gynecology
- Accession number :
- edsair.doi.dedup.....5f1f4622eb7fa54b9edbee5f450dddcc