Document Detail


Three consecutive recurrent ectopic pregnancies.
MedLine Citation:
PMID:  8181445     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A case of three consecutive repeated ectopic pregnancies is presented in a 36-year-old woman who was being managed for infertility. The first two ectopic pregnancies occurred in the right fallopian tube, and both were treated conservatively. All three ectopic pregnancies were confirmed histopathologically. The aetiology, symptoms and management of the case are discussed, and the literature is reviewed.
Staff of the infertility clinic at King Khalid University Hospital in Riyadh, Saudi Arabia, cared for a Yemeni woman who had a poor obstetric history. She had had pelvic inflammatory disease. Her 1st pregnancy concluded in a full term vaginal delivery, but gastro-enteritis caused the infant's death at 4 months. She delivered her 2nd child at 32 weeks gestation and the infant died 3 days later. Her 3rd and 4th pregnancies occurred in the right tube. A laparotomy, conservative evacuation of the conceptus from the right tube, and peritoneal lavage were used to treat the ectopic pregnancies. She experienced spontaneous abortion of the 5th pregnancy at 10 weeks. The woman presented at the hospital's gynecology clinic at 40 days amenorrhea with low abdominal pain and a small amount of vaginal bleeding. She had not passed any clots or tissue. The general examination was normal. The pregnancy test was positive. Since she had past ectopic pregnancies, the physicians conducted an ultrasound, which revealed no intrauterine pregnancy and a heterogenous 4.5 cm x 5.5 cm mass near the left tube. Laparoscopy confirmed a normal size uterus, a mass on the left tube, and bleeding into the peritoneum. Laparotomy was performed to remove the unruptured left ampullary ectopic pregnancy in such a way as to preserve the patency of the tube and therefore fertility. The surgeons also conducted peritoneal lavage with dextran saline to remove the blood in the peritoneum. The surgeons lysed the adhesions they found between the omentum, abdominal wall, and the uterus. Both ovaries were in good condition. The right tube was in good condition. She did fine postoperatively and was released 7 days after operation. The physicians could not determine the patency of the left tube, because she was lost to follow up. This case shows that conservative management of the tubes to retain tubal patency was successful, since she was able to conceive, but recurrent ectopic pregnancies may damage the tubes.
Authors:
B Adelusi; A al-Meshari; E O Akande; N Chowdhury
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  East African medical journal     Volume:  70     ISSN:  0012-835X     ISO Abbreviation:  East Afr Med J     Publication Date:  1993 Sep 
Date Detail:
Created Date:  1994-06-14     Completed Date:  1994-06-14     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0372766     Medline TA:  East Afr Med J     Country:  KENYA    
Other Details:
Languages:  eng     Pagination:  592-4     Citation Subset:  IM; J    
Affiliation:
Department of Obstetrics and Gynaecology, King Khalid University Hospital, Riyadh, Saudi Arabia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Causality
Female
Humans
Incidence
Pregnancy
Pregnancy, Tubal* / diagnosis,  epidemiology,  etiology,  therapy
Recurrence

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