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Xia W, Zhang J, Zhang D, Zhu Q, Zhang H, Huang Z, Sun F, Pan H, Duan H. Left-Right Asymmetry of Tubal Pregnancy: A 12-Year Retrospective Hospital-Based Study. J Minim Invasive Gynecol 2018; 26:671-678. [PMID: 30031208 DOI: 10.1016/j.jmig.2018.07.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 07/07/2018] [Accepted: 07/13/2018] [Indexed: 01/05/2023]
Abstract
STUDY OBJECTIVE To investigate whether there are left-right asymmetries, factors affecting lateral dominance, and clinical feature differences in the left and right sides of tubal pregnancy (TP). DESIGN Retrospective study (Canadian Task Force classification II-2). SETTING International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University. PATIENTS Patients (n = 6186) with TP treated surgically. INTERVENTIONS We used data from the digital medical records system of the hospital. Women diagnosed with ectopic pregnancy(EP) between January 2005 and December 2016 in the inpatient department of gynecology were included. All data from the medical files were obtained retrospectively, including demographic characteristics; reproductive, gynecologic, and surgical history; clinical features; and treatment. Patients who were previously treated by salpingectomy or nonsurgical management and those with unknown-site EP or non-TPs were excluded. MEASUREMENTS AND MAIN RESULTS The overall frequency of right-sided TP was 54.48% (3370/6186), which is significantly higher than 50% (p < .001, binominal test). The proportion of right-sided TPs decreased with age (p for trend = .007) and from the proximal (interstitial) end to the distal (fimbrial) end of the tube (p for trend = .017). Of the TP patients with a corpus luteum, we found the corpus luteum was more frequently located in the right ovary (p < .001) and in the contralateral ovary to the TP side in 41.38% of cases. However, tubal rupture was more frequent in left TP than the in right TP (p = .005). CONCLUSION The left-right asymmetries of TP include right-side dominance and the clinical feature differences between the 2sides of TP.
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Affiliation(s)
- Wei Xia
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China (Drs. Xia, J. Zhang, D. Zhang, Zhu, H. Zhang, Huang, Sun, and Pan); Institute of Embryo-Fetal Original Adult Disease, Schoolof Medicine, Shanghai Jiaotong University, Shanghai, China (Drs. Xia, J. Zhang, D. Zhang, Zhu, H. Zhang, Huang, Sun, Pan)
| | - Jian Zhang
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China (Drs. Xia, J. Zhang, D. Zhang, Zhu, H. Zhang, Huang, Sun, and Pan); Institute of Embryo-Fetal Original Adult Disease, Schoolof Medicine, Shanghai Jiaotong University, Shanghai, China (Drs. Xia, J. Zhang, D. Zhang, Zhu, H. Zhang, Huang, Sun, Pan)
| | - Duo Zhang
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China (Drs. Xia, J. Zhang, D. Zhang, Zhu, H. Zhang, Huang, Sun, and Pan); Institute of Embryo-Fetal Original Adult Disease, Schoolof Medicine, Shanghai Jiaotong University, Shanghai, China (Drs. Xia, J. Zhang, D. Zhang, Zhu, H. Zhang, Huang, Sun, Pan)
| | - Qian Zhu
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China (Drs. Xia, J. Zhang, D. Zhang, Zhu, H. Zhang, Huang, Sun, and Pan); Institute of Embryo-Fetal Original Adult Disease, Schoolof Medicine, Shanghai Jiaotong University, Shanghai, China (Drs. Xia, J. Zhang, D. Zhang, Zhu, H. Zhang, Huang, Sun, Pan)
| | - Huiyu Zhang
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China (Drs. Xia, J. Zhang, D. Zhang, Zhu, H. Zhang, Huang, Sun, and Pan); Institute of Embryo-Fetal Original Adult Disease, Schoolof Medicine, Shanghai Jiaotong University, Shanghai, China (Drs. Xia, J. Zhang, D. Zhang, Zhu, H. Zhang, Huang, Sun, Pan)
| | - Zhen Huang
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China (Drs. Xia, J. Zhang, D. Zhang, Zhu, H. Zhang, Huang, Sun, and Pan); Institute of Embryo-Fetal Original Adult Disease, Schoolof Medicine, Shanghai Jiaotong University, Shanghai, China (Drs. Xia, J. Zhang, D. Zhang, Zhu, H. Zhang, Huang, Sun, Pan)
| | - Feng Sun
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China (Drs. Xia, J. Zhang, D. Zhang, Zhu, H. Zhang, Huang, Sun, and Pan); Institute of Embryo-Fetal Original Adult Disease, Schoolof Medicine, Shanghai Jiaotong University, Shanghai, China (Drs. Xia, J. Zhang, D. Zhang, Zhu, H. Zhang, Huang, Sun, Pan)
| | - Hongjie Pan
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China (Drs. Xia, J. Zhang, D. Zhang, Zhu, H. Zhang, Huang, Sun, and Pan); Institute of Embryo-Fetal Original Adult Disease, Schoolof Medicine, Shanghai Jiaotong University, Shanghai, China (Drs. Xia, J. Zhang, D. Zhang, Zhu, H. Zhang, Huang, Sun, Pan)
| | - Hua Duan
- Department of Gynecology Minimally Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China (Dr. Duan)..
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Eom JM, Choi JS, Bae J, Lee WM, Lee E, Lee J, Keum JH. Coexisting ovarian and tubal pregnancies on opposite sides after intrauterine insemination: a case report. BMC Pregnancy Childbirth 2018; 18:259. [PMID: 29940883 PMCID: PMC6019221 DOI: 10.1186/s12884-018-1801-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 04/30/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Ovarian pregnancy is very rare, and contralateral tubal pregnancy coexisting with ovarian pregnancy must be even rarer. CASE PRESENTATION A 33-year-old Korean nulliparous woman was referred to our hospital because she suffered lower abdominal pain and had missed her periods after controlled ovarian hyperstimulation and intrauterine insemination. We could not identify any normal gestational sac in the endometrium, or specific ectopic pregnancies, on an initial ultrasound scan. However, there was a large hematoma in the cul-de-sac and free fluid in the right paracolic gutter. We decided to perform emergent laparoscopic surgery. We found contralateral tubal and ovarian ectopic pregnancies. CONCLUSION To the best of our knowledge, this is the first report of a case in which a patient underwent laparoscopic right salpingectomy and left ovarian ectopic mass excision due to contralateral tubal and ovarian ectopic pregnancies after assisted reproductive technology.
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Affiliation(s)
- Jeong Min Eom
- Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Full time faculty of the Department of Obstetrics and Gynecology, Hanyang University College of Medicine, 222-1 Wangsimni-ro Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Joong Sub Choi
- Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Full time faculty of the Department of Obstetrics and Gynecology, Hanyang University College of Medicine, 222-1 Wangsimni-ro Seongdong-gu, Seoul, 04763, Republic of Korea.
| | - Jaeman Bae
- Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Full time faculty of the Department of Obstetrics and Gynecology, Hanyang University College of Medicine, 222-1 Wangsimni-ro Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Won Moo Lee
- Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Full time faculty of the Department of Obstetrics and Gynecology, Hanyang University College of Medicine, 222-1 Wangsimni-ro Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Eunhyun Lee
- Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Full time faculty of the Department of Obstetrics and Gynecology, Hanyang University College of Medicine, 222-1 Wangsimni-ro Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Jongwon Lee
- Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Full time faculty of the Department of Obstetrics and Gynecology, Hanyang University College of Medicine, 222-1 Wangsimni-ro Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Ji Hyun Keum
- Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Full time faculty of the Department of Obstetrics and Gynecology, Hanyang University College of Medicine, 222-1 Wangsimni-ro Seongdong-gu, Seoul, 04763, Republic of Korea
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