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You SL, Wang Y. Omentum pregnancy resulting in severe hemoperitoneum: Lessons learned from a review of the literature along with a case report. J Int Med Res 2024; 52:3000605241261893. [PMID: 39053448 PMCID: PMC11283667 DOI: 10.1177/03000605241261893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/28/2024] [Indexed: 07/27/2024] Open
Abstract
Abdominal pregnancies are a rare form of ectopic pregnancy with omentum pregnancies being even rarer. Ectopic pregnancy should be diagnosed and terminated early to prevent the risk of harm to the mother. This case report describes a rare case of omentum pregnancy with severe hemoperitoneum. The patient had not visited a doctor until she failed to menstruate for 3 months, by which point she had developed severe hypogastralgia. The patient was diagnosed with a ruptured ectopic pregnancy after ultrasonography. The omentum pregnancy was complicated by severe hemoperitoneum, which was confirmed by emergency laparotomy. The patient was treated successfully with fetal extraction and partial omentectomy. Ultrasound examination in early pregnancy is essential to detect and treat ectopic pregnancies as early as possible, as surgery is usually required for abdominal pregnancies. Prompt treatment of ectopic pregnancies is critical, as an omentum pregnancy is dangerous and may result in severe intraperitoneal bleeding.
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Affiliation(s)
- Shu-Li You
- Department of Gynaecology and Obstetrics, The People's Hospital of Wucheng District, Jinhua City, Zhejiang Province, China
| | - Yu Wang
- Department of Gynaecology and Obstetrics, The People's Hospital of Wucheng District, Jinhua City, Zhejiang Province, China
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Li Y, Geng J, He Q, Lu J, Xu J, Zhang Y, Zhang C. Abdominal ectopic pregnancy following a frozen embryo transfer cycle: a case report. BMC Pregnancy Childbirth 2021; 21:707. [PMID: 34674658 PMCID: PMC8532271 DOI: 10.1186/s12884-021-04133-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 09/22/2021] [Indexed: 12/02/2022] Open
Abstract
Background Abdominal ectopic pregnancy (AEP) is a rare form of ectopic pregnancy. As the number of in-vitro fertilization (IVF) procedures continues to increase, the incidence of AEP will also rise. However, the rarity and atypical presentation of AEP make early diagnosis challenging. Case presentation Herein, we report an AEP following frozen-thawed embryo transfer (FET) in an artificial cycle. The patient was misdiagnosed with implantation failure when the serum human chorionic gonadotropin (hCG) level was detected as 2.59mIU/ml at fourteenth day after embryo transfer. Therefore, she was suggested to stop luteal phase support. However, a ruptured AEP was developed 33 days following embryo transfer, which was diagnosed by laparoscopic surgery. Conclusions The case highlighted the delayed serum β-hCG and massive intraperitoneal hemorrhage may be clues to make early diagnosis of AEP. Clinicians must attach great importance to close monitoring and bear in mind the possibility of abdominal pregnancy.
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Affiliation(s)
- Yan Li
- Reproductive Medical Center, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Weiwu Road, Zhengzhou, 450003, Henan, China
| | - Jiaxuan Geng
- Reproductive Medical Center, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Weiwu Road, Zhengzhou, 450003, Henan, China
| | - Qiaohua He
- Reproductive Medical Center, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Weiwu Road, Zhengzhou, 450003, Henan, China
| | - Jin Lu
- Reproductive Medical Center, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Weiwu Road, Zhengzhou, 450003, Henan, China
| | - Jin Xu
- Reproductive Medical Center, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Weiwu Road, Zhengzhou, 450003, Henan, China
| | - Ying Zhang
- Reproductive Medical Center, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Weiwu Road, Zhengzhou, 450003, Henan, China
| | - Cuilian Zhang
- Reproductive Medical Center, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Weiwu Road, Zhengzhou, 450003, Henan, China.
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Eisner SM, Ebert AD, David M. Rare Ectopic Pregnancies - A Literature Review for the Period 2007 - 2019 on Locations Outside the Uterus and Fallopian Tubes. Geburtshilfe Frauenheilkd 2020; 80:686-701. [PMID: 32675831 PMCID: PMC7360401 DOI: 10.1055/a-1181-8641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 05/19/2020] [Indexed: 02/05/2023] Open
Abstract
The majority of ectopic pregnancies (EP) are tubal pregnancies, but other implantation sites outside the uterus and tubes are also found. These rare EP locations present a particular diagnostic and therapeutic challenge. We present an overview of potential very rare locations of ectopic pregnancies, their symptoms, diagnosis and treatment, based on a systematic analysis of case reports. A literature review of the databases PubMed, Livivo and Google Scholar for the period 2007 to 2019 was carried out. A total of 113 publications were included in our review. These studies describe EP implantations in the posterior cul-de-sac, on the uterine serosa and uterine ligaments, in the vicinity of almost all intraperitoneal organs, on the abdominal wall as well as in retroperitoneal sites. The most common presenting symptom was abdominal pain occurring in different locations. The diagnostic procedures included various imaging procedures and/or explorative surgery at different advanced stages of pregnancy. The most common and preferred option was laparotomy for surgical treatment. The placenta was successfully resected in the majority of cases. A rare EP location should be considered when making a differential diagnosis in patients of child-bearing age with abdominal pain.
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Affiliation(s)
- Sophie M. Eisner
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie, Campus Virchow Klinikum, Berlin, Germany
| | - Andreas D. Ebert
- Praxis für Frauengesundheit, Gynäkologie und Geburtshilfe, Berlin, Germany
| | - Matthias David
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie, Campus Virchow Klinikum, Berlin, Germany
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Abstract
We present a case of primary omental ectopic pregnancy in a 31-year-old woman which was discovered intraoperatively during a diagnostic laparoscopy and subsequently removed via mini-laparotomy. We emphasise the rarity of this diagnosis, and the importance of careful inspection of the abdominal cavity including the omentum should an ectopic pregnancy be suspected when bilateral fallopian tubes and ovaries appear normal during surgical exploration.
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Affiliation(s)
- Swee Lin Yip
- Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore.,Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore, Singapore
| | - Wei Keat Tan
- Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore, Singapore
| | - Lay Kok Tan
- Singapore General Hospital, Singapore, Singapore
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Miyauchi A, Yamada M, Furuya M, Matsumura S, Murayama S, Yoshimura Y, Tanaka M. Peritoneal pregnancy with massive hemoperitoneum in early gestation: two case reports. Clin Case Rep 2015; 3:431-7. [PMID: 26185643 PMCID: PMC4498857 DOI: 10.1002/ccr3.266] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 12/21/2014] [Accepted: 02/20/2015] [Indexed: 11/09/2022] Open
Abstract
Peritoneal pregnancy may cause severe abdominal bleeding without genital bleeding as early as the fifth week of gestation. Awareness that pregnancy can exist in unusual locations is imperative.
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Affiliation(s)
- Azumi Miyauchi
- Department of Obstetrics and Gynecology, Keio University School of Medicine 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Mitsutoshi Yamada
- Department of Obstetrics and Gynecology, Keio University School of Medicine 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Masataka Furuya
- Department of Obstetrics and Gynecology, Eiju General Hospital 2-23-16 Higashiueno, Taito-ku, Tokyo, 110-0015, Japan
| | - Satoko Matsumura
- Department of Obstetrics and Gynecology, Keio University School of Medicine 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shinji Murayama
- Department of Obstetrics and Gynecology, Keio University School of Medicine 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yasunori Yoshimura
- Department of Obstetrics and Gynecology, Keio University School of Medicine 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Mamoru Tanaka
- Department of Obstetrics and Gynecology, Keio University School of Medicine 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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