Vázquez CEE, Alfán GF, Carbajal OD

Language: Spanish
References: 10
Page: 387-392
PDF size: 287.11 Kb.

ABSTRACT

A 40 year old woman without symptoms, with a three-week amenorrhea, and with no previous pregnancy history. Three months before she followed treatment with clomifeno and no other risk factors. A measure of beta fraction is performed, finding a probable pregnancy of 3-4 weeks. A new measure of beta fraction is made three weeks later with an ultrasound, finding an important increment in measure, but without evidence of intrauterine pregnancy in the ultrasound. A new ultrasound is made seven weeks after her last period, finding a mass in the left ovary, but without increment in beta fraction. At week ten, she presents an uterine bleeding during a trip, which is diagnosed as a probable mole without any further medical treatment and from the 12^th week, there is a considerable decrement in the beta fraction measure, without any other symptom, but the persistent adnexal mass at the left ovary, with irregular septum images at ultrasound. A laparotomy is performed finding an ectopic pregnancy surrounded by a serum cystadenoma.

REFERENCES

1. Patel MD. Practical approach to the adnexal mass. Radiol Clin N Am 2006;44:879-99.

2. Ahued-Ahued R, Fernández del Castillo SC, Bailón-Uriza R. Ginecología y obstetricia aplicadas. 2ª ed. México: El Manual Moderno, 2003;pp:875-83.

3. Giuntoli RL, Vang RS, Bristow RE. Evaluation and management of adnexal masses during pregnancy. Clin Obst Gynecol 2006;49:492.505.

4. Sherard GB, Hodsosn CA, Williams HJ, Semer DA, et al. Adnexal masses and pregnancy: A 12 years experience. Am J Obstet Gynecol 2003;189:358-63.

5. Christin-Maitre S, Bouchard P. Drug Therapy: medical termination of pregnancy. N Engl J Med 2000;342(13):946-56.

6. Graham L, American College of Obstetricians Gynecologist. ACOG releases guidelines on management of adnexal masses. Am Fam Physician 2008;77(9):1320-3.

7. Kilpatrick CC, Monga M. Approach to the acute abdomen in pregnancy. Obstet Gynecol Clin N Am 2007;34;389-402.

8. Adhikari S, Blaivas M, Lyon M. Diagnosis and management of ectopic pregnancy using bedside transvaginal ultrasonography in the ED: a 2-year experience. Am J Emerg Med 2007;25:591-6.

9. Lozeau AM, Potter B. Diagnosis and Management of Ectopic Pregnancy. Am Fam Physician 2005;72:1707-14.

10. Molina-Sosa A. Tratamiento conservador, laparoscópico y médico del embarazo ectópico. Ginecol Obstet Mex 2007;75:539-48.