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Federación Mexicana de Ginecología y Obstetricia, A.C.

2018, Number 09

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Ginecol Obstet Mex 2018; 86 (09)

Spontaneous heterotopic pregnancy with tubular breakage and hypovolemic Shok. A case report and literature review

Benavides-Calvache JP, Escobar-Vidarte MF, Hurtado-Burbano DF

Language: Spanish
References: 22
Page: 611-615
PDF size: 393.56 Kb.


ABSTRACT

Background: The heterotopic pregnancy is considered a rare condition that represents a diagnostic challenge both clinical and ultrasound requiring a high index of suspicion, the therapeutic approach and the surgical route will depend on the clinical and hemodynamic conditions of the patient, being able to achieve a successful continuity of intrauterine gestation when timely interventions are made.
Clinical case: Patient with a known diagnosis of intrauterine gestation of 11.1 weeks who was admitted to the emergency room due to vaginal bleeding, with clinical signs of shock and pelvic ultrasound that reports a suggestive image of right tubal heterotopic pregnancy and abundant free liquid. Resuscitation is performed with blood components and surgical management with emergency laparotomy, draining massive hemoperitoneum, requires salpingectomy and resection of omentum compromised, with good evolution and progression of intrauterine gestation to term
Conclusions: The treatment of choice for ectopic pregnancy remains surgical. The route of admission depends on the hemodynamic conditions of the patient. Laparoscopy is the reference standard of treatment and laparotomy is the option when laparoscopy is not possible due to technical, logistical or hemodynamic instability derived from tubal rupture.


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