medigraphic.com
SPANISH

Ginecología y Obstetricia de México

Federación Mexicana de Ginecología y Obstetricia, A.C.
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2020, Number 10

<< Back Next >>

Ginecol Obstet Mex 2020; 88 (10)

Obstetric hemorrhage and uterine rupture due to an interstitial pregnancy. Report of a case

Villagómez-Mendoza EA, Tamayo-Iturbe A
Full text How to cite this article

Language: Spanish
References: 12
Page: 707-712
PDF size: 239.57 Kb.


Key words:

Ectopic pregnancy, Uterus, Uterine rupture, Risk factors, Gestacional sac, Exploratory laparotomy, Hemoperitoneum, Total abdominal hysterectomy, conservative treatment, maternal morbidity.

ABSTRACT

Background: Interstitial ectopic pregnancy occurs in approximately 2.4% of all cases, this tubal portion is located in the proximal segment and shares the muscular portion of the uterus, due to its great myometrial compliance, it facilitates late diagnosis and its clinical presentation is By means of uterine rupture and with it an increase in morbidity and mortality due to obstetric hemorrhage, the risk factors are the same as for tubal ectopic pregnancy, treatment is assessed based on preserving fertility and according to the patient’s clinical setting.
Clinical case: A 31-year-old patient who went to the emergency department for severe and disabling abdominal pain in the hypogastrium, shock index 1.3, with signs of peritoneal irritation, ultrasound was performed, which reported free fluid in the pelvic cavity and Morrison space, extrauterine gestational sac at the level of the left annex, embryo without heartbeat, craniocaudal length of 11 weeks of gestation, exploratory laparotomy was performed, in which hemoperitoneum of 2800 cc was observed, uterine rupture in the right cornual region of approximately 8x6cm, with fetus e integrity of the amniotic sac adjacent to the uterine rupture, the patient reported satisfied parity, and therefore a total abdominal hysterectomy was decided.
Conclusions: Interstitial ectopic pregnancy shares the same risk factors as tubal pregnancy. Today, we have various diagnostic aids, so the cornerstone is timely detection, which will allow conservative treatments to decrease maternal morbidity and mortality.


REFERENCES

  1. Tulandi T, et al. Ectopic pregnancy: Epidemiology, risk factors, and anatomic site. 2020. https://www.uptodate. com/contents/ectopic-pregnancy-epidemiology-riskfactors- and-anatomic-sites

  2. Tuland T, et al. Ectopic pregnancy: Clinical manifestations and diagnosis. 2020. https://www.uptodate.com/contents/ ectopic-pregnancy-clinical-manifestations-and-diagnosis

  3. Zaragoza J, et al. Embarazo ectópico cornual, reporte de un caso y revisión de la literatura. Rev Fac Med UNAM 2009; 52 (4): 182-84. www.medigraphic.com/pdfs/facmed/ un-2009/un094j.pdf

  4. Delgado K, et al. Embarazo ectópico cornual: Reporte de un caso. Rev Cient Cienc Med 2012; 15 (1): 33-36. www. scielo.org.bo/pdf/rccm/v15n1/v15n1_a10.pdf

  5. Berlin F, et al. Embarazo ectópico cornual, diagnóstico y tratamiento: reporte de dos casos y revisión de la literatura. Rev Chil Obstet Ginecol 2019; 84 (1): 55-63. www.scielo.conicyt.cl/pdf/rchog/v84n1/0717-7526- rchog-84--01-0055.pdf

  6. Ranjana A, et al. A rare case report of ruptured cornual ectopic pregnancy. Int J Obstet Gynaecol Res 2016; 3 (7): 400-4. www.ijogr.com/2016/a-rare-case-report-ofruptured- cornual-ectopic-pregnancy/

  7. Hernández B, et al. Rotura uterina de un embarazo cornual: una urgencia obstétrica. Ginecol Obstet Mex 2012; 80 (7): 491-94. www.medigraphic.com/pdfs/ginobsmex/ gom-2012/gom127i.pdf

  8. Thakur Y, et al. Laparoscopic and ultrasound-guided transcervical evacuation of cornual ectopic pregnancy: an alternative approach. J Obstet Gynaecology 2004; 24 (7): 809-10. doi: 10.1080/001443610400009576

  9. Sanz L, et al. Hysteroscopic management of cornual ectopic pregnancy. Obstet Gynecol 2002; 99: 941-4. doi. 10.1016/ s0029-7844(02)01664-2

  10. Sepúlveda J, et al. Embarazo ectópico cornual recurrente: caso clínico y revisión de la literatura. Rev Chil Obstet Ginecol 2015; 80 (6): 503-9. www.scielo.conicyt.cl/pdf/ rchog/v80n6/art11.pdf

  11. Rizk B, et al. Challenges in the diagnosis and management of interstitial and cornual ectopic pregnancies. Middle East Fertil Soc J 2013; 18: 235-40. doi: 10.1016/j. mefs.2013.01.004

  12. Radwan F, et al. Management of cornual (interstitial) pregnancy. Royal College Obstet Gynaecol 2007; 9: 249-55. doi 10.1576/toag.9.4.249.27355




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Ginecol Obstet Mex. 2020;88