Dual extrauterine ectopic pregnancy: double management
Chandana S Bhat1, N Sanjeeva Reddy1, Radha Vembu2
1Department of Reproductive Medicine and Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
BMJ Case Reports
|November 12, 2021
Summary
This case study shows successful medical management of an advanced ovarian ectopic pregnancy using intrasac therapy. Continued monitoring of beta human Chorionic Gonadotropin (hCG) is crucial after treatment, especially following ovulation induction.
Area of Science:
- Reproductive Endocrinology and Infertility
- Medical Management of Ectopic Pregnancy
Background:
- Ectopic pregnancies, particularly ovarian gestations, pose significant risks.
- Previous tubal ectopic pregnancy and ovulation induction increase recurrence risk.
- Advanced ovarian ectopic pregnancy often necessitates surgical intervention.
Observation:
- A 30-year-old nulliparous woman presented with an 8 0/7-week left ovarian ectopic pregnancy with cardiac activity.
- The patient had a recent history of laparoscopic salpingectomy for a ruptured tubal ectopic pregnancy post-ovulation induction.
- Sonography confirmed the ovarian ectopic pregnancy.
Findings:
- Ultrasound-guided intrasac therapy with potassium chloride and methotrexate was administered.
- Serum beta human Chorionic Gonadotropin (hCG) levels normalized after 65 days.
- Successful resolution of the ovarian ectopic pregnancy was achieved without surgery.
Implications:
- Intrasac therapy is a viable medical management option for advanced ovarian ectopic pregnancies.
- Prolonged serum beta-hCG monitoring is essential after ectopic pregnancy treatment, especially with ovulation induction.
- Comprehensive patient counseling regarding conception risks during multiple ovulation cycles is critical.
Related Concept Videos
01:29Appendicitis-II: Diagnostic Studies and Management
165
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
165
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
70
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
70
01:22Mitral Valve Prolapse II: Assessment and Management
67
IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
67
01:17Pericarditis III: Medical Management
58
The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
58