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Murine Neural Plate Targeting by In Utero Nano-Injection NEPTUNE at Embryonic Day 7.5

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Angular Pregnancy: An Eccentric Implantation Within Uterine Cavity.

Nilofar Mustafa¹, Qurratulain Mushtaq¹, Syed Muhammad Bilal Shah²

¹CMH Lahore Medical College, Lahore, Pakistan.

Journal of Ayub Medical College, Abbottabad : JAMC

|February 6, 2022

Summary

Angular ectopic pregnancy is a rare condition often misdiagnosed as intrauterine pregnancy. Early suspicion is crucial for pregnant women in shock, even with initial ultrasound confirmation, to prevent maternal mortality.

Keywords:

Pregnancy; Angular; Pregnancy Trimester Second Pregnancy; Ectopic; Shock

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Area of Science:

Maternal-fetal Medicine
Surgical Obstetrics

Background:

Angular ectopic pregnancy is a rare variant of ectopic pregnancy.
It can be misdiagnosed as an intrauterine pregnancy on initial ultrasound scans.
Rupture can lead to severe maternal complications, including mortality, often in the second trimester.

Observation:

A 32-year-old primigravida presented at 18 weeks gestation with dizziness, epigastric pain, and signs of hypovolemic shock.
Initial ultrasound suggested an intrauterine pregnancy, but subsequent findings indicated a posterior uterine wall rupture and massive hemoperitoneum.
The patient experienced rapid abdominal distension and shock following vomiting and diarrhea.

Findings:

An urgent laparotomy revealed a posterior uterine perforation by the pregnancy.
The fetus, though alive in its sac initially, did not survive post-delivery.
Surgical repair involved a two-layer uterine closure and stepwise devascularization due to persistent bleeding, requiring significant blood transfusion.

Implications:

The case highlights the diagnostic challenges of angular ectopic pregnancy, emphasizing the need for a high index of suspicion.
Timely diagnosis and intervention are critical for managing this life-threatening condition.
Improved antenatal diagnostic strategies and awareness are essential for reducing maternal mortality associated with ectopic pregnancies.