In vitro fertilization complicated by rupture of tubo-ovarian abscess during pregnancy

Han, Choong‐Hee; Wang, Chen; Liu, Xiaojuan; Geng, Nv; Wang, Yingmei; Fan, Aiping; Yuan, Baoyu; Xue, Fengxia

doi:10.1016/j.tjog.2015.08.017

Cited by 15 publications

(17 citation statements)

References 31 publications

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“…There are few reported cases of TOAs in pregnancy . TOAs can lead to adverse pregnancy outcomes including miscarriage, preterm labour, chorioamnionitis, fetal or maternal death . Optimal treatment (and surgical approach if needed) in pregnancy depends on the severity of the infection and the gestation of pregnancy.…”

Section: Special Circumstances Of Toamentioning

confidence: 99%

Diagnosis and management of tubo‐ovarian abscesses

Munro

Gharaibeh

Nagabushanam

et al. 2018

The Obstetric & Gynaecologis

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Key content Tubo‐ovarian abscesses represent a severe form of pelvic inflammatory disease and carry high morbidity. Diagnosis is made by combining the clinical picture (fever, pelvic pain and pelvic adnexal mass) with raised inflammatory markers and radiological findings demonstrating an abscess. Initial management with intravenous antibiotics may not be successful. Surgical intervention may be indicated but the optimal timing is not clear and image‐guided drainage can be a possible alternative to surgery. Surgery may be conservative or involve pelvic clearance and will depend on the clinical situation. Learning objectives To be able to recognise and initiate prompt treatment of pelvic inflammatory disease and tubo‐ovarian abscesses. To understand appropriate antibiotic treatment and/or radiological drainage. To be able to identify indications for timely surgical intervention and explore the optimal surgical approach of laparoscopic versus open surgery. Ethical issues Delays in treatment may have adverse effects on future fertility. Who is appropriate for fertility‐preserving treatment?

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Section: Special Circumstances Of Toamentioning

confidence: 99%

Diagnosis and management of tubo‐ovarian abscesses

Munro

Gharaibeh

Nagabushanam

et al. 2018

The Obstetric & Gynaecologis

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“…A total of 38 cases of TOA during pregnancy are reviewed based on previous report 6 adding two cases 7 including our case. We analyzed the perinatal outcomes of TOA through total 40 cases (Table 1).…”

Section: Discussionmentioning

confidence: 99%

How to approach the rupture of tubo‐ovarian abscess during pregnancy: A case report and literature review

Kim

Chun

Koh

et al. 2021

J of Obstet and Gynaecol

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We present the case of a 26‐year‐old multiparous woman who experienced rupture of a tubo‐ovarian abscess during the second trimester of pregnancy. She presented with epigastric and right lower quadrant pain at 12 + 0 weeks' gestation. There were no other specific findings on the magnetic resonance imaging images. We recommended hospitalization to observe the changes in pain, but she refused confinement. About 3 weeks later, she revisited our emergency room at 15 + 4 weeks' gestation. She complained of worsening abdominal pain with fever. She underwent right salpingo‐oophorectomy and appendectomy due to uncontrollable, severe abdominal pain without any obstetric abnormal condition. There was a rupture site in the right adnexa, which was covered with pus. The rupture of tubo‐ovarian abscess during pregnancy is very rare. Therefore, obstetricians should carefully monitor the adnexal masses observed during pregnancy, which should be treated with caution, whether or not the patient is symptomatic.

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“…Although the risk of infection after ART is probably low [13], when it does occur during pregnancy, the outcome may be poor with 25% pregnancies resulting in abortion [18], preterm delivery or infant death [15–17]. As, infection may be diagnosed as late as 25 weeks after oocyte retrieval, in many cases the diagnosis is made after the patient has become pregnant.…”

Section: Discussionmentioning

confidence: 99%

“…In a meta-analysis performed by Cha Han and colleagues [18], only 38 cases of pelvic abscess were found during pregnancy, only 12 were associated to prior oocyte retrieval. Abortion occurred in 25% of the pregnant women.…”

Section: Review Of the Literaturementioning

confidence: 99%

Assisted Reproductive Technology as a Transcutaneous Route for Bacterial Contamination of Ovarian Endometrioma with Coagulase-Negative Staphylococcus: Case Report and Review of the Literature

Edelstein

Shachar

Ben-Amram

et al. 2019

Infectious Diseases in Obstetrics and Gynecology

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Tubo-ovarian abscess may develop in women with endometrioma following assisted reproductive technology (ART). The infection, though rare, is typically late in onset and may present several months after the procedure, and in pregnancy—with the risks of abortion and premature labor. It is thought that transcutaneous oocyte retrieval during ART is the route for bacterial contamination resulting in infection of the endometrioma. Pathogens reported in the literature include Escherichia coli (E. coli) and Group B streptococcus (GBS) but Staphylococcus lugdunensis (S. lugdunensis), a coagulase-negative staphylococcus (CoNS), and groin and perineal skin commensal was isolated from the endometrioma in this case. We discuss the challenges in diagnosis and treatment of this rare condition and the implications of the discovery that an organism previously dismissed as a contaminant has emerged as a causative organism in severe, deep-seated infections of soft tissues in recent literature.

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In vitro fertilization complicated by rupture of tubo-ovarian abscess during pregnancy

Abstract: Prolonging gestational duration when an infection situation is allowed is the principle of treatment.

Cited by 15 publications

References 31 publications

Diagnosis and management of tubo‐ovarian abscesses

Diagnosis and management of tubo‐ovarian abscesses

How to approach the rupture of tubo‐ovarian abscess during pregnancy: A case report and literature review

Assisted Reproductive Technology as a Transcutaneous Route for Bacterial Contamination of Ovarian Endometrioma with Coagulase-Negative Staphylococcus: Case Report and Review of the Literature

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