Interstitial ectopic pregnancy diagnosis by three-dimensional ultrasound and its laparoscopic management: A case report

Abstract

Background: Interstitial Ectopic Pregnancy (IEP) is an uncommon type of ectopic pregnancy with the risk of rupturing and bleeding. The incidence of IEP is about 2-4% of all EPs. The diagnosis and management are challenging. We present a well-timed and managed case of IEP.
 Case: The case was a 37-yr-old woman presented at the Royan Institute with a chief complain of sudden onset of pelvic pain and moderate vaginal bleeding, three weeks after her positive pregnancy test. She had got pregnant with in-vitro fertilization procedure. She was admitted for a two-dimensional ultrasound (2DUS). The 2DUS findings showed a gestational sac with live embryo and yolk sac which was located high in the fundus and eccentric to the endometrium. The suspicion of IEP rose after the 2DUS findings, the confirmation of further diagnosis was then done by three-dimensional ultrasound, and the treatment was done by laparoscopy. The patient underwent laparoscopic left corneal resection. She was discharged after two days and her β-hCG achieved complete resolution (< 5 mIU/mL) after two weeks’ follow-up.
 Conclusion: According to the life-threatening complications that are associated with IEP, acquaintance and suspicion about IEP is important. Specified information that obtained by three-dimensional ultrasound could be useful for exact locating and detection.
 Key words: Pregnancy, Ectopic, Diagnostic, Ultrasound, Laparoscopic assisted surgery.

Interstitial Ectopic Pregnancy Associated With Painless and Severe Vaginal Bleeding: A Rare, Atypical Clinical Presentation

“…Li et al, analyzing the results of their study, showed that a transvaginal ultrasound in the diagnosis of interstitial ectopic pregnancy has a sensitivity of 97.8% and a positive predictive value of 99.4% [ 15 ]. Additionally, three-dimensional ultrasonography, when compared to transvaginal ultrasonography, is thought to achieve better imaging of the interstitial part of fallopian tubes and significantly contribute to the diagnosis of interstitial ectopic pregnancy [ 16 ]. Furthermore, three-dimensional magnetic resonance imaging is considered to be of utmost help in differentiating interstitial ectopic pregnancy from angular pregnancy.…”

Cornual pregnancy rupture and massive hemorrhage: A case report

“…In early pregnancy, the detection rate of cornual pregnancy was about 82.9%. [ 3 ] The typical manifestation of this disease is that the pregnancy sac is an enlarged uterine horn on 1 side, surrounded by complete basal and interstitial line signs, namely that the endometrial line extends to the uterine horn and reaches the edge of the pregnancy sac. [ 4 ] Carius BM et al [ 5 ] proposed the ultrasound diagnostic criteria for cornual pregnancy.…”

Analysis of Diagnostic Values of Trans-vaginal Three-dimensional Ultrasound Parameters RI, PI, and Serum TSGF on Ovarian Space Occupying Lesions

“…RI can effectively show the correlation between the changes of blood ow velocity during the body's cardiac cycle and the maximum blood ow velocity at end systole, and the decline speed will be signi cantly accelerated and further lead to increasing change range when the peripheral circulation impedance is raised [8] . Besides, RI can also re ect the relatively signi cant increase at end impedance caused by abnormal cardiac function [9][10] . Secondly, as the mean value of maximum waveform shift of blood ow velocity during a normal cycle, PI can effectively re ect the correlation between the drop interval and mean value of blood ow velocity during diastolic period [11] .…”