La grossesse hétérotopique spontanée: à propos de deux cas

Guennoun, Ahmed; Mamouni, Nisrine; Errarhay, Sanaa; Bouchikhi, C.; Banani, Abdelaziz

doi:10.11604/pamj.2017.28.306.13696

Cited by 3 publications

(8 citation statements)

References 8 publications

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“…The majority of patients presented with pelvic pain, accompanied by vaginal bleeding and amenorrhea [4,10]. This triad seems to be encountered by all patients described in the case reports we have identified.…”

Section: Discussionmentioning

confidence: 73%

“…This triad seems to be encountered by all patients described in the case reports we have identified. However, since these symptoms may be present in normal intrauterine pregnancies, thus early diagnosis can be mistaken for a much less serious condition [4,10]. Medical staff must not underestimate pregnant woman presenting to the emergency department with abdominal pain.…”

Section: Discussionmentioning

confidence: 99%

“…Ultrasonography is a valuable imaging tool in the challenging process of diagnosing spontaneous heterotopic pregnancy [9]. Since there are no specific investigations available to screen for SHP, clinicians must rely on clinical signs in conjunction with exhaustive ultrasound examination of the uterus and adnexa [4,9,10], or even resort to exploratory laparoscopy or laparotomy in cases where the ultrasonographic findings are unclear [32]. The presence of an intrauterine pregnancy does not exclude the presence of synchronous ectopic pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…The presence of an intrauterine pregnancy does not exclude the presence of synchronous ectopic pregnancy. Careful examination of patients with normal intrauterine pregnancies who present the triad of amenorrhea, vaginal bleeding and pelvic pain is therefore mandatory [10].…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of heterotopic pregnancy has seen an increasing trend in the last decades, which may be attributed to the increased use of ovulation induction [6] and medically assisted pregnancies [7], rarely occurring with natural conception [8][9][10]. Additionally, patients who require assisted reproductive procedures often present with tubal pathology, which is one of the main causes of extrauterine pregnancy [11].…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous Heterotopic Pregnancy with Unaffected Intrauterine Pregnancy: Systematic Review of Clinical Outcomes

et al. 2020

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Background and objective: Spontaneous heterotopic pregnancy (SHP) is a rare condition represented by the synchronous coexistence of an intrauterine and an ectopic pregnancy. It rarely occurs with natural conception and is usually a consequence of assisted reproductive techniques. Diagnosis of SHP can be a challenge for the clinician. The evolution of the intrauterine pregnancy is dependent on many factors, such as the location of the heterotopic pregnancy, gestational age at the time of diagnosis, the surgical procedure, the presence of other risk factors, early or delayed management. The aim of this systematic review of the literature was to extract existing evidence on spontaneous heterotopic pregnancy with otherwise unaffected intrauterine pregnancy. Materials and Methods: From a total of 1907 database entries identified in PubMed, EMBASE and Cochrane reviews, we selected 18 papers for narrative synthesis, for which we explored the diagnostic options, treatment, and outcome of these extremely rare epidemiologic occurrences. Manuscripts were assessed using the CARE guidelines for reporting case reports. Results: The main symptom was abdominal pain, and the preferred treatment approach was surgical, more precisely, using a laparoscopic approach. Most cases presented no risk factors, and the diagnosis was mostly made in the first semester. Conclusions: Normal follow-up and evolution of intrauterine pregnancy have been observed regardless of surgical approach (open or laparoscopic). Early diagnosis and treatment are advised, as they impact maternal and fetal outcomes. Evidence on this topic is scarce, predominantly comprised of case reports with variable degrees of adherence to dissemination guidelines. More studies on this topic are required to optimize care protocols for this type of pregnancy.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Spontaneous Heterotopic Pregnancy with Unaffected Intrauterine Pregnancy: Systematic Review of Clinical Outcomes

et al. 2020

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Sarcină heterotopică spontană cu localizare ampulară a sarcinii ectopice – prezentare de caz şi review al literaturii

Dinu,

Hodorog,

Drăguşin

et al. 2023

Obstetrica şi Ginecologia

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Diagnostic tardif d’une grossesse hétérotopique à trois mois de la naissance du frère jumeau: à propos d’un cas

Admin,

SANOGO Souleymane,

COULIBALY Pierre

et al. 2020

J Afr Imag Méd

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We report a case of heterotopic pregnancy diagnosed tardly at three months from the birth of the twin brother in the radiology department of Sominé Dolo Hospital in Mopti. The aim was to describe the contribution of medical imaging in the management of this confusing entity with review of the literature. It was a 30 year old woman, a housewife and from a rural area. She had an obstetrical history of five pregnancies, five deliveries with five live children. She had given birth at home about three months ago with a living eutrophic newborn. She consulted for an abdominal mass accompanied by abdominal pain and a notion of amenorrhea. It was sent to us on 27/07/2019 for an abdominopelvic ultrasound. Ultrasound examination revealed an empty uterus and intraabdominal bone structures. An abdomen x-ray found a radiopacity occupying the lower hemi abdomen containing arciform calcified images and the gases. An abdominopelvic CT scan confirmed the presence of a putrefied fetus in the abdominal cavity. Medico-surgical management was done with favorable evolution. Spontaneous heterotopic pregnancy is a rare entity in our environment. It diagnosis remains difficult especially in our context where the patient consulted late with an unusual clinical board. In front of such a confusing rare clinical presentation, the means of medical imaging exploration are essential in the diagnosis mostly ultrasound and CT scan in our environment. Résumé Nous rapportons un cas de grossesse hétérotopique diagnostiqué tardivement à trois mois de la naissance du frère jumeau au service de radiologie de l’hôpital Sominé Dolo de Mopti. L’objectif était de décrire la contribution des moyens d’imagerie médicale dans la prise en charge de cette entité déroutante avec revue de la littérature. Il s’agissait d’une femme âgée de 30 ans, ménagère et originaire d’une zone rurale. Elle avait pour antécédents obstétricaux cinq gestations, cinq accouchements avec cinq enfants vivants. Elle avait accouché à domicile il y a trois mois environs d’un nouveau-né vivant eutrophique. Elle a consulté pour une masse abdominale accompagnée d’une douleur abdominale et d’une notion d’aménorrhée. Elle nous a été adressée le 27/07/2019 pour une échographie abdominopelvienne. L’examen échographique a objectivé un utérus vide et des structures osseuses intraabdominales. Un ASP a objectivé une radio-opacité occupant l’hémi abdomen inferieur renfermant des images calciques arciformes et des clartés. Une tomodensitométrie abdominopelvienne a confirmé la présence d’un fœtus putréfié dans la cavité abdominale. Une prise en charge médicochirurgicale a été faite avec évolution favorable. La grossesse hétérotopique spontanée est une entité rare dans notre milieu. Son diagnostic demeure difficile surtout dans notre contexte où la patiente a consulté tardivement avec un tableau clinique inhabituel. Devant une telle présentation clinique rare déroutante, les moyens d’exploration d’imagerie médicale sont incontournables dans le diagnostic notamment l’échographie et la tomodensitométrie dans notre milieu.

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La grossesse hétérotopique spontanée: à propos de deux cas

Cited by 3 publications

References 8 publications

Spontaneous Heterotopic Pregnancy with Unaffected Intrauterine Pregnancy: Systematic Review of Clinical Outcomes

Spontaneous Heterotopic Pregnancy with Unaffected Intrauterine Pregnancy: Systematic Review of Clinical Outcomes

Sarcină heterotopică spontană cu localizare ampulară a sarcinii ectopice – prezentare de caz şi review al literaturii

Diagnostic tardif d’une grossesse hétérotopique à trois mois de la naissance du frère jumeau: à propos d’un cas

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