Management of extra-tubal and rare ectopic pregnancies: case series and review of current literature

Abstract

A high index of suspicion is essential, combined with meticulous review of clinical findings and imaging modalities to make an accurate diagnosis. Treatment with the least invasive method, either by minimal access techniques, non-invasive radiological procedures or medical treatment should be encouraged.

Primary twin ovarian pregnancy: Case report and review of the literature

“…Although laparotomy has been the mainstay of treatment, a laparoscopic approach is preferred in these patients, 10 with consideration of ovarian cystectomy or wedge resection as an alternate to oophorectomy.…”

Therapeutic management of cervical ectopic pregnancy

“…The majority of these EP-related deaths were associated with substandard care. Mortality due to EP is 1.8 in 1000, which accounted for 9% of all pregnancy-related deaths in the USA between 1991 and 1993 [2].…”

“…Whereas there is an increase in EPs in general, cervical EP (CEP) remains the rarest localization of inadequate implantation [2]. The incidence of cervical pregnancies is less than 1% of all ectopic gestations, and ranges between one in 2500-18,000 pregnancies [2][3][4].…”

“…The incidence of cervical pregnancies is less than 1% of all ectopic gestations, and ranges between one in 2500-18,000 pregnancies [2][3][4]. Despite its infrequency, clinicians should take this rare diagnosis into account whenever being confronted with unusual clinical findings in early pregnancy, as the risks for hysterectomy and severe lethal hemorrhage are highly increased compared with tubal EPs.…”

“…Among these are preceding manipulation of the endocervical canal; for example, cervical or miscarriage curettage, the presence of an IUD, endometriosis in the cervical portion of the uterus enabling nidation of the ovum, endomyometritis, anatomic abnormalities such as Asherman's syndrome, fibroids, intrauterine adhesions, previous cesarean section and uterine surgery in general, assisted reproduction techniques, and a history of diethylstilbestrol exposure [4,[6][7][8][9][10]. A history of uterine curettage is considered to be the main risk factor and can be found in up to 70%, or in some reports even more, of cervical pregnancies [2,11,12]. Cigarette smoking has been detected to be a moderate risk factor for EPs in general [13].…”