MR imaging of ectopic pregnancy with an emphasis on unusual implantation sites

Köroğlu, Mert; Kayhan, Arda; Soylu, Fatma Nur; Erol, Bekir; Schmid-Tannwald, Christine; Gürses, Cemil; Karademir, İbrahim; Ernst, Randy D.; Yousuf, Ambereen; Oto, Aytekin

doi:10.1007/s11604-012-0151-y

Cited by 24 publications

(30 citation statements)

References 14 publications

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“…In later gestation, CSP may be missed if the gestational sac of an endogenic CSP grows towards the uterine cavity. MRI is useful for making a reliable diagnosis in cases of uncertain clinical and ultrasound features …”

Section: Introductionmentioning

confidence: 99%

Caesarean scar ectopic pregnancy: diagnostic challenges and management options

Jayaram

Okunoye

Konje

2017

The Obstetric & Gynaecologis

105

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Key content Incidence of caesarean scar pregnancy (CSP) is increasing because of a rising number of caesarean sections. Prompt diagnosis of the condition is required to reduce associated morbidity. A high index of suspicion is required for women with a suggestive history of CSP. Ultrasound scan is the diagnostic tool of choice. Management options include medical, surgical and interventional radiology. Appropriate patient selection is important for optimal results. Major haemorrhage and hysterectomy are the main risks associated with CSP. Therefore, adequate counselling and availability of surgical expertise and blood transfusion should be part of a comprehensive management strategy. Learning objectives Understand the clinical and ultrasound features of CSP and distinguish these from features of other low implantation pregnancies. Learn about available treatment options and the factors influencing treatment choices. Be aware of the ethical issues associated with the diagnosis of live CSP. Ethical issues Do women planning subsequent pregnancy after a resolved CSP require surgery to close the uterine defect in the scar to prevent recurrent scar ectopic pregnancy? Should the risk of CSP in a future pregnancy be routinely discussed prior to primary caesarean section?

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Section: Introductionmentioning

confidence: 99%

Caesarean scar ectopic pregnancy: diagnostic challenges and management options

Jayaram

Okunoye

Konje

2017

The Obstetric & Gynaecologis

105

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“…Since 2000, the incidence of CSP has increased significantly to 6.1% of all ectopic pregnancies in those with previous caesarean sections, which may reflect the increasing number of caesarean sections being performed and the improved accuracy of diagnosis of ectopic pregnancies using colour Doppler transvaginal ultrasonography (3). In addition, the rates of CSP may have increased as a result of the use of assisted reproduction technology (4). Typically the diagnosis was made at between 6 and 9 weeks gestation.…”

Section: Introductionmentioning

confidence: 99%

Curettage after uterine artery embolization combined with methotrexate treatment for caesarean scar pregnancy

Feng

Chen

et al. 2016

Experimental and Therapeutic Medicine

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In the present study, we evaluated the diagnosis and management modalities of caesarean scar pregnancy (CSP). Thirty patients diagnosed with CSP were retrospectively studied between February, 2010 and February, 2012. Twenty-five patients were offered prophylactic uterine artery embolization (UAE) and methotrexate (MTX) prior to uterine suction curettage. Five cases were referred from other hospitals where the initial management with uterine suction curettage had resulted in uncontrollable massive haemorrhage, 4 of the cases had UAE and one proceeded immediately to hysterectomy. In the 25 patients treated with prophylactic UAE and MTX, 12 had laparoscopy-guided curettage and 13 had ultrasound-guided curettage without complication. The results showed that the 25 patients with CSP, who received prophylactic UAE and MTX prior to uterine curettage, recovered without complications. Five patients referred from other hospitals, where uterine curettage was the primary procedure, had severe complications including uncontrolled vaginal bleeding and uterine rupture. Four of the five patients were treated successfully with emergency UAE and the remaining patient underwent emergency hysterectomy as ultrasound examination detected significant haemorrhage between the uterus and the bladder. Of the 25 patients who received prophylactic UAE combined with MTX, there were no reports of irregular menstruation or serious adverse effects. Notably, the decrease in serum human chorionic gonadotropin (HCG) levels 3 days post-surgery was greater with ultrasound-guided curettage (84.3±5.5%) than with laparoscopy-guided curettage (76.3±10.2%). In summary, the data suggested that prophylactic UAE with MTX followed by ultrasound-guided curettage is the most effective therapeutic approach in CSP.

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“…Los hallazgos ecográficos descritos en los casos de embarazo abdominal son: demostración del útero vacío adyacente a la vejiga, demostración de feto fuera del útero, reconocimiento del feto en aproximación estrecha con la pared abdominal materna, ausencia de miometrio alrededor del feto, posición fetal inusual, pobre definición de la placenta y oligohidramnios (9). Adicional a la valoración ecográfica, la resonancia magnética complementaria permite mejor visualización de las partes fetales, la placenta y el útero, y es útil a la hora de planear la intervención quirúrgica (10).…”

Section: Resultsunclassified

Embarazo abdominal avanzado: diagnóstico y manejo. Reporte de caso y revisión de la literatura

Mora-Enríquez¹,

Arreaza-Graterol²,

Nossa-Moreno³

et al. 2014

Rev. Colomb. Obstet. Ginecol.

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<p style="font: small/normal verdana; color: #000000; text-transform: none; text-indent: 0px; letter-spacing: normal; word-spacing: 0px; white-space: normal; widows: 1; font-size-adjust: none; font-stretch: normal; -webkit-text-stroke-width: 0px;">Objetivo: reportar el caso de un embarazo abdominal avanzado y realizar una revisión de la literatura sobre diagnóstico, manejo y pronóstico.<p style="font: small/normal verdana; color: #000000; text-transform: none; text-indent: 0px; letter-spacing: normal; word-spacing: 0px; white-space: normal; widows: 1; font-size-adjust: none; font-stretch: normal; -webkit-text-stroke-width: 0px;">Materiales y métodos: se presenta el caso de un embarazo abdominal avanzado, controlado en la Unidad de Medicina Materno Fetal del Hospital Simón Bolívar, hospital público de tercer nivel de complejidad ubicado en Bogotá (Colombia). Se realizó una búsqueda de literatura médica en bases de datos Medline vía PubMed, y Lilacs, con terminología MeSH "abdominal pregnancy" y "ectopic pregnancy". La búsqueda se limitó a los idiomas inglés y español, entre los años 1940 a 2013.<p style="font: small/normal verdana; color: #000000; text-transform: none; text-indent: 0px; letter-spacing: normal; word-spacing: 0px; white-space: normal; widows: 1; font-size-adjust: none; font-stretch: normal; -webkit-text-stroke-width: 0px;">Resultados: se encontró un total de 22 artículos relacionados directamente con el tema, de los cuales se incluyen 14 en la revisión: 1 artículo de revisión, 2 artículos de serie de casos, 9 reportes de caso y 2 cartas al editor.<p style="font: small/normal verdana; color: #000000; text-transform: none; text-indent: 0px; letter-spacing: normal; word-spacing: 0px; white-space: normal; widows: 1; font-size-adjust: none; font-stretch: normal; -webkit-text-stroke-width: 0px;">Conclusión: el embarazo abdominal cercano al término es una situación obstétrica infrecuente que puede acarrear problemas severos para el binomio materno-fetal. El escenario ideal es poder realizar un diagnóstico temprano y su inmediata finalización.

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MR imaging of ectopic pregnancy with an emphasis on unusual implantation sites

Cited by 24 publications

References 14 publications

Caesarean scar ectopic pregnancy: diagnostic challenges and management options

Caesarean scar ectopic pregnancy: diagnostic challenges and management options

Curettage after uterine artery embolization combined with methotrexate treatment for caesarean scar pregnancy

Embarazo abdominal avanzado: diagnóstico y manejo. Reporte de caso y revisión de la literatura

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