Author: Eva Račanská
Description:
28 year old 0 gravida arrives to the emergancy for bleeding and lower abdominal pain. 6 wks amenorrhoea, serum-hCG 91, E2 - 0,132, Progesteron 6,36. Soft abdomen, no tenderness to palpation, bimanual pelvic examination shows uterus of normal size, both adnexal regions with no palpable formation. Ultrasound examination - antevretd uterus of normal size, endometrium 6 mm, no sign gestation sac in the uterine cavity, both ovaries of normal size, no free fluid in the pouch of Douglas. Patient was admitted for dilation & curretage for incomplete spontaneus abortion and persisting bleeding. S-hCG level before D&C was 105 IU/l and after D&C 128 ...167 IU/l. Histology did not confirm gestation endometrium or chorionic villy in the material from the uterine cavity. Diagnostic laparoscopy was performed for growing levels of hCG hormone. Uterus was of normal size, both ovaries with endometrial implants in adhesions with uterine tubes. Right uterine tube was adhering to the right ovary and destroyed by the ectopic pregnancy, bleeding from the ampulla was visible, 150 ml of sanquinolent liquid in the pouch of Douglas. Left uterine tube was adhering to the left ovary and omentum, and it was of normal appearance. Right salpingectomy was performed due to the location of the ectopic pregnancy and damaged uterine tube. Histology result confirmed tubal pregnancy in the removed, right uterine tube.
Categorization:
Ectopic pregnancy, Tubal pregnancy, Uterine tube
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