Extra-uterine pregnancy following assisted conception treatment.
نویسندگان
چکیده
Ectopic pregnancy may be the only life-threatening disease in which prevalence has increased as mortality has declined. The most prominent theory to explain this phenomenon involves increased sensitivity of serum beta-human chorionic gonadotrophin (HCG) immunoassay and improved quality of transvaginal ultrasound, combined with a heightened awareness and increased suspicion of the condition among clinicians which has allowed early detection of ectopic pregnancy. Laparotomy, once the standard treatment of ectopic pregnancy, has been replaced almost entirely by operative laparoscopy. This is associated with a shorter hospital stay, fewer post-operative analgesic requirements, reduced costs and lower risk of adhesion formation. Laparotomy, however, remains necessary in cases with haemodynamic instability and with exceptional locations, e.g. cervical, abdominal and interstitial implantation. In selected cases, non-surgical management has also obtained high success rates. Among medical therapies, the most common is systemic or local administration of methotrexate. The other option is expectant management involving follow-up using serial serum HCG measurements and ultrasound scans. Thus, life-threatening ectopic pregnancy is now evolving into a medical disease, with the possibility of lower-cost treatment, faster recovery and higher subsequent fertility. In this review we assess the risk of extra-uterine implantation after assisted conception treatment, the accuracy of various diagnostic tools and focus on the efficacy, safety and the fertility outcomes of surgical and nonsurgical management of ectopic pregnancy.
منابع مشابه
A Case of Spontaneous Heterotopic Pregnancy Presenting with Heart Activity of Both Embryos
Copyright © 2012. Korean Society of Obstetrics and Gynecology Ectopic pregnancy refers to the implantation of a viable embryo outside the uterine corpus. Heterotopic pregnancy is diagnosed in the presence of simultaneous gestations at two or more implantation sites. Its occurrence is rare in spontaneous conception with an incidence of 1:30,000, while the incidence is found to be as high as 1% i...
متن کاملIntrauterine Fetal Death (IUFD) in Extra Uterus and Subsequent Pregnancy in Main Uterus: A Case Report
Abortion in an attached rndimentary uterine horn, followed by a normal intrauterine pregnancy. Pregnancy in an rudimentary uterus has been occured in many forms, and up to now about 350 cases have been reported in medical journals. Most of these malformations accompanied with other malformations in urinary tract. A case of pregnancy and abortion in an attached rudimentary uterine horn is ...
متن کاملCase report - ICSI outcome after fertility preservation in endometrial cancer
Approximately 5% of cases of endometrial cancer occur in women aged 40 years or younger. In the presence of early staged endometrial cancer, fertility sparing management may be considered in selected patients. Following high dose progestin therapy and confirmation of the regression of cancer, the patient might attempt to conceive spontaneously. However, assisted reproduction techniques might in...
متن کاملSuccessful Pregnancy after Treatment with Ulipristal Acetate for Uterine Fibroids
This case report presents a clinical pregnancy after ulipristal acetate (UA) to decrease uterine fibroid size. A 37-year-old patient, gravida 1, abortus 1, with uterine fibroids was treated with 5 mg of UA daily for 13 weeks starting eight months after a multiple laparotomic myomectomy. Fibroid shrinkage and restoration of the morphology of endometrial cavity were evaluated in order to allow a ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Human reproduction update
دوره 6 1 شماره
صفحات -
تاریخ انتشار 2000