MyMedR

Ruptured ectopic pregnancy presenting as an irreducible inguinal hernia

Prasannan S, Jabar MF, Gul YA

Acta Chir. Belg., 2004 Oct;104(5):591-2.

An inguinal hernia that suddenly becomes irreducible may be secondary to a variety of other underlying conditions which can occasionally mislead the attending surgeon. Benign, inflammatory or neoplastic processes, as well as surgical emergencies such as intraperitoneal or retroperitoneal haemorrhage, have all been previously reported to mimic an inguinal hernia that suddenly becomes irreducible with or without clinical features of strangulation. We add an additional interesting presentation to this list in the form of a ruptured ectopic pregnancy, which is the first such case reported in the literature. A swelling in the groin may be much more complicated than it seems on superficial consideration and good clinical acumen is constantly required in managing such cases if a satisfactory outcome without any morbidity is to be expected.

Matched MeSH terms: Pregnancy, Ectopic/diagnosis; Pregnancy, Ectopic/surgery

Case report of ruptured non-communicating right rudimentary horn pregnancy: an acute emergency

Hassan CH, Karim AK, Ismail NA, Omar MH

Acta Medica (Hradec Kralove), 2011;54(3):125-6.

PMID: 22250483

Ruptured pregnancy in the rudimentary horn of women who have had a vaginal delivery is rare and unpredictable. However, when undiagnosed, this condition could lead to maternal morbidity and mortality. We report a pregnancy at 19 weeks gestation presented with acute abdomen and hypovolemic shock. She was initially thought to have an intrauterine pregnancy with the provisional diagnosis of a ruptured uterus. Intraoperatively, a ruptured non-communicating right rudimentary horn with ex utero pregnancy was discovered.

Matched MeSH terms: Pregnancy, Ectopic/diagnosis*; Pregnancy, Ectopic/surgery

Fulltext A Landscape View of the Female Genital Tract Microbiome in Healthy Controls and Women With Reproductive Health Conditions Associated With Ectopic Pregnancy

Teh HE, Pung CK, Arasoo VJT, Yap PSX

Br J Biomed Sci, 2023;80:12098.

PMID: 38283642 DOI: 10.3389/bjbs.2023.12098

Disruption of the female genital microbiome is associated with several pregnancy complications, including miscarriage, preterm onset of labour, and tubal pregnancy. Ectopic pregnancy is a known cause of maternal morbidity and mortality, but early diagnosis and treatment of ectopic pregnancy remain a challenge. Despite growing established associations between genital microbiome and female reproductive health, few studies have specifically focused on its link with ectopic pregnancy. Therefore, the current review aims to provide a comprehensive account of the female genital microbiome in healthy and fertile women compared to those in ectopic pregnancy and its associated risk factors. The microbial diversity from various sites of the female genital tract was explored for a reliable proxy of female reproductive health in sequencing-based ectopic pregnancy research. Our report confirmed the predominance of Lactobacillus in the vagina and the cervix among healthy women. The relative abundance decreased in the vaginal and cervical microbiome in the disease state. In contrast, there were inconsistent findings on the uterine microbiome across studies. Additionally, we explore a spectrum of opportunities to enhance our understanding of the female genital tract microbiome and reproductive conditions. In conclusion, this study identifies gaps within the field and emphasises the need for visionary solutions in metagenomic tools for the early detection of ectopic pregnancy and other gynaecological diseases.

Matched MeSH terms: Pregnancy, Ectopic*

Laparoscopic management of 53 cases of cornual ectopic pregnancy

Ng S, Hamontri S, Chua I, Chern B, Siow A

Fertil Steril, 2009 Aug;92(2):448-52.

PMID: 18930204 DOI: 10.1016/j.fertnstert.2008.08.072

To present our experience of laparoscopic management of cornual ectopic pregnancy.

Matched MeSH terms: Pregnancy, Ectopic/diagnosis; Pregnancy, Ectopic/surgery*

Uterine-conserving approach in ruptured intramyometrial ectopic pregnancy

Esther LSY, Chew KT, Rahman RA, Zainuddin AA, Hing EY, Kampan N

Horm Mol Biol Clin Investig, 2020 Mar 13;41(2).

PMID: 32167930 DOI: 10.1515/hmbci-2020-0001

Intramyometrial ectopic pregnancy (IMEP) is a rare form of ectopic pregnancy. It is defined as a conceptus implanted within the myometrium and is completely surrounded by myometrium with clear separation from both the uterine cavity and tubes. IMEP possesses not only diagnostic but also therapeutic challenge. The majority of reported cases were managed by hysterectomy. Early management of unruptured IMEP using methotrexate may help to preserve fertility. We, for the first time, report a case of ruptured IMEP managed successfully using suction and curettage followed by Bakri balloon tamponade and avoiding hysterectomy. Post-procedure, the patient received two doses of intramuscular methotrexate 50 mg/m2 due to plateauing serial beta human chorionic gonadotropin (β-hCG) levels and subsequently achieved undetectable level 10 weeks post-methotrexate. She also had complete resolution of the ectopic intramyometrial mass.

Matched MeSH terms: Pregnancy, Ectopic/blood; Pregnancy, Ectopic/surgery*

Term interstitial pregnancy with uterine conservation

Ng PH, NorAzlin MI, Nasri NI

Int J Gynaecol Obstet, 2007 Dec;99(3):251.

PMID: 17888439

Matched MeSH terms: Pregnancy, Ectopic/drug therapy*; Pregnancy, Ectopic/pathology

Trends in selected obstetric complications from University Hospital, Kuala Lumpur, Malaysia

Zulkifli SN, Paine LL, Greener DL, Subramaniam R

Int J Gynaecol Obstet, 1991 May;35(1):29-36.

PMID: 1680072

Trends in selected pregnancy complications from 1969 to 1987 in a tertiary hospital in Malaysia are presented. Complications reviewed were abortion, ectopic pregnancy, anemia, hypertension, hyperemesis, antepartum and postpartum hemorrhage. Possible explanations for the observed trends were discussed, including the role of improved obstetric care and changes in the characteristics of the childbearing population. The data presented give some indication of maternal morbidity in the childbearing population served by this tertiary center and should lead to improvements in provision of services as well as in health data collection in the future.

Matched MeSH terms: Pregnancy, Ectopic/epidemiology

Cervical ectopic pregnancy: a management dilemma

Shafiee, M.N., Norliza, I., Lim, P.S., Shuhaila, A., Mohd Hashim, O.

Journal of Surgical Academia, 2012;2(1):30-33.

MyJurnal

A 28-year-old G3P1+1 at 6 weeks period of amenorrhea with a previous Caesarean section presented with per vaginal bleeding. A cervical ectopic pregnancy was confirmed by a transvaginal scan. An intramuscular methotrexate was given followed by intracervical route due to poor decline of the serum βHCG. However, due to persistent increment of serum βHCG, an additional four doses of intramuscular methotrexate with folinic acid rescue were administered and she responded well to the regime. Unfortunately, following the last dose, she developed an episode of excessive per vaginal bleeding which required suction and curettage of the cervical canal. A Foley‘s catheter balloon was placed intracervically as a tamponade and the bleeding was successfully arrested.

Matched MeSH terms: Pregnancy, Ectopic

Fulltext Enterobius vermicularis salpingitis seen in the setting of ectopic pregnancy in a Malaysian patient

Ngui R, Ravindran S, Ong DB, Chow TK, Low KP, Nureena ZS, et al.

J Clin Microbiol, 2014 Sep;52(9):3468-70.

PMID: 24989613 DOI: 10.1128/JCM.01191-14

We report a rare and unusual case of invasive Enterobius vermicularis infection in a fallopian tube. The patient was a 23-year-old Malaysian woman who presented with suprapubic pain and vaginal bleeding. A clinical diagnosis of ruptured right ovarian ectopic pregnancy was made. She underwent a laparotomy with a right salpingo-oophorectomy. Histopathological examination of the right fallopian tube showed eggs and adult remnants of E. vermicularis, and the results were confirmed using PCR and DNA sequencing.

Matched MeSH terms: Pregnancy, Ectopic/diagnosis*

A case of ectopic triplets

Vine LE

Journal of the Malaya Branch of the British Medical Association, 1941;5:56-7.

Matched MeSH terms: Pregnancy, Ectopic

A Narrow Escape From Methotrexate: The Importance of Correlating Ultrasound Findings With Discriminatory Level of β-hCG and the β-hCG Ratio

Lim JA, Sheng KL, Chong SE

J Ultrasound Med, 2019 08;38(8):2237-2238.

PMID: 30536687 DOI: 10.1002/jum.14899

Matched MeSH terms: Pregnancy, Ectopic*

Fulltext A case of tubal ectopic pregnancy

Muthupalaniappen L, Tong SF, Hazizi H, Hamidon AH

Malays Fam Physician, 2006;1(1):25-6.

PMID: 26998206 MyJurnal

A healthy 27 year old Para 3 presenting with abnormal menstruation without a period of amenorrhoea was diagnosed to have left tubal ectopic pregnancy after vaginal examination and abdominal ultrasonography. The case illustrates the need for careful history taking and the need for considering ectopic pregnancy in women in the reproductive age group, who have abnormal menstruation even if they are on contraception.

Matched MeSH terms: Pregnancy, Ectopic*

Fulltext A life-threatening condition - ruptured ectopic pregnancy with negative urine pregnancy test: A case report

Mohamad F, Yahya AS, Abdul Rashid A, Devaraj NK, Abdul Manap AH

Malays Fam Physician, 2021 Mar 25;16(1):121-123.

PMID: 33948151 DOI: 10.51866/cr1117

Ectopic pregnancy is an extra-uterine pregnancy and is a potentially life-threatening condition that can lead to death from intra-peritoneal hemorrhage. This case reports a rare occurrence of ruptured tubal pregnancy in which the patient presented early with abdominal pain and a negative urine pregnancy test but subsequently presented again with evidence of intra-peritoneal hemorrhage. A negative urine pregnancy test is often used to rule out pregnancy, but it is not 100% sensitive. Complete assessment is critical in this important diagnosis in order to plan for the appropriate emergency management.

Matched MeSH terms: Pregnancy, Ectopic

Predicting the outcome of pregnancy in threatened abortion using ultrasound in detecting the viability of foetus

Gabriel R

Malays J Reprod Health, 1992 Jun;10(1):19-22.

PMID: 12345025

PIP: Between December 1990 and May 1991 in Malaysia, clinicians at the Sultanah Aminah Hospital in Johor Bahru screened 200 women with a diagnosis of threatened miscarriage with ultrasound to determine whether ultrasound could evaluate the viability of the fetus and thus the outcome of pregnancy in cases of threatened abortion. A fetal heartbeat was absent in 65% of cases with the remaining 35% of cases having a fetal heartbeat. Nonviability of the fetus or an abnormal or very early pregnancy may have accounted for an absent fetal heartbeat. The pregnancy of 46% of cases continued while 41% experienced spontaneous abortion. Just 6.2% of cases with a fetal heartbeat suffered from spontaneous abortion compared with 69.7% of those without a fetal heartbeat. 93.8% of cases with a fetal heartbeat continued their pregnancies compared with 30.3% of those without a fetal heartbeat. Inability of ultrasound to detect fetal heartbeats during early pregnancy probably accounted for the somewhat high percentage of those without a fetal heartbeat who continued their pregnancies. Among patients with a fetal heartbeat, the number of pregnancies that continued. Ultrasound detected 13% abnormal pregnancies (i.e., molar pregnancy or ectopic pregnancy). Surgery on these cases confirmed the ultrasound findings. These results showed that ultrasound should be used in every case of threatened miscarriage and that a fetal heartbeat does indicate the viability of the fetus.

Matched MeSH terms: Pregnancy, Ectopic*

Ectopic pregnancies following mini-laparotomy Pomeroy female sterilization

Puraviappan A, Arshat H

Malays J Reprod Health, 1984 Jun;2(1):20-4.

PMID: 12267517

Matched MeSH terms: Pregnancy, Ectopic*

Filshie Clip sterilization trial in Malaysia

Arshat H, Puraviappan AP, Thambu J, Ali J, Harun R

Malays J Reprod Health, 1984 Jun;2(1):14-9.

PMID: 12267516

Matched MeSH terms: Pregnancy, Ectopic

Fulltext Ectopic pregnancy following levonorgesterol-only emergency contraception: the first Malaysian case report

Natasha MN, Khoo HW, Sulaiman AS, Nur Azurah AG, Md Dali AZH, Jamil MA

Medicine & Health, 2012;7(2):107-111.

MyJurnal

Levonorgestrel (LNG) is a well-known safe and efficacious emergency contraception (EC). However, ectopic pregnancy following the failure of LNG-only EC has been reported. The exact incidence of ectopic pregnancy has been hindered by lack of data due to the fact that LNG-only EC is accessible at pharmacies without a prescription. We describe a case of ectopic pregnancy in an 18 year-old single woman who took LNG-only EC within 48 hours of unprotected sexual intercourse. She presented to the emergency department at 8 weeks period of amenorrhoea with an acute abdomen and hypovolaemic shock. Laparotomy confirmed a ruptured right tubal pregnancy and salpingectomy was performed. The patient was discharged well after 2 days. We aim to highlight this potential adverse effect and to discuss the plausible causality of ectopic pregnancy following administration of LNG-only EC.

Matched MeSH terms: Pregnancy, Ectopic

Fulltext Evaluation of treatment of previous cesarean scar pregnancy with methotrexate: a systematic review and meta-analysis

Salari N, Kazeminia M, Shohaimi S, Nankali AA, Mohammadi M

Reprod Biol Endocrinol, 2020 Nov 09;18(1):108.

PMID: 33168010 DOI: 10.1186/s12958-020-00666-0

BACKGROUND: Previous caesarean scar pregnancy is one type of ectopic pregnancy in myometrium and fibrous tissue of previous caesarean scar. One of the therapeutic methods of this type of ectopic pregnancy is treatment with methotrexate. Given various findings on the treatment of caesarean scar pregnancy with methotrexate and lack of global report in this regard, we aimed to achieve a global report on the treatment of CSP with methotrexate through related literature review and analysis of the results of the studies, to enable more precise planning to reduce complications of CSP.

METHOD: This review study extracted information through searching national and international databases of SID،, Embase, ScienceDirect, ، Scopus, ، PubMed, Web of Science (ISI) between 2003 and January 2020. To perform the meta-analysis, random-effects model and heterogeneity of the studies with I2 index were investigated. Data were sanalysed using Comprehensive Meta-Analysis version 2.

RESULTS: In total, 26 articles with a sample size of 600 individuals were enrolled in the meta-analysis. According to the results of the study, the mean level of β-hCG was 28,744.98 ± 4425.1 mIU/ml before the intervention and was 23,836.78 ± 4533.1 mIU/ml after the intervention. The mean intraoperative blood loss (ml) was 4.8 ± 3.76 ml, mean hospital stay (days) was 11.7 ± 1.2 days, mean time for serum-hCG normalization (days) was 41.6 ± 3.2 days, success was 90.7% (95% CI: 86.7-93.5%), and complication was 9% (95% CI: 6.3-12.8%).

CONCLUSION: The results of the current study show methotrexate significantly reduces β-hCG levels and can be effective in treating caesarean scar pregnancy and its complications.

Matched MeSH terms: Pregnancy, Ectopic/drug therapy*; Pregnancy, Ectopic/etiology; Pregnancy, Ectopic/epidemiology

Fulltext Delayed diagnosis of cervical pregnancy: management options

Sivalingam N, Mak FK

Singapore Med J, 2000 Dec;41(12):599-601.

PMID: 11296786

Cervical pregnancy is an uncommon variety of ectopic gestation. The aetiology is obscure. Diagnosis can be missed unless early evaluation is done by experienced personnel utilising pelvic ultrasonography. Three cases of cervical pregnancy managed at this hospital are described illustrating difficulties in early diagnosis and possible association with previous uterine scar and prior curettage of the uterus for retained products of conception. Treatment options vary according to the clinical state of the patient at the time of diagnosis. Non-surgical methods including systemic methotrexate administration in one and surgical evacuation of products of conception with subsequent cervical cerclage in another are discussed. Surgical interventions like total abdominal hysterectomy with internal iliac artery ligation to arrest life-threatening pelvic haemorrhage is also described. Other treatment options include potassium chloride (KCl) alone or in combination with methotrexate.

Matched MeSH terms: Pregnancy, Ectopic/diagnosis; Pregnancy, Ectopic/therapy*; Pregnancy, Ectopic/ultrasonography*

Fulltext Cesarean scar pregnancy: What can we offer?

Ng BK, Lim PS, Ahmad S, Kampan NC, Abdul Karim AK, Omar MH

Taiwan J Obstet Gynecol, 2015 Apr;54(2):208-10.

PMID: 25951734 DOI: 10.1016/j.tjog.2014.11.022

Matched MeSH terms: Pregnancy, Ectopic/drug therapy; Pregnancy, Ectopic/etiology; Pregnancy, Ectopic/ultrasonography*

Displaying publications 1 - 20 of 33 in total