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Heterotopic Pregnancy – A Case Report

2011; Elsevier BV; Volume: 18; Issue: 6 Linguagem: Inglês

10.1016/j.jmig.2011.08.532

1553-4669

S.C.V. Archangelo, A.M.C. Francisco, F.S.M. Campos,

Ectopic Pregnancy Diagnosis and Management

Study ObjectiveDescribe a case of heterotopic pregnancy underwent laparoscopic treatment.DesignA case report.SettingDiscipline of Gynecology and Obstetrics- UNIVAS- Pouso Alegre - Minas Gerais- Brazil.PatientsPatient of 27 years with heterotopic pregnancy.InterventionLaparoscopic surgery.Measurements and Main ResultsPatient 27 years, with complaint of infertility by anovulation, undergo induction of ovulation with diagnosis of pregnancy after a cycle. After 5 weeks of delay menstrual vaginal bleeding presented in small quantity. The first control ultrasonographic accompaniment showed the presence of gestational sac intrauterine compatible with pregnancy of five/six weeks without visualization of embryo and/or attachments inside. After six days, sought care complaining of abdominal pain and vaginal bleeding type colic. Has new ultrasound which showed gestation topical with live preview of embryo inside, plus solid heterogeneous at anexial left measuring 50 mm and free net in the pelvis. The examination, the patient was in good condition overall, colored. The abdomen was flabby, painful to palpation superficial and deep, without worsening of pain to decompression. Repeated the examination ultrassonografic which showed solid training in annex left with peripheral flow. Was opted for conducting videolaparoscopy that showed tuba left dilated, with swelling in the middle third and bleeding by fimbria, in addition to moderate amount of blood in the pelvis, being made salpingectomy left. Was maintained using natural vaginal progesterone via 400 g/day and was discharged after 24 hours. Pregnancy hypertensive disease topical evolved specific to moderate pregnancy with use of methyldopa after 26 weeks. Showing fetal growth restriction, culminating in the birth by caesarean section birth of a fetus, apgar scores of 9/10, with 38 weeks gestation weighing 2.420 g.ConclusionIs essential to think about the chance of heterotopic pregnancy against a framework of abdominal pain in pregnancy in the first quarter. The precocity of treatment will directly influence the development of topical gestation. Study ObjectiveDescribe a case of heterotopic pregnancy underwent laparoscopic treatment. Describe a case of heterotopic pregnancy underwent laparoscopic treatment. DesignA case report. A case report. SettingDiscipline of Gynecology and Obstetrics- UNIVAS- Pouso Alegre - Minas Gerais- Brazil. Discipline of Gynecology and Obstetrics- UNIVAS- Pouso Alegre - Minas Gerais- Brazil. PatientsPatient of 27 years with heterotopic pregnancy. Patient of 27 years with heterotopic pregnancy. InterventionLaparoscopic surgery. Laparoscopic surgery. Measurements and Main ResultsPatient 27 years, with complaint of infertility by anovulation, undergo induction of ovulation with diagnosis of pregnancy after a cycle. After 5 weeks of delay menstrual vaginal bleeding presented in small quantity. The first control ultrasonographic accompaniment showed the presence of gestational sac intrauterine compatible with pregnancy of five/six weeks without visualization of embryo and/or attachments inside. After six days, sought care complaining of abdominal pain and vaginal bleeding type colic. Has new ultrasound which showed gestation topical with live preview of embryo inside, plus solid heterogeneous at anexial left measuring 50 mm and free net in the pelvis. The examination, the patient was in good condition overall, colored. The abdomen was flabby, painful to palpation superficial and deep, without worsening of pain to decompression. Repeated the examination ultrassonografic which showed solid training in annex left with peripheral flow. Was opted for conducting videolaparoscopy that showed tuba left dilated, with swelling in the middle third and bleeding by fimbria, in addition to moderate amount of blood in the pelvis, being made salpingectomy left. Was maintained using natural vaginal progesterone via 400 g/day and was discharged after 24 hours. Pregnancy hypertensive disease topical evolved specific to moderate pregnancy with use of methyldopa after 26 weeks. Showing fetal growth restriction, culminating in the birth by caesarean section birth of a fetus, apgar scores of 9/10, with 38 weeks gestation weighing 2.420 g. Patient 27 years, with complaint of infertility by anovulation, undergo induction of ovulation with diagnosis of pregnancy after a cycle. After 5 weeks of delay menstrual vaginal bleeding presented in small quantity. The first control ultrasonographic accompaniment showed the presence of gestational sac intrauterine compatible with pregnancy of five/six weeks without visualization of embryo and/or attachments inside. After six days, sought care complaining of abdominal pain and vaginal bleeding type colic. Has new ultrasound which showed gestation topical with live preview of embryo inside, plus solid heterogeneous at anexial left measuring 50 mm and free net in the pelvis. The examination, the patient was in good condition overall, colored. The abdomen was flabby, painful to palpation superficial and deep, without worsening of pain to decompression. Repeated the examination ultrassonografic which showed solid training in annex left with peripheral flow. Was opted for conducting videolaparoscopy that showed tuba left dilated, with swelling in the middle third and bleeding by fimbria, in addition to moderate amount of blood in the pelvis, being made salpingectomy left. Was maintained using natural vaginal progesterone via 400 g/day and was discharged after 24 hours. Pregnancy hypertensive disease topical evolved specific to moderate pregnancy with use of methyldopa after 26 weeks. Showing fetal growth restriction, culminating in the birth by caesarean section birth of a fetus, apgar scores of 9/10, with 38 weeks gestation weighing 2.420 g. ConclusionIs essential to think about the chance of heterotopic pregnancy against a framework of abdominal pain in pregnancy in the first quarter. The precocity of treatment will directly influence the development of topical gestation. Is essential to think about the chance of heterotopic pregnancy against a framework of abdominal pain in pregnancy in the first quarter. The precocity of treatment will directly influence the development of topical gestation.