BACKGROUND Ectopic pregnancy(EP) is one of the most common acute abdominal diseases in gynecology. Once the condition of EP is delayed, it may lead to massive hemorrhage, shock, and even death in a short time, serious...BACKGROUND Ectopic pregnancy(EP) is one of the most common acute abdominal diseases in gynecology. Once the condition of EP is delayed, it may lead to massive hemorrhage, shock, and even death in a short time, seriously threatening the patient’s life. Early diagnosis is the key to preventing and improving the prognosis of EP.Transabdominal ultrasound(TAS) and transvaginal ultrasound(TVS) are the main diagnostic methods for abdominal diseases. The purpose of this study is to explore the application value and effect of TAS and TVS in the diagnosis of EP,hoping to provide more valuable references for the diagnosis of EP.AIM To explore the application value of TAS and TVS in the diagnosis of EP and to improve the level of clinical diagnosis.METHODS A total of 140 patients with EP admitted to our hospital from July 2018 to July 2020 were selected for this study. All patients were divided into two groups according to the examination methods. 63 patients who underwent abdominal ultrasound examination were set as the TAS group, while 77 patients who underwent TVS examination were set as the TVS group. We compared the diagnostic accuracy and misdiagnosis rates between the two types of ultrasound examinations, as well as the postoperative pathological results of the two diagnostic methods for different types of ectopic pregnancies. We also analyzed the sonograms for the presence of mixed ectopic masses,adnexal masses, ectopic gestational sacs, the presence or absence of visible embryo and fetal heart in the ectopic sac shadow, and the detection of fluid in the rectal fossa of the uterus, such as the adnexal area, yolk sac, and embryo, etc. In addition, the diagnosis time, days of gestational sac appearance, operation time, endometrial thickness, and blood flow resistance index were compared as well.RESULTS After performing both types of ultrasound examinations in 140 patients with EP, we found that the diagnostic accuracy of TVS was significantly higher than that of TAS, and the misdiagnosis rate was significantly lower than that of TAS. The differences were statistically significant(P < 0.05). In addition, the detection rate of TVS was better than that of TAS for the presence of mixed masses,adnexal masses, ectopic gestational sacs, the presence or absence of visible embryo and fetal heart in the shadow of the ectopic sac, and sonograms such as the adnexal area, yolk sac, and embryo,etc. The coincidence rate of its postoperative pathological examination results was significantly higher than those of TAS. The diagnosis time and the days of gestational sac appearance by TVS were significantly shorter than that by TAS, and the operation time was earlier than that by TAS.What’s more, the detection rates of the endometrial thickness ￡ 1.5 mm and blood flow resistance ￡0.5 were significantly higher in TVS diagnosis of EP than in TAS. All differences were statistically significant(P < 0.05).CONCLUSION Compared with TAS, TVS has the advantages of high detection accuracy and good sonogram performance.展开更多
A 35-year-old unbooked gravida 6 para 5+0 woman with 4 living children, who was unsure of her last menstrual period but she adjudged her index pregnancy to be term. She presented to the emergency unit with six months ...A 35-year-old unbooked gravida 6 para 5+0 woman with 4 living children, who was unsure of her last menstrual period but she adjudged her index pregnancy to be term. She presented to the emergency unit with six months history of progressive weight loss, difficulty in breathing and abdominal pain that suddenly got worse about two days prior to presentation after an attempted external cephalic version by a traditional birth attendant. Ultrasound diagnosed abdominal pregnancy. An emergency laparotomy revealed collapsed fetal membranes with a rent of about 10 centimeters in diameter on the right and straw-colored amniotic fluid of about 2 litres in peritoneal cavity. A live male fetus was delivered with birth weight of 2.9 kilograms. The umbilical cord was cut and tied short close to the placenta which was left in situ and methotrexate was given. Post operative condition was satisfactory and patient had a brisk recovery. She was adequately counseled and discharged home on the 12<sup>th</sup> day after surgery and followed up subsequently.展开更多
In this report, we present a case of a term abdominal pregnancy managed in St Padre Pio Hospital Douala (Cameroon). The 28-year-old G2P1001 woman whom we received to our facility at 15 weeks gestation with an intraute...In this report, we present a case of a term abdominal pregnancy managed in St Padre Pio Hospital Douala (Cameroon). The 28-year-old G2P1001 woman whom we received to our facility at 15 weeks gestation with an intrauterine pregnancy confirmed by ultrasonography. She returned at 21 weeks with a history of syncope and blood transfusion in another facility. An obstetrical ultrasonography done that day revealed a live fetus located at the upper right side within the peritoneal cavity. She continued with her routine Antenatal visits, and at each visit, an ultrasonography was done, revealing a slowly growing fetus. At 38 weeks, a laparotomy was carried out, and the live male baby weighing 2500 grammes was extracted. The placenta was implanted in the uterus;it was removed with minimal blood loss of approximately 400 mls. The mother was heamodynamically stable post-operatively. The newborn presented with mild cyanosis, an oxygen saturation of 80%, which resolved after 24 hours of oxygen administration. Both mother and baby were discharged from the hospital one week after laparotomy in a stable state. This case illustrates that intra-abdominal pregnancies, though rare and complex, can be managed to term and produce viable fetuses. Practitioners should, therefore, understand the challenges in its management.展开更多
文摘BACKGROUND Ectopic pregnancy(EP) is one of the most common acute abdominal diseases in gynecology. Once the condition of EP is delayed, it may lead to massive hemorrhage, shock, and even death in a short time, seriously threatening the patient’s life. Early diagnosis is the key to preventing and improving the prognosis of EP.Transabdominal ultrasound(TAS) and transvaginal ultrasound(TVS) are the main diagnostic methods for abdominal diseases. The purpose of this study is to explore the application value and effect of TAS and TVS in the diagnosis of EP,hoping to provide more valuable references for the diagnosis of EP.AIM To explore the application value of TAS and TVS in the diagnosis of EP and to improve the level of clinical diagnosis.METHODS A total of 140 patients with EP admitted to our hospital from July 2018 to July 2020 were selected for this study. All patients were divided into two groups according to the examination methods. 63 patients who underwent abdominal ultrasound examination were set as the TAS group, while 77 patients who underwent TVS examination were set as the TVS group. We compared the diagnostic accuracy and misdiagnosis rates between the two types of ultrasound examinations, as well as the postoperative pathological results of the two diagnostic methods for different types of ectopic pregnancies. We also analyzed the sonograms for the presence of mixed ectopic masses,adnexal masses, ectopic gestational sacs, the presence or absence of visible embryo and fetal heart in the ectopic sac shadow, and the detection of fluid in the rectal fossa of the uterus, such as the adnexal area, yolk sac, and embryo, etc. In addition, the diagnosis time, days of gestational sac appearance, operation time, endometrial thickness, and blood flow resistance index were compared as well.RESULTS After performing both types of ultrasound examinations in 140 patients with EP, we found that the diagnostic accuracy of TVS was significantly higher than that of TAS, and the misdiagnosis rate was significantly lower than that of TAS. The differences were statistically significant(P < 0.05). In addition, the detection rate of TVS was better than that of TAS for the presence of mixed masses,adnexal masses, ectopic gestational sacs, the presence or absence of visible embryo and fetal heart in the shadow of the ectopic sac, and sonograms such as the adnexal area, yolk sac, and embryo,etc. The coincidence rate of its postoperative pathological examination results was significantly higher than those of TAS. The diagnosis time and the days of gestational sac appearance by TVS were significantly shorter than that by TAS, and the operation time was earlier than that by TAS.What’s more, the detection rates of the endometrial thickness ￡ 1.5 mm and blood flow resistance ￡0.5 were significantly higher in TVS diagnosis of EP than in TAS. All differences were statistically significant(P < 0.05).CONCLUSION Compared with TAS, TVS has the advantages of high detection accuracy and good sonogram performance.
文摘A 35-year-old unbooked gravida 6 para 5+0 woman with 4 living children, who was unsure of her last menstrual period but she adjudged her index pregnancy to be term. She presented to the emergency unit with six months history of progressive weight loss, difficulty in breathing and abdominal pain that suddenly got worse about two days prior to presentation after an attempted external cephalic version by a traditional birth attendant. Ultrasound diagnosed abdominal pregnancy. An emergency laparotomy revealed collapsed fetal membranes with a rent of about 10 centimeters in diameter on the right and straw-colored amniotic fluid of about 2 litres in peritoneal cavity. A live male fetus was delivered with birth weight of 2.9 kilograms. The umbilical cord was cut and tied short close to the placenta which was left in situ and methotrexate was given. Post operative condition was satisfactory and patient had a brisk recovery. She was adequately counseled and discharged home on the 12<sup>th</sup> day after surgery and followed up subsequently.
文摘In this report, we present a case of a term abdominal pregnancy managed in St Padre Pio Hospital Douala (Cameroon). The 28-year-old G2P1001 woman whom we received to our facility at 15 weeks gestation with an intrauterine pregnancy confirmed by ultrasonography. She returned at 21 weeks with a history of syncope and blood transfusion in another facility. An obstetrical ultrasonography done that day revealed a live fetus located at the upper right side within the peritoneal cavity. She continued with her routine Antenatal visits, and at each visit, an ultrasonography was done, revealing a slowly growing fetus. At 38 weeks, a laparotomy was carried out, and the live male baby weighing 2500 grammes was extracted. The placenta was implanted in the uterus;it was removed with minimal blood loss of approximately 400 mls. The mother was heamodynamically stable post-operatively. The newborn presented with mild cyanosis, an oxygen saturation of 80%, which resolved after 24 hours of oxygen administration. Both mother and baby were discharged from the hospital one week after laparotomy in a stable state. This case illustrates that intra-abdominal pregnancies, though rare and complex, can be managed to term and produce viable fetuses. Practitioners should, therefore, understand the challenges in its management.
