Hepatic ectopic pregnancy with hemorrhage secondary diaphragmatic adhesion:A case report

BACKGROUND Primary abdominal pregnancy is an extremely rare form of ectopic pregnancy.Ectopic pregnancies that occur in the liver and diaphragm are even rarer,limited case reports are available in the literature.CASE SUMMARY A woman of childbearing age was transferred to the emergency department due to lumbar and abdominal pain radiating to the back toward the lower right.After a series of physical and auxiliary examinations,she was clinically diagnosed with hepatic ectopic pregnancy.Laparoscopic surgery was performed to remove the pregnancy tissue and achieve hemostasis.After a period of follow-up,the patient was successfully cured.CONCLUSION Paying attention to the patient's signs and utilizing imaging examination methods can help avoid missed diagnoses of liver pregnancy.

Conservative Management of Unruptured Ectopic Pregnancy—A Retrospective Study

An ectopic pregnancy (EP) is defined as any pregnancy that occurs outside the uterine cavity. The most common site of ectopic pregnancy is the fallopian tube. The goal of this retrospective study is to address medical and conservative surgical management of unruptured fallopian tube EP as an effective manner to preserve tubes to prevent secondary infertility. This study was conducted between January 1, 2010, and April 30, 2024, in Ponni Hospital, Madurai. It included 319 women, out of 6248 pregnant women diagnosed with ectopic pregnancy by using an Inexecreen kit, trans-abdominal scan, trans-vaginal scan, and doubling of beta-human chorionic gonadotropin (β-HCG) in 48 hours and Magnetic Resonance Imaging (MRI). Medical and conservative surgical management were given to those patients effectively. Out of 319 patients, 62 patients (19.4%) had a ruptured ectopic pregnancy and underwent surgical treatment;257 patients (80.6%) had an unruptured ectopic pregnancy. The conservative medical management was provided to 257 patients. Out of 257 patients, 235 patients were treated by injecting methotrexate and folic acid rescue when the criteria were met. 14 patients had salpingostomy and injection methotrexate (Inj. Methotrexate) and inj. Prostaglandin F2 alpha was administered into the tubal wall to preserve tubes. 8 patients had a live ectopic pregnancy;for those patients, Inj. Methotrexate was injected into the gestational sac through ultrasound guidance. 225 out of 257 patients reached out to us to seek fertility treatment;the remaining 32 patients were not seeking fertility. All fertility-seeking patients had successful pregnancies. We lost follow-up of 12 patients in this study. Out of 213 patients who came for fertility treatment, a 76.1% success rate was achieved with live birth, the recurrent ectopic pregnancy rate was 13.6%, the miscarriage and stillbirth rates were 10.3%. 32 patients, who were not seeking fertility, had quality life without surgical scars for ectopic pregnancy and cost-effective treatment. 25 patients out of 32 had laparoscopic sterilization later, and 7 patients followed temporary contraception as per our advice. This clinical data was retrieved from medical records.

Evaluation of Spontaneous Fertility after Medical Treatment of Tubal Ectopic Pregnancy in Two Hospitals in the City of Yaounde

Background: Ectopic pregnancy is a major cause of maternal morbidity and mortality, estimated to occur in 1% - 2% of pregnancies worldwide. This condition also has an adverse effect on the fertility prospects of women who experience it. Objective: To determine the outcomes of subsequent spontaneous fertility after medical treatment of patients with methotrexate (MTX) in patients with ectopic pregnancy at two university teaching hospitals of Yaounde. Methodology: We carried out a cross-sectional study with retrospective data collection in two university teaching hospitals of Yaounde during a six years period from 1st January 2015 to 31st May 2021. Seventy records of patients who had medical treatment for ectopic pregnancy were included in this study. Statistical analysis was performed using SPSS. 23. The Chi-2 statistical test was used to compare qualitative variables. Binary logistic regression method was performed to identify independent risk factors associated with infertility after medical treatment of tubal ectopic pregnancy (TEP). The significance level was set at 0.05. Results: The mean age in our study population was 27.8 ± 3.8 years. According to the past medical history, 52.9% had a pelvic inflammatory disease (PID) and the most frequently germ found was C. trachomatis (47.1%). Almost 15% of our study population had previous surgery for EP. The median Fernandez score was 11 with a minimum score of 4 and a maximum score of 13. The route of administration of methotrexate was intramuscular in all our patients, and the single-dose protocol was used most frequently (58.6%). After medical treatment of the EP, we found a spontaneous conception rate of 58.6%. After multivariate analysis, we were unable to confirm that there was an association between a history of sexually transmitted infections (STIs) and fertility prognosis. Conclusion: The spontaneous fertility rate after medical management of EP was 58.6%, of which 73.2% were term pregnancies and 14.6% were recurrent ectopic pregnancies.

Ruptured Ectopic Pregnancy: Epidemiology and Management in the General Surgery Department of the Ignace Deen National Hospital, Conakry University Hospital

Introduction: The aim of this study was to contribute to improving the quality of GEUR management in the general surgery department and in the maternity ward of the Ignace Deen national hospital, Conakry University Hospital. Methodology: This was a retrospective, descriptive study lasting two years (January 1, 2020 to December 31, 2022), carried out in the general surgery and gyneco-obstetrics departments of the Ignace Deen national hospital, Conakry University Hospital. We included all patients with a ruptured ectopic pregnancy who received surgical treatment during the study period. Results: We collected 13,524 cases of surgical interventions in the two services, among them, we recorded 89 cases or 0.66% GEUR. The average age of the patients was 24.26 years. Brides were the most represented with 80.96% of cases. Women practicing a liberal profession were 51.69% (n = 46) and housewives 26.97% (n = 24). Clinically, amenorrhea was noted in all patients, i.e. 100%, abdominal-pelvic pain in 95.2% (n = 85) of cases, metrorrhagia in 94.08% (n = 84), abdominal-pelvic sensitivity in 97.44% (n = 87) of cases and anemia in 85.39% of cases. The GEUR was ampullary in 69.66% (n = 62) cases. Salpingectomy was performed in 90.72% (n = 81). The surgical outcomes were satisfactory in 98.87% (n = 88) of cases. We recorded one case of surgical site infection. We have not recorded any deaths. The average length of hospitalization was 4 days. Conclusion: GEUR is relatively high in our context. A good understanding of the prognostic factors of GEUR, awareness and family planning could reduce GEUR.

Rare uterine serosal pregnancy after in vitro fertilization in a woman with bilateral salpingectomy

Objective:To improve the understanding of ectopic pregnancy after bilateral salpingectomy through case analysis and literature review.Method:A case of uterine serosal pregnancy after in vitro fertilization and embryo transfer(IVF-ET)in a woman with bilateral salpingectomy was reported in detail and summarized,and relevant literatures searched in Pubmed were analyzed.Results:The patient had a sudden abdominal pain 18 days after transplantation.Ultrasound showed no pregnancy sac in the intrauterine cavity and bilateral adnexal areas,but there was a large amount of fluid in the Pouch of Douglas,which was an indication for surgical exploration.During the operation,the pregnancy tissue was found on the uterine serosal and cleared in time.And the patient recovered well after surgery.Review of the literatures showed that most of ectopic pregnancies after bilateral salpingectomy were treated surgically and had a good prognosis.Conclusion:Ectopic pregnancy after bilateral salpingectomy is extremely rare and should be early judged by the patients’signs.Surgical treatment timely can achieve good outcome.

Comparison of the application value of transvaginal ultrasound and transabdominal ultrasound in the diagnosis of ectopic pregnancy

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.

Ectopic Molar Pregnancy with Coexistent Normal Intrauterine Pregnancy: A Report of an Unusual Diagnosis managed in Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon

Background: Heterotopic pregnancy is a very rare event in a natural cycle. Its incidence is rising mostly due to induction of ovulation or Assisted Reproductive Technique. Most ectopic in heterotopic pregnancies are localized in the fallopian tubes. The occurrence of molar tubal ectopic pregnancy coexisting with intrauterine pregnancy is uncommon and consequently not often considered a diagnostic possibility. Case Report: We report the case of a 25-year-old woman, gravida 4 para 1, who complained of vaginal spotting and lower abdominal pain after 6 weeks of amenorrhea following clomiphene citrate ovarian stimulation. Transvaginal Ultrasonography revealed an intrauterine pregnancy and an unruptured left tubal ectopic pregnancy. She underwent successful laparoscopic salpingectomy while the intra-uterine pregnancy was allowed to continue. The ectopic pregnancy tissue histology reported an ectopic partial molar pregnancy. She subsequently had a normal vaginal delivery at 39 weeks and 3 days and her follow-up was uneventful. Conclusion: Heterotopic pregnancy is a rare but life-threatening condition. It should be suspected in a pregnant woman with a risk factor of multiple gestations who presents vaginal bleeding and lower abdominal pain in the context of early pregnancy. Laparoscopic surgery is effective for confirming the diagnosis and treating the ectopic component. Routine histological examination of tubal specimens must be taken very seriously because some findings like molar pregnancies may require specific management.

Giant cyst in heterotopic pregnancy:A case report

BACKGROUND The coexistence of a heterotopic pregnancy with a giant ovarian cyst is an incredibly rare abnormal pregnancy in cases of natural conception.The incidence of this condition has increased significantly as a result of the continuous development of assisted reproductive technologies.When this type of pregnancy occurs,both the continuation of intrauterine pregnancy and the life of the pregnant woman are severely threatened.Early diagnosis and treatment using safe and effective methods are paramount in this situation.CASE SUMMARY A 30-year-old primigravida at a gestation age determined as 8 wk 4 d by scan was admitted to the hospital with heterotopic pregnancy and a right ovarian cyst.Laparoscopic resection of the ectopic pregnancy was performed,but the intrauterine pregnancy and ovarian cyst were preserved.CONCLUSION The approach to a patient with heterotopic pregnancy and a giant ovarian cyst is individualized base on the fertility requirements.We recommend the following:(1)If the patient satisfies parity and has no fertility requirement,a laparoscopic salpingectomy should be performed and the giant ovarian cyst and intrauterine pregnancy removed;(2)If the patient has fertility requirements wishes to have more children in the future,laparoscopic salpingectomy or salpingostomy should be performed and the intrauterine pregnancy preserved.Serial ovarian cyst aspiration can be performed under ultrasound and resection can be done after delivery;and(3)Heterotopic pregnancy should be diagnosed early by active surveillance during antenatal visits using ultra sound as this is important for the avoidance of catastrophic complications.

Mummified Ovarian Pregnancy at the General Reference Hospital of Panzi in Bukavu/DRC: A Case Report

This is a 39-year-old female patient, commercial occupation, nulliparous, primigravida, 12 weeks of amenorrhea, who consulted for desire of maternity after 15 years of infertility. The physical examination showed an abdomen of normal volume, soft and tender in the right iliac fossa. On vaginal touch, the uterus was of normal volume in an anteverted anteflexed position, regular surface with palpation at the right adnexa of a firm mass about 5 cm in diameter, irregular and tender. Free douglas. A diagnosis of infertility of 15 years was retained. Infertility workup showed a normal uterus. Right ovary normal volume, left ovary normal volume. Hysterosalpingography with and without opacification showed signs suggestive of bilateral hydrosalpinx predominating on the right. There was no obvious uterine anomaly. The blood biology did not show anything particular. An exploratory laparoscopy revealed multiple epiplo-tubero-intestinal adhesions. The right trumpet was dilated and adherent to an adnexal mass. A large adhesiolysis allowed the release of the right tube, thus opening the possibility to explore the adnexal mass. The opening of the mass allowed to individualize bony structures corresponding to the forearm with the calcified hand, and other less distinct structures. The latter finding led to the diagnosis of calcified ovarian pregnancy.

Successful conservative management with methotrexate and mifepristone of cervical pregnancy

This study investigated possible effective treatments for cervical pregnancy, a rare form of ectopic pregnancy. The clinical records of 11 cases of ectopic pregnancy admitted to the Third Affiliated Hospital of Sun Yat-sen University from 1998 to 2010 were analyzed. All patients were treated with intermuscular injection of methotrexate （MTX, 50 mg）, and oral mifepristone （25 mg, bid）. All cases were successfully cured by conservative treatments using methotrexate plus mifepristone. Cervical pregnancy is a contributive factor to mutiple abortions and curettages. Methotrexate plus mifepristone, curettage through hysteroscopy and intracervical obturation with gauze are effective treatments of cervical pregnancy without the need for surgical intervention.

LAPAROSCOPIC SURGERY IN PATIENTS WITH HYPOVOLEMIC SHOCK DUE TO ECTOPIC PREGNANCY

Objective To evaluate the feasibility and safety of operative laparoscopy for ectopic pregnancy with hypovolemic shock. Methods Two hundred and fifteen women with ectopic pregnancy underwent operative laparoscopy. These patients were divided into two groups. The study group included 21 patients with shock and intraperitoneal hemorrhage more than 1000 mL, and control group included 194 patients, hemodynamically stable, with blood loss less than 1000 mL. Clinical data of perio-perative periods in two groups were retrospectively analyzed. Results All patients were tubal pregnancies. The occurrence rate of tubal rupture was higher in study group than in control group (80.95% vs. 15.98%, P < 0.001). Intraabdominal blood loss was significantly higher in study group than in control group (1900 mL vs. 300 mL, P < 0.001), and autologous blood transfusions were given to 95.24% and 9.3% of patients in study and control group, respectively (P < 0.001). Laparoscopic salpingectomy was performed on 85.7 % and 50.5% of patients in study and control group (P < 0.001). The operative time was somewhat longer in study group than that in control group (60 minutes vs. 45 minutes), but with no significant difference. All patients had no perioperative complications. Conclusion Operative laparoscopy in patients with hopovolemic shock can be safely and effectively performed by experi-enced laparoscopists with the aid of optimal anesthesia, advanced cardiovascular monitoring, and autologous blood transfusion.

Avoiding misdiagnosing an early intrauterine pregnancy as an ectopic pregnancy

In women at risk for an ectopic pregnancy, every effort should be made to exclude the presence of an intrauterine pregnancy before embarking on an irreversible treatment for ectopic pregnancy. The diagnosis of ectopic pregnancy, unless directly visualized with transvaginal ultrasound, is made with the exclusion of an intrauterine pregnancy. Measurement of human chorionic gonadotrophin and progesterone levels, and transvaginal ultrasound are the tools used to evaluate early pregnancy. In women at risk for an ectopic pregnancy, every effort should be made to exclude the presence of an intrauterine pregnancy before embarking on an irreversible treatment course. Methotrexate is an antimetabolite that inhibits DNA synthesis and repair and cell replication. It is administered to ostensible destroy a pregnancy, especially ectopic pregnancies. When administered to an intrauterine pregnancy, embryonic death and missed abortion is the most common result, but early embryos that survive this exposure are likely to have multiple anomalies. The mistaken administration of methotrexate to an intrauterine pregnancy is made because of misinterpretation of the discriminatory zone of human chorionic gonadotropin(h CG), misinterpretation of early h CG serum levels, misinterpretation of early transvaginal ultrasound images, and failure to clinically correlate h CG levels and ultrasound findings.

Ectopic pregnancy implanted under the diaphragm: A rare case report

BACKGROUND Abdominal pregnancy is a rare type of ectopic pregnancy.We describe here a case of ectopic pregnancy implanted under the surface of the diaphragm,presenting the particular features of imaging findings from ultrasound,computed tomography(CT)and magnetic resonance imaging(MRI).CASE SUMMARY A 30-year-old woman presented with complaint of intermittent abdominal pain,that had begun 5 d earlier.She had no current or abnormal vaginal bleeding,and her serum human chorionic gonadotropin level(13372.08 IU/L)indicated pregnancy.Vaginal ultrasound showed a mixed echogenic mass in the right ovary.CT(plain)scan showed a curved high density mass beneath the subhepatic space.MRI scan showed a curved mixed signal,with restricted diffusion beneath the subhepatic space.Abdominal ultrasound demonstrated a mixed echogenic mass in the right lobe of the liver near the apex of the diaphragm,with a visible yolk sac and germ cell region with a bud.Subsequent laparoscopy visualized a dark red mass under the right diaphragm,which was resected completely.Histopathological examination of the resected mass confirmed an ectopic pregnancy.The recovery was swift and uneventful,and the patient was discharged to home.CONCLUSION Ectopic pregnancy should be in the differential diagnostic workup(via multiple imaging modalities)of childbearing woman with unexplained abdominal pain.

Methotrexate Treatment of Ectopic Pregnancy: Prognosis at Senlis Hospital

Introduction: Ectopic pregnancy is dreadful and can lead to the death of the patient if it is ignored. Diagnosed early, it offers the possibility of medical treatment with methotrexate. Objective: To describe the prognosis of ectopic pregnancies treated methotrexate. Patients and Methods: Retrospective study of the management of ectopic pregnancy by Methotrexate at Senlis hospital from June 2020 to May 2021 were included in the study, patients with a Fernandez score of less than 13, and having received Methotrexate as first-line treatment. Data were collected using gynecological emergency admission registers, and telephone interviews. Results: 35 cases were identified. The average age of the patients was 32 years old. Forty-nine percent were smokers. The mean gestational age was 5 weeks + 2 days. The diagnosis was made in all of our patients with the combination of the kinetics of ß-hcg and vaginal ultrasound. The size of adnexal mass was less than 4 cm with an average size of 20 mm. The average value of ß-hcg was 1405 IU/L. All patients had received a single dose of methotrexate 1 mg/kg intramuscularly. A second dose was administered to 17.1% of patients for stagnation or re-ascension of the ß-hcg level. The success rate was 91.4%. Thirty percent were obtained spontaneous intra uterine pregnancy, the first year following methotrexate treatment. Conclusion: The success rate of medical treatment for ectopic pregnancy is high in terms of meeting the eligibility criteria for treatment. The subsequent prognosis of fertility is generally preserved.

Ectopic Pregnancy: Epidemiological, Clinical, Therapeutical, Anatomopathological Aspects and Prognosis at the Department of Obstetrics and Gynecology of the Teaching Hospital Souro Sanou of Bobo-Dioulasso: About 79 Cases and Literature Review

Objective: To study the epidemiological, clinical, therapeutical, anatomopathological aspects and prognosis of the ectopic pregnancy. Methodology: It was a transversal and descriptive study from January 1st to December 31st 2018 at the department of obstetrics and gynecology of the Teaching Hospital Sourô Sanou of Bobo-Dioulasso. Results: During the study period, we registered 4706 deliveries with 1272 cases of cesareans and 79 cases of ectopic pregnancy with a frequency of 1 ectopic pregnancy for 60 deliveries and 6 ectopic pregnancies for 100 caesareans. The average age of the patients in our study was 28.66 years old (19 - 45 years) and the average parity of 1.96 [0 - 6]. Married women represented 83.54 % of the workforce. The risk factors were dominated by sexual transmitted diseases (25.31%) and abortions (20.25%). Clinical signs were dominated by pelvic pain (100% of cases), metrorrhagea (86.5% of cases) and amenorrhea (64.6% of cases). Culdocentesis brought lysed incoagulable blood in 83.7% cases. The immunological pregnancy test was positive in 100% of cases. Plasma beta dosage was carried out in 2 cases. Salpingectomy was performed in 97.4% cases. The site of the ectopic pregnancy was interstitial in 11.3% cases, isthmic in 8.86% cases, infundibular in 11.3% cases, ampullar in 77.22% cases. On the anatomopathological level, we noted an acute salpingitis in 23.38% cases and a chronic salpingitis in 44.94% cases. Postoperative were simple in 97.7% of cases and we deplored one case maternal death. Conclusion: Ectopic pregnancy is a surgical emergency of the first trimester pregnancy. The delay in diagnosis is common in our context, with as consequence a mutilated treatment. The etiological factors are dominated by the chronic salpingitis and the acute salpingitis. The prevention is based on combatting genital infections, promoting contraceptive methods and a good post abortion care.

Viable Second Trimester Cervical Ectopic Pregnancy Managed Successfully with Uterine Preservation: Case Report

Cervical pregnancy is a rare clinical entity that accounts for less than 1% of all ectopic pregnancies. It results from implantation of the blastocyst in the cervical canal below the level of the internal os. Although non-tubal ectopic pregnancies account for only 5% of ectopics, they contribute to a significant morbidity. The cornerstone in the management of cervical ectopic is early diagnosis by high index of suspension and a qualified sonographer. Management options for cervical ectopic pregnancies range from conservative drug treatment to radical hysterectomy. Over the last few years, the mortality and morbidity rates of ectopic pregnancies have been reduced. This is mainly due to the early recognition of the condition and the wide availability of minimally invasive surgical procedures. We present a case of a 33-year-old woman that was 16 weeks pregnant. She presented initially with recurrent vaginal bleeding followed by minimal lower abdominal pain. Her early US scans were misleading. Several weeks later, a follow up MRI scan suggested cervical ectopic. She was managed surgically with uterine preservation.

Molar Ectopic Pregnancy: A Case Study from the Maternity Unit of the Bobo-Dioulasso Teaching Hospital

The authors reported a case of molar ectopic pregnancy seen and managed at the maternity unit of the Bobo-Dioulasso Teaching Hospital. The frequency of the molar ectopic pregnancy is difficult to assess. Besides, the histopathological examination of surgical specimen of the salpingectomy is not usual in our setting. For the management, we realized a total left salpingectomy with a histopathological examination of surgical specimens in association with serum b HCG follow up. During post operations period, the patient was put on estro-progestin contraception for a year, a regular checkup of the biological marker of the molar pregnancy till negativation, a clinical, ultrasound and radiological checkup. No anomaly was noticed at the end of the follow up.

Chronic cornual ectopic pregnancy presenting as large cornual mass after in vitro fertilization-embryo transfer:A case report

Chronic cornual ectopic pregnancy is rare.A 37-year-old woman,G1P0,presented with cornual mass,mild vaginal bleeding,and low serum human chorionic gonadotropin.Cornuostomy and cornual repair were performed by laparoscopy.With atypical symptoms,chronic cornual ectopic pregnancy is a challenge for the gynecologists to make accurate diagnosis and effective treatment.

Application Value of Transvaginal Ultrasound on Early Screening for Ectopic Pregnancy

Objective:To explore the effect and value of transvaginal ultrasound in screening early ectopic pregnancy.Methods:A total of 146 patients with ectopic pregnancy in our hospital were selected.The patients1 entry time was from May 2018 to December 2020.146 patients were divided into two groups.The control group was screened by abdominal ultrasound with 73 cases,and the experimental group was screened by vaginal ultrasound with 73 cases.The uterine adnexal mass,pelvic effusion,peritoneal effusion and diagnostic accuracy were detected.Results:The positive number of abdominal ultrasound was significantly higher than that of vaginal ultrasound;In the detection process of abdominal ultrasound,54 cases of ectopic pregnancy,19 cases of non-ectopic pregnancy,the detection rate was 73.97%,26 cases of ectopic pregnancy,47 cases of non-ectopic pregnancy,the detection rate was 32.62%.Conclusion:The accuracy of transvaginal ultrasound is relatively high,and the accuracy of ectopic pregnancy examined by transvaginal ultrasound is higher,which is more friendly to patients,less traumatic and high operability.It can provide more accurate reports for patients and relieve the psychological pressure of patients,which is worthy of application in actual screening.

Evaluation of 15 Years Practice of Coelioscopic Treatment of Ectopic Pregnancy in the Surgery Department“A”at the University Hospital Point G

Aim: To evaluate 15 years practice of coelioscopic Treatment of ectopicpregnancy in the Surgery Department “A” at the University Hospital Point G. Material and Methods: We conducted a descriptive retrospective study at the Surgery Department “A” at the University Hospital Point G from January 2001 to August 2015. Inclusion criteria were all pregnant women with ectopic pregnancy treated with coelioscopy. Sociodemographic, clinical, paracclinical and therapeutic aspects were recorded. Results: In 15 years, 42 cases of ectopic pregnancy out of 3840 gynecologic coelioscopies (1.04%) were collected. The average age was 28.5 years old with the extremes of 16 and 41 years old. Metrorragia was associated to pain in 83.3% (35/42);amenorrhea was found in 66.7% (28/41). Physical exam revealed pain with abdominal defense in 59.5% (25/42), adnexal mass in 31% (13/42), and pelvic contracture in 9.5% (4/42). In pre-operative, ectopic pregnancy was diagnosed complicated in 71.4% (30/42) and uncomplicated in 28.6% (12/42). Patients underwent salpingectomy in 85.7% (36/42), delivery from the fallopian tube in 9.8% (4/42), and hemostatic salpingectomy in 4.4% (2/42). The average duration of hospital stay was 1.88 day with the extremes of 1 and 7 days. The postoperative evolution was favorable in 97.6% (41/42), infection at the site of surgery was reported in 2.4% (1/42). Not a single death was registered. Conclusion: Treatment of ectopic pregnancy is of routine at the surgery department “A” in Point G. Fertility is preserved in the future.