Extrauterine (ectopic) pregnancy
Treatment of ectopic pregnancy today is possible by 2 methods: surgery and medication. Both methods are only possible in an inpatient department.
For medical treatment, a drug from the cytostatic group is used: a drug that disrupts cell division. The main use of this drug is the treatment of oncological diseases. To eliminate an ectopic pregnancy with this drug, a number of conditions must necessarily be met:
• a low concentration of hCG in the blood;
• a small nidus of ectopic pregnancy, according to ultrasound data in it is not yet visible fetus with cardiac activity.
It should be necessarily taken into account that the use of this drug may be accompanied by various side effects inherent to cytostatics and immunosuppressors. Due to the low effectiveness of this method, as well as a high risk of serious complications, I do not use this drug in my practice today. I also do not use the insertion of this drug into the fallopian tube during laparoscopy.
Year: 2020 Complex surgery case
A patient was admitted with a diagnosis of ectopic pregnancy on the right side. The left fallopian tube was removed 5 years ago by laparoscopic (?!) surgery. What actually happened during that operation is not fully known.
We planned a standard operation to remove the fetal egg from the right fallopian tube. At revision: up to 200 ml of blood, clots in the abdomen. The sigmoid colon was tightly fused to the uterine floor and the left uterine angle. The left ovary is in a adherent conglomerate. The right appendages are embedded in the pelvic wall.
After removal of clots and blood, there was no ectopic pregnancy in the right tube. Bleeding from the area of the left uterine appendages, which were embedded in the adhesions. The intestine was separated from the uterus, Douglas pocket was opened. We got to the left uterine appendages. We found a fetal egg near the fimbrial stump of the left fallopian tube, left after the last operation. The stump of the left tube was removed with the fetus egg. The left ovary was released from the adhesions.
The right uterine appendages were separated from the adhesions. The right ovary showed a yellow body and the previous ovulation site.
The patient was discharged home in the morning.
Year: 2020 The operation to remove the fetal egg performed by our team is one of the gentlest methods.
Year: 2020 Ectopic pregnancy against the background of an improperly installed spiral.
The patient complained of lower abdominal pain for a week. Past medical history: six months ago, the patient had a spiral inserted at her place of residence for contraceptive purposes. After the insertion of the spiral, the patient had nagging pains in the lower abdomen for a week.
On examination according to ultrasound examination there was no spiral in the uterine cavity. There was a small amount of fluid behind the uterus. It was decided to have a CT scan to see where the spiral is located. The CT scan showed that the spiral is outside the uterus, behind the uterus. The patient is prepared for the operation and taken to the operating room.
Laparoscopy revealed a tubal pregnancy on the right side. The tube was removed. The spiral was found behind the uterus, wrapped in a large omentum. Removed.
The patient was discharged home the next day.
Year: 2019 Dangerous ectopic pregnancy in the uterine angle
Year: 2020 Another case of an extremely dangerous ectopic pregnancy.
This time the embryo stopped practically in the uterine cavity, having begun to develop in the intramural part of the fallopian tube. To resolve this issue, temporary clipping of the uterine arteries was performed before the removal of the fetal egg.
Year: 2020 Ectopic pregnancy in the right fallopian tube.
Preservation of the fallopian tube, fimbrioplasty.
Year: 2013 Ectopic pregnancy
The operation was performed for rupture of the fallopian tube and massive bleeding. A Pfanenstil laparotomy was performed, and the fallopian tube was removed.
Year: 2007 Ectopic pregnancy
