Ectopic pregnancy in left ovary and contralateral uterine tube diagnosed one week apart in In Vitro Fertilization with donor eggs: Case report.

Bilateral ectopic pregnancy is a rare clinical condition with an estimated prevalence of 1/200 000 in spontaneous pregnancies. Studies have found that In Vitro Fertilization (IVF) is related to ectopic pregnancy independently, but the incidence of tubal disease in the donor egg recipient population is thought to be significantly lower than in the standard IVF population. We report the case of a patient participating in the egg-sharing program, who was diagnosed with ovarian ectopic pregnancy, treated with surgery. After one week, she was diagnosed with tubal ectopic pregnancy in the contralateral tube. The clinician should be aware that the treatment of one ectopic pregnancy does not preclude the occurrence of a second ectopic pregnancy in the same patient and should pay attention to the intra-operatory inspection of both side fallopian tubes in any ectopic pregnancy case. Routine ultrasound after ectopic pregnancy treatment may be reasonable, especially in high risk patients.

Bilateral ectopic pregnancy.

Bilateral simultaneous ectopic pregnancy is a very rare clinical condition. Two different subsets of patients can be distinguished: women presenting with the disease as a result of spontaneous conception and those with the condition after undergoing assisted reproduction procedures. This article reviews and analyzes 42 cases of bilateral ectopic pregnancies reported in the last 10 years, proposes a new classification of the disease, and presents some data that should be useful for the clinician who confronts this difficult entity.

Embarazo heterotópico: informe de un caso y revisión bibliográfica / Heterotopic pregnancy. One case presentation and bibliographic review

Se presenta el caso de un embarazo heterotópico tubario espontáneo, en paciente primigesta con sobrevivencia del producto intrauterino; tratada en el H.G.Z.M.F.No. 8 IMSS de Ciudad Sahagún Hgo., se señala la frecuencia en la literatura, sus posibles orígenes, su cuadro clínico, los métodos auxiliares de diagnóstico y tratamiento. Se concluye que el embarazo heterotópico es un desorden raro, pero puede ocurrir y es potencialmente peligroso para la madre y el feto intrauterino. Su detección oportuna favorece el pronóstico

Gravidez ectópica tubárea pós-fivete: relato de 2 casos / Tubal pregnancy post in vitro fertilization: report of 2 cases

Os autores relatam 2 casos de gravidez ectópica após tratamento com técnica de fertilizaçäo in vitro e transferência de embrioes (FIVETE). Este tipo de problema näo é incomum. O último senso sobre os dados de 180 clínicas na América do Norte mostrou uma incidência de 5 por cento de gravidez ectópica após FIVETE. De uma casuística de 382 ciclos e 82 gestaçöes em nosso serviço, 2 casos significam apenas 2,44 por cento de incidência, o que nos parece um índice bastante razoável. Em ambos os casos, a gravidez foi detectada precocemente através da ultrasonografia vaginal, sendo que em um caso foi suspeitada devido a sintomas como dor pélvica e sangramento e, no outro, devido a pequeno sangramento 28 dias após a transferência. Além disso, os autores discutem os prováveis mecanismos que levariam à gravidez ectópica após FIVETE, sob os pontos de vista fisiológico e fisiopatológico

[Heterotopic pregnancy in intrauterine insemination. Presentation of a case]. / Embarazo heterotópico con inseminación intrauterina. Presentación de un caso.

The heterotopic (ectopic and orthotopic simultaneous) pregnancy shows a frequency of 1 to 15,000 to 1 to 30,000 gestations. The clinical diagnosis is difficult due to the lack of precise indicators, as to diagnose an intrauterine pregnancy eliminates the possibility of ectopic pregnancy. The methods of Assisted Reproduction seem to be factors that have influenced on the increment of this type of gestations. A case of a 32 year patient with primary sterility by pelvic adhesions process, that was surgically treated, as there was no pregnancy after surgery, she was given intrauterine insemination with her husband's semen (IU) pregnancy was obtained, determined at 15 days of menstrual lack by presence of subunit B of HCG in serum and vaginal ultrasound that confirmed gestational sac. One month after she presented at Urgencies with an acute abdominal condition; laparotomy was done and salpingectomy was carried out for ruptured tubal pregnancy confirmed by histopathology. The evolution on intrauterine pregnancy was normal culminating with cesarean section at week 35 by inminence of eclampsia/Mother and child in good conditions.

Embarazo ectópico posterior a FIV-TE / Ectopic pregnancy secondary to FIV-TE

Se presenta un caso clínico de embarazo ectópico complicado izquierdo; en paciente sometida a FIV-TE por esterilidad secundaria

Etiology of tubal ectopic pregnancy

Fallopian tubes, removed at operation from 100 tubal ectopic pregnancies, were injected with barium sulphate/gelatine suspension and radiographs taken. Histologic sections were then examined. One hundred control tubes were treated in the same fashion, and the findings in the two groups were then compared. The tubes from 50 autopsies of infants and children were also injected with contrast medium and studied microscopically in a search for congenital lesions. Tubal diverticula were found in 49 percent of gravid tubes as compared with 11 percent of those of the control group. Diverticula were confined to the isthmus and the proximal portion of the ampulla. They were not seen in the tubes of infants and children examined at autopsy, but an etiologic relationship with chronic inflammation was suggested. On the basis of this study, it appears also that the lesions referred to as salpingitis isthmica nodosa are in fact diverticula (AU)