RESUMEN
RATIONALE: Tubal sterilization as a contraception method has a high success rate; however, it also carries a low risk of incidental pregnancy. A majority of these pregnancies are ectopic. In this study, we report a rare case of spontaneous right distal tubal pregnancy after bilateral laparoscopic tubal sterilization. PATIENT CONCERNS: A 36-year-old woman who had undergone bilateral laparoscopic tubal sterilization presented with abdominal pain and a positive test for pregnancy. DIAGNOSIS: Ectopic pregnancy was suspected based on absence of gestational sac in the uterine cavity on ultrasound and elevated beta-human chorionic gonadotropin (ß-hCG) level. INTERVENTION: Since the patient had unstable vitals, emergency laparoscopic surgery was performed, which revealed a right distal fallopian tube pregnancy. We performed a complete bilateral residual tubal stump excision. OUTCOMES: The patient recovered well after surgery, with a reduction in ß-hCG level, and was discharged after 3 days. LESSONS: To ensure complete sterilization, the gap at the excised end needs to be adequately widened and enhanced with electro-destruction to prevent formation of a fistula.
Asunto(s)
Laparoscopía/efectos adversos , Complicaciones Posoperatorias/etiología , Embarazo Tubario/etiología , Esterilización Tubaria/efectos adversos , Adulto , Femenino , Humanos , Laparoscopía/métodos , Complicaciones Posoperatorias/cirugía , Embarazo , Embarazo Tubario/cirugía , Salpingectomía/métodos , Esterilización Tubaria/métodosAsunto(s)
Quiste Dermoide/complicaciones , Neoplasias Ováricas/complicaciones , Ovario/anomalías , Adolescente , Calcinosis/complicaciones , Calcinosis/diagnóstico por imagen , Quiste Dermoide/diagnóstico por imagen , Femenino , Humanos , Neoplasias Ováricas/diagnóstico por imagen , Ovario/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: Noninvasive prenatal testing (NIPT) is widely used as a powerful screening tool to detect common aneuploidies. However, its application for detection of rare chromosomal abnormalities remains inconclusive. CASE REPORT: A 38-year-old woman (gravida 2, para 0) requested NIPT as a primary screening test for fetal aneuploidies at 13 weeks and 1 day of gestation. An unexpected Trisomy 9 (T9) abnormality was highly suspected. Amniocentesis was arranged for further diagnosis at 18 weeks of gestation. Final karyotyping reported 47,XX,+9 [18]/46,XX [12], indicating 60% T9 mosaicism. CONCLUSION: This case shows strong evidence that NIPT can be a powerful screening tool to detect rare fetal trisomies at very early gestation.
