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Challenges of Management of Ruptured Second Trimester Ovarian Pregnancy in Low-and Middle-Income Settings: A Case Report.

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العنوان: Challenges of Management of Ruptured Second Trimester Ovarian Pregnancy in Low-and Middle-Income Settings: A Case Report.
المؤلفون: Eleje GU; Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Awka, Nigeria.; Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Udigwe GO; Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Awka, Nigeria.; Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Njoku TK; Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Okoro CC; Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Onyejiaka CC; Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Ihekwoaba EC; Department of Surgery, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria., Ndukwe CO; Department of Anatomic Pathology and Forensic Medicine, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria., Anaedu OP; Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Chiemeka ME; Department of Anatomic Pathology and Forensic Medicine, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria., Okafor CG; Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Ekwebene OC; Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Offor CC; Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Okoye OA; Department of Surgery, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria., Okolie PC; Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Malachy DE; Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Awka, Nigeria., Maduagwu CI; Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Awka, Nigeria., Mmuotoo JI; Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Nwankwo EU; Rural Community Clinical School, School of Medicine, Deakin University, Victoria, Australia., Duru CO; Department of Family Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Igbodike EP; Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Obiegbu NP; Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Agbo JC; Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Okeke NC; Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Ezenwafor OO; Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Nneji HC; Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Dimgba OO; Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria., Okonkwo JE; Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.
المصدر: Clinical medicine insights. Case reports [Clin Med Insights Case Rep] 2023 Feb 10; Vol. 16, pp. 11795476231153285. Date of Electronic Publication: 2023 Feb 10 (Print Publication: 2023).
نوع المنشور: Case Reports
اللغة: English
بيانات الدورية: Publisher: SAGE Publications Country of Publication: United States NLM ID: 101531893 Publication Model: eCollection Cited Medium: Print ISSN: 1179-5476 (Print) Linking ISSN: 11795476 NLM ISO Abbreviation: Clin Med Insights Case Rep Subsets: PubMed not MEDLINE
أسماء مطبوعة: Publication: <2016- > : Thousand Oaks, CA : SAGE Publications
Original Publication: Auckland, N.Z. : Libertas Academica
مستخلص: Background: Ovarian ectopic pregnancy is a rare form of non-tubal ectopic pregnancy. It can rupture before the end of the first trimester, causing hemoperitoneum, and present with signs and symptoms similar to other commoner abdominal emergencies or the pregnancy can continue intraperitoneally. Therefore, they are not often diagnosed preoperatively. Ultrasound can assist in diagnosis of ovarian ectopic pregnancy but the findings could be ambiguous or inconclusive. We present a case of ruptured ovarian ectopic pregnancy at the second trimester causing massive hemoperitoneum that was suspected as an intrabdominal malignancy co-existing with intrabdominal pregnancy.
Case Presentation: She was a 34 year-old Nigerian unbooked G4P3+0, (3 alive), who presented to the labor ward on 21st January, 2021 with a complaint of a 6-week history of abdominal pain and swelling. Pain was insidious in onset, generalized, non-colicky, non-radiating, constant, no known aggravating or relieving factor, but it was of moderate intensity. She had amenorrhea with a positive serum pregnancy test without prior early ultrasound. At presentation, initial abdominopelvic ultrasound revealed intra-uterine viable pregnancy but repeat ultrasound done showed a left adnexal ectopic gestation and an echo-rich intraperitoneal fluid collection. Laparotomy was done and ovarian pregnancy was accurately diagnosed intra-operatively. Tissue samples from the ovary confirmed normal products of conception, namely chorionic villi, trophoblastic cells and ovarian stroma at histology.
Conclusion: Despite advances in imaging techniques, the diagnosis of ovarian ectopic gestation is still very difficult. When premenopausal women present with amenorrhea, generalized non-colicky abdominal pain and swelling in combination with ambiguous findings of pregnancy on ultrasound in the absence of trauma, differential diagnoses should include ruptured ovarian pregnancy. Obstetricians should maintain a high index of suspicion to forestall delayed diagnosis and the potential maternal morbidity and mortality. However, the need for high-index of suspicion should be for any ectopic, not just ovarian pregnancy.
Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
(© The Author(s) 2023.)
References: Obstet Gynecol Sci. 2020 Mar;63(2):209-212. (PMID: 32206662)
Int J Surg Case Rep. 2022 Feb;91:106742. (PMID: 35026683)
Case Rep Emerg Med. 2022 Mar 31;2022:5568711. (PMID: 35399742)
World J Clin Cases. 2021 Oct 16;9(29):8894-8900. (PMID: 34734072)
J Clin Diagn Res. 2015 Apr;9(4):QR01-3. (PMID: 26023609)
J Ultrasound Med. 2014 Jul;33(7):1143-6. (PMID: 24958399)
Arch Gynecol Obstet. 2009 Jul;280(1):123-5. (PMID: 19043727)
Ann Med Health Sci Res. 2013 Apr;3(2):166-70. (PMID: 23919183)
J Reprod Med. 2016 Jan-Feb;61(1-2):58-62. (PMID: 26995890)
Rom J Morphol Embryol. 2020 Oct-Dec;61(4):985-997. (PMID: 34171048)
Obstet Gynecol. 1991 Oct;78(4):656-9. (PMID: 1810289)
Emerg Radiol. 2022 Feb;29(1):161-172. (PMID: 34618256)
Clin Pract Cases Emerg Med. 2019 Jan 29;3(1):62-64. (PMID: 30775668)
فهرسة مساهمة: Keywords: Ectopic pregnancy; implantation; ovarian pregnancy; pelvic inflammatory disease
تواريخ الأحداث: Date Created: 20230217 Latest Revision: 20230218
رمز التحديث: 20230218
مُعرف محوري في PubMed: PMC9926361
DOI: 10.1177/11795476231153285
PMID: 36798956
قاعدة البيانات: MEDLINE
الوصف
تدمد:1179-5476
DOI:10.1177/11795476231153285