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ectopic pregnancy and failed oocyte retrieval during in vitro fertilization stimulation:Two case reports

World Journal of Clinical Cases 2022年第28期10卷 10310-10316页

作者： Wen-Jie Zhou Bu-Fang Xu Zhi-Hong Niu Department of Obstetrics and Gynecology Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China

BACKGROUND Due to a slight rise in beta-human chorionic(β-h CG)levels that are undetectable,and vaginal bleeding that is similar to regular menstruation,ectopic pregnancy(EP)that occurs during the expected menstrual cycle prior to ovulation induction as part of in vitro fertilization(IVF)is likely to be *** present two cases of unexpected EP and emphasize the importance of theβ-h CG assay when an unexplained increase in progesterone is present prior to the triggering of ovulation during controlled ovarian stimulation(COS).CASE SUMMARY A 26-year-old woman with primary infertility and a 31-year-old woman with secondary *** patients sought IVF treatment due to fallopian tube obstruction and underwent COS using the gonadotropin-releasing-hormone(Gn RH)-antagonist *** the late stage of COS,progesterone levels in both patients significantly increased,and luteinizing hormone levels decreased,followed by oocyte retrieval failure.A right salpingectomy was performed and tubal ectopic pregnancy was diagnosed by pathology in the first patient,and the second patients was diagnosed with a suspected EP abortion because herβ-h CG levels declined to 12.5 m IU/m *** full recovery for 2 mo,the first patient entered a new IVF treatment cycle with a Gn RH-antagonist regimen and successfully achieved eight oocytes and three viable *** 6 mo,the second patient received another COS treatment with a progestin-primed ovarian stimulation protocol and successfully achieved nine oocytes and five viable ***β-h CG levels in the initial and midterm phases of COS must be considered in patients with unusual hormone dynamics.

关键词： Infertility ectopic pregnancy In vitro fertilization Ovarian induction Case report

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ectopic pregnancy implanted under the diaphragm: A rare case report

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World Journal of Clinical Cases 2021年第36期9卷 11437-11442页

作者： Qiang-Le Wu Xiao-Man Wang Dong Tang Department of Radiology The Affiliated Hospital of Hangzhou Normal UniversityHangzhou 310015Zhejiang ProvinceChina Department of Ultrasound The Affiliated Hospital of Hangzhou Normal UniversityHangzhou 310015Zhejiang ProvinceChina

BACKGROUND Abdominal pregnancy is a rare type of ectopic *** 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 *** had no current or abnormal vaginal bleeding,and her serum human chorionic gonadotropin level(13372.08 IU/L)indicated *** ultrasound showed a mixed echogenic mass in the right ***(plain)scan showed a curved high density mass beneath the subhepatic *** scan showed a curved mixed signal,with restricted diffusion beneath the subhepatic *** 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 *** laparoscopy visualized a dark red mass under the right diaphragm,which was resected *** examination of the resected mass confirmed an ectopic *** recovery was swift and uneventful,and the patient was discharged to *** ectopic pregnancy should be in the differential diagnostic workup(via multiple imaging modalities)of childbearing woman with unexplained abdominal pain.

关键词： ectopic pregnancy Diaphragmatic Ultrasonography Computed tomography Magnetic resonance Case report

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

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World Journal of Clinical Cases 2023年第13期11卷 2945-2955页

作者： Hui-Juan Hu Juan Sun Rui Feng Liang Yu Department of Ultrasonic Hangzhou Red Cross HospitalAffiliated Hangzhou Chest HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina Department of Ultrasonic Zhejiang Provincial People’s HospitalPeople’s Hospital of Hangzhou Medical CollegeHangzhou 310000Zhejiang ProvinceChina Department of Interventional Medicine Zhejiang Provincial People’s HospitalPeople’s Hospital of Hangzhou Medical CollegeHangzhou 310000Zhejiang ProvinceChina Department of Radiology Zhejiang Provincial People’s HospitalPeople’s Hospital of Hangzhou Medical CollegeHangzhou 310000Zhejiang ProvinceChina

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 *** 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 *** To explore the application value of TAS and TVS in the diagnosis of EP and to improve the level of clinical *** 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 *** 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

关键词： Transvaginal ultrasound Transabdominal ultrasound ectopic pregnancy Application value

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LAPAROSCOPIC SURGERY IN PATIENTS WITH HYPOVOLEMIC SHOCK DUE TO ectopic pregnancy

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Chinese Medical Sciences Journal 2005年第1期20卷 40-43,页

作者： Zhi-gangLi Jin-huaLeng Jing-heLang Zhu-fengLiu Da-weiSun ZhuLan DepartmentofObstetricsandGynecology GuangdongProvincialPeople＇sHospitalGuangzhou510080 DepartmentofObstetricsandGynecology PekingUnionMedicalCollegeHospitalChineseAcademyofMedicalSciences＆PekingUnionMedicalCollegeBeijing100730

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.

关键词： laparoscopic surgery ectopic pregnancy hypovolemic shock gynecologic surgical procedures

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Laparoscopic management of an ectopic pregnancy after in vitro fertilization and embryo transfer at CHRACERH:A case report

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Laparoscopic, Endoscopic and Robotic Surgery 2018年第3期1卷 70-73页

作者： Belinga Etienne Noa Ndoua Claude Cyrille Ayissi Gregory Kasia Onana Yves Bertrand Kasia Jean-Marie Department of Gynecology and Obstetrics Faculty of Medicine and Biomedical ScienceUniversity of Yaounde IYaoundeCameroon Hospital Center for Research and Application in Endoscopic Surgery and Human Reproduction YaoundeCameroon

*** Initially,in vitro fertilization and embryo transfer(IVF-ET)was designed to solve tubal factors infertility(TFI)by placing the embryo(s)within the uterine ***,in some cases,an ectopic implantation occurs as the embryo can enter the *** pregnancy(EP)is the location of the pregnancy outside the intrauterine *** prevalence of EP following assisted reproductive technology(ART)ranges between 2.1%and 8.6%of all pregnancies and it can reach up to 11%inwomen with tubal factors infertility history.

关键词： ectopic pregnancy Laparoscopic management In vitro fertilization Embryo transfer

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

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World Journal of Hepatology 2024年第9期16卷 1289-1296页

作者： Xiu-Ci Yang Miao Fang Yi-Gen Peng Liang Wang Rong Ju Department of Emergency The Affiliated Jiangning Hospital of Nanjing Medical UniversityNanjing 211100Jiangsu ProvinceChina Department of Gynecology and Obstetrics Nanjing Medical UniversityNanjing 211100Jiangsu ProvinceChina Department of Hepatological Surgery The Affiliated Jiangning Hospital of Nanjing Medical UniversityNanjing 211100Jiangsu ProvinceChina Department of Gynecology The Affiliated Jiangning Hospital of Nanjing Medical UniversityNanjing 211100Jiangsu ProvinceChina

BACKGROUND Primary abdominal pregnancy is an extremely rare form of ectopic *** pregnancies that occur in the liver and diaphragm are even rarer,limited case reports are available in the *** 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 *** a series of physical and auxiliary examinations,she was clinically diagnosed with hepatic ectopic *** surgery was performed to remove the pregnancy tissue and achieve *** a period of follow-up,the patient was successfully *** Paying attention to the patient's signs and utilizing imaging examination methods can help avoid missed diagnoses of liver pregnancy.

关键词： ectopic pregnancy Liver Diaphragm Diagnosis Case report

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Contralateral Tubal ectopic pregnancy after Ovulation of Another Side Ovary in Spontaneous Cycles:A Case Report and Review of the Literature

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Journal of Reproduction and Contraception 2013年第2期24卷 121-125页

作者： Pin-xiu HUANG Ji-hong WEI Li-hong WEI Department of Reproductive Medicine Maternal and Child Health Care Hospital of Guangxi Liuzhou City

Pregnancies in the same side tube after the same side ovary ovulation are more common. We report an unusual case of contralateral tubal ectopic pregnancy after ovulation of another side ovary in spontaneous cycles. A 32-year-old woman underwent laparoscopic left fallopian tube conservative surgery because of left tubal pregnancy two years ago. She returned to our hospital with a positive pregnancy test and lower abdominal pain 28 d after the dominant follicle discharged in the right side ovary detected by transvaginal ultrasound in spontaneous cycles. Transvaginal ultrasonography revealed no intrauterine gestational sac but a left adnexal mass measuring 2.6 cm X2.5 cm. Videolaparoscopy was performed, and the diagnosis of an ectopic pregnancy in the let fallopian tube was confirmed by pathologic report. Tubal damage is the most important risk factor for tubal ectopic pregnancy. Embryos can be reversely migrated toward fallopian tubes, due to retrograde action of endometrial waves and uterine contractions, that is another necessary reason which contributes to such tubal pregnancy. Total salpingectomy or tubal sterilization is necessary for avoiding repeated tubal ectopic pregnancy.

关键词： ectopic pregnancy repeated ectopic pregnancy tubal pregnancy ovary

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A Recurrent ectopic pregnancy within A Previous Caesarean Scar: A Case Report

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Journal of Reproduction and Contraception 2011年第1期22卷 45-49页

作者： Yu-xian WANG Fang-fang BAI Sheng-hui LU Department of Obstetrics and Gynecology The First Clinical Hospital Affiliated To Shanxi Medical University Taiyuan 030001 China

Objective To investigate the clinical diagnosis and treatment of caesarean scar pregnancy （CSP）. Methods We reported here a case of recurrent ectopic pregnancy within a previous cesarean scar and reviewed the literature. Results Surgical evacuation of a CSP was a small side effect and effective treatment of CSP. Conclusion Early and accurate diagnosis, timeliness and effective treatment were extremely important in saving patients＇ life and retaining their fertility.

关键词： cesarean scar pregnancy (CSP) ectopic pregnancy case report

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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

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Open Journal of Obstetrics and Gynecology 2022年第1期12卷 1-10页

作者： Bambara Moussa Togbe Alihonou Eric Serge Lankoande David Dembele Adama Ouedraogo Issa Head Department of Obstetrics and Gynaecology Teaching Hospital Sour&ocirc Sanou of Bobo-Dioulasso Bobo-Dioulasso Burkina Faso Gynaecologist Obstetrician UHO Ouayigouya Burkina Faso

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 pregna

关键词： ectopic pregnancy Surgical Emergency Salpingectomy Prognosis

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Factors associated with the incidence of ectopic pregnancy in women undergoing assisted reproductive treatment

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Chinese Medical Journal 2020年第17期133卷 2054-2060页

作者： Xiao-Ying Jin Chao Li Wen Xu Liu Liu Min-Ling Wei Hai-Yi Fei Jing Li Feng Zhou Song-Ying Zhang Assisted Reproduction Unit Department of Obstetrics and GynecologySir Run Run Shaw HospitalZhejiang University School of MedicineHangzhouZhejiang 310016China Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province HangzhouZhejiang 310016China

Background:ectopic pregnancy(EP)is a common complication in women undergoing assisted reproductive treatment,but the underlying causes for this remain *** study aimed to explore factors affecting the incidence of EP in in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI).Methods:This was a retrospective study on the incidence of EP in IVF/ICSI cycles between January 1,2013 and December 31,*** age,infertility diagnosis(tubal factor or not),primary or secondary infertility,type of cycle(frozen-thawed or fresh),type of embryo(s)transferred(cleavage embryo or blastocyst),number of embryos transferred(one,two,or three),previous history of EP,and endometrial combined thickness were analyzed to explore their relationships with the incidence of *** on clinical typing results,the patients were divided into an EP group or a non-EP *** variables were analyzed using Chi-squared test or Fisher exact *** regression analysis was performed to explore their associations with the incidence of ***:The percentage of patients with primary infertility in EP group was significantly lower than that in non-EP group(31.3%vs.46.7%,χ^2=26.032,P<0.001).The percentage of patients with tubal infertility in EP group was also significantly higher than that in non-EP group(89.2%vs.63.6%,χ^2=77.410,P<0.001).The percentages of patients with transfer of cleavage-stage embryo or blastocyst(91.4%vs.84.4%,χ^2=10.132,P=0.001)and different endometrial combined thickness(ECT)(χ^2=18.373,P<0.001)differed significantly between EP and non-EP *** patients who had a previous history of one to four EPs,the percentage of patients undergoing transfer of a cleavage-stage embryo was significantly higher in EP group than that in non-EP group(92.2%vs.77.6%,χ^2=13.737,P<0.001).In multivariate logistic regression analysis,tubal infertility was strongly associated with EP(adjusted odds ratio:3.995,95%confidence interval:2.706-5.897,P<0.001).Conclusi

关键词： Prognostic factor ectopic pregnancy Tubal factor In vitro fertilization Intracytoplasmic sperm injection

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