Intramural ectopic pregnancy following pelvic adhesion: case report and literature review
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Intramural pregnancy is an uncommon type of ectopic pregnancy, where the gestational sac is completely encircled by myometrium and unconnected with endometrial cavity, fallopian tubes or round ligament. Owing to its potentially life-threatening hemorrhage and uterine rupture, early diagnosis and management are urgently required. We present a case of a woman undergoing zigzag medical procedures, which featured non-consensus preoperative diagnosis of intramural and interstitial pregnancy and an intramural ectopic pregnancy ultimately confirmed and successfully removed by emergency laparoscopy. Additionally, we present a review of the related literature and discuss its varied clinical features, imageological characters, diagnosis, differential diagnosis and multiple treatments.
A comprehensive bibliographic search through PubMed, using keywords: intramural ectopic pregnancy. Relevant literatures published from January 2013 to April 2019 were reviewed.
Twenty-four cases in total for intramural ectopic pregnancy including this report were reviewed. Diagnoses were mainly made by ultrasound images. Most patients had a history of uterine surgery or intrauterine operation and had been surgically resected. None of the mothers were in danger, but only one case had live birth at 37 weeks of gestation.
Non-specific clinical presentation and non-uniform ultrasound criteria pose a challenge for us to make timely and accurate management. Integrated radiological examinations and communication and cooperation between sonographers and gynecologists play a vital role in diagnostic accuracy and selecting the optimal therapeutic method of an intramural pregnancy.
KeywordsIntramural pregnancy Transvaginal ultrasound Transabdominal ultrasound Power Doppler sonography Management
QZ was involved in protocol/project development, data collection and management, data analysis and manuscript writing. XXX was involved in project development, images collection, data analysis and manuscript writing. SQL was involved in project development, data analysis, manuscript review and editing. XX was involved in data collection and analysis, manuscript review and editing. XL was involved in patient management and data collection. FQ was involved in manuscript review and editing. YPL was involved in project development, manuscript review and editing.
There are no funding issues as this is a case study couple with review.
Compliance with ethical standards
Conflict of interest
All authors declare no conflict of interest.
Our institutional ethics committee approved the publication of this case report.
Research involving human participants
All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from the patient for publication of this article.
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