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Ectopic pregnancies with unusual location and an angular pregnancy: Report of eight cases

Ektope Schwangerschaften mit untypischer Lokalisation und eine angulare Schwangerschaft: Bericht von acht Fällen

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Zusammenfassung

ZWECK DER STUDIE: Durch die vermehrte Anwendung von assistierter Reproduktionstechnologie kommt es auch zu einer Zunahme von ektopen Schwangerschaften mit untypischen Lokalisationen und der damit vergesellschafteten erhöhten mütterlichen Morbidität und Mortalität. Sieben Fallberichte von ektopen Schwangerschaften mit seltenen Lokalisationen und eine anguläre Schwangerschaft werden vorgestellt, die diagnostischen und therapeutischen Optionen diskutiert sowie eine kurze Literaturübersicht inklusive genauer Nomenklatur wird präsentiert. UNTERSUCHUNGEN UND METHODEN: Fallberichtserie von sieben ektopen Schwangerschaften in untypischer Lokalisation, nach künstlicher Befruchtung oder spontan entstanden (Sectionarbenschwangerschaft, Bauchhöhlenschwangerschaft im Mesoappendix) sowie eine anguläre Schwangerschaft. Alle Patienten wurden in den letzen acht Jahren an unserer Klinik behandelt. Eine retrospektive Analyse. ERGEBNISSE: Interstitielle Schwangerschaft, cornuale Schwangerschaft, Sectionarbenschwangerschaft, Bauchhöhlenschwangerschaft im Omentum majus, heterotope-zervikale Schwangerschaft, Bauchhöhlenschwangerschaft im Mesoappendix, anguläre Schwangerschaft. Alle Patienten wurden operativ therapiert. SCHLUSSFOLGERUNG: Die Diagnose von ektopen Schwangerschaften, besonders derer in unüblichen Lokalisationen, ist schwierig und wird verkompliziert durch die embryonale Einnistung in unmittelbarer Nähe des Ostium uterinum tubae. Hier besonders hinsichtlich der genauen Beurteilung einer intra- oder extrauterinen Lokalisation. Hohe Komplikationsraten und verschiedene Behandlungsmöglichkeiten erschweren die Situation.

Summary

OBJECTIVE: The increased use of assisted reproduction techniques has been accompanied by an increase in ectopic pregnancies with unusual location being associated with significant maternal morbidity and mortality. This article reports on seven cases of ectopic pregnancies with unusual location and an angular pregnancy. Diagnostic and therapeutic strategies are discussed and a brief review of literature is presented. STUDY DESIGN: Case series of seven cases with ectopic pregnancy in unusual location, following assisted reproductive technique or conceived spontaneously (cesarean scar pregnancy and early abdominal pregnancy in mesoappendix) and an angular pregnancy, having presented at our hospital during the last eight years. Retrospective analyses. RESULTS: Interstitial pregnancy, cornual pregnancy, cesarean scar pregnancy, early abdominal pregnancy in omentum majus, heterotopic (cervical) pregnancy, early abdominal pregnancy in mesoappendix, angular pregnancy. All patients were surgically treated. CONCLUSION: Diagnosis of ectopic pregnancy with unusual location may be difficult, and differentiation of intact intrauterine or extrauterine pregnancy with adequate consideration of the area of uterine ostium of the fallopian tube may be delicate. Moreover, varying treatment strategies and high rates of complications aggravate the situation.

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Authors and Affiliations

  1. Landes-Frauen- und Kinderklinik, Kinderwunschzentrum, Linz, Austria

    Richard B. Mayer, Thomas Ebner, Omar Shebl, Johannes Hartl & Gernot Tews

  2. General Hospital Linz, Linz, Austria

    Cemil Yaman

  3. Landeskrankenhaus Gmunden, Gmunden, Austria

    Michael Sommergruber

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  1. Richard B. Mayer
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  2. Cemil Yaman
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  3. Thomas Ebner
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  4. Omar Shebl
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  5. Michael Sommergruber
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  6. Johannes Hartl
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  7. Gernot Tews
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Correspondence to Richard B. Mayer.

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Mayer, R., Yaman, C., Ebner, T. et al. Ectopic pregnancies with unusual location and an angular pregnancy: Report of eight cases. Wien Klin Wochenschr 124, 193–197 (2012). https://doi.org/10.1007/s00508-011-0115-8

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  • DOI: https://doi.org/10.1007/s00508-011-0115-8

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