2020, Number 10
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Ginecol Obstet Mex 2020; 88 (10)
Obstetric hemorrhage and uterine rupture due to an interstitial pregnancy. Report of a case
Villagómez-Mendoza EA, Tamayo-Iturbe A
Language: Spanish
References: 12
Page: 707-712
PDF size: 239.57 Kb.
ABSTRACT
Background: Interstitial ectopic pregnancy occurs in approximately 2.4% of all
cases, this tubal portion is located in the proximal segment and shares the muscular
portion of the uterus, due to its great myometrial compliance, it facilitates late diagnosis
and its clinical presentation is By means of uterine rupture and with it an increase in
morbidity and mortality due to obstetric hemorrhage, the risk factors are the same as
for tubal ectopic pregnancy, treatment is assessed based on preserving fertility and
according to the patient’s clinical setting.
Clinical case: A 31-year-old patient who went to the emergency department for
severe and disabling abdominal pain in the hypogastrium, shock index 1.3, with signs
of peritoneal irritation, ultrasound was performed, which reported free fluid in the pelvic
cavity and Morrison space, extrauterine gestational sac at the level of the left annex,
embryo without heartbeat, craniocaudal length of 11 weeks of gestation, exploratory
laparotomy was performed, in which hemoperitoneum of 2800 cc was observed, uterine
rupture in the right cornual region of approximately 8x6cm, with fetus e integrity of
the amniotic sac adjacent to the uterine rupture, the patient reported satisfied parity,
and therefore a total abdominal hysterectomy was decided.
Conclusions: Interstitial ectopic pregnancy shares the same risk factors as tubal
pregnancy. Today, we have various diagnostic aids, so the cornerstone is timely
detection, which will allow conservative treatments to decrease maternal morbidity
and mortality.
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