Treatment experiences about uterine horn ectopic pregnancy

Authors

Keywords:

ectopic horn pregnancy, interstitial pregnancy, cornual pregnancy, surgical treatment, drawstring suture.

Abstract

Introduction: Interstitial pregnancy is rare and its mortality is higher than in other locations. Its increasingly early diagnosis allows the choice of less aggressive treatments. The cornerstone is hemostasis.
Objective: To describe the results of the treatment of patients treated for ectopic horn pregnancy.
Method: A descriptive study was carried out in 18 women with interstitial ectopic pregnancy, treated at the Hospital Militar Central "Dr. Luis Díaz Soto" from 2010 to 2019. They were treated by laparotomy and circular suture of the horn, with subsequent cornual resection and extraction of ovular material. The variables age, risk factors, surgical time, intraoperative bleeding, evolution (complications, recovery, beta fraction of chorionic gonadotropin, postoperative ultrasound controls) and hospital stay were studied.
Results: 72% of the patients were between 20 - 25 years old, 61.1% had a history of induced abortions, followed by pelvic inflammatory disease in 44.4%. The mean surgical time was 36 minutes. No patient had bleeding at the surgery site. The beta fraction of chorionic gonadotropin was negative at the fourth week and postoperative ultrasound controls of all patients were normal on day 15. The drawstring suture was used in all patients.
Conclusions: The results in the treatment of the patients attended for interstitial pregnancy were favorable, the repair of the uterine wall was carried out by means of a safe procedure that showed the applicability of the drawstring suture. Blood loss and complications such as hysterectomy were avoided.

Downloads

Download data is not yet available.

Author Biography

Iraisa León Cid, Hospital Militar Central "Dr. Luis Diaz Soto". La Habana, Cuba

Servicio d Ginecología y Obstetricia

References

1. Pantoja-Garrido M, Cabezas-Palacios MN, Tato-Varela S. Protocolo de tratamiento multidosis con metotrexato a pacientes con embarazo ectópico cornual. Ginecol Obstet Mex. 2016[acceso: 16/01/2020];84(5):319-23. Disponible en: https://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=1&sid=027-dbaea-ab9b-47ae-8363-53754a9a1d7f%40pdc-v-sessmgr04

2. Sepúlveda J, Torrado D. Embarazo ectópico cornual recurrente. Caso clínico y revisión de la literatura. Rev Chil Obstet Ginecol. 2015[acceso: 16/01/2020];80(6):503-9. Disponible en: https://dx.doi.org/10.4067/S0717-75262015000600011

3. Zarama Márquez F, Buitrón García R, Córdoba Guacan E, Cortés Cortés L, Zarama Eraso MA. Embarazo ectópico cornual. Tratamiento combinado con metrotexato e histerotomía y evacuación por laparoscopia. Reporte de un caso. Ginecol Obstet Mex. 2019[acceso: 16/01/2020];87(10):676-9. Disponible en: https://www.sanmartin.edu.co/1/wp-content/uploads/2019/10/articulo-dr.-fabio-zarama-marquez.pdf

4. Partal Lorente AB, Oliver Díaz M, Cueva Carrascosa I, Cidraque Orraj MA, López Moreno ME, Pérez López S. Opciones terapéuticas del embarazo ectópico sobre cicatriz de cesárea. Prog Obstet Ginecol. 2017;60(6):586-9.

5. Ruiz-Sánchez E. Embarazo cornual roto. ¿Por qué no debemos olvidar el embarazo con causa de dolor abdominal?. Ginecol Obstet Mex 2017[acceso: 16/01/2020];85(9):634-39. Disponible en: https://doi.org/10.24245/gom.v85i9.1410

6. Martín de Vega R. Embarazo ectópico cornual. Caso clínico de ecografía de matrona. Rev Matronas 2018[acceso: 16/01/2020];6(2):14-17. Disponible en: https://www.enfermeria21.com/revistas/matronas/articulo/140/embarazo-ectopico-cornual-casoclinico-de-ecografia-de-matrona/

7. Ibáñez Cayón F, Soto del Pino Y, Pérez González Y, Portales Cárdenas Y. Tratamiento con metotrexate para el embarazo ectópico cornual. Rev Cubana Obstet Ginecol. 2017[acceso: 07/02/2020];43(3):[aprox. 10 p.]. Disponible en: https://www.revginecobstetricia.sld.cu/index.php/gin/article/-view/244/189

8. Gador Manrique M, Redondo R, Delgado L, González V, Mauro L, Aceituno L. Rotura uterina en gestante de 13 semanas: Embarazo ectópico intersticial. Rev Chil Ginec Obstet 2015[acceso: 07/02/2020];80(5):55-9. Disponible en: https://scielo.conicyt.cl/pdf/rchog/v80n1/art08.pdf

9. Bertin F, Montecinos M, Torres P, Pinto P. Embarazo ectópico cornual, diagnóstico y tratamiento: reporte de dos casos y revisión de la literatura. Rev Chil Obstet Ginecol. 2019[acceso: 07/02/2020];84(1):55-63. Disponible en: https://scielo.conicyt.cl/scielo.php?pid=S0717-75262019000100055&script=sci_arttext

10. Monzón Castillo EP, Tejada Martínez G, Oliva García AB, Gutiérrez Salas N. Embarazo cornual. Presentación de un caso de evolución inusual con dosis única de metotrexato. Rev Peru Ginecol Obstet. 2020[acceso: 07/02/2020];66(1):[Aprox. 13 p.]. Disponible en: https://www.scielo.org.pe/scielo.php?pid=S2304-51322020000100083&script=sci_arttext&tlng=en

11. Ruiz A. Evolución histórica de la cirugía laparoscópica. Asoci Mex Cirg Endosc 2016[acceso: 07/02/2020]; 17(3):93-106. Disponible en: https://www.medigraphic.com/pdfs/endosco/ce-2016/ce162i.pdf

12. Szylit NA, Podgaec S, Traina E, Oliveira Rde C. Video laparoscopic intervention for an interstitial pregnancy after failure of clinical treatment. Sao Paulo Med J. 2012[acceso: 07/02/2020];130:202-7. Disponible en: https://doi.org/10.1590/S1516-31802012000300011

13. Lee ES, Hahn HS, Park BJ, Ro DY, Kim JH, Kim Y. Single-port laparoscopic cornual resection for a spontaneous cornual ectopic pregnancy following ipsilateral salpingectomy. Fertil Steril. 2011[acceso: 07/02/2020];96(2):106-10. DOI: 10.1016/j.fertnstert.2011.05.09

14. Alagbe OA, Adeniyi TO, Abayomi OA, Onifade EO. Interstitial ectopic pregnancy: A case report. PanAfrican Med J. 2017[acceso: 07/02/2020];28:2-5. DOI: 10.11604/pamj.2017.28.135.13889

15. Sargin MA, Tug N, Ayas S, Yassa M. Is interstitial pregnancy clinically different from cornual pregnancy? A case report. J Clin Diagnostic Res. 2015[acceso: 07/02/2020];9(4):5-6. DOI: 10.7860/JCDR/2015/12198.5836

16. Kahramanoglu I, Mammadov Z, Turan H, Urer A, Tuten A. Management options for interstitial ectopic pregnancies: a case series. Pakistan J Med Sci. 2017[acceso: 07/02/2020];33(2):476. DOI: 10.12669/pjms.332.12093

17. Corioni S, Perelli F, Bianchi C, Cozzolino M, Maggio L, Msini G. Interstitial pregnancy treated with a single dose of systemic methotrexate: a succesful management. J Res Med Sci. 2015[acceso: 07/02/2020];20:312-6. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4468238/

18. Yassin A, Taha M. Interstitial Ectopic Pregnancy, Diagnosis and Management. Ann Clin Case Reports. 2017[acceso: 16/01/2020];2:1352. Disponible en: https://www.anncaserep.com/full-text/accr-v2-id1352.php

19. Wang S, Zhang Y, Zhao Y, Lu S. Cornual pregnancy in 2 cases. Beijing Da Xue Xue Bao. 2018[acceso: 16/01/2020];50(3):576-9. Disponible en: https://dx.doi.org/10.4067/S0717-75262019000100055

20. Álvarez Goris M, Martínez Enríquez MA. Embarazo ectópico intersticial asociado a técnicas de reproducción asistida y ligadura tubaria bilateral. Reporte de caso. Rev Iberoam Fert Rep Hum. 2017[acceso: 16/01/2020]; 34:18-21. Disponible en: https://medes.com/publication/136699

21. Grindler NM, Ng J, Tocce K, Alvero R. Considerations for management of interstitial ectopic pregnancies: two case reports. J Med Case Rep. 2016[acceso: 16/01/2020];10(1):106. DOI: 10.1186/s13256-016-0892-9

Published

2020-10-06

How to Cite

1.
León Cid I, Rodríguez Iglesias G, Segura Fernández AB. Treatment experiences about uterine horn ectopic pregnancy. Rev Cubana Med Milit [Internet]. 2020 Oct. 6 [cited 2024 Dec. 29];49(4):e0200678. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/678

Issue

Section

Research Article

Most read articles by the same author(s)