Rare forms of ectopic pregnancy in the rudimentary horn and ovary. How not to miss the main thing?

Abstract

This article presents two cases of ectopic pregnancy in the ovary and rudimentary horn, which had a life-threatening course. Despite availability of modern high-quality diagnostics, determining the condition remains challenging, because the definitive diagnosis is established and confirmed only intraoperatively. Hence, the clinical picture can be used primarily in making a diagnosis and choosing an appropriate treatment strategy. Rare localizations, such as in the ovary and rudimentary horn, which cause difficulties in making a diagnosis, should not be overlooked. If an ectopic pregnancy is not detected promptly and the risks are underestimated, death may occur. Two clinical cases clearly demonstrate timely diagnosis, regardless of additional examination methods (e.g., pelvic ultrasound, human chorionic gonadotropin test), and adequate choice of access and scope of surgical intervention. Moreover, the lack of awareness among women about this type of pathology should be considered. Patients often do not complain, do not remember the date of their last menstruation, do not monitor their menstrual cycle, and do not seek medical help in a timely manner. The combination of several factors can lead to fatal events. In this study, both cases of ectopic pregnancy with a rare localization ended favorably.

Keywords

ectopic pregnancy / clinical case / ovarian pregnancy / pregnancy in the rudimentary horn / fetal egg

References

[1] Sarsembayeva MM. Extra uterine pregnancy. Reasons, symptoms, treatment, forecasts. Bulletin of Surgery of Kazakhstan. 2012;(4):64–65. EDN: IZSLUK

[2] Сарсембаева М.М. Внематочная беременность. Причины, симптомы, лечение, прогнозы // Вестник хирургии Казахстана. 2012. № 4. С. 64–65. EDN: IZSLUK

[3] Sarsembayeva MM. Extra uterine pregnancy. Reasons, symptoms, treatment, forecasts. Bulletin of Surgery of Kazakhstan. 2012;(4):64–65. EDN: IZSLUK

[4] Fetishcheva LE, Ushakova GA, Petrich LN. Ectopic pregnancy: risk factors, a problems of diagnosis, treatment, the restoration of fertility. Mother and Baby in Kuzbass. 2017;(1):16–24. EDN: YFUHAN

[5] Фетищева Л.Е., Ушакова Г.А., Петрич Л.Н. Внематочная беременность: факторы риска, проблемы диагностики, лечения, восстановления фертильности // Мать и дитя в Кузбассе. 2017. № 1. С. 16–24. EDN: YFUHAN

[6] Fetishcheva LE, Ushakova GA, Petrich LN. Ectopic pregnancy: risk factors, a problems of diagnosis, treatment, the restoration of fertility. Mother and Baby in Kuzbass. 2017;(1):16–24. EDN: YFUHAN

[7] Lebedev VA, Shahlamova MN, Davydov AI. The rare forms of ectopic pregnancy. Difficult Patient. 2016;14(8–9):13–18. EDN: XROKZZ

[8] Лебедев В.А., Шахламова М.Н., Давыдов А.И. Редкие формы эктопической беременности // Трудный пациент. 2016. Т. 14, № 8–9. С. 13–18. EDN: XROKZZ

[9] Lebedev VA, Shahlamova MN, Davydov AI. The rare forms of ectopic pregnancy. Difficult Patient. 2016;14(8–9):13–18. EDN: XROKZZ

[10] Taran FA, Kagan KO, Hübner M, et al. The diagnosis and treatment of ectopic pregnancy. Dtsch Arztebl Int. 2015;112(41):693–704. doi: 10.3238/arztebl.2015.0693

[11] Taran F.A., Kagan K.O., Hübner M., et al. The diagnosis and treatment of ectopic pregnancy // Dtsch Arztebl Int. 2015. Vol. 112, N 41. P. 693–704. doi: 10.3238/arztebl.2015.0693

[12] Taran FA, Kagan KO, Hübner M, et al. The diagnosis and treatment of ectopic pregnancy. Dtsch Arztebl Int. 2015;112(41):693–704. doi: 10.3238/arztebl.2015.0693

[13] Ishutina TM. Instrumental methods of diagnosis of ectopic pregnancy. Journal of Obstetrics and Womens Diseases. 2015;64(5):77–86. EDN: VKFYAJ

[14] Ишутина Т.М. Инструментальные методы диагностики эктопической беременности // Журнал акушерства и женских болезней. 2015. Т. 64, № 5. С. 77–86. EDN: VKFYAJ

[15] Ishutina TM. Instrumental methods of diagnosis of ectopic pregnancy. Journal of Obstetrics and Womens Diseases. 2015;64(5):77–86. EDN: VKFYAJ

[16] Wong CH, Wang YL, Huang JP. Postoperative reproductive outcomes in women with ovarian pregnancy: A retrospective analysis. Taiwan J Obstet Gynecol. 2021;60(2):295–298. doi: 10.1016/j.tjog.2021.01.007

[17] Wong C.H., Wang Y.L., Huang J.P. Postoperative reproductive outcomes in women with ovarian pregnancy: A retrospective analysis // Taiwan J Obstet Gynecol. 2021. Vol. 60, N 2. Р. 295–298. doi: 10.1016/j.tjog.2021.01.007

[18] Wong CH, Wang YL, Huang JP. Postoperative reproductive outcomes in women with ovarian pregnancy: A retrospective analysis. Taiwan J Obstet Gynecol. 2021;60(2):295–298. doi: 10.1016/j.tjog.2021.01.007

[19] Kolesnikova NB, Marochko TY, Chuikova AS, Artymuk NV. Pregnancy in the rudimentary uterine horn. Fundamental and clinical medicine. 2020;5(1):94–98. EDN: NETOAE doi: 10.23946/2500-0764-2020-5-1-94-98

[20] Колесникова Н.Б., Maрочко Т.Ю., Чуйкова А.С., Артымук Н.В. Врастание плаценты в рудиментарный рог матки // Фундаментальная и клиническая медицина. 2020. Т. 5, № 1. С. 94–98. EDN: NETOAE doi: 10.23946/2500-0764-2020-5-1-94-98

[21] Kolesnikova NB, Marochko TY, Chuikova AS, Artymuk NV. Pregnancy in the rudimentary uterine horn. Fundamental and clinical medicine. 2020;5(1):94–98. EDN: NETOAE doi: 10.23946/2500-0764-2020-5-1-94-98

[22] Mamouni N, Ghazal N, Erraghay S, et al. Grossesse dans une corne rudimentaire: difficultés diagnostiques et prise en charge thérapeutique [Rudimentary horn pregnancy diagnostic: difficulties and therapeutic management]. Pan Afr Med J. French. 2016;24:14. doi: 10.11604/pamj.2016.24.14.6659

[23] Mamouni N., Ghazal N., Erraghay S., et al. Grossesse dans une corne rudimentaire: difficultés diagnostiques et prise en charge thérapeutique [Rudimentary horn pregnancy diagnostic: difficulties and therapeutic management] // Pan Afr Med J. French. 2016. Vol. 24. P. 14. doi: 10.11604/pamj.2016.24.14.6659

[24] Mamouni N, Ghazal N, Erraghay S, et al. Grossesse dans une corne rudimentaire: difficultés diagnostiques et prise en charge thérapeutique [Rudimentary horn pregnancy diagnostic: difficulties and therapeutic management]. Pan Afr Med J. French. 2016;24:14. doi: 10.11604/pamj.2016.24.14.6659

[25] Hussain A, Jawaid H, Faisal N, et al. Ruptured rudimentary horn pregnancy revealed on emergency laparotomy: a case of primigravida presenting in a developing country. Cureus. 2018;10(5):e2591. doi: 10.7759/cureus.2591

[26] Hussain A., Jawaid H., Faisal N., et al. Ruptured rudimentary horn pregnancy revealed on emergency laparotomy: a case of primigravida presenting in a developing country // Cureus. 2018. Vol. 10, N 5. P. e2591. doi: 10.7759/cureus.2591

[27] Hussain A, Jawaid H, Faisal N, et al. Ruptured rudimentary horn pregnancy revealed on emergency laparotomy: a case of primigravida presenting in a developing country. Cureus. 2018;10(5):e2591. doi: 10.7759/cureus.2591

[28] Amer WM, Altraigey A. A triplet’s ectopic pregnancy in a non-communicating rudimentary horn and spontaneous rupture. Ginekol Pol. 2020;91(9):569–570. doi: 10.5603/GP.2020.0089

[29] Amer W.M., Altraigey A. A triplet’s ectopic pregnancy in a non-communicating rudimentary horn and spontaneous rupture // Ginekol Pol. 2020. Vol. 91, N 9. P. 569–570. doi: 10.5603/GP.2020.0089

[30] Amer WM, Altraigey A. A triplet’s ectopic pregnancy in a non-communicating rudimentary horn and spontaneous rupture. Ginekol Pol. 2020;91(9):569–570. doi: 10.5603/GP.2020.0089

[31] Sulima AN, Rybalka AN, Baskakov PN, et al. Pregnancy in the rudimental uterine horn: two clinical cases of successful treatment. Tavricheskiy Mediko-Biologicheskiy Vestnik. 2018;21(1):168–172. EDN: OWFJNL

[32] Сулима А.Н., Рыбалка А.Н., Баскаков П.Н., и др. Беременность в рудиментарном роге матки: два клинических случая успешного органосохраняющего лечения // Таврический медико-биологический вестник. 2018. Т. 21, № 1. C. 168–172. EDN: OWFJNL

[33] Sulima AN, Rybalka AN, Baskakov PN, et al. Pregnancy in the rudimental uterine horn: two clinical cases of successful treatment. Tavricheskiy Mediko-Biologicheskiy Vestnik. 2018;21(1):168–172. EDN: OWFJNL

[34] Dovgopolyy AV, Popov YV, Vanke NS, et al. Ovarian pregnancy on the background of the use of intrauterine spirals (a clinical case). Tumors of Female Reproductive System. 2018;14(2):96–99. EDN: XVLHZZ DOI: 10.17650/1994-4098-2018-14-2-96-99

[35] Довгополый А.В., Попов Ю.В., Ванке Н.С., и др. Яичниковая беременность на фоне использования внутриматочных спиралей (клинический случай) // Опухоли женской репродуктивной системы. 2018. Т. 14, № 2. C. 96–99. EDN: XVLHZZ doi: 10.17650/1994-4098-2018-14-2-96-99

[36] Dovgopolyy AV, Popov YV, Vanke NS, et al. Ovarian pregnancy on the background of the use of intrauterine spirals (a clinical case). Tumors of Female Reproductive System. 2018;14(2):96–99. EDN: XVLHZZ DOI: 10.17650/1994-4098-2018-14-2-96-99

[37] Aryutin DG, Barinova EK, Ordiyants IM, et al. Ovarian pregnancy. Obstetrics and Gynecology. News. Views. Education. 2020;8(S3):116–120. EDN: KWKMHU doi: 10.24411/2303-9698-2020-13919

[38] Арютин Д.Г., Баринова Э.К., Ордиянц И.М., и др. Яичниковая беременность: клинический случай // Акушерство и гинекология. Новости. Мнения. Обучение. 2020. Т. 8, № S3. C. 116–120. EDN: KWKMHU doi: 10.24411/2303-9698-2020-13919

[39] Aryutin DG, Barinova EK, Ordiyants IM, et al. Ovarian pregnancy. Obstetrics and Gynecology. News. Views. Education. 2020;8(S3):116–120. EDN: KWKMHU doi: 10.24411/2303-9698-2020-13919

[40] Ranaivoson HV, Ranaivomanana VF, Nomenjanahary L, et al. Grossesse ovarienne: à propos de 3 cas et une revue de la literature [Ovarian pregnancy: about 3 cases and review of the literature]. Pan Afr Med J. 2016;25:128. doi: 10.11604/pamj.2016.25.128.10834

[41] Ranaivoson H.V., Ranaivomanana V.F., Nomenjanahary L, et al. Grossesse ovarienne: à propos de 3 cas et une revue de la literature [Ovarian pregnancy: about 3 cases and review of the literature] // Pan African Medical Journal. 2016. Vol. 25. P. 128. doi: 10.11604/pamj.2016.25.128.10834

[42] Ranaivoson HV, Ranaivomanana VF, Nomenjanahary L, et al. Grossesse ovarienne: à propos de 3 cas et une revue de la literature [Ovarian pregnancy: about 3 cases and review of the literature]. Pan Afr Med J. 2016;25:128. doi: 10.11604/pamj.2016.25.128.10834

[43] Dosmaganbetova ZA. Ultrasound diagnosis of progressive ovarian pregnancy. Medicine and Ecology. 2012;(4):66–68.

[44] Досмаганбетова З.А. Ультразвуковая диагностика прогрессирующей яичниковой беременности // Медицина и экология. 2012. № 4. C. 66–68.

[45] Dosmaganbetova ZA. Ultrasound diagnosis of progressive ovarian pregnancy. Medicine and Ecology. 2012;(4):66–68.

[46] Zoukar O, Zouari I, Jemaa Y, et al. La grossesse ovarienne à propos d’un cas et revue de la littérature [Ovarian pregnancy case study and literature review]. Pan Afr Med J. 2021;40:208. doi: 10.11604/pamj.2021.40.208.32011

[47] Zoukar O., Zouari I., Jemaa Y., et al. La grossesse ovarienne à propos d’un cas et revue de la littérature [Ovarian pregnancy case study and literature review] // Pan Afr Med J. 2021. Vol. 40. P. 208. doi: 10.11604/pamj.2021.40.208.32011

[48] Zoukar O, Zouari I, Jemaa Y, et al. La grossesse ovarienne à propos d’un cas et revue de la littérature [Ovarian pregnancy case study and literature review]. Pan Afr Med J. 2021;40:208. doi: 10.11604/pamj.2021.40.208.32011

[49] Szadok P, Kubiaczyk F, Bajorek A, Suchocki S. Ovarian ectopic pregnancу. Ginekol Pol. 2019;90(12):728.

[50] Szadok P., Kubiaczyk F., Bajorek A., Suchocki S. Ovarian ectopic pregnancy // Ginekol Pol. 2019. Vol. 90, N 12. P. 728. doi: 10.5603/GP.2019.0125

[51] Szadok P, Kubiaczyk F, Bajorek A, Suchocki S. Ovarian ectopic pregnancу. Ginekol Pol. 2019;90(12):728.

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