This is a case of a 29 year old 2nd gravida with 14.2 weeks amenn. who was referred for bleeding per vaginum after a failed attempt of a second trimester termination in the peripheral hospital (Ultrasonography off course was not done.
Patient was hemodynamically stable,with mild pallor and a Hb of 9.5 grm percent. Per abdominal examination showed 14 weeks size non tender mass ,more towards the right of midline with audible fetal heart sounds on Doppler.Per vaginal examination findings were almost the same ,with a the fetus lying more towards the right side.
Patient was subjected for sonography (4-D) and the finding was something shocking,a live ectopic pregnancy of 14.2 weeks on the right side with good fetal movements and no gross anomalies.
After the basic workup was subjected to laparoscopy which showed right sided unruptured ampullary pregnancy witha minimal amount of blood in the Pouch of Douglas. With a linear incision on the antemesenteric border of the tube,the fetus was removed along with the placenta. Since there were quite a few bleebing points,right salpingectomy was done. The fetus was removed through the 10 mm port.Surfery was terminated after a through lavage.Patient recovered quickly,without any transfusions and was discharged after 18 hrs of surgery
Tags: 14.2 weeks live ampullary tubal ectopic pregnancy, live ectopic pregnancy
July 31, 2011 at 4:41 pm |
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