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Title: Ectopic pregnancy in patients using intrauterine contraception. Author: El-maraghy MA, Abo-senna IY, El-tawil A. Journal: J Egypt Soc Obstet Gynecol; 1981 Jan; 7(1):71-5. PubMed ID: 12279356. Abstract: 4 cases of extrauterine pregnancy with IUDs were studied both clinically and pathologically at the Faculty of Medicine of Ain Shams University in Cairo, Egypt. In 3 cases the gestation sac was tubal, with 2 in the ampullary portion and 1 in the isthmic portion. The 4th case was a left tubo-ovarian mass, showing an embryo within an ovarian gestation sac. Microscopic examination of the tube revealed chorionic villi intermingled with areas of necrosis, hemorrhage, and inflammatory cell infiltration. The diagnosis of the ovarian pregnancy was based on the demonstration of chorionic villi in relation to the ovarian medullary portion, showing a loose connective tissue structure and prominent congested blood vessels. Case 1, a 27-year old, para 2+0, presented with pain, amenorrhea, bleeding, and fever. The clinical diagnosis was septic abortion with IUD in situ. The loop was removed and curettage was scanty. Antibiotics were administered. The fever subsided but the abdominal pain persisted and mass in the right adnexa could be felt. Laparoscopy was performed, confirming the diagnosis of right tubal pregnancy. Laparotomy and right salpingectomy were performed. The 2nd case, para 1+0, had an IUD for 1 year and was admitted as an emergency. The diagnosis was acute abdomen, mostly disturbed ectopic pregnancy. Laparotomy was performed, and ectopic pregnancy in the region of the isthmus of the right tube was diagnosed. Right salpingectomy was performed. Both cases 3 and 4 had IUDs for a period of between 1-2 years and had amenorrhea, bleeding, and tenesmus. They were treated as colitis. The amenorrhea ranged between 2-3 months. Examination revealed a mass on the left side. Laparotomy was performed. In case 3 it was ampullary pregnancy on the left side. In case 4 there was a tubo-ovarian mass with an amniotic sac protruding from this mass. Left salpingo-oophorectomy was performed. All patients had uneventful recoveries. Figures illustrate these tubal and ovarian pregnancies.[Abstract] [Full Text] [Related] [New Search]