Vargas-Hernandez Victor Manuel*, Machuca-Hernandez Violeta Fabiola, Ambriz-Morales Miguel, Torres-Nieves Lucila, Tovar Rodriguez Jose Maria and Agustin I Rodriguez Blaz
Gynecology and Radiology Hospital Juarez de Mexico, MexicoFulltext PDF
Background: Pregnancies achieved by assisted reproduction techniques have doubled in the last decade occupying 1% of annual births, but have maternal complications such as ectopic pregnancy, which should be suspected mainly in patients in sterility management.
Objective: A case of abdominal pregnancy related to in vitro fertilization and review of the literature is presented. Case
Presentation: A 40-year-old woman with controlled hypothyroidism and infertility, who achieved pregnancy with in vitro fertilization and embryo transfer, quantified the beta fraction of hGC serial with levels of 150/IU considering biochemical pregnancy; During its follow-up the transvaginal ultrasound finding an extrauterine amniotic sac, without fetal vitality of 12 weeks, compatible with abdominal pregnancy. The exploratory laparotomy was performed, finding a peritoneal cavity with multiple adhesions to the intestine, extracting the gestational sac with the fetus and placenta in a partial manner due to adherence to the omentum and left salpinge, presenting severe haemorrhage under hemodynamic control and during the postoperative period developing partial occlusion and ilium which was resolved with conservative management and is released a month in good condition.
Conclusion: Abdominal pregnancy is rare; with low incidence and absence of specific symptomatology that makes diagnosis difficult, there are no criteria for diagnosis or therapeutics. These will be adapted to the site of implantation, gestational age in an individualized way, the management requires the surgical extraction of the fetus, leaving the placenta in situ and adjuvant metrotexate. This is the first report in our country, of an abdominal bladder associated with in vitro fertilization that is diagnosed opportunely with proper management.
Ectopic pregnancy; In vitro fertilization and Embryo transfer; Ultrasound; Conservative management; Methotrexate
Victor Manuel V-H, Violeta Fabiola M-H, Miguel A-M, Lucila T-N, Jose Maria TR, Rodriguez Blaz AI. Abdominal Pregnancy and In Vitro Fertilization with Embryonic Transfer. J Clin Obstet Gynecol Infertil. 2018; 2(1): 1027.