RESUMO
Heterotopic cervical pregnancy is an uncommon condition, with a rising incidence due to the increasing number of pregnancies resulting from in-vitro fertilization (IVF). Although it is associated with maternal-fetal complications, there is no consensus in the literature about the best approach for this condition. This study aims to report a case of cervical heterotopic gestation after IVF in which the intrauterine pregnancy was preserved, with spontaneous elimination of the cervical gestational sac after patient sedation and introduction of the vaginal speculum. In addition, we reviewed the literature on the subject, which demonstrated that most cases have a favorable outcome, especially after treatment with surgical excision of the cervical pregnancy. The growing body of evidence is still scarce to define the best treatment for this condition.
Assuntos
Colo do Útero/patologia , Fertilização in vitro/efeitos adversos , Gravidez Heterotópica/diagnóstico , Gravidez Heterotópica/etiologia , Adulto , Feminino , Humanos , Gravidez , Gravidez Heterotópica/patologia , Gravidez Heterotópica/terapiaRESUMO
Métodos: Presentamos un caso de una paciente femenina de 31 años con dolor abdominal de fuerte intensidad, tipo punzante, en fosa iliaca derecha, de aparición brusca, con signos de irritación peritoneal y ß-HCG positiva, cuadro clínico de abdomen agudo quirúrgico por embarazo ectópico. Resultados: El resultado quirúrgico de la intervención arrojó una trompa derecha aumentada de tamaño, rota, sangrante y cuyo reporte de anatomía patológica fue un embarazo tubárico roto y aumento de volumen del útero de aspecto gestante. En el postoperatorio mediato se realiza ecosonograma transvaginal evidenciándose embarazo intrauterino de 7 semanas + 2 días, por lo cual fue egresada con el diagnóstico de embarazo heterotópico. Conclusión: Se define embarazo heterotópico como la gestación intrauterina y extrauterina que coexisten de forma simultánea. Este se manifiesta como cuadros de dolor abdominal, signos de shock hipovolémico y en raras ocasiones escaso sangrado genital. Es una patología poco frecuente cuando se presenta de manera espontánea(AU)
Methods: We present a case of a female patient aged 31 with abdominal pain of high intensity , sharp stabbing pain, right lower quadrant , with abrupt onset, with signs of peritoneal irritation and ß-HCG positive, disease pattern of acute abdomen ectopic pregnancy. Results: Surgical intervention resulted in a raised right Falopian tube, broken, bleeding and resulting pathology reported broken tubal pregnancy and increased uterine volume of pregnant look. In the immediate postoperative transvaginal sonogram is performed evidencing intrauterine pregnancy 7 weeks + 2 days, which was discharged with the diagnosis of heterotopic pregnancy. Conclusion: Heterotopic pregnancy is defined as intrauterine and extrauterine gestation coexisting simultaneously. This manifests as abdominal pain, signs of hypovolemic shock and rarely scarce genital bleeding. It is a rare disease when it occurs spontaneously(AU)