A Case Series of Live Ectopic Pregnancy in a Medical College in Kanchipuram

Abstract

An ectopic pregnancy, which occurs outside the uterus, represents approximately two percent of all pregnancies. In the first instance, a 25-year-old woman experienced lower abdominal pain and vaginal bleeding, along with a three-month history of irregular oral contraceptive usage and amenorrhea. During laparotomy, a live ectopic pregnancy of 12 weeks and 3 days gestation was discovered in the right fallopian tube, and a right salpingectomy was performed. In the second case, a third-time pregnant woman presented with vaginal bleeding and lower abdominal pain, with a history of 2.5 months of amenorrhea and chronic pelvic inflammatory disease. During laparotomy, both sides of hydrosalpinx and a live ectopic pregnancy were found on the distal end of the fallopian tube on the left side. A left salpingectomy with fibroidectomy and right-sided tubal ligationwase performed. In the third case, a third-time pregnant woman with a history of a lower uterine Caesarean section and a previous ruptured left-sided tubal ectopic pregnancy presented with lower abdominal pain after a two-month amenorrhea. Ultrasonography revealed a live right-sided cornual ectopic pregnancy of 6 weeks and 6 days, and conservative management with methotrexate injections was initiated. Emergency laparotomy was performed due to sudden hemodynamic instability, which revealed a ruptured right cornual ectopic pregnancy that was treated with a total abdominal hysterectomy. All cases were successfully managed. This case series highlights the importance of early serological and sonographic diagnosis of ectopic pregnancy location, as well as maintaining a high suspicion for ectopic pregnancy even beyond the first trimester. Conservative management of early ectopic pregnancy should be carefully considered after evaluating all patient parameters.