• Clinical and Experimental Reproductive Medicine
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• 제30권3호
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• pp.249-254
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• 2003

Ectopic pregnancy is a common medical problem that is difficult to diagnose and potentially may lead to significant mortality or morbidity. The incidence of ectopic pregnancy is definitely increasing ue to the rise in pelvic inflammatory disease (PID), pelvic surgery, intrauterine device (IUD), and assisted reproductive technologies, such as in vitro fertilization and embryo transfer (IVF-ET). Combined ectopic gestations are much rare and their true incidence is unknown. Multiple ectopic gestations may occur in a variety of locations. The majority involve one or both fallopian tubes. We report a case of combined tubal and cervical pregnancies, and discuss their management.

• Journal of Yeungnam Medical Science
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• 제14권1호
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• pp.262-268
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• 1997

Combined intrauterine and ectopic (heterotopic) pregnancy occurs in approximately 1 in 30,000 spontaneous gestations. Heterotopic gestations are increased in women who have had reconstructive pelvic surgery, pelvic inflammatory disease and artificial ovarian hyperstimulation. Patients who require assisted reproductive technologies, such as in vitro fertilization / embryo transfer and gamete intrafallopian transfer, also have an increased risk of a heterotopic pregnancy. We experienced two cases of combined pregnancy following IVF-ET. Following is a report of these cases with a brief review of references.

• 대한간호학회지
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• 제1권1호
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• pp.64-76
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• 1970

This report will present a clinical and statistical analysis of 210 case of Ectopic pregnancies who were treated at the Department of Obstetrics and Gynecology at Chung Nam Medical Center from January, 1966 to March, 1970. The results obtained are as follows; 1. The total number of Ectopic pregnancies was 8.22%. 2. The occurrence of Ectopic pregnancy was high in June(13.81%), low in October(2.98%). There was a higher occurrence of Ectopic pregnancy in the summer than in the winter. 3. The average age of all patients was 33.25 years. The most frequent age for this type of pregnancy was 31-35 years (32.86%) . The youngest patient was 18 years old and the oldest was 50. 4. Multipara occurred in 82.38% of the cases; Mulipara in 17. 62% and the occurrence of primipara was especially high, 20.95%. 5. 48.09% of the women had previously experienced normal deliveries; 42.8% had received artificial abortions and 5.23% had experienced spontaneous abortions. 3.8% had a previous history of Ectopic pregnancy. It was found that the occurrence of Ectopic pregnancy was more frequent in those women who had a D & C in the Past. 6. The average length of infertility was 21.7 months. The shortest length was 60 days; longest period of infertility was 19 years. 7. The occurrence of Ectopic pregnancy is higher (29.27%) in patient who have experienced only one previous D & C. The total number of patients who received a D & C was 58.57%. 3. Ectopic symptoms appeared during the first 4.7 weeks (mean) and most frequently occurred between the 5th and 6th weeks (48.57%) of pregnancy. The Symptoms were: -99.04% complained of lower abdominal pains. -80.95% experienced abnormal uttering bleeding. -42.38% experienced bleeding before the occurrence of pain. -18.57% experienced pain before the occurrence of bleeding. -8.57% experienced both pain and bleeding. -7.62% experienced only bleeding. -22.86% experienced only pain. 9. In-77.62% of the cases the annexal mass palpated. 91.42% complained of abdominal tenderness. 42.38% complained of pain when the cervix was examined. 10. Culdocentesis was performed in 86.19% of the cases. In 92.82% of the cases the presence of an Ectopic pregnancy was accurately diagnosed 11. 71.90% of the Ectopic pregnancies occurred in the ampule portion of the ovarian tube, of the total number of gestations, 40.95% were tubal abortions and 59.05% were ruptured. The ruptured group occurred more frequently in the islamic portion and interstitial portion of the tube than the aborted group. The aborted group occurred more frequently in the fimbrial extremities of the tube. 12. The blood pressure (systolic) was noted at 119-80mmHg in 81.89% of the total cases. Hemoglobin value was noted at over 8gm/㎗ in 58.57% of the cases. The average blood transfusion was 2.3 pints. 13. In 52.86% of the Ectopic pregnancies the right side of the ovarian tube was affected. The left side of the tube was affected in 47.14% of the cases. 14. 3.33% of the patients were not given an accurate diagnosis. 15. The kinds of operation performed were as follows; Salpingectomy, 41.43%; Adnectomy, 38.57% and Adnectomy with total hysterectomy, 19.05%. 16. The patient mortality rate was significantly small; only 1 case out of 210 died. This patient most likely had a profuse hemorrhage because of a ruptured tube before her admission to the hospital. 17. The patients personal feelings and attitudes must be treated with care. Particularly patients who are concerned about vaginal bleeding or the impossibility of another pregnancy.

• Clinical and Experimental Reproductive Medicine
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• 제36권2호
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• pp.129-136
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• 2009

자궁외 임신은 자궁강내 내막 이외의 장소에 주머니배가 착상하는 것을 의미하며, 최근 조기 진단 및 치료의 가능성이 증가했지만, 여전히 주요한 모성 사망의 한 원인이다. 불임 환자의 경우 배란약제 사용 및 보조생식술과 연관되어 일반적인 경우에 비해 자궁외 임신 및 다태 임신, 동시 양측성 난관 임신 같은 복합성 자궁외 임신의 발생도 증가하고 있는데, 아직까지 전체 자궁외 임신 중 보조생식술 후 발생한 복합성 자궁외 임신이 차지하는 발생 비율에 대한 정확한 통계는 이루어 지지 않고 있으나 이러한 시술이 점차 늘고 있기 때문에 그 발생률도 증가할 것으로 생각된다. '자궁각 임신' (cornual pregnancy)은 자궁외 임신중 비교적 드문 경우로서, 흔히 '간질성 임신' (interstitial pregnancy)과 비슷한 의미로 사용된다. '간질성 임신'의 발생은 전체 자궁외 임신의 약 2~4% 정도에 해당하며, 간질성 임신으로 인한 모성 사망률은 전체 간질성 임신의 약 2~3% 정도에 달한다고 알려져 있다. 이는 전체 난관 임신으로 인한 사망률의 2배 정도에 해당하는 수치이다. 저자들은 체외수정 및 배아 이식술 후 좌측 난관과 우측 자궁각 부위에 임신이 된 복합성 자궁외 임신 1예를 경험하였기에 간단한 문헌 고찰과 함께 보고하는 바이다.