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Clinical and Experimental Obstetrics & Gynecology  2021, Vol. 48 Issue (4): 974-979    DOI: 10.31083/j.ceog4804154
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Diagnosis and management of intramural ectopic pregnancy
Qian Hu1, 2, Mohammed Sharooq Paramboor3, Tao Guo1, 2, *()
1Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Department of Pediatrics, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
2Department of Obstetrics & Gynecology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
3West China Medical School, Sichuan University, 610041 Chengdu, Sichuan, China
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Abstract  
Background: Intramural pregnancy is a rare form of ectopic pregnancy where the embryo is implanted within the myometrium, separate from the endometrial cavity. Preoperative diagnosis of intramural pregnancy is difficult and it can easily be misdiagnosed for other diseases such as intrauterine pregnancy or gestational trophoblastic disease. Medical therapy and surgery are used to treat intramural pregnancy, with surgery often being performed via laparotomy and also including hysterectomy. Case: We present a case of intramural pregnancy that was misdiagnosed and wrongly managed by a local hospital. It was finally diagnosed correctly and managed in our hospital by combining hysteroscopy and laparoscopy under the guidance of intra-abdominal ultrasound. Our experience again highlights the difficulty in diagnosing intramural pregnancy preoperatively due to the lack of standard diagnostic criteria. This can in turn lead to inappropriate treatments. Earlier surgical intervention would allow faster diagnosis and also simultaneous treatment of the disease. The majority of intramural ectopic pregnancies have high blood flow that can cause severe hemorrhage and are therefore treated by medication or laparotomy and hysterectomy. Conclusion: Our experience reveals that a minimally invasive procedure is also safe and effective in select cases where advanced endoscopic expertise is available.
Key words:  Intramural ectopic pregnancy      Minimally invasive surgery      Diagnosis and management     
Submitted:  03 August 2020      Revised:  25 September 2020      Accepted:  15 October 2020      Published:  15 August 2021     
*Corresponding Author(s):  Tao Guo     E-mail:  ivan.gt@163.com

Cite this article: 

Qian Hu, Mohammed Sharooq Paramboor, Tao Guo. Diagnosis and management of intramural ectopic pregnancy. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(4): 974-979.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog4804154     OR     https://ceog.imrpress.com/EN/Y2021/V48/I4/974

[1] Eren Akbaba, Burak Sezgin, Ahmet Akın Sivaslıoğlu. Anatomical and clinical outcomes of vaginally assisted laparoscopiclateral suspension in comparison with laparoscopic lateral suspension[J]. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(4): 935-941.
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