Heterotropik Gebelik: 7 Haftalık Kornual Rüptüre Ektopik Gebelik ve 38.Gebelik Haftasına Ulaşan İntrauterin Gebelik Olgu Sunumu:

Heterotopic Pregnancy: 7th Week Cornual Ruptured Ectopic Pregnancy and Intrauterine Pregnancy Reaching 38th Gestational Week

Ünal TURKAY, Fulya DEMET, Ayfer Özer CORA, Hasan TERZİ, Yasemin ÇOBANYILDIZI

Özet

Giriş:İntrauterin ve ekstrauterin gebeliğin birlikte olması olarak tanımlanan heterotopik gebelik spontan olarak oldukça nadir görülmesine rağmen yardımcı üreme teknikleri (YÜT) ile oluşan gebeliklerde 100 de 1 olarak görülmektedir. Olgu: 26 yaşında gravida 1 Parite 0 olan hasta şiddetli karın ağrısı şikayeti ile acil polikliniğimize başvurdu. Özgeçmişinde geçirilmiş batın operasyonu , endometriozis ve pelvik inflamatuvar hastalık tespit edilmedi. YÜT ile oluşan gebeliği olan hastanın yapılan transvajinal usg sinde 7 haftalık intrauterin canlı gebelik ve yaygın serbest sıvı tespit edildi. Akut batın tespit edilen hastaya acil laparatomi cerrahi uygulandı.Operasyonda literatürdede oldukça nadir görülen kornual rüptüre ektopik gebelik (heterotopic gebelik) tanısı konuldu. Kornual onarım yapılan ve operasyon sonrası intrauterin gebeliği 38. gebelik haftasına ulaşan ve nihayetinde sağlıklı bir bebek doğuran bu olgumuzu sizlerle paylaşmayı amaçladık. Sonuç: YÜT oluşan gebeliklerde heterotopik gebelik açısından kapsamlı transvaginal ultrasonografi yapılmalı. Akut batın tablosu ile başvuran hastalarda maternal mortalite açısından cerrahi konusunda tereddüt edilmemelidir.

Abstract

Introduction: Heterotopic pregnancy, defined as the coexistence of intrauterine and extrauterine gestation, is rarely seen spontaneously, but is seen as 1 in 100 pregnancies with assisted reproductive techniques (ART)Case: 26 years old gravida 1 Parity 0 patient applied to our emergency polyclinic with severe abdominal pain. Past history were not detected such as abdominal operation, endometriosis and pelvic inflammatory disease. In the transvaginal ultrasound of the pregnant patient with ART, 7 weeks of intrauterine live pregnancy and common free fluid were detected. Emergency laparotomy was applied to the patient who was diagnosed as acute abdomen. In operation, a rarely seen cornual ruptured ectopic pregnancy (heterotopic pregnancy) in the literature was diagnosed. We aimed to share with you our patient who has delivered a healthy baby after reaching the gestational week of 38th week of intrauterine pregnancy which has been treated with cornual repair.Conclusion: Comprehensive transvaginal ultrasonography should be performed for heterotopic pregnancy in pregnancies with ART. Patients presenting with an acute abdomen should not be hesitated about surgery in terms of maternal mortality ndometriosis and pelvic inflammatory disease. In the transvaginal ultrasound of the pregnant patient with ART, 7 weeks of intrauterine live pregnancy and common free fluid were detected. Emergency laparotomy was applied to the patient who was diagnosed as acute abdomen. In operation, a rarely seen cornual ruptured ectopic pregnancy (heterotopic pregnancy) in the literature was diagnosed. We aimed to share with you our patient who has delivered a healthy baby after reaching the gestational week of 38th week of intrauterine pregnancy which has been treated with cornual repair. Conclusion: Comprehensive transvaginal ultrasonography should be performed for heterotopic pregnancy in pregnancies with ART. Patients presenting with an acute abdomen should not be hesitated about surgery in terms of maternal mortality

Anahtar kelimeler: Heterotopik gebelik, Rüptüre Cornual Gebelik, İntrauterin gebelik, Laparatomi