Ectopic Pregnancy

CONCLUSION: Thinner endometrial thickness is associated with an increased risk of ectopic pregnancy in IVF; however, this finding should be interpreted cautiously due to the observational design, potential confounding, and publication bias. Clinically, this may aid in risk stratification but should not be used alone, and further prospective studies are needed to confirm its independent predictive value.

Ectopic pregnancy (EP) remains a major cause of early pregnancy-related morbidity and mortality. It can significantly impact future fertility and is associated with various risk factors. To investigate the incidence, clinical profile, and risk factors of EP among admitted women to the tertiary hospital. A prospective, cross-sectional study was conducted on 393 women with early pregnancy at the Maternity Teaching Hospital, Sulaymaniyah, Iraq from January 2024 to April 2025. Collected data...

This study aimed to improve the diagnosis and treatment of intramural pregnancy (IMP). A retrospective analysis was conducted of 8 cases of IMP admitted between November 2016 and June 2024. Data on patients' clinical characteristics, diagnosis, treatment, and prognosis were systematically reviewed. All 8 patients experienced IMP following embryo transfer due to tubal factor infertility. Among them, 2 had adenomyosis. All patients had a history of pelvic surgery, including 4 with tubal pregnancy...

RATIONALE: Ectopic gestational trophoblastic disease is an extremely rare subtype of gestational trophoblastic disease, with perimenopausal cases especially scarce and prone to preoperative misdiagnosis as a common ectopic pregnancy, leading to potential delays in proper management.

We present a case of a woman in her 20s with right iliac fossa pain. Initial investigations showed mildly elevated inflammatory markers and serum beta human chorionic gonadotrophin (hCG) <1 mIU/mL. She was taken to theatres as a presumed early appendicitis but found to have haemoperitoneum with a free-floating cystic structure in the pouch of Douglas with intact pelvic organs. This was subsequently confirmed histologically as a gestational sac which had likely been expelled via the abdominal...

CONCLUSIONS: This descriptive synthesis indicates uterine horn communication may be associated with later diagnosis/rupture and reported live births were significantly more frequent in published CHP vs. NCHP cases. However, all comparisons are exploratory and must be interpreted with extreme caution, as data limitations preclude causal inference. Exhaustive imaging and diagnosis are essential to characterize horn type. Surgical termination is advised, but if expectant management is chosen, close...

CONCLUSIONS: Medical abortion before visible IUP is as effective as standard treatment. Very early medical abortion can be implemented safely and effectively with structured follow-up, allowing for earlier treatment without compromising safety.

Abdominal ectopic pregnancy is an uncommon form of ectopic pregnancy with few cases reported in Nigeria. We present a case report of abdominal ectopic pregnancy with haemoperitoneum in an unbooked multipara at advanced gestational age. She subsequently had an emergency exploratory laparotomy and right salpingectomy. Diagnosis of this condition can be challenging due to non-specific clinical symptoms, while definitive management can also pose a challenge due to the site of placental attachment.

RATIONALE: Ectopic pregnancy (EP) with implantation in the upper abdomen is exceptionally rare. It represents a challenging clinical scenario with very limited evidence confined to case reports. It seriously endangers maternal health and early diagnosis and treatment can significantly improve patient prognosis.

Ectopic pregnancy represents a prevalent gynecological emergency with incompletely characterized pathophysiology, creating substantial clinical challenges in timely diagnosis and effective management. The causal interplay between gut microbiota and ectopic pregnancy, particularly through plasma proteomics mediation, remains undefined. We derived Gut microbiota GWAS data (n=412) from the Dutch Microbiome Project meta-analysis and Ectopic pregnancy data from IEU OpenGWAS and FinnGen project. The...

Abdominal pregnancy is a rare form of ectopic pregnancy associated with increased maternal and perinatal risks. In low-resource countries, diagnostic challenges complicate management. Prompt diagnosis requires a high level of suspicion. We report a 34-year-old, G3P1A+1SA, referred as a suspected abdominal pregnancy. Despite several ultrasounds and clinical signs, the diagnosis was delayed until 29 weeks' gestation with a live fetus. She was managed conservatively. A live infant was successfully...

CONCLUSIONS: In this cohort, treatment selection was individualized based on clinical evaluation. The surgical approach chosen in practice was strongly aligned with the CSP subtype, with both hysteroscopy and laparoscopy being demonstrated as feasible.

CONCLUSION: EP management, even within a country with a homogeneous healthcare system, may demonstrate considerable heterogeneity, strongly influenced by institutional size. These findings highlight the need for national guidelines to ensure standardized and evidence-based care.

CONCLUSION: The neural network model demonstrated statistically significant superior accuracy and reliability in diagnosing ectopic pregnancy compared to the Naïve Bayes model (McNemar's test, p < 0.001), suggesting the potential of machine learning models, particularly deep learning, to enhance early diagnosis and clinical decision-making.

BACKGROUND This report describes the rare occurrence of a unilateral live tubal twin ectopic pregnancy, diagnosed by transvaginal ultrasound and confirmed surgically. This case is presented to emphasize diagnostic and management challenges. CASE REPORT A 29-year-old primigravid woman at 5 weeks and 6 days by last menstrual period was referred with a suspected pregnancy of unknown location. She was asymptomatic, and vital signs were within normal limits. Her medical history was unremarkable...

CONCLUSION: Surgical excision of uterine scar lesions, laparoscopic or ultrasound-guided curettage, and interventional embolization combined with perfusion chemotherapy, especially when integrated with adjunctive therapies, represent safe and effective approaches for the management of CSP.

Cervical insufficiency is rarely observed during the first trimester of pregnancy. Its diagnosis during early pregnancy is challenging; however, it may be suspected by carefully evaluating the implantation site in combination with obstetric history, serial ultrasound assessments of cervical length, and inflammatory markers. Nevertheless, the optimal management strategy remains unclear. Herein, we report a case of cervical insufficiency resulting from a previous cervical ectopic pregnancy...

CONCLUSION: Implementation of the M6NP model or NICE guidelines would result in up to 10-12% theoretical cost reduction compared with current practice; patient safety must remain a key consideration in PUL management.

CONCLUSIONS: MTX is an effective, safe, fertility-sparing option for IP, achieving high resolution rates across protocols. Local administration and 1 mg/kg regimens may reduce failure. Multicenter studies are needed for standardized guidelines.

CONCLUSIONS: Morphological defect severity, short interpregnancy interval, and low early-pregnancy hormone levels were associated with CSP risk in women with CSD. The model may support early risk stratification and clinical management.

CONCLUSION: Splenic pregnancy is difficult to diagnose owing to the lack of typical clinical manifestations. Expanded ultrasound scanning or computed tomography/magnetic resonance imaging can help to detect ectopic pregnancy lesions, and laparoscopic exploration can be performed when necessary in patients who cannot be definitively diagnosed.

CONCLUSIONS: In this cohort, vNOTES demonstrated shorter operative times, reduced insufflation pressures, and enhanced postoperative recovery compared with conventional laparoscopy. The results indicate that vNOTES could serve as a promising surgical alternative for selected patients presenting with ruptured ectopic pregnancy. Future multicenter investigations involving larger populations and extended follow-up periods-including assessments of fertility and quality of life-will be crucial to...

CONCLUSION: Despite high risks associated with continuing a CSP pregnancy, outcomes can be favorable when management is carefully planned and individualized. Given the increasing prevalence of ART, clinicians should remain aware of the risk of CSP in patients with prior cesarean delivery and focus on early recognition, comprehensive imaging evaluation, and personalized management strategies to ensure optimal maternal and neonatal outcomes.

CONCLUSION: This study identifies three key predictors of ectopic pregnancy in younger PCOS (<35 year) patients undergoing ART: IVF cycle number, endometrial thickness, and frozen embryo transfer. The developed nomogram provides a validated assessment tool, particularly for younger patients. These findings highlight the need for personalized risk stratification and further research into underlying mechanism.

CONCLUSIONS: In IMP, Pelvic fluid and larger gestational mass size were independent predictors of uterine rupture. Both cohorts offer favorable reproductive outcomes when timely diagnosis and individualized management are provided.

Objective: To present a rare case of partial molar pregnancy implanted in a previous cesarean section scar and summarize the literature. Case report: A 33-year-old woman (gravida 5, two prior cesarean deliveries, two spontaneous abortions) presented with vaginal spotting and lower abdominal pain at 6 weeks of gestation. Transvaginal ultrasonography revealed a 28 × 19 mm gestational sac at the cesarean scar site, containing a 4mm fetus with positive cardiac activity. Vacuum curettage was...

CONCLUSIONS: vNOTES salpingectomy for ectopic pregnancy appears to be a safe and feasible procedure, with high levels of patient satisfaction and low pain scores. The heterogeneity of data of the control groups is acknowledged and patients undergoing vNOTES versus conventional laparoscopic salpingectomy had reductions in length of stay but similar duration of surgery, while vNOTES salpingectomy versus laparoendoscopic single-site surgery incurred similar duration of surgery and length of stay....

Splenic ectopic pregnancy is a rare and life-threatening condition, with no prior studies exploring its immune microenvironment. We analyzed immune cell alterations in splenic ectopic pregnancy and the potential role of macrophages in pregnancy using immunohistochemical staining, transcriptomic profiling, and histological analysis. Our findings suggest that M2 macrophages may play a crucial role in maintaining successful pregnancy. The biological effects of macrophages on trophoblast cells were...

CONCLUSION: Integrated approaches combining molecular diagnostics, imaging, and targeted therapies are essential to bridge laboratory research and clinical practice. Standardized diagnostic criteria, validated biomarkers, and improved reproductive health equity are critical to reducing the global burden of salpingitis.

CONCLUSION: CSP may represent an early phenotype within the PAS. Standardized terminology, early first-trimester screening and risk-based management strategies are essential to reduce maternal morbidity and optimize reproductive outcomes. Multicenter prospective studies are needed to guide evidence-based prevention and treatment strategies.

CONCLUSION: This case highlights the diagnostic complexity of abdominal pregnancy in low-resource environments, especially when presenting with atypical gastrointestinal symptoms. It underscores the importance of high clinical suspicion, detailed ultrasonographic assessment, and multidisciplinary preparedness in achieving favorable maternal outcomes. Early recognition and appropriate surgical intervention remain key to reducing morbidity and mortality in these rare but high-risk pregnancies.

RATIONALE: Primary abdominal pregnancy, though a variant of extrauterine gestation, is exceedingly rare in clinical practice and is associated with a disproportionately high maternal mortality rate, necessitating vigilant diagnostic approaches and prompt therapeutic interventions.

CONCLUSIONS: The most common presenting symptom was abdominal pain in patients in the age group of 31-35 years. Most patient presented with ruptured ectopics.

An ectopic pregnancy in a retroperitoneal location is an extremely rare and life-threatening situation. Here, we present a case report of a nulliparous woman in her 30s who presented with rising β-human chorionic gonadotropin (hCG) titre after embryo transfer but with no pregnancy detected on transvaginal scan. She was referred to us after two negative laparoscopies done outside and finally an MRI revealing a retroperitoneal pregnancy embedded close to the aorta near the origin of the left renal...

CONCLUSION: Cesarean scar ectopic pregnancy is an emerging, potentially life-threatening complication in low-resource settings, where limited diagnostic capacity and low clinical suspicion often impede timely diagnosis and management. The avoidance of blind uterine evacuation until cesarean scar ectopic pregnancy is excluded, the adoption of lesion-tailored treatment strategies, and the strengthening of targeted clinical training and diagnostic access are critical to improve maternal health...

Abdominal ectopic pregnancy is a rare and life-threatening condition, often misdiagnosed due to its nonspecific clinical presentation and imaging challenges. We present a case of a 20-year-old primigravida at 39+6 weeks of gestation that was initially misdiagnosed as complete placenta previa with transverse lie and was only identified as abdominal ectopic pregnancy intraoperatively. An emergency cesarean section was planned for suspected placenta previa, during which an intact amniotic sac was...

Ectopic pregnancy (EP) is a leading cause of maternal morbidity and mortality in early pregnancy. Current diagnostic approaches, which rely on ultrasound scanning and blood measurements, are limited by low detection sensitivity. Herein, we propose a one-step system that uses EP-associated serum metabolic fingerprints (ESF) for efficient EP diagnosis and risk prediction. The system employs nanoparticle-assisted laser desorption/ionization mass spectrometry to rapidly record ESF. A machine...

CONCLUSIONS: Prior TB is independently associated with compromised ART success in normo-responders through residual reproductive dysfunction, with young patients experiencing heightened ectopic pregnancy risk.

CONCLUSIONS: There are significant methodological gaps in the study of ectopic pregnancy temporal patterns. To improve temporal analysis and generalizability, future research should use data sets that include outpatient records and conduct conception date-based analysis with universal units of time like weeks or months.

CONCLUSION: Lauromacrogol injection around the pregnancy sac combined with curettage and uterine artery embolization combined with curettage demonstrated comparable efficacy in terms of bleeding control, β-HCG recovery, and menstrual resumption for the treatment of cesarean scar pregnancy. However, the lauromacrogol approach offered significant advantages including lower cost, better preservation of ovarian function, faster ovulation recovery, reduced postoperative pain, and fewer adverse...

Abdominal pregnancy is a rare type of ectopic pregnancy, accounting for about 1% of ectopic pregnancies. Early diagnosis of abdominal pregnancy is challenging and may lead to serious complications. This article reports a case of a patient who was 58 days postmenopausal and presented with acute lower abdominal pain. The patient's preoperative ultrasound suggested ectopic pregnancy. Laparoscopy and therapeutic surgery were performed. During the surgical procedure, the gestational sac was...

CONCLUSIONS: Both single-port and four-port laparoscopic surgeries showed favorable short-term perioperative outcomes in this cohort and were feasible approaches for the management of ectopic pregnancy. The single-port method provided advantages of reduced postoperative pain and improved cosmetic outcomes but was associated with a slightly slower recovery of bowel function.

CONCLUSION: These findings suggest that elevated 3-HK and 3-HAA levels are associated with EP and may reflect immunometabolic dysregulation underlying abnormal implantation, rather than implying a causal relationship. Therefore, these metabolites may offer complementary biomarker potential in selected research settings.

CONCLUSION: The present study outlines the higher incidence of surgically managed ectopic pregnancies in our population. Furthermore, we explored predisposing factors to EP which mostly mimic the pattern and occurrence in other populations. This study forms the index study in a series that looks at the pattern of surgically managed EP with the last study outlining the cost effectiveness of surgical management.

CONCLUSIONS: This study elucidated significant differences in reproductive outcomes between tubal reanastomosis and in vitro fertilisation in women with a history of tubal ligation, emphasising the critical role of age.

CONCLUSION: Our study highlights the importance of taking into account risk factors for EP, including in patients who have undergone in vitro fertilization.

CONCLUSION: This case highlights the diagnostic challenges associated with twin ectopic pregnancy and emphasizes that elevated beta-human chorionic gonadotropin levels do not exclude an ectopic gestation. Early imaging and timely surgical intervention are essential to preventing tubal rupture, reducing maternal morbidity, and preserving reproductive health.

CONCLUSION: Intra-arterial MTX and UAE, following systemic MTX, appear to be a safe and effective treatment for CSP.

CONCLUSIONS: With a prevalence of 6.58 per 1000 deliveries, ectopic pregnancy remains a major health problem in ACSH. Most patients presented with acute symptoms requiring surgical intervention. Early detection and improved access to reproductive health services could reduce the morbidity of ectopic pregnancy in the region.

CONCLUSION: Retroperitoneal ectopic pregnancy is a rare but potentially life-threatening entity that requires early diagnosis via serum β-hCG and imaging studies (ultrasound, CT), as well as immediate surgical treatment to prevent catastrophic complications.