Serum concentration of vascular endothelial growth factor and depth of trophoblastic invasion in ampullary ectopic pregnancy

OBJECTIVE: To evaluate the association between the depth of trophoblastic infiltration and serum vascular endothelial growth factorconcentration in patients with an ampullary pregnancy. METHODS: This prospective cross-sectionalstudy involved 34 patients with an ampullary ectopic pregnancy who underwent salpingectomy between 2012 and 2013. Maternal serum vascular endothelial growth factor concentrations were measured using Luminex technology. Trophoblastic invasion was classified histologically as follows: stage I, limited to the tubal mucosa; stage II, reaching the muscle layer; and stage III,involving the full thickness. The qualitative data were compared using Fisher's exact test. The nonparametric Kruskal-Wallis and Mann-Whitney tests were used to evaluate differences in serum vascular endothelial growth factor among the degrees of trophoblastic invasion. ROC curves were constructed to determine vascular endothelial growth factor cut-off values that predict the degree of tubal invasion based on the best sensitivity and specificity. RESULTS: Eight patients had stage I trophoblastic invasion, seven had stage II, and 19 had stage III. The median serum vascular endothelial growth factorconcentration was 69.88 pg/mL for stage I, 14.53 pg/mL for stage II and 9.08 pg/mL for stage III, with a significant difference between stages I and III. Based on the ROC curve, a serum vascular endothelial growth factor concentration of 25.9 pg/mL best differentiated stage I from stages II and III with asensitivity of 75.0%, specificity of 76.9%, and area under the curve of 0.798. CONCLUSIONS: The depth of trophoblastic penetration into the tubal wall isassociated with serum vascular endothelial growth factor concentration in ampullary pregnancies.

Recurrence of uterine rupture in a pseudo-unicornuate uterus at 17 weeks of amenorrhea: case report and literature review

Pregnancy in a rudimentary horn is a very rare condition. It is responsible for several complications. Prognosis is reserved because the natural evolution generally leads to a cataclysmic uterine rupture at the beginning of the second trimester. Classically, the treatment after foetal extraction consists of ablation of the rudimentary horn and associated fallopian tube. We report the obstetric outcome of a patient with history of rudimentary uterine horn rupture, the treatment of which was ablation of the rudimentary horn

Embarazo tubárico bilateral / Bilateral ectopic pregnancy

En este artículo se presenta el inusual caso de un embarazo tubárico bilateral, en una paciente de 27 años de edad, con dos embarazos previos, uno de ellos gemelar. Cinco años atrás se había realizado un Pomeroy

Embarazo tubárico bilateral simultáneo: reporte de un caso / Simultaneous bilateral tubal pregnancy: report of a case

Describimos un caso de embarazo tubárico bilateral simultáneo, con reporte anatomopatológico respectivo, basado en los criterios de Fishback y Norris. Así mismo, se realizan comentarios acerca de la incidencia y etiopatogenia de la afección, luego de revisar bibliografía nacional e internacional

Chroriocarcinoma presenting as a ruptured tubal ectopic pregnancy

A case of a choriocarcinoma of the fallopian tube presenting as a ruptured tubal ectopicpregnancy is described. The patient's satisfaactory clinical course over a twelve-month period is docimented, and factors that govern the prognosis of this once rapidly fatal disease are discussed

Prenhez tubária perfurada em gestaçäo avançada / Late perforated tubal pregnancy

Apresenta-se um caso de prenhez tubária perfurada em gestaçäo avançada na 21ª semana com morte fetal recente