Retroperitoneal ectopic pregnancy: successful expectant management in condition of early pregnancy failure.

BACKGROUND: Retroperitoneal ectopic pregnancy (REP) refers to abnormal implantation of the fertilized egg in the retroperitoneal cavity. REP can be divided into pelvic and abdominal positions. Extremely rare, the incidence of REP is less than 1% of ectopic pregnancy (EP). Herein, we report the first case of paraaortic-located REP in association with successful expectant management, thus raising awareness among healthcare providers, particularly in low-resource settings. CASE PRESENTATION: A reproductive-age woman presented at our tertiary referral hospital because of amenorrhea and a positive pregnancy test. Based on serial serum ß-hCG levels and imaging modalities including transabdominal ultrasound, transvaginal sonography, and magnetic resonance imaging (MRI), a REP of 7-9 weeks of gestational age adherent to abdominal paraaortic region was detected. Since the pregnancy was spontaneously arrested without clinical symptoms, expectant management was first indicated following careful evaluation. After a 1-month follow-up, the ectopic mass naturally degenerated without complications and her ß-hCG concentration returned to a negative value. Therefore, the patient recovered completely and avoided unnecessary surgery as well as toxicity of medical treatment when using systemic methotrexate. CONCLUSIONS: In addition to transvaginal and transabdominal ultrasound, MRI is necessary for the diagnosis of nonviable REP. Alongside the great vessels in the abdominal cavity should be taken into consideration in all suspected cases relating to this rare entity. Expectant management may be carefully indicated in conditions of nonviable REP and unruptured REP, where applicable.

Uterine Arteriovenous Malformation: A Pictorial Review of Diagnosis and Management.

Uterine arteriovenous malformation (UAVM) is a rare condition and is classified as either congenital or acquired UAVM. Patients with UAVMs usually experience miscarriages or recurrent menorrhagia. Ultrasound is used for the initial estimation of UAVMs. Computed tomography and magnetic resonance imaging are noninvasive and valuable methods that provide good compatibility with digital subtraction angiography to support the diagnosis and treatment of UAVM. Timely diagnosis is crucial to provide appropriate treatment for alleviating complications. This article presents a pictorial and literature review of the current evidence of the diagnosis and management of UAVM.

Acquired life-threatening uterine arteriovenous malformation treated by endovascular embolization.

Uterine arteriovenous malformation (AVM) is a rare condition that may lead to a life-threatening state. The urgency of diagnosis and treatment for uterine AVM should be emphasized. This case report describes a 42-year-old woman with a vaginal hemorrhage. In the previous month, the patient also had a hemorrhage after induced abortion that required a bilateral artery suture hemostasis of the uterus. On ultrasound, there was a lesion suspected by acquired AVM. Magnetic Resonance Angiography and Digital Subtraction Angiography was indicated to confirm the diagnosis. The patient was successfully treated by uterine artery embolization. After 6 months, the re-examined result showed no lesion of AVM.