RESUMO
BACKGROUND: Spontaneous bilateral ectopic pregnancy is a rare event and difficult to diagnose preoperatively. CASE: A unique case occurred of bilateral ectopic pregnancy involving the left fallopian tube and right cornu, or interstitial segment. CONCLUSION: This case demonstrates the difficulty in diagnosing heterotopic pregnancies and in particular those pregnancies with an interstitial component and also demonstrates the limits of ultrasound and laparoscopy in making such a diagnosis.
Assuntos
Gravidez Ectópica/diagnóstico , Gravidez Múltipla , Gravidez Tubária/diagnóstico , Adolescente , Gonadotropina Coriônica Humana Subunidade beta/sangue , Feminino , Humanos , Laparoscopia , Gravidez , Gravidez Ectópica/diagnóstico por imagem , Gravidez Ectópica/cirurgia , Gravidez Tubária/diagnóstico por imagem , Gravidez Tubária/cirurgia , Gêmeos , UltrassonografiaRESUMO
Molar pregnancy has always been of interest to physicians because of the diagnostic and management challenges it presents. Its occurrence in patients older than 50 years of age is rare and misdiagnosis is common. A 51 year old black female presented to the gynecology emergency room with vaginal bleeding for twenty days. She was diagnosed with a molar pregnancy by a pelvic ultra-sound. Prior to presenting to the emergency room she had a negative work-up for hyperthyroidism, including a biopsy of a benign thyroid nodule and was also started on Inderal for new onset hypertension. She underwent a primary hysterectomy and subsequently required five courses of actinomycin D for plateauing of the BhCG. The different forms of presentation of gestational trophoblastic disease should be kept in mind so that the diagnosis can be made promptly and appropriate treatment started early, especially in patients with advanced age.
