[Abdominal ectopic pregnancy].

This review summarises the knowledge of abdominal ectopic pregnancy (AEP), which is a rare condition with higher morbidity and mortalilty than other types of ectopic pregnancies. The condition can be primary, if the pregnancy implants directly on to an abdominal site, or it can be secondary after a tubar abortion. AEP differs from tubal pregnancies by a normal level of human chorionic gonadotropin and rare vaginal bleeding, which causes a diagnostic delay. In an early pregnancy the treatment is laparoscopic removal, but in second and third trimester pregnancies laparotomy is preferred, if possible preceded by MRI for mapping of vascular involvement and location of placenta.

[Lipschütz ulcus as a differential diagnosis of vulvar ulcus].

Lipschütz ulcus (LU) is a rare and probably underdiagnosed non-venereal disease, which usually presents in young women. It is characterised by an acute onset of influenza-like symptoms with painful, necrotic ulcerations on the vulva or lower vagina, and the aetiology and pathogenesis is unknown. The diagnosis is clinical after exclusion of other causes of vulvar ulcers. LU heals spontaneously within 4-6 weeks, and treatment is mainly symptomatic.

[Asymptomatic spontaneous rupture of the uterus without previous sectio].

Rupture of the uterus is rare but catastrophic. Rupture often results in fetal bradycardia, abdominal pain, haemodynamic changes and vaginal bleeding. A 36-year-old healthy woman, gravida 3, para 1, went into spontaneous labour at gestation age 39 + 4, and at orificium 7 cm she received epidural analgesia. Following the epidural, the fetal heartbeat could not be registered by external cardiotocography, and caput could not be palpated. Spontaneous birth was attempted, but a caesarean section was necessary. The baby was found in the abdomen. Uterus was successfully contracted, thus preventing fatal bleeding. Asymptomatic rupture of the unscarred uterus is rare and difficult to diagnose.