Diagnosi precocissima di gravidanza tubarica non perforata: ruolo dell’ecografia in urgenza per la tempestiva risoluzione chirurgica


COD: 06_2009_483-488 Categorie: ,

Antonella Russo, Antonio Zaottini

Ann. Ital. Chir., 2009; 80: 483-488

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AIM: TO emphasize the role of clinical suspect and echographic approach to heterotopic pregnancy in young women complaining
of acute abdominal pain
MATERIAL OF STUDY: Tubal pregnancy in a young woman has been reported. Diagnostic clinical suspect, also supported
by serum hormonal substances (beta HCG), has been confirmed by US in urgency; transabdominal investigation requires
skilled operator, preferably surgically trained, to identify early stady of heterotopic pregnancy (fifth week of gestation),
which has undergone left salpingectomy in our experience.
RESULTS: The early diagnosis of unruptured tubal pregnancy in our experience prevented hemorragic shock and other
potential fatal complications, usually occurring in this condition
DISCUSSION: Ectopic pregnancy is a life threatening condition, rarely occurring during natural cycle; however its incidence
is increasing, considering the wider and wider use of assisted reproductive techniques and of gynecological surgical
diagnostic and therapeutic procedures. The rupture of ectopic part causes acute abdomen and potentially fatal hemorrhage,
whose only solution relies on surgical operation in urgency.
CONCLUSIONS: Clinical and anamnestic evaluation, ultrasonography and serum gonadotropin concentration are the first
choice approach to fertile women suffering from abdominal recurrent pain, when no other causes are suspected. The heterotopic
tubal pregnancy described is a very rare condition; in spite of early diagnosis, radical surgery consisting in left
salpingectomy has been the only surgical feasible option, patient’s life-sparing.