Küretaj Sonrası Tubal Ektopik Gebeliğe Bağlı Hemorajik Şok: Bir Olgu Sunumu

Abstract

Bu makale, küretaj uygulanan ve sonrasında rüptüre olmuş tubal ektopik gebelik nedeniyle hemorajik şok gelişen genç bir kadında görülen nadir fakat yaşamı tehdit eden heterotopik gebelik vakasını sunmaktadır. Bu raporun, özellikle yanıltıcı klinik tabloların görüldüğü küretaj sonrası vakalarda, acil tıp ortamlarındaki tanı zorlukları ve kritik karar verme süreçleri hakkında önemli klinik bilgiler sunduğuna inanıyoruz.

Keywords

• heterotropik gebelik
• ektopik gebelik
• hemorajik şok
• küretaj
• salpinjektomi

Hemorrhagic Shock Due to Tubal Ectopic Pregnancy Following Curettage: A Case Report

Abstract

This manuscript presents a rare but life-threatening case of heterotopic pregnancy in a young woman who underwent curettage and subsequently developed hemorrhagic shock due to a ruptured tubal ectopic pregnancy. We believe this report offers significant clinical insights into the diagnostic challenges and critical decision-making processes in emergency medicine settings, particularly in post-curettage cases with misleading clinical presentations.

Keywords

• Heterotopic Pregnancy
• Ectopic Pregnancy
• Hemorrhagic Shock
• Curettage
• Salpingectomy

References

1. Bouyer J, Coste J, Fernandez H, Pouly JL, Job-Spira N. Sites of ectopic pregnancy: a 10year population-based study of 1800 cases. Hum Reprod. 2003;17(12):3224–30.
2. Barnhart KT. Ectopic pregnancy. N Engl J Med. 2009;361(4):379–87.
3. ACOG Practice Bulletin No. 193: Tubal Ectopic Pregnancy. Obstet Gynecol. 2018;131(3): e91–e103.
4. World Health Organization. Maternal mortality: Levels and trends 2000–2020. Geneva: WHO; 2021.
5. Tal J, Haddad S, Gordon N, Timor-Tritsch I. Heterotopic pregnancy after assisted reproductive technologies: a review. Obstet Gynecol Surv. 1996;51(11):705–9.
6. Reece EA, Petrie RH, Sirmans MF, Finster M, Todd WD. Combined intrauterine and extrauterine gestations: a review. Am J Obstet Gynecol. 1983;146(3):323–30.
7. Barrenetxea G, Barinaga-Rementeria L, Lopez de Larruzea A, Agirregoikoa JA, Mandiola M, Carbonero K. Heterotopic pregnancy: two cases and a comparative review. Fertil Steril. 2007;87(2): 417.e9–15.
8. Kirk E, Bottomley C, Bourne T. Diagnosing ectopic pregnancy and current concepts in the management of pregnancy of unknown location. Hum Reprod Update. 2007;13(5):567–76.

9. Nyberg DA, Filly RA, Mahony BS. Ectopic pregnancy: Doppler US findings. Radiology. 1991;178(3):557–60.
10. Seeber BE, Sammel MD, Guo W, Zhou L, Hummel AC, Barnhart KT. Application of serum biomarkers in the diagnosis and prediction of ectopic pregnancy. Fertil Steril. 2006;86(5):1235–41.
11. Hendriks E, MacNab M, Baird SM. Clinical guidelines for post-abortion care. Am Fam Physician. 2019;99(2):104–10.
12. Kajdy A, et al. A unique case of diagnosis of a heterotopic pregnancy at 26 weeks–case report and literature review. BMC Pregnancy Childbirth. 2020;20(1):1–6