ECTOPIC PREGNANCY AS A COMPLICATION OF ASSISTED REPRODUCTIVE TECHNIQUES FOLLOWING BILATERAL SALPHINGECTOMIES

Öz

Ectopic pregnancy continues to be one of the important reasons for maternal mortality. With the widespread and frequent use of Assisted Reproductive Techniques (ART), the frequency of abnormally located pregnancies also rises. In this article, we presented a case of an ectopic pregnancy occurring in the right tubal stump after an intracytoplasmic sperm injection – embryo transfer performed on a 39 year-old patient with secondary infertility and bilateral salphingectomy. Although a bilateral salphingectomy was performed in IVF cycles for an early diagnosis in order to decrease maternal morbidity and mortality, an ectopic pregnancy in the stump should be definitely taken into consideration in cases where no intrauterine pregnancy is observed.

Anahtar Kelimeler

• Ectopic pregnancy
• Bilateral salphingectomy
• Assisted Reproductive Techniques (ART)

BİLATERAL SALPENJEKTOMİ SONRASI UYGULANAN YARDIMLA ÜREME TEKNİKLERİNİN BİR KOMPLİKASYONU OLARAK OLUŞAN EKTOPİK GEBELİK OLGUSU

Öz

Ektopik gebelik halen maternal mortalitenin önemli nedenlerinden biri olmaya devam etmektedir. Yardımla Üreme Teknikleri (YÜT)' nin yaygın ve sık kullanılması ile birlikte anormal yerleşimli gebeliklerin sıklığı da artmaktadır. Bu yazıda 39 yaşında sekonder infertil ve bilateral salpenjektomili hastaya uygulanan intrasitoplazmik sperm injeksiyonu embryo transferi sonrası sağ tubal stump ta meydana gelen ektopik gebelik vakasını sunduk. Maternal morbidite ve mortaliteyi azaltmak amacıyla erken tanı için İVF sikluslarında bilateral salpenjektomi yapılmış olsa da intrauterin gebelik izlenmediği durumlarda ayırıcı tanıda mutlaka stumpta ektopik gebelik düşünülmelidir.

Anahtar Kelimeler

• Ektopik gebelik
• Bilateral salpenjektomi
• Yardımla üreme teknikleri (YÜT)

Kaynakça

1. Khan KS, Wojdyla D, Say L, Gulmenzoglu AM, van Look PF. WHO analysis of causes of maternal death:a systematic review. Lancet 2006;367:1066–
2. Tal S, Einat PS, Eylon L, Ofer F, Adrian E.Unusual case of recurrent heterotopic pregnancy after bilateral salpingectomy and literature review. RBM Online 2013;26:59-61.
3. Elisabetta G, Lavinia Q, Anna R, Gabriella C, Federica P , Massimo C. Interstitial Pregnancy after In Vitro Fertilization and Embryo Transfer Following Bilateral Salpingectomy: Report of Two Cases and Literature Review. Royan Institute Internat J Fertil Steril 2012;6(2):131-4.
4. W. P. Dmowski, N. Rana, J. Ding, and W. T. Wu. Retroperitoneal Subpancreatic Ectopic Pregnancy Following In Vitro Fertilization in a Patient with Previous Bilateral Salpingectomy: How Did It Get There? J Assist Reprod and Genetics 2002;19(2):90
5. Assisted reproductive technology in the United States: 2001 results generated from the American
6. Society for Reproductive Medicine/Society for Assisted Reproductive Technology registry Society for Assisted Reproductive Technology and the American Society for Reproductive Medicine. Fertil Steril 2007;87:1253-66.
7. Marcus SF, Brinsden P. Analysis of incidence and risk factors associated with ectopic pregnancy following in-vitro fertilization and embryo transfer. Hum Reprod 1995;10:190–203.
8. Po-Chun K, Ching-Chung L, Tsia-Shu L, Hong-Yuan H. Six cases of tubal stump pregnancy: complication of assisted reproductive technology? Fertil Steril 2011;95:2432,e1-e4.

9. Karen ES, Lisa B, James PT,Sergio O, Suheil JM. Salpingectomy improves the pregnancy rate in in- vitrofertilization patients with hydrosalpinx.Human Reproduction 1996;11:523-5.
10. Mandakini P, Aparna M, Reshma H. Hydrosalpinx or importance of Hydrosalpinx fluid in assisted reproductive tecnologies. J Gyn Endos Surg 2009;1:12-6. salpingectomy? The Takeda, S. Manabe, T. Mitsui, H.
11. NakamuraSpontaneous ectopic pregnancy occurring in the isthmic portion of the remnant tube after ipsilateral adnexectomy: report of two cases. J Obstet Gynaecol Res 2006;32:190–4.
12. Bernardini, M. Valenzano, G. Foglia Spontaneous interstitial pregnancy on a tubal stump after unilateral adnectomy followed by trasnvaginal colour 1998;13:1723–6. Hum Reprod
13. S.K. Agarwal, A.L. Wisot, G. Garzo, D.R. MeldrumCornual pregnancies in patients with prior salpingectomy undergoing in vitro fertilization and embryo transfer. Fertil Steril 1996;65:659–60. Claudi A, Hansen CS, Nİrgaard LN. Life- threatening extrauterine pregnancy after in vitro fertilization Laeger. 2015;177/2A:112-3. Ugeskr