Bleeding Ectopic Pregnancy



Fig. 6.1
Bleeding tubal ectopic pregnancy with hemoperitoneum. (Courtesy of Dr. Togas Tulandi)



A321655_1_En_6_Fig2_HTML.jpg


Fig. 6.2
Injecting dilute vasopressin solution into an adherent and bleeding ectopic pregnancy


A321655_1_En_6_Fig3_HTML.jpg


Fig. 6.3
Adhesiolysis of ectopic pregnancy to ovary and pelvic sidewall led to even more bleeding


A321655_1_En_6_Fig4_HTML.jpg


Fig. 6.4
Continued bleeding and abnormal tubal anatomy that could not be salvaged led to the final decision to perform salpingectomy




Outcome


The patient underwent laparoscopy . The ectopic was clearly identified and the remainder of her tube appeared normal. Therefore, salpingostomy with excision of the ectopic pregnancy was performed but this was complicated by brisk bleeding. Pressure and bipolar cautery were applied with unsatisfactory result. The bleeding was too brisk for hemostatic agents and interrupted, 6–0 polyglactic sutures were placed. Pneumoperitoneum was then decreased and slow, bright red oozing was noted from a sutured area. Therefore, a thrombin matrix hemostatic agent was applied. The area was reinspected and was confirmed to be hemostatic. The patient recovered uneventfully and her serum beta-hCG was followed to undetectable levels.

Only gold members can continue reading. Log In or Register to continue

Stay updated, free articles. Join our Telegram channel

Oct 17, 2016 | Posted by in GYNECOLOGY | Comments Off on Bleeding Ectopic Pregnancy

Full access? Get Clinical Tree

Get Clinical Tree app for offline access