Table 5 Clinical data of fourteen patients with special site HP treated with surgery
Case | Fertilization way (embryo type and number if ET) | Gestational age (days after ET or intercourse) | Clinical symptoms | Presentation and outcome of IUP | Extrauterine pregnancy presentation | Bilateral fallopian tubes | EP site + treatment |
|---|---|---|---|---|---|---|---|
37 | IVF-ET (fresh 2) | 28 | Vaginal bleeding 24 days | CRL 0.3 cm, heart beaten | Right adnexal mass 2 cm CRL 0.2 cm without heart beaten | Right salpingectomy and left ligament for EP | Tubal stumps + laparotomy tubal stumps resection |
38 | IVF-ET (frozen 2) | 18 | Vaginal bleeding 12 days | Yolk sac without embryonic pole → live birth | Left adnexal mass 7 cm, yolk sac without embryonic pole | Left isthmus ligament | Tubal stumps + laparotomy tubal stumps and part cornual resection |
39 | IVF-ET (fresh 2) | 57 | Vaginal bleeding 3 days | CRL 3.7 cm, heart beaten | Left cornual CRL 3.2 cm with heart beaten (3 weeks later) | Bilateral tubal unobstructed by HSG, history of pelvic surgery | Interstitial + laparotomy salpingectomy and part cornual resection |
40 | IVF-ET (frozen 3) | 26 | Abdominal pain 3 day | CRL 0.2 cm, heart beaten | Left adnexal mass 4 cm | Bilateral salpingectomy for EP | posterior uterine + laparotomy mass removal, abdominal haematocele 1400 ml |
41 | IVF-ET (unknown) | > 70 | Abdominal pain and vaginal bleeding 12 + days | CRL 4.7 cm, heart beaten | Left fundus mass 5 cm | Left tubal hydrosalpinx | Interstitial + laparotomy salpingectomy and cornual resection |
42 | IVF-ET (fresh 2) | 46 | Vaginal bleeding and abdominal distension 6 days | CRL 0.3 cm, live birth→missed abortion | Right adnexal mass 4 cm, CRL1.8 cm without heart beaten | Bilateral salpingectomy | Cornual EP ruption + laparotomy cornual removal,abdominal haematocele 2000 ml |
43 | IVF-ET (unknown) | 22 | Vaginal bleeding 11 days and abdominal pain 3 days | Abortion | Mass behind uterus 9 cm | Bilateral unobstructed by laparoscope | Abdominal gestation + laparotomy mass removal |
44 | IVF-ET (frozen 3) | 39 | Asymptomatic, routine ultrasound test found | CRL 0.4 cm without heart beaten → missed abortion | Right cornual mass 2.5 cm | Right salpingectomy for EP and left salpingostomy for hydrosalpinx | Interstitial + laparoscopy part cornual resection and local MTX 20 mg |
45 | Ovulation induction + spontaneous | > 63 | Asymptomatic, routine ultrasound test found | CRL 2.6 cm, heart beaten | Right interstitial portion mass 5 cm CRL 2.4 cm, with heart beaten | Left tubal obstructed and right tubal unobstructed by HSG | Interstitial + laparotomy salpingectomy and part cornual resection |
46 | IVF-ET (frozen 2) | 32 | Asymptomatic, routine ultrasound test found | CRL 0.6 cm, heart beaten | Left cornual CRL 0.7 cm with heart beaten | Left salpingectomy and right tubal repair surgery | Interstitial + laparotomy part cornual resection |
47 | IVF-ET (frozen 2) | 35 | Asymptomatic, routine ultrasound test found | CRL 1.2 cm, heart beaten | Right cornual CRL 0.7 cm with heart beaten | Right salpingectomy and cornual resection both for EP | Cornual–interstitial EP + laparotomy salpingostomy |
48 | IVF-ET (fresh 2) | 36 | Asymptomatic, routine ultrasound test found | CRL 1.1 cm, heart beaten | Right cornual CRL 1.1 cm with heart beaten | Bilateral salpingectomy | Cornual ruption + laparotomy cornual resection |
49 | IVF-ET (frozen 3) | 38 | Asymptomatic, routine ultrasound test found | CRL 1.2 cm, heart beaten | Right adnexal mass 3 cm | Bilateral tubal obstructed by HSG | Interstitial + laparotomy salpingectomy and cornual resection |
50 | Ovulation induction + spontaneous | 30 | Nausea and vomiting | CRL 3.1, 3.2, 4.4 and 1.9 cm all with heart beaten | Right adnexal mass 3 cm | Ovulation induction for PCOS and bilateral tubal unobstructed by HSG | Isthmic EP ruption + laparotomy salpingectomy, abdominal haematocele 2000 ml |