Ectopic pregnancy and acute appendicitis during intrauterine pregnancy after in vitro fertilization

Abstract

The paper presents a clinical case of the Patient T., 34years old, who underwent the treatment in the Department of ART of the Regional Perinatal Center for tubal peritoneal infertility for seven years. In the anamnesis: one spontaneous uterine pregnancy, culminating in medical abortion for up to 12 weeks, treatment for chronic salpingo-oophoritis, tubectomy on the right side for a progressing ectopic pregnancy. The patient denied the presence of Chlamydia infection in the anamnesis. Studies on sexually transmitted infections before the 1VF program were negative. During laparoscopic tubectomy, no endometriotic foci were found. There were four programs of ART in anamnesis: in 2009, 2012, 2014,2016. During the fourth ART program in 2016, two embryos were transferred to the uterine cavity, resulting in a uterine pregnancy in combination with an ectopic pregnancy diagnosed in the ultrasound study at 4 to 5 weeks of gestation, in the absence of clinical symptoms. The patient underwent emergency laparoscopic tubectomy on the left, the course of the postoperative period proceeded without complications. Later, in the period of uterine pregnancy of 7-8 weeks, with a clinical picture of acute appendicitis, the woman was hospitalized in the surgical department where she underwent laparoscopic appendectomy. Later the pregnancy proceeded without complications, at 39 weeks the planned cesarean section was performed, a girl weighing 3480 grams, 51 cm long with an Apgar score of 9-10 points was extracted on the operation. The course of the early postoperative period without complications, the patient was discharged with the child on the 4th day.

Keywords

• tubal-peritoneal infertility
• in vitro fertilization
• embryo transfer
• ectopic pregnancy
• pregnancy
• acute appendicitis