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Embarazo heterotópico espontáneo complicado con sobrecarga circulatoria asociada a transfusión.

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Title: Embarazo heterotópico espontáneo complicado con sobrecarga circulatoria asociada a transfusión.
Alternate Title: Spontaneous heterotopic pregnancy complicated by transfusion-associated circulatory overload.
Authors: Useche Beltrán, Cristhian Alexander1 alexucch18@hotmail.com, Candela Herrán, Johana Andrea2, García Zambrano, Andrés Felipe2
Source: Ginecología y Obstetricia de México. dic2024, Vol. 92 Issue 12, p263-267. 5p.
Subjects: PREGNANCY complications, ACUTE abdomen, ECTOPIC pregnancy, ORAL drug administration, HYPOVOLEMIC anemia
Abstract (English): BACKGROUND: One of the major complications of heterotopic pregnancy is hypovolemic shock, which often requires transfusion of blood products to correct clinical instability. However, transfusion can be a risk factor for adverse reactions, which in extreme situations can lead to death. CLINICAL CASE: A 31-year-old female patient with a history of three pregnancies and two deliveries and no other relevant medical data. She was admitted to the obstetrics department at 9.2 weeks' gestation with a three-hour clinical presentation of abdominal pain located in the hypogastrium, colicky, intensity 6-10, non-radiating and associated with nausea, emesis and dysuria, which did not subside with oral administration of butyl hyoscine bromide. Emergency exploratory laparotomy revealed a violaceous mass of approximately 3 cm in the infundibulum of the left fallopian tube associated with 1000 cc of hemoperitoneum, consistent with a heterotopic and ruptured ectopic pregnancy. She was evaluated in the outpatient clinic at 16 weeks' gestation with favorable clinical evolution, healed surgical wound, pathology report confirming the diagnosis of ectopic pregnancy, and no bleeding or other alarming signs at that time. CONCLUSIONS: Heterotopic pregnancy is an exceptional complication that is difficult to diagnose because the clinical symptoms are nonspecific and the main manifestation may be acute abdomen associated with shock that may require emergency surgical care or blood transfusion. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): ANTECEDENTES: Una de las principales complicaciones del embarazo heterotópico es el choque hipovolémico que, en muchas ocasiones, puede requerir transfusión de hemoderivados para corregir la inestabilidad clínica. Sin embargo, la transfusión puede ser un factor de riesgo de reacciones adversas que, en situación extrema, puede derivar en la muerte. CASO CLÍNICO: Paciente de 31 años, con antecedente de tres embarazos y dos partos, sin otros datos médicos relevantes. Ingresó al servicio de Obstetricia con 9.2 semanas de embarazo, con un cuadro clínico de tres horas de evolución de dolor abdominal localizado en el hipogastrio, tipo cólico, de intensidad 6-10, no irradiado y asociado con náuseas, episodios eméticos y disuria, sin disminución con la administración oral de butil bromuro de hioscina. La laparotomía exploradora de urgencia, con hallazgos de masa violácea en el infundíbulo de la trompa uterina izquierda, de aproximadamente 3 cm asociada con 1000 cc de hemoperitoneo fue compatible con embarazo heterotópico y ectópico roto. A las 16 semanas de embarazo fue valorada en la consulta externa, con evolución clínica favorable, herida quirúrgica cicatrizada, reporte de patología que confirmó el diagnóstico de embarazo ectópico y, al momento, sin sangrado ni otros signos de alarma. CONCLUSIONES: El embarazo heterotópico es una complicación excepcional y de difícil diagnóstico porque los síntomas clínicos son inespecíficos y en donde la principal manifestación puede ser el abdomen agudo asociado con choque que puede requerir atención quirúrgica de urgencia o requerimiento de transfusión sanguínea. [ABSTRACT FROM AUTHOR]
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Database: MedicLatina
Description
Abstract:BACKGROUND: One of the major complications of heterotopic pregnancy is hypovolemic shock, which often requires transfusion of blood products to correct clinical instability. However, transfusion can be a risk factor for adverse reactions, which in extreme situations can lead to death. CLINICAL CASE: A 31-year-old female patient with a history of three pregnancies and two deliveries and no other relevant medical data. She was admitted to the obstetrics department at 9.2 weeks' gestation with a three-hour clinical presentation of abdominal pain located in the hypogastrium, colicky, intensity 6-10, non-radiating and associated with nausea, emesis and dysuria, which did not subside with oral administration of butyl hyoscine bromide. Emergency exploratory laparotomy revealed a violaceous mass of approximately 3 cm in the infundibulum of the left fallopian tube associated with 1000 cc of hemoperitoneum, consistent with a heterotopic and ruptured ectopic pregnancy. She was evaluated in the outpatient clinic at 16 weeks' gestation with favorable clinical evolution, healed surgical wound, pathology report confirming the diagnosis of ectopic pregnancy, and no bleeding or other alarming signs at that time. CONCLUSIONS: Heterotopic pregnancy is an exceptional complication that is difficult to diagnose because the clinical symptoms are nonspecific and the main manifestation may be acute abdomen associated with shock that may require emergency surgical care or blood transfusion. [ABSTRACT FROM AUTHOR]
ISSN:03009041
DOI:10.24245/gom.v1i12.9591