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Ciąża heterotopowa – jak łatwo o pomyłkę diagnostyczną? Studium przypadku

100%
Ciebiera M., Słabuszewska-Jóźwiak A., Zaręba K., Jakiel G.
Journal of Ultrasonography
|
2018
|
vol. 18
|
issue 75
355-358
EN
Introduction: Heterotopic pregnancy is a rare, but potentially life-threatening pathology. The diagnosis of heterotopic pregnancy is still one of the biggest challenges in modern gynecology. The incidence of those pregnancies in natural conception is about 1:30000. Case presentation: We present an unusual case of a heterotopic pregnancy which was misdiagnosed in the first trimester as a dichorionic twin pregnancy. At 13 weeks of gestation, the patient presented with an acute abdomen, she was diagnosed with a heterotopic pregnancy, and therefore was operated on, with the excision of the ruptured fallopian tube and the ectopic pregnancy performed. Discussion: The presence of an intrauterine pregnancy does not rule out the presence of a coexisting ectopic pregnancy. Clinicians should always keep in mind that a heterotopic pregnancy may occur in a woman of reproductive age. Careful ultrasound scan of the uterus and appendages is a must in all women of reproductive age with clinical symptoms.
PL
Wstęp: Ciąża heterotopowa jest rzadką, jednak potencjalnie zagrażającą życiu jednostką kliniczną. Jej rozpoznanie pozostaje jednym z największych wyzwań współczesnej ginekologii. Częstość występowania ciąż heterotopowych wynosi około 1 : 30 000. Opis przypadku: W niniejszej pracy opisujemy rzadki przypadek ciąży heterotopowej, która w pierwszym trymestrze została mylnie rozpoznana jako ciąża bliźniacza dwukosmówkowa. W 13. tygodniu ciąży u pacjentki wystąpił zespół objawów ostrego brzucha i wówczas zostało postawione rozpoznanie ciąży heterotopowej oraz wdrożone leczenie operacyjne polegające na usunięciu pękniętego jajowodu i znajdującej się w nim ciąży pozamacicznej. Omówienie: Obecność ciąży wewnątrzmacicznej nie wyklucza współwystępowania równoległej ciąży pozamacicznej. U kobiet w wieku rozrodczym lekarze powinni zawsze brać pod uwagę możliwość wystąpienia ciąży pozamacicznej. Dokładne badanie ultrasonograficzne macicy i przydatków jest niezbędne u wszystkich pacjentek w wieku rozrodczym, u których występują objawy kliniczne.
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Conditions of Attending Prophylactic Gynecological Examinations by Women

76%
Pilewka-Kozak A. B., Łepecka-Klusek C., Stadnicka G., Syty K., Kozak Ł., Jakiel G.
Polish Journal of Public Health
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2015
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vol. 124
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issue 3
115-119
EN
Introduction. Low percentage of women who attend prophylactic examinations and also react early to the first symptoms of a disease is a common problem. Aim. The aim of the study was to determine demographic and environmental characteristics which had positive effects on having prophylactic gynecological examinations by women as well as to investigate what significance women's practicing of hormonal contraception had in that question. Material and methods. The study covered 430 women. The conditions of including women into the study group were as follows: age <45 years, commencement of sexual intercourses, maintaining of sexual activity, consent to participate in the study. The method of the study was a diagnostics survey using the questionnaire. Results. The majority of the surveyed women said that they attended prophylactic gynecological examinations regularly. Having prophylactic gynecological examinations was significantly affected (p<0.05) by mean monthly income per capita in the family, practicing and the type of contraception. The joint effect of the surveyed characteristics proved to be significant (p<0.05). Conclusions. The model woman who willingly attends prophylactic gynecological examinations is a young person who lives in a big city, has a university education and a very good financial position confirmed by high family income per capita. Practicing of hormonal contraception by women is a factor that has a beneficial effect on women's care of their health understood as having regular prophylactic gynecological examinations.
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