Geburtshilfe Frauenheilkd 2016; 76(08): 906-909
DOI: 10.1055/s-0042-106086
Case Report
GebFra Science
Georg Thieme Verlag KG Stuttgart · New York

Laparoscopic Chromopertubation, Myomectomy with Opening of the Uterine Cavity and Hysteroscopy during the Early Implantation Phase of an Undetected Pregnancy: Delivery of a Child with a Complex Brain Malformation

Laparoskopische Chromopertubation, Myomenukleation mit Öffnung der Gebärmutterhöhle und Hysteroskopie im Frühstadium der Nidation bei einer unentdeckten Schwangerschaft: Geburt eines Kindes mit komplexer Hirnfehlbildung
C. Mann
1   Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, Ludwig-Maximilians-University Hospital, Maistr. 11, 80337 Munich, Germany
,
K. Karl
2   Prenatal Diagnosis, Department of Obstetrics and Gynecology, Ludwig-Maximilians-University Hospital, Maistr. 11, 80337 Munich, Germany; now: Prenatal Diagnosis Munich, Tegernseer Landstr. 64, 81541 Munich, Germany
,
B. Ertl-Wagner
3   Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany
,
H. Weigand
4   Department of Pediatric Neurology Ludwig-Maximilians-University Hospital, Munich, Germany
,
C. J. Thaler
1   Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, Ludwig-Maximilians-University Hospital, Maistr. 11, 80337 Munich, Germany
5   Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, Ludwig-Maximilians-University Hospital, Marchioninistr. 15, 81377 Munich, Germany
› Author Affiliations
Further Information

Publication History

received 22 November 2015
revised 09 February 2016

accepted 05 April 2016

Publication Date:
25 August 2016 (online)

   Permissions and Reprints

Abstract

A previously infertile woman underwent laparoscopic myomectomy involving opening of the uterine cavity and chromopertubation that showed closed Fallopian tubes during the early implantation stage of an undetected pregnancy. The pregnancy was not terminated, and a child with a complex brain malformation was delivered at 37 weeks of gestation by Cesarean section.

Zusammenfassung

Bei einer Patientin mit sekundärer Infertilität wurde, im Frühstadium der Einnistungsphase einer unbekannten Schwangerschaft, eine laparaskopische Myomenukleation mit Eröffnung des Cavums und Chromopertubation durchgeführt. Die Untersuchung zeigte verschlossene Tuben beidseits. Die Schwangerschaft wurde nicht abgebrochen, in der 37. SSW wurde die Patientin per Sectio caesarea von einem Kind mit einer komplexen Hirnfehlbildung entbunden.

Key words

embryonic period - malformation - infertility - pregnancy - reproductive medicine - sonography

Schlüsselwörter

Embryonalstadium - Fehlbildung - Unfruchtbarkeit - Schwangerschaft - Reproduktionsmedizin - Ultraschall
 

  • References

  • 1 AL-Mizyen E, Barnick CG, Grudzinskas JG. Early pregnancy is elusive and robust. Early Pregnancy 2001; 5: 144-148
    Google Scholar
  • 2 Dwivedee K, Banfield PJ. A case report of inadvertent hysteroscopy and laparoscopy in a patient of uterus didelphys with early pregnancy. J Obstet Gynaecol 2007; 27: 638-639
    CrossrefGoogle Scholar
  • 3 Erenus M, Sezen D. Ongoing pregnancy in a woman who inadvertently underwent office hysteroscopy during early pregnancy. Fertil Steril 2005; 83: 211-212
    CrossrefGoogle Scholar
  • 4 Novak ER, Woodruff JD. Myoma and other benign Tumors of the Uterus. Gynecologic and Obstetrics Pathology. 8th ed. Philadelphia, USA: Saunders; 1979: 260-278
    Google Scholar
  • 5 Hurst BS, Matthews ML, Marshburn PB. Laparoscopic myomectomy for symptomatic uterine myomas. Fertil Steril 2005; 83: 1-23
    CrossrefGoogle Scholar
  • 6 Genbacev OD, Prakobphol A, Foulk RA et al. Trophoblast L-selectin-mediated adhesion at the maternal-fetal interface. Science 2003; 299: 405
    CrossrefGoogle Scholar
  • 7 Steeber DA, Engel P, Miller AS et al. Ligation of L-selectin through conserved regions within the lectin domain activates signal transduction pathways and integrin function in human, mouse, and rat leukocytes. J Immunol 1997; 159: 952-963
    Google Scholar
  • 8 James JL, Carter AM, Chamley LW. Human placentation from nidation to 5 weeks of gestation. Part I: What do we know about formative placental development following implantation?. Placenta 2012; 33: 327-334
    CrossrefGoogle Scholar
  • 9 Knoth M, Larsen J. Ultrastructure of a human implantation site. Acta Obstet Gynecol Scand 1972; 51: 385-393
    CrossrefGoogle Scholar
  • 10 Johnston MV, Barks J, Greenamyre T et al. Use of Toxins to disrupt Neurotransmitter Circuitry in the developing Brain. In: Boer GJ, Feenstra MGP, Mirmiran M, Swaab DF, van Haaren F, eds. Biochemical Basis of functional Neuroteratology. Amsterdam: Elsevier; 1988: 425-446
    Google Scholar
  • 11 Lindvall O, Nilsson B. Cerebellar atrophy following phenytoin intoxication. Ann Neurol 1984; 16: 258-260
    CrossrefGoogle Scholar
  • 12 Sugita K, Ando M, Makino M et al. Magnetic resonance imaging of the brain in congenital rubella virus and cytomegalovirus infections. Neuroradiology 1991; 33: 239-242
    CrossrefGoogle Scholar
  • 13 Perlman JM, Argyle C. Lethal cytomegalovirus infection in preterm infants: clinical, radiological, and neuropathological findings. Ann Neurol 1992; 31: 64-68
    CrossrefGoogle Scholar
  • 14 Nakamura Y, Hashimoto T, Sasaguri Y et al. Brain anomalies found in 18 trisomy: CT scanning, morphologic and morphometric study. Clin Neuropathol 1986; 5: 47-52
    Google Scholar
  • 15 Crome L, Cowie V, Slater E. A statistical note on cerebellar and brainstem weight in mongolism. J Ment Defic Res 1966; 10: 69-72
    Google Scholar
  • 16 Garcia-Alix A, Blanco D, Cabanas F et al. Early neurological manifestations and brain anomalies in Marden-Walker syndrome. Am J Med Genet 1992; 44: 41-45
    CrossrefGoogle Scholar
  • 17 Reedy MB, Källén B, Kuehl TJ. Laparoscopy during pregnancy: a study of five fetal outcome parameters with use of the Swedish Health Registry. Am J Obstet Gynecol 1997; 177: 673-679
    CrossrefGoogle Scholar