Ibrahim Alkatout, M. D. , M. A. , Christiane Stuhlmann-Laeisz, M. D

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Presentation transcript:

Organ-preserving management of ovarian pregnancies by laparoscopic approach Ibrahim Alkatout, M.D., M.A., Christiane Stuhlmann-Laeisz, M.D., Liselotte Mettler, M.D., Ph.D., Walter Jonat, M.D., Ph.D., Thoralf Schollmeyer, M.D. Fertility and Sterility Volume 95, Issue 8, Pages 2467-2470.e2 (June 2011) DOI: 10.1016/j.fertnstert.2010.12.060 Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions

Histologic examination of the material (hematoxylin and eosin) Histologic examination of the material (hematoxylin and eosin). (A) Hemorrhage into the gestational sac and orthotopic normal ovarian cortical tissue (star) next to decidualized stroma (bold arrow) at low magnification. Alongside, trophoblastic giant cells (thin arrow). (B) Hemorrhage (thin arrow) and regressive villous stroma (short arrow) in addition to decidualized stroma (bold arrow). (C) Gestational material (short arrow) and regressive villous stroma (bold arrow), in between hemorrhage and fibrin (thin arrow). (D) Regressive villous stroma (short arrow) next to trophoblast tissue (bold arrow) trophoblastic giant cells (thin arrow) at higher magnification. Fertility and Sterility 2011 95, 2467-2470.e2DOI: (10.1016/j.fertnstert.2010.12.060) Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions

(A) Overview after creating a pneumoperitoneum for diagnostic laparoscopy. Bleeding from the ruptured ectopic pregnancy of the left ovary. In the background, the slightly enlarged uterus and the right ovary with the corpus luteum cyst. (B) Suction of the blood out of the cul-de-sac. (C) Preparation of the left ovary and injection of ornipressin into the infundibulo pelvic ligament. (D) Blunt preparation and enucleation of the gestational sac from the orthotopic ovarian tissue. Removal of the product of conception by (E) enucleation. Healthy ovarian tissue can be seen on the left. (F) Removal after complete separation of the trophoblast from the ovary. Fertility and Sterility 2011 95, 2467-2470.e2DOI: (10.1016/j.fertnstert.2010.12.060) Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions