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Uterine infarction in a patient with uterine adenomyosis following biochemical pregnancy.

Lee JY, Hwang KR, Won KH, Lee DY, Jeon HW, Moon MH - Clin Exp Reprod Med (2014)

Bottom Line: Focal uterine infarction after IVF-ET in a patient with adenomyosis following biochemical pregnancy has not been previously reported, although it occurs after uterine artery embolization in order to control symptoms caused by fibroids or adenomyosis.We report a case of a iparous woman who had uterine adenomyosis presenting with fever, pelvic pain and biochemical abortion after undergoing an IVF-ET procedure and the detection of a slightly elevated serum hCG.This case demonstrates that focal uterine infarction should be considered in the differential diagnosis of acute abdominal pain, vaginal bleeding and infectious signs in women experiencing biochemical abortion after an IVF-ET procedure.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, SMG-SNU Boramae Medical Center, Seoul, Korea. ; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT
Adenomyosis is a common gynecological disorder characterized by the presence of endometrial glands and stroma deep within the myometrium associated with myometrial hypertrophy and hyperplasia. Focal uterine infarction after IVF-ET in a patient with adenomyosis following biochemical pregnancy has not been previously reported, although it occurs after uterine artery embolization in order to control symptoms caused by fibroids or adenomyosis. We report a case of a iparous woman who had uterine adenomyosis presenting with fever, pelvic pain and biochemical abortion after undergoing an IVF-ET procedure and the detection of a slightly elevated serum hCG. Focal uterine infarction was suspected after a pelvic magnetic resonance imaging demonstrated preserved myometrium between the endometrial cavity and inner margin of the necrotic myometrium. This case demonstrates that focal uterine infarction should be considered in the differential diagnosis of acute abdominal pain, vaginal bleeding and infectious signs in women experiencing biochemical abortion after an IVF-ET procedure.

No MeSH data available.


Related in: MedlinePlus

Magnetic resonance imaging of the pelvis in the (A) axial and (B) sagittal planes demonstrated a wedge-shaped, irregularly marginated, non-enhancing area (arrows) in the anterior uterine wall.
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Figure 1: Magnetic resonance imaging of the pelvis in the (A) axial and (B) sagittal planes demonstrated a wedge-shaped, irregularly marginated, non-enhancing area (arrows) in the anterior uterine wall.

Mentions: Computed tomography at the Emergency Department revealed a wedge-shaped low attenuation area in the anterior uterine corpus. The radiology department recommended a further contrast-enhanced pelvic MRI study. Focal uterine infarction was suspected, and the pelvic MRI revealed a wedge-shaped, irregularly marginated, non-enhancing area in the anterior uterine wall and the presence of preserved myometrium between the endometrial cavity and the inner margin of the necrotic myometrium (Figure 1). These findings were suggestive of uterine infarction without uterine perforation. Pelvic MRI also revealed peritoneal inflammation.


Uterine infarction in a patient with uterine adenomyosis following biochemical pregnancy.

Lee JY, Hwang KR, Won KH, Lee DY, Jeon HW, Moon MH - Clin Exp Reprod Med (2014)

Magnetic resonance imaging of the pelvis in the (A) axial and (B) sagittal planes demonstrated a wedge-shaped, irregularly marginated, non-enhancing area (arrows) in the anterior uterine wall.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4295945&req=5

Figure 1: Magnetic resonance imaging of the pelvis in the (A) axial and (B) sagittal planes demonstrated a wedge-shaped, irregularly marginated, non-enhancing area (arrows) in the anterior uterine wall.
Mentions: Computed tomography at the Emergency Department revealed a wedge-shaped low attenuation area in the anterior uterine corpus. The radiology department recommended a further contrast-enhanced pelvic MRI study. Focal uterine infarction was suspected, and the pelvic MRI revealed a wedge-shaped, irregularly marginated, non-enhancing area in the anterior uterine wall and the presence of preserved myometrium between the endometrial cavity and the inner margin of the necrotic myometrium (Figure 1). These findings were suggestive of uterine infarction without uterine perforation. Pelvic MRI also revealed peritoneal inflammation.

Bottom Line: Focal uterine infarction after IVF-ET in a patient with adenomyosis following biochemical pregnancy has not been previously reported, although it occurs after uterine artery embolization in order to control symptoms caused by fibroids or adenomyosis.We report a case of a iparous woman who had uterine adenomyosis presenting with fever, pelvic pain and biochemical abortion after undergoing an IVF-ET procedure and the detection of a slightly elevated serum hCG.This case demonstrates that focal uterine infarction should be considered in the differential diagnosis of acute abdominal pain, vaginal bleeding and infectious signs in women experiencing biochemical abortion after an IVF-ET procedure.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, SMG-SNU Boramae Medical Center, Seoul, Korea. ; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT
Adenomyosis is a common gynecological disorder characterized by the presence of endometrial glands and stroma deep within the myometrium associated with myometrial hypertrophy and hyperplasia. Focal uterine infarction after IVF-ET in a patient with adenomyosis following biochemical pregnancy has not been previously reported, although it occurs after uterine artery embolization in order to control symptoms caused by fibroids or adenomyosis. We report a case of a iparous woman who had uterine adenomyosis presenting with fever, pelvic pain and biochemical abortion after undergoing an IVF-ET procedure and the detection of a slightly elevated serum hCG. Focal uterine infarction was suspected after a pelvic magnetic resonance imaging demonstrated preserved myometrium between the endometrial cavity and inner margin of the necrotic myometrium. This case demonstrates that focal uterine infarction should be considered in the differential diagnosis of acute abdominal pain, vaginal bleeding and infectious signs in women experiencing biochemical abortion after an IVF-ET procedure.

No MeSH data available.


Related in: MedlinePlus