1.Double trouble in an ectopic pregnancy
Shalini Singh ; Vandana Kamatham ; Sharmila Vijayan ; Prashant Joshi
Philippine Journal of Obstetrics and Gynecology 2023;47(6):329-332
Gestational trophoblastic diseases are histologically different types of tumors originating from the
placenta with an incidence of 0.2–5.8/1000 pregnancies. Ectopic pregnancy is the implantation of
the fertilized ovum outside the uterine cavity, and a 0.64% incidence is reported. Ectopic cornual
pregnancy and molar pregnancy are rare cases, and a combination of these two rare entities occurring
simultaneously is even rare and very few cases have been reported in the literature. A cornual
pregnancy refers to the implantation and development of a gestational sac in one of the upper and
lateral portions of the uterus, whereas an interstitial pregnancy is a gestational sac that implants
within the proximal, intramural portion of the fallopian tube that is enveloped by the myometrium. We
present one of the rare combinations of molar pregnancy and cornual/interstitial ectopic pregnancy
in a 30‑year‑old G3
P1
who presented with a triad of amenorrhea, vaginal bleeding, and abdominal
pain. Laparotomy was done in view of an ultrasound which was suggestive of a well‑defined complex
thick‑walled lesion of size 3.2 × 3.3 with a gestational sac and no cardiac activity in the right fallopian
tube/adnexa suggesting tubal ectopic pregnancy. Beta‑human chorionic gonadotropin (β‑hCG) levels
were done and noted to be as high as 9998 mIU/mL. Intraoperatively, a cornual ectopic pregnancy was
found with no hemoperitoneum which was excised. Histopathology showed chorionic villi with variable
size and hydropic change, myxoid stromal changes, and cistern formation with polar trophoblastic
proliferation, based on which a diagnosis of molar pregnancy was made. Although ultrasonography
and higher than usual serum β‑hCG levels are diagnostic of uterine molar pregnancy, they do not
yield a proper diagnosis in ectopic molar pregnancy, hence, making it difficult to distinguish between
an early ectopic molar pregnancy from a nontrophoblastic tubal pregnancy. The final diagnosis is
usually made only after histopathology. A high degree of clinical suspicion of cornual pregnancy
followed by histopathological examination of the products of conception is the standard for arriving
at an appropriate diagnosis. Serial serum β‑hCG level follow‑up is recommended to rule out its
malignant potential.
Pregnancy, Cornual
;
Pregnancy, Ectopic
;
Hydatidiform Mole
2.Successful pregnancy after Whipple’s procedure for pancreatic neoplasm
Shruthi Dyamappa ; Priyanka P. Yoga ; Vijayan Sharmila
Philippine Journal of Obstetrics and Gynecology 2025;49(1):77-79
Pregnancy after undergoing major gastrointestinal surgeries like the Whipple’s procedure (pancreaticoduodenectomy) for pancreatic neoplasm is rare. This case report describes a 24-year-old woman who conceived and delivered a healthy baby after undergoing a Whipple’s procedure 5 months earlier for a pancreatic tumor. Her pregnancy was managed by a multidisciplinary team, and she delivered at 37 weeks of gestation through cesarean section without any complications. This case highlights the potential for successful pregnancy following a Whipple’s procedure, with proper counseling, coordinated care, and close monitoring during pregnancy.
Pancreatic Neoplasms
;
Pancreaticoduodenectomy
;
Pregnancy