Journal List > Korean J Obstet Gynecol > v.55(11) > 1088562

Park, Song, Kim, Lee, Kim, Kim, Yoon, Seong, and Shim: Tuboovarian abscess in pregnancy after in vitro fertilization and embryo transfer

Abstract

Tuboovarian abscess occurred in pregnancy is a rare disease, especially which occurs after in vitro fertilization and embryo transfer (IVF-ET) is extremely rare. It is also difficult in diagnosis, because of its low incidence and nonspecific symptoms. Most of diagnosis is made in surgery. Although IVF currently is considered an effective treatment in women with endometriosis, there is the risk causing the infection of the endometrioma after oocyte retrieval. A case of tuboovarian abscess in IVF-ET pregnancy was presented and reviewed briefly.

Figures and Tables

Fig. 1
Transabdominal sonography. A 12.5 cm-sized right ovarian cyst.
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Fig. 2
Magnetic resonance imaging findings. Right ovarian cyst and intrauterine pregnancy (T2 weight image).
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Fig. 3
Laparoscopic image of right ovarian cyst. There was a 10 cm-sized right ovarian cyst including pus, which made severe adhesion with surrounding pelvic organs and peritoneum. It also had endometriotic lesion.
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Fig. 4
Microscopic findings. (A) The specimen consisted of many fragmented pieces of tissue showing fibrinous necrotic exudate, infiltration of acute and chronic inflammatory cells and fibrosis (H&E, ×40). (B) High power view showed infiltration of many neutrophils, lymphocytes and plasma cells (H&E, ×200).
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Table 1
Clinical features of 9 cases of tuboovarian abscess in pregnancy after IVF-ET
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IVF, in vitro fertilization; ET, embryo-transfer; OP, operation; WBC, white blood cell count (/mm3); BT, body temperature; GA, gestational age; CDS, cul-de-sac; IUP, intrauterine pregnancy; NA, not available; IV, intravenous; LSO, left salpingo-oophorectomy; PO, per oral.

aIt contains vaginal irrigation method in oocyte retrieval and use of peri-retrieval antibiotics; bIt is time of 1st operation for tuboovarian abscess; cAll data are in time of diagnosis; dSymptom was developed 45 days after Cesarean section at 38 weeks; eOperation was done 15 days after delivery at 22 weeks; fShe had only painless vaginal discharge at the first time; gThe second operation was done 24 hours after delivery at 21 weeks.

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