Successful tubal blastocyst transfer after laparoscopic cervical cerclage: cesarean delivery of a live very low-birth-weight infant and later hysterectomy for uterine rupture.

Abstract

OBJECTIVE:

To report the management of a woman who presented with secondary infertility and amenorrhea after 2 Lletz procedures and a cone biopsy and who had cervical stenosis, a foreshortened cervix, and hematometra.

DESIGN:

Case report.

SETTING:

Fertility clinic and tertiary hospital.

PATIENT(S):

A 34-year-old woman who wanted further children but had had a previous cesarean delivery and then a cone biopsy for cervical intraepithelial neoplasia III that resulted in a foreshortened cervix and cervical obstruction.

INTERVENTION(S):

Laparoscopic cervical cerclage, IVF, blastocyst tubal transfer, cesarean delivery, hysterectomy.

MAIN OUTCOME MEASURE(S):

Pregnancy; morbidity for the woman and her infant.

RESULT(S):

An intrauterine pregnancy occurred after blastocyst intrafallopian transfer, but there was uterine herniation necessitating premature delivery of a very low-birth-weight infant that had lung problems but is now healthy. The mother later developed a hematometra that ruptured, requiring an emergency hysterectomy from which her recovery was protracted.

CONCLUSION(S):

This first report of a blastocyst intrafallopian transfer was associated with an intrauterine pregnancy; however, when the indication for blastocyst tubal transfer of an obstructed cervix is associated with a foreshortened cervix requiring cervical cerclage, there can be major health risks for infant and mother.

• Authors: Andrew Murray, John Hutton
• Journal: Fertility and sterility (Fertil Steril) Vol. 96 Issue 4 Pg. 895-7 (Oct 2011) ISSN: 1556-5653 [Electronic] United States
• PMID: 21802668 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Topics

• Adult
• Cerclage, Cervical (adverse effects)
• Cesarean Section (methods)
• Embryo Transfer (methods)
• Female
• Humans
• Hysterectomy (methods)
• Infant, Newborn
• Infant, Very Low Birth Weight
• Laparoscopy (adverse effects)
• Male
• Pregnancy
• Uterine Rupture (diagnosis, etiology, surgery)