title: Laparoscopic cholecystectomy due to acute calculous cholecystitis in 16 weeks' in vitro fertilization and embryo transfer pregnancy: report of the first case.
abstract: The most common cases of acute abdomen during pregnancy are acute appendicitis followed by acute cholecystitis. The case presented is a 33-year-old patient in 16 weeks' in vitro fertilization and embryo transfer pregnancy who developed acute cholecystitis. Previously there were two unsuccessful cycles, one complicated with ovarian hyperstimulation syndrome. Due to clinical deterioration during intravenous antibiotic therapy laparoscopic cholecystectomy was performed and acute cholecystitis found. The postoperative course was uneventful. During the first 24 h tocolysis with intravenous fenoterol in addition to peroral atenolol 2 Χ 50 mg was administered. Postoperative course was uneventful with further normal pregnancy. Elective cesarean section was made in term pregnancy (39 weeks) with singleton with Apgar 10/10. Current guidelines do not recommend prophylactic tocolysis in pregnant population with acute abdomen but there is no mention of the IVF-ET subpopulation of patients. Also, there are no guidelines for thromboprophylaxis in such patients with increased risk of thromboembolic accidents. To our knowledge this is the first case report of a laparoscopic cholecystectomy during IVF-ET gestation.
authors.affiliation: Department of Surgery, University Hospital Center Zagreb, Kišpaticeva 12, Croatia.
authors.forename: G
authors.initials: G
authors.lastname: Augustin
authors.forename: H
authors.initials: H
authors.lastname: Vrcic
authors.forename: B
authors.initials: B
authors.lastname: Zupancic
mesh_terms: D000328:Adult; D002585:Cesarean Section; D017081:Cholecystectomy, Laparoscopic; D041881:Cholecystitis, Acute / Q000175:diagnosis / Q000601:surgery*; D004624:Embryo Transfer / Q000009:adverse effects; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000601:surgery*; D011256:Pregnancy Outcome; D016896:Treatment Outcome; D014463:Ultrasonography