Case report.
Obstetrics and Gynecology, Community Hospital \"S. Maria delle Croci.\"
A 28-year-old patient with a previous cesarean delivery was admitted to our hospital for management of a presumed angular ectopic pregnancy. Transvaginal ultrasound confirmed an ectopic dichorionic diamniotic twin pregnancy eccentrically located in the right superior angle of the uterine cavity: the first gestational sac appeared to have right angular implantation, whereas the second gestational sac seemed to deepen inside the myometrium, with a thin myometrial margin of only 3 mm.
After discussing the risks, the patient requested to proceed with termination. A single intramuscular injection of 75 mg of methotrexate was administered, followed by ultrasound-guided hysterosuction after 19 days due to severe vaginal bleeding.
An early and accurate ultrasound diagnosis of a high-risk condition allowed for conservative medical treatment.
The serum beta-human chorionic gonadotropin levels progressively decreased. After 1 month, a clinical and ultrasound examination showed a regular endometrial line with a regular reappearance of menstrual bleeding.
Although there are remarkable advances in ultrasound techniques, angular pregnancy remains a condition of difficult diagnosis and management; it is potentially dangerous and may lead to severe complications. An early and accurate diagnosis of this condition is necessary to avoid complications and individualize the subsequent management.
病例报告。
妇产科,社区医院MariadelleCroci.\"
一名28岁的既往剖腹产患者因推测角状异位妊娠而入院治疗。经阴道超声证实异位双胎双胎妊娠位于子宫腔右上角:第一个孕囊似乎有直角植入,而第二个妊娠囊似乎在子宫肌层内部加深,只有3毫米的子宫肌层边缘薄。
在讨论了风险之后,患者要求继续终止。单次肌肉注射75毫克甲氨蝶呤,由于严重的阴道出血,在19天后进行超声引导下的宫腔抽吸。
对高风险疾病的早期准确超声诊断可以进行保守治疗。
血清β-人绒毛膜促性腺激素水平逐渐降低。一个月后,临床和超声检查显示子宫内膜有规律,月经出血有规律再现。
虽然超声技术有了显著的进步,角度妊娠仍然是诊断和管理困难的条件;它是潜在的危险,并可能导致严重的并发症。必须对这种情况进行早期和准确的诊断,以避免并发症并个性化后续管理。