Abstract:
Tubal ectopic pregnancies remain a challenging and life-threatening obstetric condition in the early stages that unavoidably lead to abortion or rupture, further reflected by the associated maternal mortality. Therefore, in the present case report, we report the experience of a 36-year-old woman who presented to our Emergency Department with a history of moderate hypogastric pain, mild vaginal bleeding, and bilateral mastalgia, symptoms that started 20 days ago after uterine curettage for a declarative eight-week pregnancy. On admission, a physical examination showed regular standard signs. The ultrasound examination revealed in the left abdominal flank a gestational sac with a live fetus corresponding to the gestational age of 13 weeks. Given the position of the gestational sac, we suspected a possible abdominal pregnancy. Independently on her human chorionic gonadotropin (hCG) of 33.980 mIU/mL and hemoglobin (Hb) of 13.4 g/dL, the exact location of the pregnancy following ultrasound was hard to establish. Magnetic resonance imaging (MRI) examination was requested, after which we suspected the diagnosis of ovarian pregnancy. Given the paraclinical and clinical context of the worsening of painful symptoms, we decided to perform an exploratory laparoscopy in the multidisciplinary team (digestive and vascular surgeon) that showed the existence of a tubal pregnancy.
摘要:
输卵管异位妊娠在早期阶段仍然是一种具有挑战性和危及生命的产科疾病,不可避免地导致流产或破裂,相关的孕产妇死亡率进一步反映了这一点。因此,在本案例报告中,我们报告了一位36岁的女性的经历,她到我们的急诊科就诊,有中度胃下疼痛史,轻度阴道出血,和双侧乳腺痛,症状开始于20天前,在清宫后进行8周妊娠。一入场,体检显示有规律的标准体征。超声检查显示,左腹侧有一个孕囊,其活胎对应于13周的胎龄。鉴于孕囊的位置,我们怀疑可能是腹部妊娠.独立于33.980mIU/mL的人绒毛膜促性腺激素(hCG)和13.4g/dL的血红蛋白(Hb),超声检查后妊娠的确切位置很难确定.要求进行磁共振成像(MRI)检查,之后我们怀疑诊断为卵巢妊娠。鉴于疼痛症状恶化的临床和临床背景,我们决定在多学科团队(消化和血管外科医生)中进行探查性腹腔镜检查,结果显示存在输卵管妊娠.