Abstract：
We describe the case of a woman with mild endometriosis and Allen-Masters syndrome after in vitro fertilisation (IVF), presenting at 7 weeks 2 days gestation with abdominal pain. A transvaginal ultrasound revealed a gestational sac with a non-viable fetus near the right ovary. Laparoscopy was performed due to escalating abdominal pain which revealed a ruptured ectopic pregnancy at the right uterosacral ligament (USL) and blood in the pouch of Douglas. A peritoneal incision along the USL facilitated drainage and removal of the ectopic pregnancy. A pathological investigation described the presence of endometrial tissue directly adjacent to products of conception, which suggested a retroperitoneal implantation that may have been facilitated by the presence of an endometriotic lesion. This case underscores the distinctive clinical trajectory of unconventional ectopic pregnancies, provides novel insights into the pathophysiological mechanism of ectopic implantation and underscores the crucial role of comprehensive patient assessment during IVF and subsequent pregnancy in ensuring effective management.
摘要：
我们描述了在体外受精（IVF）后患有轻度子宫内膜异位症和Allen-Masters综合征的女性的情况，在妊娠7周2天时出现腹痛。经阴道超声检查显示，右卵巢附近有一个妊娠囊，胎儿无法存活。由于腹痛加剧，进行了腹腔镜检查，发现右子宫骶韧带（USL）和道格拉斯袋中的血液破裂了异位妊娠。沿USL的腹膜切口有助于引流和去除异位妊娠。病理研究描述了子宫内膜组织的存在，与受孕产物直接相邻，这表明腹膜后植入可能是由于子宫内膜异位病变的存在而促进的。该病例强调了非常规异位妊娠的独特临床轨迹，提供了对异位植入的病理生理机制的新见解，并强调了在IVF和随后的妊娠期间对患者进行全面评估在确保有效治疗中的关键作用。
