背景:妊娠始于通常附着在子宫内膜上的受精卵。然而,当受精卵植入并在子宫腔外生长时,就会发生异位妊娠。输卵管异位妊娠是最常见的类型(超过95%),卵巢,腹部,子宫颈,阔韧带,子宫角妊娠不太常见。随着越来越多的异位妊娠病例在早期被诊断和治疗,成活率和生育力保持率明显提高。然而,腹部妊娠的并发症有时会危及生命,并有严重的后果。
方法:我们介绍一例腹膜内异位妊娠伴胎儿存活的病例。超声和磁共振成像显示右角妊娠伴继发性腹部妊娠。2021年9月,我们进行了紧急剖腹手术,随着额外的程序,如经尿道输尿管镜检查,双J支架置入术,腹部胎儿切除,胎盘切除术,修复右子宫角,盆腔粘连松解术,在怀孕的第29周。在剖腹手术中,我们诊断为腹部妊娠继发于子宫角不足。母亲和她的婴儿出院8天又41天,分别,手术后。
结论:腹部妊娠是一种罕见的疾病。异位妊娠的可变性会导致及时诊断的延误,导致发病率和死亡率增加,特别是在医疗和社会服务不足的地区。高度怀疑,加上适当的成像研究,有助于在任何疑似病例中诊断。
BACKGROUND: Pregnancy begins with a fertilized ovum that normally attaches to the uterine endometrium. However, an ectopic pregnancy can occur when a fertilized egg implants and grows outside the uterine cavity. Tubal ectopic pregnancy is the most common type (over 95%), with ovarian, abdominal, cervical, broad ligament, and uterine cornual pregnancy being less common. As more cases of ectopic pregnancy are diagnosed and treated in the early stages, the survival rate and fertility retention significantly improve. However, complications of abdominal pregnancy can sometimes be life-threatening and have severe consequences.
METHODS: We present a case of intraperitoneal ectopic pregnancy with fetal survival. Ultrasound and magnetic resonance imaging showed a right cornual pregnancy with a secondary abdominal pregnancy. In September 2021, we performed an emergency laparotomy, along with additional procedures such as transurethral ureteroscopy, double J-stent placement, abdominal fetal removal, placentectomy, repair of the right uterine horn, and pelvic adhesiolysis, in the 29th week of pregnancy. During laparotomy, we diagnosed abdominal pregnancy secondary to a rudimentary uterine horn. The mother and her baby were discharged eight days and 41 days, respectively, after surgery.
CONCLUSIONS: Abdominal pregnancy is a rare condition. The variable nature of ectopic pregnancy can cause delays in timely diagnosis, resulting in increased morbidity and mortality, especially in areas with inadequate medical and social services. A high index of suspicion, coupled with appropriate imaging studies, can help facilitate its diagnosis in any suspected case.