Pregnancy in a Non-Communicating Rudimentary Uterine Horn Managed With Laparoscopy in the First Trimester

IF 3.3 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Journal of minimally invasive gynecology Pub Date : 2024-12-30 DOI:10.1016/j.jmig.2024.12.020
Rajesweri Ponniah MBBS, MD, DNB, Surakshith Battina MBBS, MD, Sarat Battina MBBS, DGO, MD
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“妊娠早期用腹腔镜处理未连通的初级子宫角妊娠”。
一位23岁的女性,通过排卵诱导怀孕,在10周闭经,腹痛和尿β HCG阳性。二维超声提示右侧异位妊娠。在3D超声成像中,诊断为独角形子宫,右侧角状妊娠,大小为6cm[图1]。腹腔镜检查显示左管正常。然而,在右侧,只有一条纤维条纹进入子宫角[图2],妊娠位于独角形子宫(IIB类)的非连通的初级角。切除右半角、妊娠和输卵管[图3],术后恢复顺利。组织病理学检查证实了滋养层组织的存在,与初级角妊娠相一致。早期角妊娠并不常见,发生率为7.5万分之一至15万分之一,其中50%的病例导致子宫破裂,估计产妇死亡率为0.5%。在与子宫颈没有联系的非连通角中怀孕是由于精子经腹膜迁移到对侧的初级角,使该侧的卵子受精。二维超声诊断准确率仅为26%。3D超声提高了准确率。腹腔镜手术因其微创性、减少恢复时间和降低感染风险而受到青睐[4,5]。
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来源期刊
CiteScore
5.00
自引率
7.30%
发文量
272
审稿时长
37 days
期刊介绍: The Journal of Minimally Invasive Gynecology, formerly titled The Journal of the American Association of Gynecologic Laparoscopists, is an international clinical forum for the exchange and dissemination of ideas, findings and techniques relevant to gynecologic endoscopy and other minimally invasive procedures. The Journal, which presents research, clinical opinions and case reports from the brightest minds in gynecologic surgery, is an authoritative source informing practicing physicians of the latest, cutting-edge developments occurring in this emerging field.
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