输卵管切除术后复发性同侧间质性异位妊娠

Federica Zammit, Sarah Sultana Grixti, Charles Savona-Ventura
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摘要

本病例强调了输卵管切除术后的长期产科风险。这些包括复发性同侧间质性异位妊娠和子宫破裂。病例报告:一位29岁的女性在妊娠14周时表现为急性腹痛以及失血性休克的体征和症状。她随后被诊断为右侧间质性宫外孕破裂,手术治疗。患者曾在妊娠12周时因复杂的右侧异位妊娠累及卵巢而行开放输卵管卵巢切除术。一年后她又怀孕了,在怀孕30周时子宫破裂。剖腹产生下了一个健康的婴儿。结论:无论何种病理,在进行输卵管切除术时,一丝不苟的手术技术是至关重要的。复发同侧间质性异位妊娠的风险必须始终考虑。此外,产前和产时子宫破裂的风险必须解决在今后怀孕后的间质妊娠。
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Recurrent ipsilateral interstitial ectopic pregnancy after salpingectomy
Introduction: This case highlights the long-term obstetric risks following salpingectomy. These include recurrent ipsilateral interstitial ectopic pregnancy and uterine rupture. Case Report: A 29-year-old lady presented with acute abdominal pain as well as signs and symptoms of hemorrhagic shock at 14 weeks of gestation. She was subsequently diagnosed with a ruptured right-sided interstitial ectopic pregnancy, which was managed surgically. The patient had a past history of open salpingo-oophorectomy for a complicated right-sided ectopic pregnancy involving the ovary at 12 weeks of gestation in her previous pregnancy. A subsequent pregnancy a year later was complicated by impending uterine rupture at 30 weeks of gestation. A healthy baby was delivered by Cesarean section. Conclusion: A meticulous surgical technique is of the essence when performing a salpingectomy for whatever pathology. The risk of a recurrent ipsilateral interstitial ectopic pregnancy must always be considered. Also, the risk of antenatal and intrapartum uterine rupture must be addressed in future pregnancies following interstitial pregnancies.
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