早期腹腔早孕:病例报告

Reuben Nyongesa, Caren Otadoh, Stephen Gwer
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摘要

背景:腹腔妊娠是一种罕见的异位妊娠,对孕妇和胎儿都有很大风险。并发症的严重程度取决于发病时的孕龄、腹腔妊娠的位置以及与腹腔器官的附着情况:病例介绍:一名 38 岁的 3+0 孕 4 级孕妇在孕龄 30 周时出现腹痛和中度苍白,产科超声推断为末次正常月经不详。她是 HIV 阳性,正在接受高活性抗逆转录病毒治疗。她在受孕前有口服避孕药史。超声检查显示腹腔内妊娠30周,胎盘附着在右上腹的肠系膜上,子宫为非葡萄胎。术中,上腹妊娠囊和胎膜破裂。胎盘附着在左侧输卵管和阔韧带上。由于早产,婴儿被送入新生儿科。术后一切顺利,在撰写本摘要时母婴情况良好:结论:早期腹腔早孕应通过选择性开腹手术来处理,以优化母亲和胎儿的结局。内脏附着受限的病例往往会有较好的预后。新生儿的预后主要取决于分娩时的胎龄。
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Early preterm abdominal pregnancy: A case report
Background: Abdominal pregnancies, a rare form of ectopic pregnancy, pose significant risks to themother and fetus. The severity of complications depends on the gestational age at presentation,abdominal pregnancy location, and attachment to abdominal organs.Case presentation: A 38-year-old, para 3+0 gravida 4 presented with abdominal pain and moderatepallor at 30 weeks gestational age, extrapolated from obstetric ultrasound due to an unknown last normalmenstrual period. She was HIV-positive and on highly active antiretroviral therapy. She had a history oforal contraceptive use before conception. Ultrasound revealed a viable intraabdominal pregnancy at 30weeks with the placenta attached to the mesentery in the right upper quadrant with a nongravid uterus.She was transfused with four units of packed red blood cells before elective laparotomy. Intraoperatively,the gestational sac in the upper quadrants and membranes were ruptured. A live male infant wasdelivered, weighing 990g, Apgar scores of 8 at 1 and 9 at 5. The placenta, which was attached to the leftfallopian tube and the broad ligament was extracted. The infant was admitted to the newborn unitbecause of prematurity. The postoperative period was uneventful, and the mother and baby were doingwell at the writing of this abstract.Conclusion: Early preterm abdominal pregnancy should be managed by elective laparotomy to optimizeoutcomes for both the mother and fetus. Cases with limited attachment to the viscera tend to havefavorable outcomes. Neonatal outcome primarily depends on gestational age at delivery.
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