Paillocher N, Biquard F, Paris L, Catala L, Descamps P
Service de gynécologie-obstétrique, CHU d'Angers, 4, rue Larrey, 49000 Angers, France.
Gynecol Obstet Fertil. 2005 Oct;33(10):772-5. doi: 10.1016/j.gyobfe.2005.07.038.
We report a case of a patient who presented an isthmic pregnancy successfully treated with an intramuscular injection of methotrexate. The diagnosis of isthmic pregnancy was made clinically (cervical colour was normal, inferior segment soft and enlarged) and echographically (long cervix, foetal sack situated in the isthmus and the uterine body was empty). An isthmic full term pregnancy is possible but would carry major haemorrhagic risk. There are several therapeutic options if the pregnancy is interrupted: medical treatment of methotrexate, curettage, curettage with embolisation of the uterine arteries and as a last resort, hysterectomy. The success of conservative treatment seems to be related to the criteria known for the cervical pregnancy, which are cardiac activity, the level of HCG, gestational age and cranial-caudal length.
我们报告了一例峡部妊娠患者，该患者通过肌肉注射甲氨蝶呤成功治愈。峡部妊娠的诊断通过临床检查（宫颈颜色正常，下段柔软且增大）和超声检查（宫颈长，孕囊位于峡部且子宫体为空）做出。峡部足月妊娠是可能的，但会有大出血风险。如果终止妊娠，有几种治疗选择：甲氨蝶呤药物治疗、刮宫术、子宫动脉栓塞刮宫术，以及作为最后手段的子宫切除术。保守治疗的成功似乎与已知的宫颈妊娠标准有关，这些标准包括心搏、HCG水平、孕周和头臀长度。
