Gutiérrez Cruz Oswaldo, Romero Sánchez Guadalupe, Velasco Pérez Luis
Hospital Angeles, México.
Ginecol Obstet Mex. 2006 Jul;74(7):389-93.
The heterotopic pregnancy is a combination of an intra-uterine and extra-uterine pregnancy, at the same time. The spontaneous heterotopic pregnancy is a rare illness with an estimated frequency below one per 20,000 and one per 30,000. The first case was reported in France by Duverney in 1708 during an autopsy. The frequency of this pregnancy has increased with the implementation of assisted reproduction techniques. This paper is the report of a case of spontaneous heterotopic pregnancy seen at the Angeles Mexico Hospital. A 32 year old woman, gravida 1; dilatation and curettage was performed on 13th February because of a blighted ovum, a lot of products of conception were obtained. The patient was discharged the next day only with analgesics. She returns to the emergency room on February 16th with hypovolemic shock and acute abdomen. A normocitic normocromic anemia was found on the hematic biometry, the transvaginal ultrasound reported amount of blood in the cul-de-sac, echogenic adnexal mass, suggesting a gestational sac with embryo. An emergency laparotomy was used to perform a left cornual resection; the findings were 600 cc of hemoperitoneum and a left ruptured ectopic pregnancy. She had an uneventful postoperative course, and was discharged 72 hours later without complications. Heterotopic pregnancy is a rare illness and must always be considered for the increase in pregnancy related with assisted reproduction techniques, although, it should be considered in a spontaneous pregnancy too.
异位妊娠是指子宫内妊娠和子宫外妊娠同时存在的情况。自然发生的异位妊娠是一种罕见疾病，估计发生率低于万分之零点五至万分之零点三三。首例病例于1708年由迪韦尔内（Duverney）在法国尸检时报告。随着辅助生殖技术的应用，这种妊娠的发生率有所上升。本文报告了一例在墨西哥安吉利斯医院发现的自然异位妊娠病例。一名32岁女性，孕1产0；因胚胎停育于2月13日行刮宫术，刮出大量妊娠物。患者次日仅带镇痛药出院。她于2月16日因低血容量性休克和急腹症返回急诊室。血液检查发现正细胞正色素性贫血，经阴道超声报告阴道后穹窿有积血，附件区有回声团块，提示妊娠囊伴胚胎。急诊行剖腹手术，切除左侧子宫角；术中发现腹腔积血600毫升，左侧异位妊娠破裂。术后恢复顺利，72小时后出院，无并发症。异位妊娠是一种罕见疾病，鉴于辅助生殖技术导致的妊娠增加，必须始终予以考虑，不过，自然妊娠时也应予以考虑。
