采用宫颈环扎术、卡前列素、刮宫术和球囊填塞法治疗早期宫颈妊娠。
Treatment of early cervical pregnancy with cerclage, carboprost, curettage, and balloon tamponade.
作者信息
De La Vega Guillermo A, Avery Caudrean, Nemiroff Richard, Marchiano Dominic
机构信息
Department of Obstetrics and Gynecology, Pennsylvania Hospital, University of Pennsylvania, Philadelphia, Pennsylvania 19107-6192, USA.
出版信息
Obstet Gynecol. 2007 Feb;109(2 Pt2):505-7. doi: 10.1097/01.AOG.0000220599.74326.94.
BACKGROUND
Cervical pregnancy, an uncommon variety of ectopic gestation is associated with high morbidity and adverse consequences for future fertility. Currently there are no specific recommendations for the best treatment of this entity.
CASE
A 35-year-old nullipara presented with 8 weeks of amenorrhea and painless brown discharge. The patient was diagnosed with cervical pregnancy with embryonic cardiac activity. A conservative surgical treatment under general anesthesia involved intracervical infiltration of carboprost, cerclage, suction curettage of cervix, and Foley balloon tamponade was performed. The Foley was removed on day 2 and the cerclage on day 7.
CONCLUSION
Early cervical pregnancy was treated with combined cervical cerclage, intracervical infiltration of carboprost, curettage, and balloon tamponade. Severe hemorrhage during suction curettage and the adverse effects and complications of systemic methotrexate treatment were avoided.
背景
宫颈妊娠是一种罕见的异位妊娠类型，具有较高的发病率，并对未来生育产生不良后果。目前对于该疾病的最佳治疗方法尚无具体建议。
病例
一名35岁未孕女性，停经8周，出现无痛性褐色分泌物。该患者被诊断为宫颈妊娠且胚胎有心跳。在全身麻醉下进行了保守手术治疗，包括宫颈内注射卡前列素、宫颈环扎、宫颈吸刮术以及Foley球囊填塞。Foley球囊在术后第2天取出，宫颈环扎在术后第7天拆除。
结论
早期宫颈妊娠采用宫颈环扎、宫颈内注射卡前列素、刮宫术及球囊填塞联合治疗。避免了吸刮术期间的严重出血以及全身甲氨蝶呤治疗的不良反应和并发症。
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