残角子宫妊娠的综合药物与手术治疗
Combined medical and surgical management of rudimentary uterine horn pregnancy.
作者信息
Park John K, Dominguez Celia E
机构信息
Emory University School of Medicine, Department of Gynecology and Obstetrics, Atlanta, Georgia, USA.
出版信息
JSLS. 2007 Jan-Mar;11(1):119-22.
Abstract
BACKGROUND
Pregnancy within a noncommunicating rudimentary horn is a known complication of unicornuate uterus. The risk of rupture approximates 50%, most of which occur in the second trimester.
CASE
A rudimentary horn pregnancy was discovered at 8 weeks gestation. Medical termination was then performed with fetal intracardiac potassium chloride and intraplacental methotrexate. Magnetic resonance imaging (MRI) of the pelvis was obtained. Laparoscopic uterine horn resection 6 weeks after medical termination was performed.
DISCUSSION
While surgical resection of a rudimentary horn pregnancy is necessary, early diagnosis affords the opportunity to take steps that minimize surgical risks. MRI assists surgical planning by demonstrating the form of attachment of the uterine horn to the unicornuate uterus. Preoperative medical termination may decrease vascularity of the gestation, thereby decreasing operative blood loss.
摘要
背景
残角子宫妊娠是单角子宫已知的一种并发症。破裂风险约为50%，其中大部分发生在孕中期。
病例
妊娠8周时发现残角子宫妊娠。随后采用经胎儿心脏注射氯化钾及经胎盘注射甲氨蝶呤进行药物流产。进行了盆腔磁共振成像（MRI）检查。药物流产6周后进行了腹腔镜残角子宫切除术。
讨论
虽然手术切除残角子宫妊娠是必要的，但早期诊断为采取措施将手术风险降至最低提供了机会。MRI通过显示残角子宫与单角子宫的附着形式辅助手术规划。术前药物流产可能会减少妊娠组织的血供，从而减少术中失血。
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