腹腔镜下处理卵巢妊娠
Laparoscopic management of ovarian pregnancy.
作者信息
Tinelli Andrea, Hudelist Gernot, Malvasi Antonio, Tinelli Raffaele
机构信息
Department of Obstetrics and Gynaecology, Vito Fazzi Hospital, Lecce, Italy.
出版信息
JSLS. 2008 Apr-Jun;12(2):169-72.
BACKGROUND
Ovarian pregnancy (OP) comprises 0.15% of all pregnancies and 1% to 3% of ectopic gestations.
CASE REPORT
Two cases of OP detected and treated during laparoscopy for suspected ectopic pregnancy are described. We used clinical examination, serum beta-hCG levels, and transvaginal ultrasonography (TVS) preoperatively to confirm the suspected diagnosis of extrauterine pregnancy. In the first patient, oophorectomy was performed, whereas the second patient was treated by an ovarian wedge resection to restore and preserve ovarian integrity. Postoperative recovery periods were normal in both patients, with no further therapeutic intervention in the follow-up course.
CONCLUSION
Primary OP may occasionally occur in patients with a suspected ectopic pregnancy. Signs and symptoms suggestive of extrauterine pregnancy, TVS, and serum beta-hCG dynamics can be a useful adjunct to allow the preoperative diagnosis of OP prior to the use of the diagnostic gold standard, diagnostic laparoscopy. Preservation of ovarian tissue should be the therapeutic goal to maintain ovarian reserve and preserve fertility in young women with OP.
背景
卵巢妊娠（OP）占所有妊娠的0.15%，占异位妊娠的1%至3%。
病例报告
描述了两例在腹腔镜检查疑似异位妊娠时发现并治疗的OP病例。我们术前采用临床检查、血清β-人绒毛膜促性腺激素（β-hCG）水平及经阴道超声检查（TVS）来确诊疑似宫外孕。首例患者行卵巢切除术，而第二例患者接受卵巢楔形切除术以恢复并保留卵巢完整性。两名患者术后恢复期均正常，随访过程中无需进一步治疗干预。
结论
原发性OP偶尔可发生于疑似异位妊娠的患者。提示宫外孕的体征和症状、TVS及血清β-hCG动态变化有助于在使用诊断金标准——诊断性腹腔镜检查之前对OP进行术前诊断。保留卵巢组织应作为治疗目标，以维持年轻OP患者的卵巢储备并保留生育能力。
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