Sentilhes Loïc, Bouet Pierre-Emmanuel, Gromez Alexis, Poilblanc Mathieu, Lefebvre-Lacoeuille Céline, Descamps Philippe
Department of Obstetrics and Gynecology, Angers University Hospital, Angers, France.
Fertil Steril. 2009 Mar;91(3):934.e11-3. doi: 10.1016/j.fertnstert.2008.09.072. Epub 2008 Oct 30.
To report the obstetric outcome after expectant management for a right cornual heterotopic pregnancy.
Case report.
University hospital.
PATIENT(S): A 33-year-old salpingectomized woman with an 8-year history of primary infertility who conceived after in utero transfer of two embryos obtained by in vitro fertilization.
INTERVENTION(S): Expectant management and close ultrasonographic and clinical monitoring.
MAIN OUTCOME MEASURE(S): Obstetric outcome.
RESULT(S): The intrauterine pregnancy proceeded unremarkably. A caesarean section was performed for dystocia and allowed the delivery of a healthy 4170 g male infant. The examination of the uterus showed a prerupture of the right uterine horn.
CONCLUSION(S): Expectant management for cornual heterotopic pregnancy could be considered a successful option in a symptom-free patient where the ectopic embryo has a limited craniocaudal length with no cardiac activity. Our case also suggests that elective cesarean section could be the optimal mode of delivery for rare cases of successful management for cornual heterotopic pregnancy, regardless of the therapeutic option chosen for the cornual pregnancy, due to the theoretical increase risk of uterine rupture during labor.
报告对右宫角异位妊娠进行期待治疗后的产科结局。
病例报告。
大学医院。
一名33岁女性，因输卵管切除术后原发性不孕8年，经体外受精获得两个胚胎并进行子宫内移植后受孕。
期待治疗及密切的超声和临床监测。
产科结局。
宫内妊娠进展顺利。因难产行剖宫产，娩出一名健康的4170g男婴。子宫检查显示右子宫角有先兆破裂。
对于无症状且异位胚胎头臀长度有限且无心跳的患者，期待治疗宫角异位妊娠可被视为一种成功的选择。我们的病例还表明，由于分娩时子宫破裂的理论风险增加，对于宫角异位妊娠成功治疗的罕见病例，无论对宫角妊娠选择何种治疗方案，选择性剖宫产可能是最佳分娩方式。
