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残角破裂后足月存活的继发性腹腔妊娠罕见病例:病例报告

A rare case of term viable secondary abdominal pregnancy following rupture of a rudimentary horn: a case report.

作者信息

Amritha Bhandary, Sumangali Thirunavukkarasu, Priya Ballal, Deepak Shedde, Sharadha Rai

机构信息

Department of Obstetrics and Gynecology, Kasturba Medical College, Mangalore, India.

出版信息

J Med Case Rep. 2009 Jan 29;3:38. doi: 10.1186/1752-1947-3-38.

Abstract

INTRODUCTION

Abdominal pregnancy is a rare event, but one that represents a grave risk to the health of the pregnant woman. An abdominal pregnancy is defined as an ectopic pregnancy that implants in the peritoneal cavity. Early abdominal pregnancy is self-limited by hemorrhage from trophoblastic invasion with complete abortion of the gestational sac that leaves a discrete crater. Advanced abdominal pregnancy is a rare event, with high fetal and maternal morbidity and mortality.

CASE PRESENTATION

This is a case report of a 22-year-old primigravida with an abdominal pregnancy from a ruptured rudimentary horn. She was diagnosed as a case of term pregnancy with placenta previa with a transverse fetal lie and cervical fibroid and was prepared for an elective cesarean section. Intra-operatively, a live term female baby was extracted from the peritoneal cavity and it turned out to be an abdominal pregnancy from a ruptured rudimentary horn of a unicornuate uterus, which is a very rare condition. Mother and baby were in good condition after such a catastrophic event.

CONCLUSION

This case illustrates a rare obstetric condition which can be a severe catastrophic condition leading to maternal mortality and morbidity. It is imperative for every obstetrician to have in mind the possibility of abdominal pregnancy, although rare, especially in pregnant patients with persistent abdominal pain and painful fetal movements.

摘要

引言

腹腔妊娠是一种罕见的情况,但对孕妇的健康构成严重风险。腹腔妊娠被定义为植入腹膜腔的异位妊娠。早期腹腔妊娠因滋养层侵入导致出血而自我限制,妊娠囊完全流产,留下一个离散的坑洼。晚期腹腔妊娠是罕见事件,胎儿和母亲的发病率及死亡率都很高。

病例报告

这是一例22岁初产妇的病例报告,其腹腔妊娠源于残角子宫破裂。她最初被诊断为足月妊娠、前置胎盘、横位胎儿及宫颈肌瘤,准备进行择期剖宫产。术中,从腹膜腔取出一个足月活女婴,结果发现是单角子宫残角子宫破裂导致的腹腔妊娠,这是一种非常罕见的情况。在如此灾难性事件后,母婴状况良好。

结论

本病例说明了一种罕见的产科情况,它可能是导致孕产妇死亡和发病的严重灾难性情况。每位产科医生都必须牢记腹腔妊娠的可能性,尽管罕见,尤其是对于有持续性腹痛和胎动疼痛的孕妇。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce1e/2640409/deca8e7f4c53/1752-1947-3-38-1.jpg

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