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诊断为慢性异位妊娠的病例,通过超声检查可看到胎儿的完整形态。

Case of chronic ectopic pregnancy diagnosed in which the complete shape of the fetus was visible by ultrasonography.

作者信息

Harada Miyuki, Hiroi Hisahiko, Fujiwara Toshihiro, Fujimoto Akihisa, Kikuchi Akihiko, Osuga Yutaka, Momoeda Mikio, Kugu Koji, Yano Tetsu, Taketani Yuji

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan.

出版信息

J Obstet Gynaecol Res. 2010 Apr;36(2):462-5. doi: 10.1111/j.1447-0756.2009.01154.x.

Abstract

Preoperative diagnosis of chronic ectopic pregnancy is often difficult because of the high incidence of negative results on pregnancy tests as a consequence of the very small amount of live villi, subtle symptoms, and the poor specificity of ultrasonographic patterns. A 45-year-old woman was referred to our department for evaluation of a mass 8 cm in diameter with solid parts in the right adnexal area. Transvaginal ultrasonography showed a mass consisting of a cystic part with an irregular thick capsule distinct from the right ovary. In the center of the cystic part, a fetus-like image, 20 mm in length was seen. Preoperative diagnosis was confirmed by the laparoscopy, which revealed a swollen right tube containing a fetus with highly necrotic changes. This case was unique because chronic ectopic pregnancy was detected at an early stage before absorption of the conceptus occurred, which coincidentally is an appropriate time for morphological diagnosis.

摘要

由于活绒毛数量极少、症状不明显以及超声图像特异性差,妊娠试验结果呈阴性的发生率很高,因此慢性异位妊娠的术前诊断往往很困难。一名45岁女性因右侧附件区有一个直径8厘米、有实性部分的肿块而被转诊至我科。经阴道超声检查显示一个肿块,由一个囊性部分和一个与右侧卵巢不同的不规则厚包膜组成。在囊性部分的中心,可见一个长20毫米的胎儿样图像。腹腔镜检查证实了术前诊断,发现右侧输卵管肿胀,内有一个胎儿,伴有高度坏死性改变。该病例很独特,因为在孕体吸收之前的早期就检测到了慢性异位妊娠,而这恰好是进行形态学诊断的合适时机。

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