Department of Obstetrics and Gynecology, La Fe University Hospital, Valencia, Spain.
Fertil Steril. 2011 Jun;95(7):2433.e1-3. doi: 10.1016/j.fertnstert.2011.02.026. Epub 2011 Mar 5.
To report the exceptional condition of retroperitoneal ectopic pregnancy after intrauterine insemination.
Case report.
University hospital.
PATIENT(S): A 37-year-old woman, gravida 2, para 1, presented to the emergency department 1 month after intrauterine insemination complaining of lower abdominal pain.
INTERVENTION(S): A transvaginal ultrasound assessment revealed a complex mass containing a gestational sac with vitelline vesicle behind the left ovary. At laparoscopy, a nodular lesion was seen next to the left uterosacral ligament, suggesting the presence of an ectopic pregnancy in the retroperitoneal space.
MAIN OUTCOME MEASURE(S): The unusual location of an ectopic pregnancy such as in the retroperitoneum should be examined in patients with clinical findings that suggest ectopic pregnancy if both the uterus and adnexa are normal during laparoscopic exploration.
RESULT(S): The patient's retroperitoneal pregnancy was treated with a wide laparoscopic excision. To allow the removal of all trophoblastic tissue, a 3×2×2 cm hemorrhagic mass containing the ectopic pregnancy was removed from the retroperitoneal space. Retroperitoneal ectopic pregnancy was confirmed by the pathology diagnosis.
CONCLUSION(S): Retroperitoneal pregnancy after assisted reproductive techniques is an exceptional condition that must be considered in patients with clinical findings that suggest ectopic pregnancy if both the uterus and adnexa are normal during laparoscopic exploration.
报告宫腔内人工授精后罕见的腹膜后异位妊娠病例。
病例报告。
大学医院。
一名 37 岁妇女，孕 2 产 1，宫腔内人工授精后 1 个月因下腹疼痛就诊于急诊。
经阴道超声检查显示左卵巢后方有一个包含孕囊和卵黄囊的复杂包块。腹腔镜检查时，在左子宫骶韧带旁可见一结节状病变，提示腹膜后异位妊娠。
如果腹腔镜检查时子宫和附件均正常，对于有疑似异位妊娠临床表现的患者，应检查腹膜后等异常位置的异位妊娠。
患者的腹膜后妊娠采用腹腔镜广泛切除术治疗。为了清除所有滋养细胞组织，从腹膜后间隙切除了一个 3×2×2cm 大小的含有异位妊娠的出血性肿块。病理诊断证实为腹膜后异位妊娠。
辅助生殖技术后腹膜后妊娠是一种罕见情况，如果腹腔镜检查时子宫和附件均正常，对于有疑似异位妊娠临床表现的患者，应考虑这种情况。
