未破裂的32周残角妊娠，表现为右上腹疼痛。
Unruptured 32-week rudimentary horn pregnancy presenting as right upper quadrant pain.
作者信息
Cuppett Courtney D, Stitely Michael L, Toffle Roger C
机构信息
Magee-Womens Hospital, Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Maternal-Fetal Medicine, Pittsburgh, PA, USA.
出版信息
W V Med J. 2011 Jul-Aug;107(4):8-10.
BACKGROUND
An unruptured third trimester rudimentary horn pregnancy is rare, life threatening, and can go undetected until the onset of symptoms. Given the high risk of uterine rupture, conservative management after viability is controversial.
CASE
A 21 year-old with a 32-week rudimentary horn pregnancy, diagnosed via exploratory laparotomy five days earlier, presented with acute right upper quadrant pain. The patient underwent cesarean delivery. The rudimentary horn was noted to be intact, but so thin it was transparent.
CONCLUSION
Advanced ectopic pregnancy or rudimentary horn pregnancy should be considered in cases of unusual or undiagnosed abdominal pain in pregnancy. When surgical exploration is performed, an incision allowing optimal visualization and exposure is recommended.
背景
妊娠晚期未破裂的残角子宫妊娠罕见、危及生命，且在症状出现前可能未被发现。鉴于子宫破裂风险高，胎儿存活后保守治疗存在争议。
病例
一名21岁女性，孕32周，5天前经剖腹探查诊断为残角子宫妊娠，现出现急性右上腹疼痛。患者接受了剖宫产。发现残角子宫完整，但薄如透明。
结论
妊娠期间出现异常或未确诊的腹痛时，应考虑晚期宫外孕或残角子宫妊娠。进行手术探查时，建议做一个能实现最佳视野和暴露的切口。
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