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位置异常和角状妊娠的异位妊娠:8 例报告。

Ectopic pregnancies with unusual location and an angular pregnancy: Report of eight cases.

机构信息

Landes-Frauen- und Kinderklinik, Kinderwunschzentrum, Linz, Austria.

出版信息

Wien Klin Wochenschr. 2012 Mar;124(5-6):193-7. doi: 10.1007/s00508-011-0115-8. Epub 2012 Jan 4.

Abstract

OBJECTIVE

The increased use of assisted reproduction techniques has been accompanied by an increase in ectopic pregnancies with unusual location being associated with significant maternal morbidity and mortality. This article reports on seven cases of ectopic pregnancies with unusual location and an angular pregnancy. Diagnostic and therapeutic strategies are discussed and a brief review of literature is presented.

STUDY DESIGN

Case series of seven cases with ectopic pregnancy in unusual location, following assisted reproductive technique or conceived spontaneously (cesarean scar pregnancy and early abdominal pregnancy in mesoappendix) and an angular pregnancy, having presented at our hospital during the last eight years. Retrospective analyses.

RESULTS

Interstitial pregnancy, cornual pregnancy, cesarean scar pregnancy, early abdominal pregnancy in omentum majus, heterotopic (cervical) pregnancy, early abdominal pregnancy in mesoappendix, angular pregnancy. All patients were surgically treated.

CONCLUSION

Diagnosis of ectopic pregnancy with unusual location may be difficult, and differentiation of intact intrauterine or extrauterine pregnancy with adequate consideration of the area of uterine ostium of the fallopian tube may be delicate. Moreover, varying treatment strategies and high rates of complications aggravate the situation.

摘要

目的

辅助生殖技术的应用日益增多,随之而来的是异位妊娠的增加,而位置异常的异位妊娠与显著的母亲发病率和死亡率相关。本文报告了 7 例位置异常的异位妊娠病例,包括角状妊娠。讨论了诊断和治疗策略,并对文献进行了简要回顾。

设计

在过去 8 年中,我院收治了 7 例接受辅助生殖技术或自然受孕(剖宫产瘢痕妊娠和中阑尾早期腹部妊娠)后出现位置异常的异位妊娠病例(包括间质妊娠、宫角妊娠、剖宫产瘢痕妊娠、大网膜上的早期腹部妊娠、异位妊娠、中阑尾早期腹部妊娠、角状妊娠)的病例系列回顾性分析。

结果

间质妊娠、宫角妊娠、剖宫产瘢痕妊娠、大网膜上的早期腹部妊娠、异位妊娠、中阑尾早期腹部妊娠、角状妊娠。所有患者均接受手术治疗。

结论

位置异常的异位妊娠的诊断可能较为困难,且在充分考虑输卵管子宫口区域的情况下,对宫内或宫外妊娠的完整性进行鉴别可能较为棘手。此外,不同的治疗策略和高并发症发生率使情况更加复杂。

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