Yamoah Kofi Kwenu, Girn Zeenie
Department of Obstetrics and Gynaecology, Harrogate District Hospital, Hull Royal Infirmary, Harrogate, North Yorkshire, UK.
BMJ Case Rep. 2012 Nov 19;2012:bcr2012006497. doi: 10.1136/bcr-2012-006497.
The coexistence of intrauterine and ectopic pregnancy (heterotopic pregnancy) occurs in 1/30,000 of spontaneous pregnancies. However, it is getting more common at 1/900 in clomiphene citrate-induced pregnancies and rises to 1% in assisted reproduction. It is a potentially life-threatening condition with diagnostic and therapeutic complexities. Our patient is a 40-year-old who has been trying to get pregnant for 3 years. A planned non-instrumentation of the uterus at laparoscopy despite clear signs of a ruptured ectopic pregnancy has given her a chance of a continuing intrauterine pregnancy. With the increasing number of in vitro fertilisation-embryo transfers, the incidence of heterotopic pregnancies is also increasing, hence issues discussed here is whether the uterus should be instrumented at all during laparoscopy in early pregnancy and misdiagnosis with its sequel.
宫内妊娠与异位妊娠（异位妊娠）并存的情况在自然妊娠中发生率为1/30000。然而，在枸橼酸氯米芬诱导的妊娠中更为常见，发生率为1/900，在辅助生殖中则升至1%。这是一种潜在的危及生命的情况，诊断和治疗都很复杂。我们的患者是一位40岁的女性，她已经尝试怀孕3年了。尽管有明确的异位妊娠破裂迹象，但在腹腔镜检查时计划不对子宫进行器械操作，这给了她继续宫内妊娠的机会。随着体外受精 - 胚胎移植数量的增加，异位妊娠的发生率也在上升，因此这里讨论的问题是在妊娠早期腹腔镜检查时是否根本就应对子宫进行器械操作以及误诊及其后果。
