Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Tao-Yuan, Taiwan.
J Minim Invasive Gynecol. 2013 Jan-Feb;20(1):123-6. doi: 10.1016/j.jmig.2012.08.783.
Intramural pregnancy is a rare form of ectopic pregnancy, wherein the fetus is implanted within the myometrium, separate from the endometrial cavity. In the early reported cases, a diagnosis was only possible after an operation for uterine rupture; however, recent developments in ultrasonography and magnetic resonance imaging assist in early diagnosis. Early diagnosis prevents potential life-threatening hemorrhage and preserves fertility. Both medical therapy and surgery are used to treat intramural pregnancy: surgery is often performed via laparotomy and includes hysterectomy. Here, we report the first case of successfully combining hysteroscopy and laparoscopy in the early diagnosis and management of intramural pregnancy. Our experience reveals that the minimally invasive procedure is safe and effective in select cases where advanced endoscopic expertise is available.
子宫壁内妊娠是一种罕见的异位妊娠形式，胎儿植入子宫肌层，与子宫内膜腔分离。在早期报道的病例中，只有在进行子宫破裂手术后才能做出诊断；然而，超声和磁共振成像的最新发展有助于早期诊断。早期诊断可防止潜在的危及生命的出血并保留生育能力。子宫壁内妊娠的治疗方法包括药物治疗和手术治疗：手术通常通过剖腹手术进行，包括子宫切除术。在这里，我们报告了首例成功结合宫腔镜和腹腔镜诊断和治疗子宫壁内妊娠的病例。我们的经验表明，在具备先进内镜专业知识的情况下，对于选择的病例，这种微创方法是安全有效的。
