Boukhanni Lahcen, Ait Benkaddour Yassir, Bassir Ahlam, Aboulfalah Abdrahim, Asmouki Hamid, Soummani Abderraouf
Department of Obstetrics and Gynecology, University Hospital of Marrakesh, Cadi Ayyad University, 40 000 Marrakesh, Morocco ; Department of Obstetrics & Gynecology, Mother and Child Hospital, Mohammed VI University Hospital, Cadi Ayyad University, School of Medicine, 40 000 Marrakesh, Morocco.
Department of Obstetrics and Gynecology, University Hospital of Marrakesh, Cadi Ayyad University, 40 000 Marrakesh, Morocco.
Case Rep Obstet Gynecol. 2014;2014:893935. doi: 10.1155/2014/893935. Epub 2014 Mar 18.
Intramyometrial pregnancy is a rare form of ectopic pregnancy. It makes a diagnostic and therapeutic challenge. If misdiagnosed the intramyometrial pregnancy can cause a uterine rupture and become life-threatening condition. We report a case of intramyometrial pregnancy in twin pregnancy following IVF with spontaneous abortion of the first twin At 9 weeks of gestation. The 10 weeks scan showed a normal fetus which was described to be highly localized in the uterus but the diagnosis of intramyometrial pregnancy was not suspected. The patient was admitted at 14 weeks of gestation with pelvic pain, hemorrhage, and shock. She was operated and the diagnosis of ruptured intramyometrial pregnancy was done and managed conservatively. This case illustrates the diagnostic difficulties of intramyometrial pregnancy. We discuss pathophysiology, diagnosis, and treatment of this exceptional form of ectopic pregnancy.
子宫肌层内妊娠是一种罕见的异位妊娠形式。它带来了诊断和治疗方面的挑战。如果误诊，子宫肌层内妊娠可能导致子宫破裂并成为危及生命的状况。我们报告一例体外受精后双胎妊娠中的子宫肌层内妊娠病例，其中第一胎在妊娠9周时自然流产。妊娠10周时的超声检查显示一个正常胎儿，其位置高度局限于子宫内，但当时并未怀疑子宫肌层内妊娠的诊断。该患者在妊娠14周时因盆腔疼痛、出血和休克入院。她接受了手术，诊断为子宫肌层内妊娠破裂，并进行了保守治疗。该病例说明了子宫肌层内妊娠的诊断困难。我们讨论了这种特殊形式异位妊娠的病理生理学、诊断和治疗。
