Fouedjio Jeanne Hortence, Fouelifack Florent Ymele, Fouogue Jovanny Tsuala, Sando Zacharie
Obstetrics and Gynecology Unit of the Yaounde Central Hospital-Cameroon ; Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1- Cameroon.
Obstetrics and Gynecology Unit of the Yaounde Central Hospital-Cameroon.
Pan Afr Med J. 2013 Nov 18;16:106. doi: 10.11604/pamj.2013.16.106.3506. eCollection 2013.
Heterotopic pregnancy is very rare under natural circumstances. We report the case of a 28 year old Gravida2 Para1001 woman at 9 weeks of pregnancy who consulted in emergency for acute pelvic pain following metrorrhagia. Physical exam revealed hemoperitoneum without shock. An emergency ultrasonography revealed two gestational sacs, one intra-uterine and the other extra-uterine. Laparotomy was done and the findings were: a ruptured right tubal pregnancy with 1,300 milliliters of hemoperitoneum, type B left utero-adnexal adhesions and an increased uterus consistent with a 9 weeks pregnancy. Right total salpingectomy was done and the patient did well postoperatively. That intrauterine pregnancy evolved normally under progesterone supply and the woman delivered a termed live female baby weighing 3.1 kilogrammes. In our context where ultrasound is not always available, practitioners carrying out salpingectomy for ruptured ectopic pregnancies should bear in mind the plausibleness of heterotopic pregnancy in order to properly handle the uterus.
异位妊娠在自然情况下非常罕见。我们报告一例28岁、孕2产1001的女性，妊娠9周，因出血后急性盆腔疼痛前来急诊。体格检查发现腹腔积血但无休克。急诊超声检查发现两个妊娠囊，一个在子宫内，另一个在子宫外。进行了剖腹手术，结果如下：右侧输卵管妊娠破裂，腹腔积血1300毫升，左侧子宫附件B型粘连，子宫增大与妊娠9周相符。行右侧输卵管全切术，患者术后恢复良好。宫内妊娠在补充孕激素的情况下正常进展，该女性分娩了一名足月活女婴，体重3.1千克。在我们这种并非总能进行超声检查的情况下，为破裂异位妊娠实施输卵管切除术的医生应牢记存在异位妊娠的可能性，以便正确处理子宫。
