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卵巢异位妊娠的医学处理:一例病例报告

Medical management of an ovarian ectopic pregnancy: a case report.

作者信息

Birge Ozer, Erkan Mustafa Melih, Ozbey Ertugrul Gazi, Arslan Deniz

机构信息

Nyala Sudan Turkey Training and Research Hospital, Department of Gynecology and Obstetrics, West Alezza District, Southern Nyala, Darfur, Sudan.

Celal Bayar University Hospital, Department of Gynecology and Obstetrics, Manisa, Turkey.

出版信息

J Med Case Rep. 2015 Dec 20;9:290. doi: 10.1186/s13256-015-0774-6.

Abstract

BACKGROUND

Primary ovarian ectopic pregnancy is a rare type of ectopic pregnancy which has an estimated prevalence ranging from 1:7000 to 1:70,000 accounting for almost 3 % of all ectopic cases. Here we report the case of a 25-year-old woman who presented to our clinic with abdominal pain, 6 weeks' delay of menstruation and 3 days of vaginal bleeding, whose transvaginal ultrasonography showed an ectopic gestational sac with yolk sac inside, in her right ovary. This case shows that early diagnosis is very important particularly in places like the Sub-Saharan region of Africa.

CASE PRESENTATION

A 25-year-old African woman was referred to our clinic with 6 weeks' delay of menstruation, frequent increasing abdominal pain and 3 days of vaginal bleeding. Her general condition was good and her vital signs were normal. She felt tenderness in an abdominal examination and had a small amount of vaginal bleeding. Transvaginal ultrasonography showed an ectopic gestational sac with yolk sac inside, in her right ovary. Our final diagnosis was ectopic ovarian pregnancy and we successfully treated her with methotrexate. After 3 weeks of methotrexate administration her beta human chorionic gonadotropin was negative and a sonographic examination was completely normal.

CONCLUSIONS

Ectopic ovarian pregnancy is a very important medical situation. It should be diagnosed in its early stages otherwise it could be life-threatening and surgical treatment may be inevitable. Because of the importance of fertility, medical treatment is an acceptable option and can be feasible with early diagnosis.

摘要

背景

原发性卵巢异位妊娠是一种罕见的异位妊娠类型,估计患病率在1:7000至1:70000之间,约占所有异位妊娠病例的3%。在此,我们报告一例25岁女性病例,该患者因腹痛、月经推迟6周及阴道出血3天前来我院就诊,经阴道超声检查显示其右卵巢内有一个包含卵黄囊的异位妊娠囊。该病例表明,早期诊断非常重要,尤其是在非洲撒哈拉以南地区等地。

病例介绍

一名25岁的非洲女性因月经推迟6周、腹痛频繁加剧及阴道出血3天被转诊至我院。她的一般情况良好,生命体征正常。腹部检查时有压痛,并有少量阴道出血。经阴道超声检查显示其右卵巢内有一个包含卵黄囊的异位妊娠囊。我们最终诊断为卵巢异位妊娠,并成功地用甲氨蝶呤对她进行了治疗。甲氨蝶呤给药3周后,她的β人绒毛膜促性腺激素呈阴性,超声检查完全正常。

结论

卵巢异位妊娠是一种非常重要的医学情况。应在早期进行诊断,否则可能危及生命,手术治疗可能不可避免。由于生育的重要性,药物治疗是一种可接受的选择,且早期诊断时可行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b91/4684938/cd87b6a28bb0/13256_2015_774_Fig1_HTML.jpg

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