保留宫内妊娠的剖宫产瘢痕部位异位妊娠的手术治疗
Surgical Management of a Heterotopic Cesarean Scar Pregnancy With Preservation of an Intrauterine Pregnancy.
作者信息
Vetter Monica Hagan, Andrzejewski Joseph, Murnane Alan, Lang Christopher
机构信息
Department of Obstetrics and Gynecology, Wexner Medical Center, The Ohio State University, and the Department of Obstetrics and Gynecology, Mount Carmel Health System, Columbus, Ohio.
出版信息
Obstet Gynecol. 2016 Sep;128(3):613-616. doi: 10.1097/AOG.0000000000001514.
BACKGROUND
Spontaneously conceived heterotopic pregnancies are rare. A heterotopic cesarean scar pregnancy involves an intrauterine pregnancy and a second pregnancy in the cesarean scar. Treatment approaches include both medical and surgical management. We present a surgical approach to the treatment of a heterotopic cesarean scar pregnancy with preservation of an intrauterine gestation.
CASE
A 29-year-old woman, gravida 4 para 1021, presented at 5 weeks of gestation with spotting. Ultrasonography revealed a heterotopic cesarean scar pregnancy. The patient underwent resection of the ectopic pregnancy through minilaparotomy in an attempt to conserve the intrauterine pregnancy. She subsequently delivered an early-term neonate.
CONCLUSION
Laparotomy with resection of the ectopic pregnancy is an option for treatment of an early heterotopic cesarean scar pregnancy when the patient desires conservation of the intrauterine pregnancy. Excision was not associated with pregnancy complications.
背景
自然受孕的异位妊娠较为罕见。剖宫产瘢痕部位的异位妊娠是指子宫内妊娠同时合并剖宫产瘢痕处的另一妊娠。治疗方法包括药物治疗和手术治疗。我们介绍一种保留宫内妊娠的剖宫产瘢痕部位异位妊娠的手术治疗方法。
病例
一名29岁女性，孕4产1021，妊娠5周时出现点滴出血。超声检查显示为剖宫产瘢痕部位异位妊娠。患者通过小切口剖腹术切除异位妊娠，试图保留宫内妊娠。她随后分娩了一名早产新生儿。
结论
当患者希望保留宫内妊娠时，剖腹术切除异位妊娠是早期剖宫产瘢痕部位异位妊娠的一种治疗选择。切除手术未导致妊娠并发症。
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