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保守治疗与计划性手术治疗可存活的晚期宫外腹腔妊娠并取得良好结局:两例报告

Conservative Management and Planned Surgery for Periviable Advanced Extrauterine Abdominal Pregnancy with Favorable Outcome: Report of Two Cases.

作者信息

Harirah Hassan M, Smith J Michael, Dixon C Luke, Hankins Gary D V

机构信息

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, Texas.

The University of Texas Medical Branch at Galveston, Galveston, Texas.

出版信息

AJP Rep. 2016 Jul;6(3):e301-8. doi: 10.1055/s-0036-1588003.

Abstract

Advanced abdominal pregnancy is an extremely rare condition that poses diagnostic and management challenges. A high index of suspicion and careful assessment of the patient's symptoms, supplemented with obstetric ultrasound, and magnetic resonance imaging, are crucial for timely diagnosis and management to prevent life-threatening complications. The presence of periviable fetuses in advanced abdominal pregnancies increases the challenge to achieve a balance between maternal and fetal benefits and risks. Early diagnosis and management decisions via a multidisciplinary approach and planned delivery are of paramount importance to minimize complications and achieve favorable maternal and fetal outcomes. Even in the setting of oligohydramnios and suspected preterm premature rupture of membranes, in-patient conservative management and an individualized planned surgical approach that includes removing or leaving the placenta in place are appropriate for managing the periviable abdominal pregnancy.

摘要

晚期腹腔妊娠是一种极其罕见的情况,会带来诊断和管理方面的挑战。高度的怀疑指数以及对患者症状进行仔细评估,并辅以产科超声和磁共振成像,对于及时诊断和管理以预防危及生命的并发症至关重要。晚期腹腔妊娠中可存活胎儿的存在增加了在母体和胎儿的益处与风险之间取得平衡的挑战。通过多学科方法进行早期诊断和管理决策以及计划分娩对于将并发症降至最低并实现良好的母婴结局至关重要。即使在羊水过少和疑似胎膜早破早产的情况下,住院保守治疗以及包括移除胎盘或保留胎盘原位的个体化计划手术方法也适用于处理可存活的腹腔妊娠。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a11/5008960/5729103aab8c/10-1055-s-0036-1588003-i160045-1.jpg

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