Hernández Núñez Jónathan, Abreu Díaz Alexander, Michael Ndwambi Ndivhuwo, Martínez Fermín Luis
Departamento de Obstetricia y Ginecología, Hospital Tshilidzini, Thohoyandou, Limpopo, Sudáfrica. Address: Phundamaria Main Road, Shayandima, Thohoyandou 0945, Limpopo, Sudáfrica. Email:
Departamento de Cirugía General, Hospital Tshilidzini, Thohoyandou, Limpopo, Sudáfrica.
Medwave. 2017 Jul 17;17(6):e7000. doi: 10.5867/medwave.2017.06.7000.
Secondary abdominal ectopic pregnancy is rare in clinical practice, but may lead to an increased maternal mortality. We present the case of a patient with an abdominal pregnancy secondary to a uterine perforation caused by a voluntary attempt to interrupt pregnancy that presented with nine weeks of abdominal pain and minimal vaginal bleeding which was mistakenly diagnosed as acute pelvic inflammatory disease, urinary tract infection, and post-abortion products of conception. Finally, the abdominal ultrasound test found an abdominal ectopic pregnancy. An exploratory laparotomy was performed and the fetus and placenta were removed without difficulties with a favorable postoperative course. It was concluded that uterine perforation during curettage of the cavity went unnoticed, leading to secondary abdominal implantation of pregnancy with a inconclusive clinical presentation, where ultrasound plays a fundamental diagnostic role. Laparotomy is indicated in most of these cases.
继发性腹腔异位妊娠在临床实践中较为罕见,但可能导致孕产妇死亡率增加。我们报告一例因自愿终止妊娠导致子宫穿孔继发腹腔妊娠的患者,该患者出现了9周的腹痛和少量阴道出血,最初被误诊为急性盆腔炎、尿路感染和流产后妊娠产物残留。最终,腹部超声检查发现腹腔异位妊娠。随后进行了剖腹探查术,顺利取出胎儿和胎盘,术后恢复良好。结论是刮宫时子宫穿孔未被察觉,导致妊娠继发腹腔着床,临床表现不明确,超声在其中发挥了重要的诊断作用。大多数此类病例需要进行剖腹探查术。