Diakosavvas Michail, Blontzos Nikolaos, Daskalakis Georgios, Protopapas Athanasios, Kathopoulis Nikolaos, Antsaklis Panagiotis, Derdelis Grigorios, Angelou Kyveli, Fasoulakis Zacharias, Loutradis Dimitrios, Theodora Marianna
1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, 80 Vasilissis Sofias Avenue, 11528 Athens, Greece.
Department of Obstetrics and Gynecology, Mitera Hospital, 6 Erythrou Stavrou Street, 15123, Marousi, Athens, Greece.
Case Rep Obstet Gynecol. 2020 Sep 2;2020:8892273. doi: 10.1155/2020/8892273. eCollection 2020.
. The coexistence of an intrauterine pregnancy and an ectopic pregnancy (heterotopic pregnancy) is an extremely rare, yet major, complication during pregnancy. The early diagnosis of a heterotopic pregnancy is of great importance for fetal viability, maternal safety, and the progression of an uncomplicated intrauterine pregnancy. . We report a case of a naturally conceived heterotopic tubal pregnancy in a 37-year-old primigravida. The patient presented with continuous, dull, lower abdominal pain and a positive urine pregnancy test which was conducted a week prior to the start of the pain. The patient was hospitalized, and based on the clinical image and after strict monitoring, she was diagnosed with a heterotopic pregnancy. She was treated with laparoscopic salpingectomy after the rupture of the ectopic pregnancy while the desired intrauterine gestation continued without any complications. The pregnancy resulted in the birth of a healthy infant through vaginal delivery. . Strict monitoring with multiple sonographic evaluations should always be conducted in women with abnormal serum beta-hCG, adnexal abnormalities, or clinical symptoms, while heterotopic pregnancy should be in differential diagnosis and treatment should not be delayed since emerge management is important for the progression of the intrauterine pregnancy.
宫内妊娠与异位妊娠(异位妊娠)并存是妊娠期极为罕见但严重的并发症。早期诊断异位妊娠对于胎儿存活、母体安全以及未并发的宫内妊娠进展至关重要。我们报告一例37岁初产妇自然受孕的输卵管异位妊娠病例。患者出现持续性钝痛的下腹部疼痛,在疼痛开始前一周进行的尿妊娠试验呈阳性。患者入院,根据临床表现并经过严格监测,被诊断为异位妊娠。异位妊娠破裂后,她接受了腹腔镜输卵管切除术,而期望的宫内妊娠继续进行且无任何并发症。此次妊娠通过阴道分娩诞下一名健康婴儿。对于血清β - hCG异常、附件异常或有临床症状的女性,应始终进行多次超声评估的严格监测,而异位妊娠应进行鉴别诊断,且治疗不应延迟,因为及时处理对于宫内妊娠的进展很重要。