Chatziioannidou Kyriaki, Fehlmann Aurore, Dubuisson Jean
Department of Paediatrics, Gynaecology, and Obstetrics, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Front Surg. 2020 Nov 2;7:582954. doi: 10.3389/fsurg.2020.582954. eCollection 2020.
Ectopic pregnancy in a non-communicating rudimentary uterine horn is a rare gynecological condition associated with a high risk of uterine rupture and important maternal mortality and morbidity. A surgical excision of the rudimentary horn is the standard treatment, usually performed by laparotomy in the second trimester. A 36-year-old woman, secundigravida and nulliparous, was admitted to the emergency obstetric unit with acute pelvic pain. The ultrasound found an ectopic pregnancy at 15 weeks gestational age with fetal cardiac activity. As her hemodynamic status was stable, a diagnostic laparoscopy was performed and confirmed the development of the pregnancy in a left rudimentary uterine horn. We report a total laparoscopic removal of a pre-ruptured rudimentary uterine horn containing a second trimester ectopic pregnancy, using a vessel-sealer device. To our knowledge, only three other cases of successful laparoscopic treatment of second trimester rudimentary horn pregnancies have been reported in the literature. Laparoscopy is an efficient and safe surgical option for treating rudimentary horn second trimester pregnancy in patients with hemodynamic stability.
残角子宫妊娠且残角子宫不通是一种罕见的妇科疾病，与子宫破裂的高风险以及严重的孕产妇死亡率和发病率相关。残角子宫切除术是标准治疗方法，通常在孕中期通过剖腹手术进行。一名36岁的经产妇、未产妇因急性盆腔疼痛入住产科急诊病房。超声检查发现妊娠15周，有胎心搏动，为异位妊娠。由于其血流动力学状态稳定，遂进行诊断性腹腔镜检查，证实妊娠位于左侧残角子宫。我们报告了一例使用血管闭合器通过全腹腔镜切除含有孕中期异位妊娠的未破裂残角子宫的病例。据我们所知，文献中仅报道了另外三例成功的腹腔镜治疗孕中期残角子宫妊娠的病例。对于血流动力学稳定的患者，腹腔镜检查是治疗孕中期残角子宫妊娠的一种有效且安全的手术选择。
