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三例间质部妊娠经局部注射氯化钾成功治疗:避免了潜在的子宫角部造口术。

Successful management of three cases of interstitial pregnancies with local instillation of potassium chloride: avoiding a potential cornuostomy.

作者信息

Shetty Vineetha, Padavagodu Shivananda Roopa, Vasudeva Akhila, Shetty Jyothi

机构信息

Obstetrics and Gynecology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Obstetrics and Gynecology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India

出版信息

BMJ Case Rep. 2021 Mar 23;14(3):e239918. doi: 10.1136/bcr-2020-239918.

Abstract

Here, we present three cases of women with interstitial pregnancy who were managed with local instillation of potassium chloride. These women were in their 20s-30s and presented in stable condition. Of them, two had a history of previous ectopic pregnancy. Interstitial pregnancy was diagnosed by transvaginal sonography which showed an empty uterine cavity with a gestational sac 1 cm away from the lateral edge of the uterine cavity, with <5 mm myometrium surrounding it in all planes. Two of the three cases failed to respond to methotrexate injection. Due to the presence of high-end ultrasound machine and technical expertise, local instillation of potassium chloride was offered as an alternative to surgical treatment, which is definitive, and all three patients had a successful outcome. One patient returned with pain in the abdomen, which required inpatient monitoring and was later diagnosed with urinary tract infection and was given appropriate antibiotics.

摘要

在此,我们呈现三例间质部妊娠女性患者,她们接受了氯化钾局部注射治疗。这些女性年龄在20多岁至30多岁之间,就诊时情况稳定。其中两人有过异位妊娠史。经阴道超声检查诊断为间质部妊娠,显示子宫腔空虚,妊娠囊距子宫腔外侧边缘1厘米,各平面均有<5毫米的肌层包绕。三例中有两例对甲氨蝶呤注射无反应。由于拥有高端超声设备和技术专长,提供了氯化钾局部注射作为手术治疗的替代方案,手术治疗是确定性的,所有三名患者均取得了成功的治疗结果。一名患者因腹痛复诊,需要住院监测,后来被诊断为尿路感染,并给予了适当的抗生素治疗。

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Current diagnosis and treatment of interstitial pregnancy.当前的间质部妊娠的诊断与治疗。
Am J Obstet Gynecol. 2010 Jan;202(1):15-29. doi: 10.1016/j.ajog.2009.07.054.
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Ultrasound Obstet Gynecol. 2008 Mar;31(3):245-51. doi: 10.1002/uog.5277.
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