Department of Obstetrics and Gynaecology, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Department of Obstetrics and Gynaecology, Klerksdorp Hospital, Klerksdorp, South Africa.
Afr Health Sci. 2020 Dec;20(4):1895-1897. doi: 10.4314/ahs.v20i4.47.
It is uncommon to find ampullary tubal pregnancy in the second trimester.
A 35-year-old G4P3 at 16 gestational weeks presented with a day history of sudden severe lower abdominal pain and no vaginal bleeding. The patient had a normal pulse of 82/minutes, haemoglobin concentration of 6.3 g/dl and ultrasonography showed an empty uterus with an alive fetus in the right adnexa. She was provisionally diagnosed to have an abdominal pregnancy.
The patient had an emergency laparotomy where 2.2 L of haemoperitoneum and a slow-leaking right ampullary tubal pregnancy were found. Right total salpingectomy was performed and she had an uncomplicated post-operative follow-up. Histology of the lesion confirmed tubal pregnancy.
The growth of a pregnancy in the ampulla beyond the first trimester is possibly due to increased thickness and or distensibility of the fallopian tube. A tubal pregnancy may present with a normal pulse despite significant haemorrhage.
在妊娠中期，罕见壶腹部输卵管妊娠。
一位 35 岁，G4P3 的患者，孕 16 周，突发下腹剧烈疼痛 1 天，无阴道流血。脉搏 82 次/分，血红蛋白浓度 6.3g/dl，超声显示子宫空虚，右侧附件区有存活胎儿。患者被诊断为腹腔妊娠。
患者行剖腹探查术，术中发现 2.2L 血腹和缓慢渗漏的右侧壶腹部输卵管妊娠。行右侧输卵管全切除术，术后恢复良好。病变组织学证实为输卵管妊娠。
妊娠在壶腹部的生长超过了第一个三个月，可能是由于输卵管的厚度和/或伸展性增加。尽管有大量出血，输卵管妊娠的脉搏仍可能正常。
