Mittal Shweta, Shekhar Bhawani
Centre of IVF and Human Reproduction, Department of Obstetrics and Gynaecology, Sir Gangaram Hospital, New Delhi, IND.
Cureus. 2021 Nov 5;13(11):e19280. doi: 10.7759/cureus.19280. eCollection 2021 Nov.
The purpose of the present report is to highlight the challenges in diagnosing interstitial ectopic pregnancy and to describe its management by laparoscopic cornuostomy. A 28-year-old gravida 3, para 1 woman was referred to us at 12 weeks period of gestation after failed medical termination following a diagnosis of missed abortion. On presenting to us, a large interstitial ectopic pregnancy was diagnosed by ultrasonography and managed by laparoscopic cornuostomy. Intra myometrial vasopressin and purse string sutures at the base of ectopic pregnancy bulge were used to reduce intra-operative bleeding. Intra-operative blood loss was 50 ml. Patient was discharged after two days of surgery. Interstitial pregnancy may be misdiagnosed as an intrauterine pregnancy, due to lack of suspicion and expertise. Large interstitial ectopic pregnancies can be successfully managed by a conservative surgical approach such as laparoscopic cornuostomy instead of cornual resection or hysterectomy.
本报告的目的是强调诊断间质部异位妊娠的挑战，并描述通过腹腔镜子宫角造口术对其进行的处理。一名28岁、孕3产1的妇女在诊断为稽留流产后药物流产失败，于妊娠12周时转诊至我院。就诊时，经超声检查诊断为巨大间质部异位妊娠，并通过腹腔镜子宫角造口术进行处理。在异位妊娠隆起底部的子宫肌层内注射血管加压素并使用荷包缝合以减少术中出血。术中失血50毫升。患者术后两天出院。由于缺乏怀疑和专业知识，间质部妊娠可能被误诊为宫内妊娠。巨大间质部异位妊娠可通过腹腔镜子宫角造口术等保守手术方法成功处理，而非子宫角切除术或子宫切除术。
