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腹腔镜手术成功治疗非交通性残角子宫妊娠:病例报告及文献综述

Successful Management of a Noncommunicating Rudimentary Uterine Horn Pregnancy by Laparoscopic Surgery: A Case Report and Literature Review.

作者信息

Isono Wataru, Tsuchiya Akira, Honda Michiko, Saito Ako, Tsuchiya Hiroko, Matsuyama Reiko, Fujimoto Akihisa, Nishii Osamu

机构信息

Department of Obstetrics and Gynecology, University Hospital Mizonokuchi, Teikyo University School of Medicine, Kawasaki, Japan.

出版信息

Gynecol Minim Invasive Ther. 2022 Feb 14;11(1):7-16. doi: 10.4103/GMIT.GMIT_157_20. eCollection 2022 Jan-Mar.

Abstract

Pregnancy in a noncommunicating rudimentary horn is extremely rare but can cause serious clinical complications, such as uterine rupture. The standard treatment is excision of the rudimentary horn, and recently, in some cases, laparoscopic resection has been performed in the first trimester of gestation. Herein, we present a case of noncommunicating rudimentary horn pregnancy (NCRHP), which was diagnosed by magnetic resonance imaging at 6 weeks of gestation and treated by laparoscopic surgery. However, we have also found some rare cases in which patients could obtain live newborn babies. Since management is affected by the different levels of obstetric medical care and diagnostic tools, we also performed a review and analysis of NCRHP. A PubMed search yielded 103 cases reported in the English literature. Correct diagnosis and laparoscopic treatment were achieved more frequently in developed countries, especially in the first trimester of gestation. On the other hand, symptoms, including abdominal pain and hypovolemic shock, tended to occur in the second trimester of gestation. This period was also found to be a risk factor for uterine rupture. Among 18 patients at the third trimester of gestation, 13 obtained live neonatal infants. Therefore, detailed information about this disease is crucial for proper treatments.

摘要

残角子宫妊娠极为罕见,但可导致严重的临床并发症,如子宫破裂。标准治疗方法是切除残角子宫,最近,在某些情况下,已在妊娠早期进行腹腔镜切除。在此,我们报告一例残角子宫妊娠(NCRHP),在妊娠6周时通过磁共振成像诊断,并接受了腹腔镜手术治疗。然而,我们也发现了一些罕见病例,患者产下了活产新生儿。由于管理受到产科医疗护理水平和诊断工具的不同影响,我们还对NCRHP进行了综述和分析。PubMed搜索得出英文文献中报道的103例病例。在发达国家,尤其是在妊娠早期,更常实现正确诊断和腹腔镜治疗。另一方面,包括腹痛和低血容量性休克在内的症状往往在妊娠中期出现。这一时期也被发现是子宫破裂的危险因素。在18例妊娠晚期患者中,13例产下了活产新生儿。因此,关于这种疾病的详细信息对于恰当治疗至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e5a/8926057/82321f659b34/GMIT-11-7-g001.jpg

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