Xie Qi-Jun, Li Xin, Ni Dan-Yu, Ji Hui, Zhao Chun, Ling Xiu-Feng
Department of Reproductive Medicine, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, Jiangsu Province, China.
World J Clin Cases. 2022 Mar 26;10(9):2871-2877. doi: 10.12998/wjcc.v10.i9.2871.
Intramural pregnancy is a rare type of ectopic pregnancy, which is diagnosed by transvaginal ultrasound and magnetic resonance imaging. Management strategies vary depending on the site of the pregnancy, the gestational age and the desire to maintain fertility. The incidence of intramural pregnancy in assisted reproductive technology is higher than that in natural pregnancy.
We present a case of intramural pregnancy after fertilization and elective single embryo transfer following salpingectomy. The patient was completely asymptomatic and her serum β-human chorionic gonadotropin level increased from 290 mIU/mL to 1759 mIU/mL. Three-dimensional transvaginal ultrasound indicated a heterogeneous echogenic mass arising from the uterine fundus which was surrounded by myometrium and a slender and extremely hypoechoic area stretching to the uterine cavity which was thought to be a fistulous tract. Therefore, we considered a diagnosis of intramural pregnancy and laparoscopic surgery was conducted at 7 wk gestation.
Early diagnosis and treatment of intramural pregnancy is significant for maintaining fertility.
子宫肌壁间妊娠是一种罕见的异位妊娠类型,通过经阴道超声和磁共振成像进行诊断。治疗策略因妊娠部位、孕周以及保留生育能力的意愿而异。辅助生殖技术中子宫肌壁间妊娠的发生率高于自然妊娠。
我们报告一例输卵管切除术后受精并选择性单胚胎移植后发生子宫肌壁间妊娠的病例。患者完全无症状,其血清β-人绒毛膜促性腺激素水平从290 mIU/mL升至1759 mIU/mL。经阴道三维超声显示子宫底部有一不均匀回声团块,被肌层包绕,且有一细长且极低回声区延伸至子宫腔,考虑为瘘管。因此,我们考虑诊断为子宫肌壁间妊娠,并在妊娠7周时进行了腹腔镜手术。
子宫肌壁间妊娠的早期诊断和治疗对于保留生育能力具有重要意义。