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发展中国家一家区级医院的未诊断出的腹腔妊娠:一个奇迹般的婴儿。

Undiagnosed Term Abdominal Pregnancy in a District-Level Hospital of a Developing Country: A Miracle Baby.

作者信息

Than Win Win, Binti Pg Baharuddin Dg Marshitah, Hossain Parash M Tanveer, Mra Aung

机构信息

Obstetrics and Gynaecology Unit, Faculty of Medicine, AIMST University (Asian Institute of Medicine, Science and Technology), Bedong, MYS.

Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MYS.

出版信息

Cureus. 2023 Feb 17;15(2):e35092. doi: 10.7759/cureus.35092. eCollection 2023 Feb.

Abstract

Term abdominal pregnancy is a sporadic ectopic pregnancy associated with high maternal and perinatal morbidity and mortality. As symptoms are non-specific and resemble those of other ectopic pregnancies, early diagnosis is the major challenge in poor health setups. A 24-year-old primigravida at 38 weeks gestation was planned to undergo a cesarean section for the transverse lie. Abdominal pregnancy was accidentally discovered during the cesarean section, and a healthy, normal baby boy was delivered. The placenta was attached to the greater omentum, so its removal required omentectomy without compromising the blood supply to the bowels. Both patient and her baby boy were discharged on the seventh day without complications. No congenital anomalies were detected in the baby. In a term abdominal pregnancy, the most significant challenges are the control of bleeding and the decision on placenta removal, followed by prompt delivery of the fetus. Therefore, along with the gynecologist, the availability of trained personnel, such as anesthetists, pediatricians, and general surgeons, is necessary for a successful management outcome.

摘要

足月腹腔妊娠是一种散发性异位妊娠,与孕产妇和围产期的高发病率及死亡率相关。由于症状不具特异性且与其他异位妊娠相似,在医疗条件较差的地区,早期诊断是一项重大挑战。一名孕38周的24岁初产妇因横位计划行剖宫产。剖宫产时意外发现为腹腔妊娠,随后娩出一名健康、正常的男婴。胎盘附着于大网膜,因此其切除需要行网膜切除术,同时不影响肠道血供。患者及其男婴均在术后第七天出院,无并发症。婴儿未检测到先天性异常。在足月腹腔妊娠中,最显著的挑战是控制出血和决定胎盘的去除,其次是及时娩出胎儿。因此,除了妇科医生外,还需要有训练有素的人员,如麻醉师、儿科医生和普通外科医生,才能取得成功的治疗结果。

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