腹腔镜治疗孕中期宫角部异位妊娠破裂并成功分娩活婴：一例报告及文献复习
Laparoscopic management of second trimester ruptured cornual heterotopic pregnancy with subsequent live birth delivery: A case report and literature review.
作者信息
Li Yi-Ling, Chuang Fei-Chi, Lan Kuo-Chung
机构信息
Department of Obstetrics and Gynecology, Jen Ai Hospital, Taichung 412, Taiwan; Department of Obstetrics and Gynecology, Chang Chung Memorial Hospital, Kaohsiung 833, Taiwan.
Department of Obstetrics and Gynecology, Chang Chung Memorial Hospital, Kaohsiung 833, Taiwan.
出版信息
Taiwan J Obstet Gynecol. 2023 Mar;62(2):363-368. doi: 10.1016/j.tjog.2022.07.013.
OBJECTIVE
Heterotopic pregnancy (HP) is the coexistence of extra- and intrauterine gestation implantation sites. A rare case of a second-trimester ruptured cornual HP (CHP) treated with laparoscopic cornual resection with the primary repair is presented. Risk factors, clinical presentations, treatments, and outcomes of CHPs are also reviewed.
CASE REPORT
A 35-year-old pregnant woman with CHP presented with lower abdominal pain with hemoperitoneum and her hemoglobin level dropped. Laparoscopic management of a ruptured HP was performed, leaving the surplus intrauterine fetus intact. She delivered a 2360 g male infant via cesarean section at 34 weeks' gestation due to preterm premature rupture of membranes. We found a well-healed wound over the left uterine cornua during the cesarean section.
CONCLUSION
Ruptured CHP is a rare but life-threatening complication of an obstetric emergency. Although the pregnant uterus becomes congested and fragile, using reliable laparoscopic energy devices and barbed sutures, successful treatment is feasible.
目的
异位妊娠（HP）是指子宫外和子宫内妊娠着床部位同时存在的情况。本文报告了一例罕见的孕中期子宫角部异位妊娠（CHP）破裂病例，采用腹腔镜下子宫角部切除术并进行一期修复治疗。同时还回顾了CHP的危险因素、临床表现、治疗方法及治疗结果。
病例报告
一名35岁的CHP孕妇因下腹痛伴腹腔内出血就诊，血红蛋白水平下降。对破裂的HP进行了腹腔镜手术治疗，保留了宫内剩余胎儿。由于胎膜早破，她在孕34周时通过剖宫产分娩了一名体重2360g的男婴。剖宫产时，我们发现子宫左角处有一个愈合良好的伤口。
结论
破裂的CHP是一种罕见但危及生命的产科急症并发症。尽管妊娠子宫会变得充血且脆弱，但使用可靠的腹腔镜能量设备和倒刺缝线，成功治疗是可行的。
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