Department of Obstetrics and Gynecology and the Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Obstet Gynecol. 2023 Nov 1;142(5):1244-1247. doi: 10.1097/AOG.0000000000005312. Epub 2023 Aug 10.
An intramyometrial pregnancy is a rare form of ectopic pregnancy, making up an estimated 1% of all ectopic pregnancies. Previously described management options have included surgical excision in the emergency setting.
A 32-year-old woman, gravida 4 para 0, at 6 0/7 weeks of gestation by last menstrual period, was noted to have a gestational sac implanted entirely within the uterine myometrium. Ultrasonography and magnetic resonance imaging confirmed the presence of an intramyometrial ectopic pregnancy within a septate uterus. The patient's abnormal pregnancy was successfully treated with multidose methotrexate.
Intramyometrial pregnancy is a rare entity that should be considered when it is suggested by ultrasonography or if an intrauterine pregnancy is surgically inaccessible from the endometrial cavity. In a stable patient, multidose systemic methotrexate may be a feasible management strategy.
子宫肌层妊娠是一种罕见的异位妊娠形式，约占所有异位妊娠的 1%。之前描述的治疗选择包括在紧急情况下进行手术切除。
一名 32 岁妇女，末次月经周期为 6 周零 7 天，妊娠 4 次，产 0 次，超声检查和磁共振成像均提示子宫纵隔内有子宫肌层妊娠。患者的异位妊娠采用多次甲氨蝶呤成功治疗。
子宫肌层妊娠是一种罕见的疾病，当超声检查提示或宫内妊娠无法从子宫内膜腔进入时，应考虑这种疾病。对于稳定的患者，多次全身甲氨蝶呤可能是一种可行的治疗策略。
