Lin M M, Ge Y M, Yang S, Yang R, Li R
Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetric and Gynecologic Diseases, Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China.
Zhonghua Fu Chan Ke Za Zhi. 2024 Jan 25;59(1):49-55. doi: 10.3760/cma.j.cn112141-20231112-00184.
To investigate the clinical characteristics, treatments and fertility recovery of rudimentary horn pregnancy (RHP). The clinical data of 12 cases with RHP diagnosed and treated in Peking University Third Hospital from January 1, 2010 to December 31, 2022 were retrospectively analyzed. Clinical informations, diagnosis and treatments of RHP and the pregnancy status after surgery were analyzed. The median age of 12 RHP patients was 29 years (range: 24-37 years). Eight cases of pregnancy in residual horn of uterus occurred in type Ⅰ residual horn of uterus, 4 cases occurred in type Ⅱ residual horn of uterus; among which 5 cases were misdiagnosed by ultrasound before surgery. All patients underwent excision of residual horn of uterus and affected salpingectomy. After surgery, 9 patients expected future pregnancy, and 3 cases of natural pregnancy, 2 cases of successful pregnancy through assisted reproductive technology. Four pregnancies resulted in live birth with cesarean section, and 1 case resulted in spontaneous abortion during the first trimester of pregnancy. No uterine rupture or ectopic pregnancy occurred in subsequent pregnancies. Ultrasonography could aid early diagnosis of RHP while misdiagnosis occurred in certain cases. Thus, a comprehensive judgment and decision ought to be made based on medical history, physical examination and assisted examination. Surgical exploration is necessary for diagnosis and treatment of RHP. For infertile patients, assisted reproductive technology should be applied when necessary. Caution to prevent the occurrence of pregnancy complications such as uterine rupture, and application of cesarean section to terminate pregnancy are recommended.
探讨残角子宫妊娠(RHP)的临床特征、治疗方法及生育恢复情况。回顾性分析2010年1月1日至2022年12月31日在北京大学第三医院诊断并治疗的12例RHP患者的临床资料。分析RHP的临床信息、诊断、治疗及术后妊娠情况。12例RHP患者的中位年龄为29岁(范围:24 - 37岁)。子宫残角妊娠8例发生于Ⅰ型子宫残角,4例发生于Ⅱ型子宫残角;其中5例术前超声误诊。所有患者均行子宫残角切除术及患侧输卵管切除术。术后9例患者期望未来妊娠,3例自然妊娠,2例通过辅助生殖技术成功妊娠。4例妊娠经剖宫产分娩活婴,1例在妊娠早期自然流产。后续妊娠未发生子宫破裂或异位妊娠。超声检查有助于RHP的早期诊断,但部分病例存在误诊。因此,应根据病史、体格检查及辅助检查进行综合判断并决策。手术探查对RHP的诊断和治疗是必要的。对于不孕患者,必要时应应用辅助生殖技术。谨慎预防子宫破裂等妊娠并发症的发生,建议应用剖宫产终止妊娠。