Teyib Roughaya, Kassou Oumaima, Zeraidi Najia, Lakhdar Amina, Baidada Aziz
Gynecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco.
Ann Med Surg (Lond). 2024 Jul 18;86(9):5492-5496. doi: 10.1097/MS9.0000000000002194. eCollection 2024 Sep.
Interstitial pregnancy is rare and exhibit a mortality rate notably higher than that observed in other types of ectopic pregnancies.
The authors report a 38-year-old female admitted for a hemorrhagic shock. She was 10 weeks pregnant. The suspicion of a ruptured ectopic pregnancy arose based on amenorrhea accompanied by abdominal pain and a pelvic ultrasound showing an empty uterus and abundant free fluid in the abdomen. Emergent exploratory laparotomy was indicated by hemodynamic instability, revealing a ruptured left interstitial ectopic pregnancy.
The use of three-dimensional ultrasonographic imaging specially in the first trimester improves the rate for early detection. The medical or surgical management of an interstitial pregnancy depends on the patient's hemodynamic stability considering the rupture of the pregnancy.
Interstitial pregnancy is linked to elevated morbidity. Early diagnosis and adequate management both can avoid its catastrophic outcomes.
间质部妊娠较为罕见,其死亡率显著高于其他类型的异位妊娠。
作者报告了一名38岁因失血性休克入院的女性。她怀孕10周。基于闭经伴腹痛以及盆腔超声显示子宫空虚且腹腔内有大量游离液体,怀疑为异位妊娠破裂。血流动力学不稳定提示需紧急进行剖腹探查术,术中发现左侧间质部异位妊娠破裂。
特别是在孕早期使用三维超声成像可提高早期检测率。间质部妊娠的药物或手术治疗取决于考虑到妊娠破裂时患者的血流动力学稳定性。
间质部妊娠与发病率升高有关。早期诊断和适当治疗均可避免其灾难性后果。