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残角子宫非交通性妊娠中的异位妊娠:成功药物治疗1例及文献复习

Ectopic Pregnancy in a Non-communicating Rudimentary Uterine Horn: A Case of Successful Medical Management and Literature Review.

作者信息

Harpey Amelie M, McNierney Bridget P, O'Connell Alexis A, Lingo Emily G, Wood Ellen G

机构信息

Obstetrics and Gynecology, Philadelphia College of Osteopathic Medicine, Philadelphia, USA.

Obstetrics and Gynecology, Hospital Corporation of America (HCA) East Florida, Fort Lauderdale, USA.

出版信息

Cureus. 2024 Oct 19;16(10):e71856. doi: 10.7759/cureus.71856. eCollection 2024 Oct.

Abstract

A non-communicating rudimentary uterine horn is a Müllerian abnormality that manifests due to abnormal Müllerian duct development. This abnormality is associated with endometriosis, infertility, and pregnancy complications, including ectopic pregnancy, abnormal fetal presentation, abruption, increased fetal mortality and morbidity, preterm rupture of membranes, preterm birth, intrauterine growth restriction, and uterine rupture. If pregnancy does occur, there is a high risk of complications, most notably rupture of the rudimentary horn. For this reason, such pregnancies are managed similarly to an ectopic pregnancy with either administration of methotrexate, laparoscopic removal, or a combination of both. This article describes a case of a pregnancy in a previously diagnosed, non-communicating rudimentary uterine horn that was managed medically. We aim to explore the need for early identification of rudimentary uterine horns and the management of pregnancy in these individuals.

摘要

非交通性残角子宫是一种苗勒管异常,由于苗勒管发育异常而表现出来。这种异常与子宫内膜异位症、不孕和妊娠并发症有关,包括异位妊娠、胎位异常、胎盘早剥、胎儿死亡率和发病率增加、胎膜早破、早产、胎儿宫内生长受限和子宫破裂。如果确实发生妊娠,并发症风险很高,最显著的是残角子宫破裂。因此,此类妊娠的处理方式与异位妊娠相似,可采用甲氨蝶呤治疗、腹腔镜切除或两者结合。本文描述了一例先前诊断为非交通性残角子宫的妊娠病例,该病例采用药物治疗。我们旨在探讨早期识别残角子宫的必要性以及这些个体妊娠的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8c0/11572001/5280021c8a0b/cureus-0016-00000071856-i01.jpg

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