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腹腔镜手术治疗宫角部异位妊娠破裂的替代方案

Laparoscopic surgical alternative in the treatment of ruptured cornual heterotopic pregnancy.

作者信息

Herrera Castañeda Enrique, Luna Gustavo, Sejnaui Sayegh Jessica, Vacca Orrego Luisa M, Tobar Parra Juan Manuel

机构信息

Universidad del Valle Universidad del Valle Facultad de Salud Departamento de Ginecología y Obstetricia Cali Colombia.

Clínica Imbanaco Cali Colombia.

出版信息

Colomb Med (Cali). 2025 Mar 30;56(1):e5005576. doi: 10.25100/cm.v56i1.5576. eCollection 2025 Jan-Mar.

Abstract

CASE DESCRIPTION

A 35-year-old woman with a history of intrauterine device use for family planning presented with a spontaneously conceived heterotopic pregnancy.

CLINICAL FINDINGS

The patient developed a ruptured cornual ectopic pregnancy, leading to hemodynamic instability and an acute abdomen, while concurrently carrying a viable intrauterine pregnancy.

TREATMENT AND OUTCOME

A laparoscopic intervention was performed to manage the ruptured ectopic pregnancy. The surgical technique employed minimized the impact on maternal blood volume, ensuring patient stabilization and favorable progression of the intrauterine pregnancy.

CLINICAL RELEVANCE

Heterotopic pregnancy is the coexistence of gestation in two different implantation sites, both intrauterine and extrauterine. This condition is associated with significant maternal morbidity and mortality. Management remains a challenge due to the lack of consensus and limited clinical experience. The primary goal is maternal stabilization while preserving the intrauterine pregnancy whenever possible. This case highlights the importance of modern surgical strategies tailored to optimize maternal and fetal outcomes.

摘要

病例描述

一名有宫内节育器避孕史的35岁女性自然受孕后发生了异位妊娠。

临床发现

患者发生了宫角部异位妊娠破裂,导致血流动力学不稳定和急腹症,同时子宫内怀有活胎。

治疗及结果

进行了腹腔镜手术干预以处理破裂的异位妊娠。所采用的手术技术将对母体血容量的影响降至最低,确保了患者病情稳定以及子宫内妊娠的顺利进展。

临床意义

异位妊娠是指妊娠同时存在于两个不同的着床部位,即子宫内和子宫外。这种情况与严重的母体发病率和死亡率相关。由于缺乏共识且临床经验有限,治疗仍然是一项挑战。主要目标是在尽可能保留子宫内妊娠的同时使母体病情稳定。本病例凸显了采用现代手术策略以优化母婴结局的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/709d/12097782/a75ad0ed3175/1657-9534-cm-56-01-e5005576-gf1.jpg

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