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[超声诊断与腹腔镜治疗卵巢妊娠。1例病例报告并文献复习]

[Ultrasonic diagnosis and laparoscopic treatment of an ovarian pregnancy. A case report and review of the literature].

作者信息

Riethmuller D, Sautière J L, Benoit S, Roth P, Schaal J P, Maillet R

机构信息

Clinique Universitaire de Gynécologie, d'Obstétrique et de la Reproduction, CHRU Saint-Jacques, Besançon.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 1996;25(4):378-83.

PMID:8815136
Abstract

Ovarian pregnancy is an uncommon type of ectopic pregnancy. Incidence has been estimated at 1 per 7 000 pregnancies and 1 to 6% of ectopic pregnancies. Pathogenesis is different from tubal pregnancy. Generally it occurs as a single event in an otherwise healthy woman. Early diagnosis of ectopic pregnancy is essential and is now possible with the advent of endovaginal sonography associated with serum beta-hCG assay. There are various forms of ectopic pregnancies. Macroscopically, 4 forms can be distinguished: hematoma, clar ovum, embryonnized ovum, and placenta with fetus. Histology alone can confirm the diagnosis and distinguish between the 4 forms: intrafollicular, justafollicular, justacortical and interstitial pregnancy. For many authors, laparotomy is required in all cases, but in any case, the ovary can generally be preserved as implantation is usually superficial. We describe here a case of ovarian pregnancy after stimulated ovulation. Early diagnosis with correct localization was achieved with endovaginal sonography. Conservative treatment with laparoscopy was successful.

摘要

卵巢妊娠是一种罕见的异位妊娠类型。据估计,其发生率为每7000次妊娠中有1例,占异位妊娠的1%至6%。其发病机制与输卵管妊娠不同。一般来说,它在其他方面健康的女性中作为单一事件发生。异位妊娠的早期诊断至关重要,随着经阴道超声检查与血清β - 人绒毛膜促性腺激素检测的出现,现在已经可以做到。异位妊娠有多种形式。从宏观上看,可以区分出4种形式:血肿、清亮卵、胚胎化卵和带胎儿的胎盘。仅靠组织学检查才能确诊并区分这4种形式:卵泡内、卵泡旁、皮质旁和间质妊娠。对于许多作者来说,所有病例都需要开腹手术,但无论如何,由于着床通常较浅,卵巢一般可以保留。我们在此描述一例促排卵后卵巢妊娠的病例。经阴道超声检查实现了早期诊断并正确定位。腹腔镜保守治疗取得成功。

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