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[双侧异位妊娠的保守性腹腔镜治疗。2例报告及文献复习]

[Conservative laparoscopic treatment of bilateral ectopic pregnancy. 2 case reports and review of the literature].

作者信息

Bustos López H H, Rojas-Poceros G, Barrón Vallejo J, Cintora Zamudio S, Kably Ambe A, Valle R F

机构信息

Instituto Nacional de Perinatología, Northwestern University Medical School, Chicago, Illinois, USA.

出版信息

Ginecol Obstet Mex. 1998 Jan;66:13-7.

PMID:9528215
Abstract

Ectopic pregnancy is a frequent clinic entity, with an incidence from 4.5 to 16.8 for 1000 pregnancies. The frequency of ectopic pregnancy has been triplicated in the last years, mainly owed to increase of sexual transmitted diseases, increase in salpinges' surgery and in assisted reproductive medicine. The ectopic pregnancy is also the most frequency cause of maternal death during the first trimester of pregnancy. The frequency of bilateral tubal ectopic pregnancy is extremely rare, it is reported from 1:125 to 1:1580 of all ectopic pregnancies. The first case of bilateral tubal ectopic pregnancy was reported n 1918 by Bledsoe. In Mexico, Molina described the first case in 1993, with conservative laparoscopic treatment. Two clinic cases are presented of bilateral ectopic pregnancy, treated conservatively by laparoscopy. The first one with background of sterility because of anovulation, receiving treatment with menotropins for ovarian hyperstimulation, the other one. In the second case, was a spontaneous pregnancy, in a patient with a history of several pelvic surgeries. In this case a bilateral salpingostomy was realized. In both cases was demonstrated chorionic villi by histopathology. These cases are a model of nature to evaluate the real utility of several diagnostic and therapeutic methods which are available nowadays for the treatment of ectopic pregnancy.

摘要

异位妊娠是一种常见的临床病症,每1000例妊娠中的发病率为4.5至16.8。在过去几年中,异位妊娠的发生率增加了两倍,主要归因于性传播疾病的增加、输卵管手术以及辅助生殖医学的增加。异位妊娠也是妊娠早期孕产妇死亡的最常见原因。双侧输卵管异位妊娠极为罕见,据报道在所有异位妊娠中占比为1:125至1:1580。1918年,布莱索报道了首例双侧输卵管异位妊娠病例。1993年,莫利纳在墨西哥描述了首例病例,并采用了保守性腹腔镜治疗。本文介绍了两例双侧异位妊娠的临床病例,均采用腹腔镜保守治疗。第一例患者因无排卵导致不孕,接受促性腺激素治疗以进行卵巢过度刺激;另一例患者为自然受孕,有多次盆腔手术史。在第二例中,进行了双侧输卵管造口术。两例病例经组织病理学检查均证实有绒毛膜绒毛。这些病例是评估目前可用于治疗异位妊娠的多种诊断和治疗方法实际效用的自然模型。

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