特殊部位异位妊娠临床分析

Clinical Analysis of Specific Ectopic Pregnancies

特殊部位异位妊娠病人17例,其中输卵管间质部妊娠5例,卵巢妊娠9例,宫角妊娠、宫颈妊娠及残角子宫妊娠各1例,占同期异位妊娠(175例)的9.7％。结果提示:输卵管间质部妊娠易引起致命性腹腔出血,卵巢妊娠术前不易确诊,宫角妊娠子宫不对称性增大,残角子宫妊娠少数可发展为胎儿宫内死亡而潴留,宫颈妊娠以阴道大出血为主要临床表现。除宫颈妊娠可行宫颈骚刮术及填塞止血外,其余均行剖腹手术。意义:提高对特殊部位异位妊娠的认识,降低误诊率。

Seventeen cases of specific ectopic pregnancy which occurred between January 1991 and May 1996 were analyzed. The group included 5 tubal interstitial pregnancy cases, 9 ovarian pregnancy cases, 1 cor-nual pregnancy case, 1 cervical pregnancy case,and 1 pregnancy in rudimentary horn case. This group accounted for 9-7% of all ectopic pregnancies occurring during this period. Tubal interstital pregnancies often had fatal intraperitoneal hemorrhage. It is difficult to diagnose ovarian pregnancy prior to surgical exploration. Cornual pregnancy presented unsymmetrical uterus enlargement. A few cases of pregnancy in rudimentary horn developed fatal outcome. Vaginal hemorrhage is main clinical manifestation in cervical pregnancy. Ectopic pregnancy needs laparotomy except that cervical pregnancy needs cervical curettage and cervical canal packing. It is advantageous to recognize specific ectopic pregnancy to decrease misdiagnosis rate.