宫内孕合并宫角妊娠手术后足月分娩1例病例报告及文献回顾

A case report of term labor after intrauterine pregnancy combined with kyphosis pregnancy and the literature review

目的通过报道1例宫内孕合并宫角妊娠病例的成功施治,并结合文献回顾,了解该病例的治疗要点及手术技巧和术后管理方法。方法 2015年8月本院收治了1例宫内孕10+周合并宫角妊娠患者,急诊行经腹左侧宫角妊娠切除术+子宫修补术,术后定期产检,孕期平顺。2016年2月11日该患者因"孕37周、胎膜早破"急诊行子宫下段剖宫产,娩出一健康男婴。结果通过开腹手术切除患侧宫角,使宫内胎儿继续妊娠,最后足月分娩,成功施治。结论对于宫内孕合并宫角妊娠者,在术前充分评估并与患者充分沟通后,行开腹手术切除异位妊娠,保留并继续宫内正常胎儿的妊娠,是可行的。手术时机的选择、手术技巧、术后孕妇的孕期管理和监测都是病例治疗成功的关键因素。

Objective To study the key points of treatment and operative techniques and postoperative management based on the report on successful treatment to a case of intrauterine pregnancy merging with cornual pregnancy as well as literature review. Method On August, 2015, a case of 10＋ weeks intrauterine pregnancy merging with cornual pregnancy was received in Beijing Obstetrics and Gynecology Hospital. The emergency treatment carried out abdominal hysterectomy on the left side and uterine repair. The patient had postoperative regular prenatal examinations and did well during pregnancy. On February 11, 2016, the patient was received by emergency due to premature rupture of membranes at 37 weeks, and was carried out cesarean section at the lower uterine segment delivering a healthy baby boy. Result Removing affected side of cornual uterine by abdominal hysterectomy is able to make the intrauterine fetus continue in pregnancy to term, resulting in successful treatments. Conclusion It is possible for the patient of intrauterine pregnancy merging with cornual pregnancy to have abdominal hysterectomy removing affected section so as to preserve and continue normal fetal intrauterine pregnancy based on sufficient preoperative assessment and communication with the patient. The timing of operation, operative techniques, postoperative management and monitoring of the pregnant woman during the pregnancy are all key factors of successful treatment.