子宫肌壁间妊娠误诊为妊娠滋养细胞肿瘤1例并相关文献分析

Intermural Pregnancy Was Misdiagnosed as Gestational Trophoblastic Tumor: A Case Report and Related Literature Analysis

子宫肌壁间妊娠(intramural pregnancy, IMP)是极为罕见的异位妊娠部位之一,发病率 < 1%,指受精卵完全被子宫肌层包围,与子宫腔及输卵管均不相通。子宫肌壁间妊娠早期诊断困难,若延误治疗可导致子宫破裂、失血性休克甚至切除子宫而丧失生育功能。目前尚缺乏相关指南,国内外文献仅报道相关个案,与其他部位异位妊娠、妊娠滋养细胞疾病、变性肌瘤等难以鉴别。近年来随着辅助生殖技术、宫腔操作史、既往子宫手术史发生率的升高,IMP的发生率也逐渐提高,临床上对该病警惕性不足,提高对该病的认识有助于早期诊断,本文报道1例青岛大学附属医院诊治为IMP的临床罕见病例,并复习相关文献资料,旨在提高对该病的认识,并为其诊治提供参考。

Intramural pregnancy (IMP) is one of the very rare ectopic pregnancy sites, with an incidence of <1%, in which the fertilized egg is completely surrounded by the myotome of the uterus and does not communicate with the uterine cavity and fallopian tubes. Early diagnosis of intramural preg-nancy is difficult, and delayed treatment may lead to uterine rupture, hemorrhagic shock, or even hysterectomy and loss of reproductive function. At present, there is a lack of relevant guidelines, and only related cases have been reported in domestic and foreign literatures, which are difficult to distinguish from other parts of ectopic pregnancy, gestational trophoblastic disease, and degenera-tive myoma. In recent years, with the increasing incidence of assisted reproductive technology, uterine operation history, and previous uterine operation history, the incidence of IMP has also gradually increased. Clinical vigilance of the disease is insufficient, and improving the understand-ing of the disease is helpful for early diagnosis. This paper reports a rare clinical case of IMP diag-nosed and diagnosed in the Affiliated Hospital of Qingdao University, and reviews the relevant lit-erature. The aim is to improve the understanding of the disease and provide reference for its diag-nosis and treatment.