Cornual heterotopic pregnancy is an extremely rare,life-threatening complication during pregnancy.Here,we report a 33-year-old woman who suffered cornual heterotopic pregnancy after in vitro fertilization embryo trans...Cornual heterotopic pregnancy is an extremely rare,life-threatening complication during pregnancy.Here,we report a 33-year-old woman who suffered cornual heterotopic pregnancy after in vitro fertilization embryo transfer.To prevent rupture during heterotopic pregnancy,she received laparoscopic surgery to remove the ectopic gestational sac at 7^(+2) weeks of gestation.Ultimately,she delivered a healthy boy at 38^(+3) weeks of gestation.Here,we also review the clinical presentations,risk factors,treatment options and outcomes of cornual heterotopic pregnancy.展开更多
Chronic cornual ectopic pregnancy is rare.A 37-year-old woman,G1P0,presented with cornual mass,mild vaginal bleeding,and low serum human chorionic gonadotropin.Cornuostomy and cornual repair were performed by laparosc...Chronic cornual ectopic pregnancy is rare.A 37-year-old woman,G1P0,presented with cornual mass,mild vaginal bleeding,and low serum human chorionic gonadotropin.Cornuostomy and cornual repair were performed by laparoscopy.With atypical symptoms,chronic cornual ectopic pregnancy is a challenge for the gynecologists to make accurate diagnosis and effective treatment.展开更多
We read the Yang et al,published case report in Laparoscopic,Endoscopic and Robotic Surgery.2019.https://doi.org/10.1016/j.lers.2019.09.001,with great interest.Yang et al,in the introduction mentioned that the cornual...We read the Yang et al,published case report in Laparoscopic,Endoscopic and Robotic Surgery.2019.https://doi.org/10.1016/j.lers.2019.09.001,with great interest.Yang et al,in the introduction mentioned that the cornual ectopic pregnancy is defined as a pregnancy that is abnormally located in the proximal portion of the fallopian tube,lying within the muscular wall of the uterus.展开更多
Objective: To evaluate cornual patency and integrity following laparoscopic cornuotomy. Study Design: This is a prospective cohort study on seven women who underwent laparoscopic cornuotomy for interstitial pregnancy....Objective: To evaluate cornual patency and integrity following laparoscopic cornuotomy. Study Design: This is a prospective cohort study on seven women who underwent laparoscopic cornuotomy for interstitial pregnancy. The cornual patency and integrity were evaluated using hysterosalpingography (HSG) and magnetic resonance imaging (MRI). On MRI, the entire cornual wall thickness were measured bilaterally at 5-mm intervals. The thickness of the affected and unaffected cornua matched at the corresponding contralateral point in each of the women. Statistically, all possible pairwise 28 comparisons were compared using paired t-tests. Results: Among six eligible women, four women had excellent cornual patency on the affected side. Among seven women (i.e., 28 pairs), no significant difference was observed in cornual thickness compared to the unaffected cornu and no remarkable defects were seen in the endometrial and cornual contour. But there is no statistical significance. Conclusion: Laparoscopic cornuotomy seems to have advantage to preserve the cornu in interstitial pregnancy.展开更多
The objective of this report is to describe the possible use of intramiometrial vasoconstrictive agents for laparoscopic management of interstitial pregnancy and the consequences in anatomical results and reproductive...The objective of this report is to describe the possible use of intramiometrial vasoconstrictive agents for laparoscopic management of interstitial pregnancy and the consequences in anatomical results and reproductive outcomes. Cornual resection can be performed by laparoscopy, but the high vascularization of this area may result in profuse bleeding and laparoscopic suturing under these conditions might be impossible for the majority of the surgeons. We present a case that describes the possible use of intramiometrial instillation of a solution of diluted epinephrine and levobupivacaine under laparoscopic guidance that permitted a bloodless cornual excision with complete reconstruction. Vasoactive agents might have potentially serious cardiovascular side effects and the correct election of the active principle and the dosage is essential to reduce the risk of the surgery and obtain good anatomical results and reproductive outcomes. In conclusion, unruptured interstitial pregnancies can be managed successfully with intramyometrial instillation of epinephrine and bupivacaine. This simple technique is particularly attractive as it facilitates anatomical reconstruction of the cornual area, gives enough time to perform a complete suture of the defect and reduces the risk of laparotomic conversion.展开更多
The clinical presentations of gestational choriocarcinoma vary markedly, and a misdiagnosis could be made in atypical patients if simply relying on clinical features. Laparoscopic resection of uterine mass lesion is r...The clinical presentations of gestational choriocarcinoma vary markedly, and a misdiagnosis could be made in atypical patients if simply relying on clinical features. Laparoscopic resection of uterine mass lesion is rarely used in gestational choriocarcinoma diagnosis because of the fear of heavy blood loss and distant metastasis. Five patients who were preoperatively diagnosed as having cornual pregnancy underwent laparoscopic resection of mass lesion and then proved to have gestational choriocarcinoma based on pathological examinations. Chemotherapy was started within two days after surgery, and the rate of complete remission was 100%. The mean follow-up time was 29.8±19.1 months, and no patient showed signs of relapse. Laparoscopic resection of uterine mass followed by timely postoperative chemotherapy may be an effective and safe way to obtain pathologic results in patients with suspected gestational choriocarcinoma.展开更多
文摘Cornual heterotopic pregnancy is an extremely rare,life-threatening complication during pregnancy.Here,we report a 33-year-old woman who suffered cornual heterotopic pregnancy after in vitro fertilization embryo transfer.To prevent rupture during heterotopic pregnancy,she received laparoscopic surgery to remove the ectopic gestational sac at 7^(+2) weeks of gestation.Ultimately,she delivered a healthy boy at 38^(+3) weeks of gestation.Here,we also review the clinical presentations,risk factors,treatment options and outcomes of cornual heterotopic pregnancy.
基金This case report was supported by the Key Research and Development Program of Zhejiang Province(2017C03022).
文摘Chronic cornual ectopic pregnancy is rare.A 37-year-old woman,G1P0,presented with cornual mass,mild vaginal bleeding,and low serum human chorionic gonadotropin.Cornuostomy and cornual repair were performed by laparoscopy.With atypical symptoms,chronic cornual ectopic pregnancy is a challenge for the gynecologists to make accurate diagnosis and effective treatment.
文摘We read the Yang et al,published case report in Laparoscopic,Endoscopic and Robotic Surgery.2019.https://doi.org/10.1016/j.lers.2019.09.001,with great interest.Yang et al,in the introduction mentioned that the cornual ectopic pregnancy is defined as a pregnancy that is abnormally located in the proximal portion of the fallopian tube,lying within the muscular wall of the uterus.
文摘Objective: To evaluate cornual patency and integrity following laparoscopic cornuotomy. Study Design: This is a prospective cohort study on seven women who underwent laparoscopic cornuotomy for interstitial pregnancy. The cornual patency and integrity were evaluated using hysterosalpingography (HSG) and magnetic resonance imaging (MRI). On MRI, the entire cornual wall thickness were measured bilaterally at 5-mm intervals. The thickness of the affected and unaffected cornua matched at the corresponding contralateral point in each of the women. Statistically, all possible pairwise 28 comparisons were compared using paired t-tests. Results: Among six eligible women, four women had excellent cornual patency on the affected side. Among seven women (i.e., 28 pairs), no significant difference was observed in cornual thickness compared to the unaffected cornu and no remarkable defects were seen in the endometrial and cornual contour. But there is no statistical significance. Conclusion: Laparoscopic cornuotomy seems to have advantage to preserve the cornu in interstitial pregnancy.
文摘The objective of this report is to describe the possible use of intramiometrial vasoconstrictive agents for laparoscopic management of interstitial pregnancy and the consequences in anatomical results and reproductive outcomes. Cornual resection can be performed by laparoscopy, but the high vascularization of this area may result in profuse bleeding and laparoscopic suturing under these conditions might be impossible for the majority of the surgeons. We present a case that describes the possible use of intramiometrial instillation of a solution of diluted epinephrine and levobupivacaine under laparoscopic guidance that permitted a bloodless cornual excision with complete reconstruction. Vasoactive agents might have potentially serious cardiovascular side effects and the correct election of the active principle and the dosage is essential to reduce the risk of the surgery and obtain good anatomical results and reproductive outcomes. In conclusion, unruptured interstitial pregnancies can be managed successfully with intramyometrial instillation of epinephrine and bupivacaine. This simple technique is particularly attractive as it facilitates anatomical reconstruction of the cornual area, gives enough time to perform a complete suture of the defect and reduces the risk of laparotomic conversion.
基金supported by a grant of Beijing Municipal Science&Technology Commission,China(Grant No.Z131107002213173)
文摘The clinical presentations of gestational choriocarcinoma vary markedly, and a misdiagnosis could be made in atypical patients if simply relying on clinical features. Laparoscopic resection of uterine mass lesion is rarely used in gestational choriocarcinoma diagnosis because of the fear of heavy blood loss and distant metastasis. Five patients who were preoperatively diagnosed as having cornual pregnancy underwent laparoscopic resection of mass lesion and then proved to have gestational choriocarcinoma based on pathological examinations. Chemotherapy was started within two days after surgery, and the rate of complete remission was 100%. The mean follow-up time was 29.8±19.1 months, and no patient showed signs of relapse. Laparoscopic resection of uterine mass followed by timely postoperative chemotherapy may be an effective and safe way to obtain pathologic results in patients with suspected gestational choriocarcinoma.
