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早期腹腔妊娠破裂一例

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腹腔妊娠在临床上比较罕见,又分为继发性腹腔妊娠及原发性腹腔妊娠,其中原发性腹腔妊娠更是鲜有。报告1例原发性腹腔妊娠,伴有腹腔内出血,急诊行腹腔镜探查后发现妊娠组织种植于宫骶韧带,遂予手术清除妊娠组织,术后人绒毛膜促性腺激素β亚单位(β-hCG)下降满意。临床上一般结合病史、β-hCG水平、妇科超声进行诊断,必要时可结合磁共振成像检查辅助诊断。但特殊部位的异位妊娠诊断较困难,发现时往往伴随腹腔内出血,确诊方法及腹腔妊娠治疗的关键主要依靠手术探查,早期发现并彻底清除腹腔妊娠病灶,防止继发性腹腔妊娠的发生,必要时可加用小剂量甲氨蝶呤联合治疗,术中积极止血,以防严重并发症的发生。
A Case of Early Abdominal Pregnancy Rupture
Abdominal pregnancy is relatively rare in clinical practice,and can be divided into secondary abdominal pregnancy and primary abdominal pregnancy.The primary abdominal pregnancy is rarer than the secondary abdominal pregnancy.This paper reports a case of primary abdominal pregnancy with intraperitoneal hemorrhage.After an emergency laparoscopic exploration,it was found that the pregnancy tissue was implanted in the uterine sacral ligaments.The pregnancy tissue was removed under laparoscopy,and the level of β-human chorionic gonadotropin(β-hCG)reduced well after surgery.Clinical diagnosis of abdominal pregnancy is generally combined with the medical history,the level of β-hCG and gynecologic ultrasound,and can be combined with magnetic resonance imaging as a assisted method if necessary.It is worth noting that the diagnosis of ectopic pregnancy in this special site is difficult,and that abdominal pregnancy is often accompanied by intraperitoneal hemorrhage.The key method of definite diagnosis is laparoscopic exploration,and the key treatment of abdominal pregnancy is also mainly relied on surgical exploration,early detection and thorough removal of intra-abdominal pregnancy lesions to prevent the occurrence of secondary abdominal pregnancy.If necessary,low-dose methotrexate as a combined treatment can be added.To stop bleeding actively can prevent serious complications during the operation.

Pregnancy,abdominalPregnancy,ectopicAbdominal painUltrasonographyCase reports

夏梦瑶、杨玲、赵飞、郭璐璐、王凤卿

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266000 青岛市黄岛区中心医院妇科

妊娠,腹腔 妊娠,异位 腹痛 超声检查 病例报告

2024

国际生殖健康/计划生育杂志
天津市医学科学技术信息研究所

国际生殖健康/计划生育杂志

CSTPCD
影响因子:0.694
ISSN:1674-1889
年,卷(期):2024.43(3)
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