Analysis of misdiagnosis of intramural pregnancy and literature review
Objective To analyze the clinical characteristics,diagnosis and treatment process of 3 cases of intramural pregnancy(IMP),and summarize the measures to prevent misdiagnosis of IMP.Methods Clinical data of 1 case misdiagnosed as gestational trophoblastic tumor and 2 cases misdiagnosed as early intrauterine pregnancy of IMP diagnosed in Hubei Maternal and Child Health Hospital from May 2020 to August 2022 were collected,and their clinical characteristics,diagnosis and treatment process were retrospectively analyzed.Results The misdiagnosis time of 3 IMP patients was 10 days-1 month.One case was misdiagnosed as gestational trophoblastic tumor and underwent uterine laparoscopy combined with subcutaneous IMP removal+diagnostic curettage.Two cases were misdiagnosed as early intrauterine pregnancy and underwent hysteroscopic electroresection of intrauterine IMP and hysteroscopy and laparoscopy combined with subcutaneous IMP removal respectively.All the 3 patients recovered and were discharged from hospital after postoperative reexamination.Conclusions IMP patients have no specific clinical manifestations in the early stage,which is easy to miss diagnosis and misdiagnosis.When the increase of human chorionic gonadotropin(hCG)is found,B-ultrasound examination indicates that there is no pregnancy sac shadow in intrauterine,and there is a history of induced abortion,patients should be highly alert to IMP.If the ultrasound examination showed the pregnancy sac is not clear,magnetic resonance imaging(MRI)should be performed to further distinguish the relationship between the pregnancy sac and the endometrium.If neither ultrasound nor MRI can make a clear diagnosis,surgical exploration should be performed in time to make a clear diagnosis.Hysteroscopy combined with laparoscopy can quickly make a clear diagnosis and can provide treatment.
万方数据
维普
