To See or Not to See? A Visually Directed Approach to the Hysteroscopic Removal of RPOC from an Angular Pregnancy in an Arcuate Uterus

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology Pub Date : 2024-11-01 DOI:10.1016/j.jmig.2024.09.030

CAZ Mabini , T Tam , S Siddique

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Abstract

Study Objective

This video aims to review the diagnosis and management of retained products of conception (RPOC) and underscores the diagnostic utility of 3D transvaginal ultrasound (TVUS) in differentiating between interstitial ectopic pregnancy (IEP) and angular pregnancy (AP). We demonstrate a visually-directed approach to the hysteroscopic removal of retained products of conception (RPOC) of an angular pregnancy in an arcuate uterus.

Design

Case review.

Setting

Procedure was performed by a MIGS fellowship-trained surgeon at a community-based hospital.

Patients or Participants

A 45-year-old G6P0 with a known septate uterus and prior history of infertility referred by REI for surgical consultation of a suspected IEP versus AP measuring approximately 6 wga on initial TVUS.

Interventions

Visually-directed hysteroscopic removal of RPOC.

Measurements and Main Results

Complete removal of RPOC confirmed on final pathology. Patient experienced an uncomplicated postoperative course with complete resolution of symptoms.

Conclusion

This case highlights the diagnostic capabilities of 3D sonography in distinguishing between an IEP and AP and its implications in management strategies. It also demonstrates the advantages of utilizing a visually-directed hysteroscopic removal of RPOC over traditional dilation and curettage (D&C), in regards to diagnostic and therapeutic efficacy, patient safety, and favorable outcomes.

查看原文本刊更多论文

看还是不看？弧形子宫角状妊娠RPOC宫腔镜切除术的视觉引导方法

研究目的本视频旨在回顾残留受精产物（RPOC）的诊断和处理，并强调三维经阴道超声（TVUS）在区分间质性异位妊娠（IEP）和角妊娠（AP）方面的诊断作用。我们展示了一种以视觉为导向的方法，在宫腔镜下切除弧形子宫内角妊娠的受孕产物（RPOC）.设计病例回顾.设置手术由一家社区医院接受过 MIGS 研究培训的外科医生实施。患者或参与者一名45岁的G6P0患者，已知子宫有隔，既往有不孕史，由REI转诊，因初步TVUS检查发现疑似IEP对AP，妊娠大小约为6wga，需进行手术会诊.干预措施视觉引导下宫腔镜下切除RPOC.测量和主要结果最终病理证实RPOC完全切除。本病例突出显示了三维超声在区分 IEP 和 AP 方面的诊断能力及其对治疗策略的影响。该病例还展示了在可视引导下使用宫腔镜切除 RPOC 比传统的扩张刮宫术（D&C）在诊断和治疗效果、患者安全性和良好预后方面的优势。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of minimally invasive gynecology 医学-妇产科学

CiteScore

5.00

自引率

7.30%

发文量

272

审稿时长

37 days

期刊介绍： The Journal of Minimally Invasive Gynecology, formerly titled The Journal of the American Association of Gynecologic Laparoscopists, is an international clinical forum for the exchange and dissemination of ideas, findings and techniques relevant to gynecologic endoscopy and other minimally invasive procedures. The Journal, which presents research, clinical opinions and case reports from the brightest minds in gynecologic surgery, is an authoritative source informing practicing physicians of the latest, cutting-edge developments occurring in this emerging field.