A case of heterotopic pregnancy with intrauterine and cervical pregnancy coexisting: intrasacular KCl injection, intrauterine pregnancy being preserved, and then massive bleeding at 32 weeks

IF 0.4 4区 医学 Q4 OBSTETRICS & GYNECOLOGY
J. Sierra, Andrea Espiau Romera, M. J. Puente Luján, Rebeca Herrero Serrano, Maria Jesús Franco Royo, Carlos De Bonrostro Torralba, Belén Rodríguez Solanilla
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引用次数: 0

Abstract

Background: Heterotopic pregnancy is the condition in which intrauterine and ectopic pregnancy coexist. The conservative management of the ectopic pregnancy, with the intrauterine pregnancy preserved, has been reported. Case(s): Here, we report a very rare case: intrauterine and cervical pregnancy coexist: intrasacular Potassium chloride (KCL) injection successfully terminated cervical pregnancy with intrauterine pregnancy preserved, but later massive bleeding occurred from the cervix. A 39-year-old woman at 7 weeks was diagnosed with a heterotopic cervical gestation, with intrauterine and cervical sac, both with live embryos. The ectopic pregnancy was successfully terminated with intrasacular injection of KCl, preserving the intrauterine pregnancy. At 32 weeks of gestation the patient started with a profuse bleeding from the cervical sac, causing maternal hypotension (80/45 mmHg) and tachycardia (160 bpm) and a decelerative pattern in the cardiotocographic fetal monitoring, prompting us to perform caesarean section. The cessation of bleeding was achieved using a double balloon intracervical catheter, which was withdrawn 24 hours after its insertion without observing a new bleeding episode. The patient was discharged after 8 days and the newborn after 35 days of life, both in good health. Conclusions: Conservative treatment of a heterotopic gestation is possible, managing to preserve the viability of the intrauterine pregnancy.
异位妊娠合并宫内妊娠和宫颈妊娠1例:黄带内注射KCl,宫内妊娠保留,32周大出血
背景:异位妊娠是指宫内妊娠和异位妊娠并存的情况。异位妊娠的保守治疗,保留宫内妊娠,已有报道。病例:在这里,我们报告了一个非常罕见的病例:宫内妊娠和宫颈妊娠共存:支架内氯化钾(KCL)注射成功终止了宫颈妊娠,保留了宫内妊娠,但后来宫颈出现大出血。一名39岁的妇女在7周时被诊断为异位宫颈妊娠,有宫内和宫颈囊,均有活胚胎。经支架内注射氯化钾成功终止异位妊娠,保留了宫内妊娠。在妊娠32周时,患者开始从宫颈囊大量出血,导致产妇低血压(80/45毫米汞柱)和心动过速(160次/分),并在胎心监护中出现减速模式,促使我们进行剖腹产。使用双球囊颈内导管止血,插入后24小时取出,未观察到新的出血事件。患者8天后出院,新生儿35天后出院,两人健康状况良好。结论:异位妊娠的保守治疗是可能的,能够保持宫内妊娠的生存能力。
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来源期刊
CiteScore
0.50
自引率
0.00%
发文量
241
审稿时长
1 months
期刊介绍: CEOG is an international, peer-reviewed, open access journal. CEOG covers all aspects of Obstetrics and Gynecology, including obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine. All submissions of cutting-edge advances of medical research in the area of women''s health worldwide are encouraged.
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