间质性妊娠引起的产科出血和子宫破裂。病例报告

Q4 Medicine
Edgar Allan Villagómez-Mendoza, Anabel Tamayo-Iturbe
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引用次数: 0

摘要

背景:间质性异位妊娠约占所有病例的2.4%,该输卵管部分位于子宫近端,与子宫肌肉部分共用,由于其对子宫肌层的高度顺应性,有助于晚期诊断,其临床表现为子宫破裂,产科出血导致的发病率和死亡率增加,危险因素与输卵管异位妊娠相同,治疗是根据保留生育能力和患者的临床情况进行评估的。临床病例:一名31岁的患者因下腹部严重和致残性腹痛,休克指数1.3,伴有腹膜刺激迹象而去急诊室,进行了超声检查,报告盆腔和Morrison间隙有游离液体,左侧附件水平的宫外孕囊,胚胎无心跳,妊娠11周,进行了剖腹探查,观察到腹腔积血2800cc,右侧角部子宫破裂约8x6cm,子宫破裂附近羊膜囊的胎儿e完整,患者报告产程满意,因此决定进行全腹子宫切除术。结论:间质性异位妊娠与输卵管妊娠具有相同的危险因素。今天,我们有各种诊断辅助工具,因此基石是及时检测,这将使保守治疗能够降低孕产妇发病率和死亡率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hemorragia obstétrica y rotura uterina por un embarazo intersticial. Reporte de un caso
BACKGROUND: Interstitial ectopic pregnancy occurs in approximately 2.4% of all cases, this tubal portion is located in the proximal segment and shares the muscular portion of the uterus, due to its great myometrial compliance, it facilitates late diagnosis and its clinical presentation is By means of uterine rupture and with it an increase in morbidity and mortality due to obstetric hemorrhage, the risk factors are the same as for tubal ectopic pregnancy, treatment is assessed based on preserving fertility and according to the patient’s clinical setting. CLINICAL CASE: A 31-year-old patient who went to the emergency department for severe and disabling abdominal pain in the hypogastrium, shock index 1.3, with signs of peritoneal irritation, ultrasound was performed, which reported free fluid in the pelvic cavity and Morrison space, extrauterine gestational sac at the level of the left annex, embryo without heartbeat, craniocaudal length of 11 weeks of gestation, exploratory laparotomy was performed, in which hemoperitoneum of 2800 cc was observed, uterine rupture in the right cornual region of approximately 8x6cm, with fetus e integrity of the amniotic sac adjacent to the uterine rupture, the patient reported satisfied parity, and therefore a total abdominal hysterectomy was decided. CONCLUSIONS: Interstitial ectopic pregnancy shares the same risk factors as tubal pregnancy. Today, we have various diagnostic aids, so the cornerstone is timely detection, which will allow conservative treatments to decrease maternal morbidity and mortality.
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来源期刊
Ginecologia y obstetricia de Mexico
Ginecologia y obstetricia de Mexico Medicine-Obstetrics and Gynecology
CiteScore
0.20
自引率
0.00%
发文量
107
期刊介绍: Indizada en: Artemisa, Embase Cd/Obstetrics and Gynecology, Embase. Co/Pediatrics, Excerfta Médica, Índice Médico Latinoamericano, Lulacs, Medline, Science Citation Index, Ulrich, Ebsco.
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