黄体囊肿破裂与妊娠早期未诊断宫内妊娠和卵巢破裂的鉴别诊断和治疗挑战

IF 0.4 4区 医学 Q4 OBSTETRICS & GYNECOLOGY
A. Takeda, Shiori Tsuge, S. Iyoshi
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引用次数: 0

摘要

背景:黄体囊肿破裂(RCLC)与妊娠早期未诊断的宫内妊娠(RCLC-P)和卵巢破裂妊娠在临床特征上的相似性已得到充分证实。然而,识别这两种疾病之间的差异对于确定原因和在不破坏RCLC-P妊娠的情况下处理腹腔积血是重要的。此外,患有RCLC-P的女性腹腔镜手术后的妊娠结局尚不清楚。方法:对6例RCLC-P妇女和7例卵巢破裂妊娠妇女进行回顾性观察研究。结果:所有病例都被强烈怀疑是由于下腹疼痛引起的异位妊娠破裂,以及自发受孕后尿妊娠试验呈阳性。RCLC-P中估计的中位妊娠周数(5周)显著低于卵巢破裂妊娠(7周)。在分诊时,RCLC-P中β-人绒毛膜促性腺激素(β-hCG)的中位血清水平(592 IU/L)显著低于卵巢破裂妊娠(3723 IU/L)(P=0.01)。在四名接受术后补充黄体酮的妇女中,有三例在足月时顺利阴道分娩。结论:孕龄早、分诊时血清β-hCG水平较低,以及术后第二天血清β-hCG水平未下降,是RCLC-P而非卵巢破裂妊娠的重要预测因素。腹腔镜手术是管理RCLC-P的可行选择,并提供适当的术后黄体支持,以获得成功的产科结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Differential-diagnostic and therapeutic challenges in the management of ruptured corpus luteum cyst with undiagnosed intrauterine pregnancy in the early first trimester and ruptured ovarian pregnancy
Background: The similarities in clinical features between ruptured corpus luteum cyst (RCLC) with undiagnosed intrauterine pregnancy in the early first trimester (RCLC-P) and ruptured ovarian pregnancy are well established. However, the identification of differences between these two morbid conditions is important to determine the causes and manage the hemoperitoneum without devastation of pregnancy in RCLC-P. Furthermore, the pregnancy outcomes after laparoscopic surgery in women with RCLC-P are not recognized. Methods: Retrospective observational study of six women with RCLC-P and seven women with ruptured ovarian pregnancy. Results: All cases were referred under strong suspicion of ruptured ectopic pregnancy due to lower abdominal pain and positive urinary pregnancy test after spontaneous conception. The estimated median number of gestational weeks in RCLC-P (5 weeks) was significantly lower than that for ruptured ovarian pregnancy (7 weeks). At triage, the median serum levels of beta-human chorionic gonadotropin (β -hCG) were significantly lower in RCLC-P (592 IU/L) than ruptured ovarian pregnancy (3723 IU/L) (p = 0.01). In all six cases with RCLC-P, laparoscopic ovary-sparing surgerywas performed. Among the four womenwho received postoperative supplementation of progesterone, uneventful vaginal delivery occurred at term in three cases. Conclusions: Early gestational age and lower serum β -hCG levels at triage, as well as non-declining levels of serum β -hCG on the day after surgery, were significant predictors of RCLC-P rather than ruptured ovarian pregnancy. Laparoscopic surgery was a feasible option for the management of RCLC-P with appropriate postoperative luteal support to achieve successful obstetric outcomes.
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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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