腹式妊娠——一个绝对不能错过的诊断

IF 0.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL
V. Dinwoke, Michael Amara, Linda Uzo Amara
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引用次数: 1

摘要

腹部怀孕是非常罕见的,只有少数妇科医生在他们的职业生涯中有幸遇到过这种情况。它仅占所有异位妊娠的1%,但围产期和产妇死亡率分别高达95%和18%。出血性和感染性并发症是主要原因。剖腹手术切除胎盘是一个很大的难题,因为可能会出现大出血。我们报告了一例本科青少年,在不安全的阴道器械后,被一名专利药物经销商(未经正规药学培训但在零售基础上销售正统药物的人)以败血症和贫血的特征转介,以终止宫外妊娠。超声检查证实有20周腹内妊娠。结果经剖腹探查取出死胎,胎盘完全取出。术后恢复顺利。结论考虑到腹式妊娠晚期胎盘潴留可能伴随盆腔脓肿、弥散性血管内凝血和肠梗阻等严重并发症,建议在可行的情况下手术切除胎盘。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Abdominal pregnancy—a diagnosis never to miss
Background

Abdominal pregnancy is very rare, with only a few gynecologists being fortunate to encounter it all through their professional careers. It makes up only 1% of all ectopic pregnancies but has very high perinatal and maternal mortality of 95% and 18% respectively. Hemorrhagic and infectious complications account for these. Removal of the placenta at laparotomy is a big dilemma as torrential bleeding may ensue.

Case

We report the case of an undergraduate teenager who was referred with features of septicemia and anemia following unsafe vaginal instrumentation by a patent medicine dealer (a person without formal training in pharmacy but sells orthodox medications on retail basis) in a bid to terminate an extrauterine pregnancy. Ultrasonography confirmed a nonviable abdominal pregnancy of 20 weeks.

Result

She had exploratory laparotomy with the evacuation of the dead fetus and successful complete removal of the placenta. Her postoperative recovery was uneventful.

Conclusion

In view of the grave complications like a pelvic abscess, disseminated intravascular coagulation and bowel obstruction that may accompany retention of the placenta in advanced abdominal pregnancy, optimal placental removal at surgery is recommended whenever feasible.

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来源期刊
AIMS Medical Science
AIMS Medical Science MEDICINE, RESEARCH & EXPERIMENTAL-
自引率
14.30%
发文量
20
审稿时长
12 weeks
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