异位双胎妊娠:1例

K. Moussaoui, A. Kharbach
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引用次数: 1

摘要

单侧输卵管双胎妊娠发生率约为125000分之一。由于缺乏资料,关于双输卵管异位妊娠的适当处理建议很少。我们报告一个临床病例,28岁的女性,患有1型糖尿病,胰岛素治疗,没有明显的外科或妇科病史,患者在6sa-2j闭经的情况下,因子宫内膜炎进展2天而被送往急诊室。临床检查发现患者血流动力学稳定,腹部压迫柔软,对右髂窝敏感,子宫翻转轻微疼痛,有子宫内腔出血,子宫活动。急诊室尿妊娠试验呈阳性血清β Hcg为3966 mUI/ml。经阴道超声显示子宫反向空,子宫内膜细而均匀,大小为7.8 mm,右侧输卵管位处有两个胎袋,尺寸分别为(7.2mm - 5.8mm)和(7mm-5.6 mm),两个胚胎分别为3.8mm和3.6mm,均为心脏活动阳性。在道格拉斯气囊层,有一个积液叶片。诊断为双羊膜双宫位双宫位异位妊娠。腹腔镜下行右侧输卵管切除术。术后进展良好。医疗保健提供者应该对异位妊娠有很高的临床怀疑指数。单侧输卵管双胎异位妊娠虽然罕见,但经阴道超声检查可以正确诊断。腹腔镜输卵管切除术是单侧输卵管双胎妊娠的有效治疗方法,恢复时间短。由于文献资料的缺乏,关于异位双胎妊娠的适当处理的建议很少。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ectopic Twin Pregnancy : About A Case
Unilateral tubal twin pregnancies occur in approximately 1 in 125,000 spontaneous pregnancies. Due to the lack of data, there are few recommendations on the appropriate management of a twin tubal ectopic pregnancy. We report a CLINICAL CASE of A 28-year-old woman, with type 1 diabetes on insulin and with no significant surgical or gynaecological history, the patient presented to the emergency room for metrorragia evolving for two days in a context of 6sa-2j amenorrhea. Clinical examination finds a hemodynamically stable patient, a depressible flexible abdomen with sensitivity to the right iliac pit and a slightly painful reversed uterus has mobilization with a moderate bleeding abundance of endo uterine origin. The emergency room urine pregnancy test was positive. Beta Hcg serum was 3,966 mUI/ml. Transvaginal ultrasound showed a reversed empty uterus, a fine and homogeneous endometrium of 7.8 mm with the presence at the right tubal level of two gestational bags measuring (7.2mm5.8mm) and (7mm-5.6 mm) with two embryos of 3.8mm and 3.6mm respectively, both had positive cardiac activity. at the douglas bag cul level, the presence of an effusion blade. the diagnosis of bi-amniotic bi-horoial bi-chorial ectopic pregnancy was made.a laparoscopy was performed with a right salpingectomy. postoperative evolution was favourable. Health care providers should have a high index of clinical suspicion for ectopic pregnancies. Unilateral tubal twin ectopic pregnancies, although rare, can be correctly diagnosed by transvaginal ultrasound. Laparoscopic salpingectomy provides an effective treatment for unilateral tubal twin gestation with a short recovery time. Due to the lack of data in the literature, there are few recommendations on the appropriate management of an ectuous ectopic twin pregnancy.
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