共查询到20条相似文献，搜索用时 62 毫秒
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放置宫内节育器后异位妊娠患者输卵管超微结构的观察 总被引：10，自引：0，他引：10
放置宫内节育器后异位妊娠患者输卵管超微结构的观察郑黎炯张东生放置宫内节育器（ＩＵＤ）是世界上广泛采用的节育措施，我国已有７４００万妇女使用。近年来异位妊娠发生率有上升趋势，放置ＩＵＤ是否会增加异位妊娠，已引起国内外学者的关注。从１９９１年２月至１９９... 相似文献
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宫内节育器与异位妊娠 总被引：9，自引：0，他引：9
杨秀兰 《中国实用妇科与产科杂志》1995,11(4):205-207
宫内节育器与异位妊娠上海市计划生育技术指导所（２０００３０）杨秀兰自宫内节育器（ＩＵＤ）问世之日起，人们就十分关注其安全性问题。特别是伴随着ＩＵＤ使用的增多，出现了异位妊娠增加的趋势，引起不少学者的极大关注。本文通过最近几年的一些文献复习及我们的一些... 相似文献
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<正> 1 病例简介例1 36y,G_2P_(10)因停经1月余,腰痛,下腹痛5d,于1996年4月30日入院。患者4a前行人工流产术并放置宫内避孕环后常感下腹胀痛,并白带增多,呈脓样。月经正常。LMP1996年3月15 相似文献
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宫内节育器带器妊娠及异位妊娠的研究 总被引：14，自引：0，他引：14
宫内节育器(IUD)是我国育龄妇女采取的主要长效避孕方式,其与带器妊娠和异位妊娠的关系各家报道不一,存在一定争议。本文综述了近年来宫内节育器带器妊娠和异位妊娠的发病率及影响因素、病因学、节育器移位诊断、预后等方面的研究进展。 相似文献
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异位妊娠误诊为宫内妊娠9例分析 总被引：5，自引：0，他引：5
袁香梅 《中国实用妇科与产科杂志》2001,17(6):381-381
1 临床资料1.1 一般资料 自 1996年 6月至 2 0 0 0年 6月 ,我院共收治异位妊娠 390例 ,其中误诊为宫内妊娠有 9例 ,其中未产妇 7例 ,经产妇 2例 ,最小年龄 2 4岁 ,最大年龄 42岁 ,平均年龄 32 4岁 ,孕产次为 2～ 6次 ,均有 2次及 2次以上人工流产史 ,最多者达 4次 ;9例中有 5例未采取避孕措施 ,有 3例为带环妊娠。1.2 临床诊断及处理 9例均有明确停经史 ,停经最短者34天 ,最长者 45天 ,仅 2例有厌食等早孕反应 ;9例中有 3例未做Ｂ超检查 ,仅根据停药史及尿妊娠试验阳性诊为早期妊娠 ,行人工流产术 ,术后 2周内突发下腹痛 ,出现急腹症… 相似文献
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宫内节育器与宫外孕关系的研究 总被引：5，自引：0，他引：5
本文对1986年2月～1987年10月上海市14所医院中发生的宫外孕802例,采用宫外孕病例和宫内妊娠、非妊娠的妇女为对照,进行回顾性研究。调查节育及其他病史和宫外孕的关系,重点调查宫内节育器使用情况并测定其相对危险度。结果提示:1.总体而言节育器不增加宫外孕的危险性。2.带器妊娠时宫外孕危险增加。3.宫外孕的危险性与腹部或子宫手术史可能有关。 相似文献
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An Atypical Presentation of Ectopic Pregnancy With Unicornuate Uterus and Undescended Fallopian Tube
Bonnie Woolnough Charlotte Ballermann 《Journal d'obstetrique et gynecologie du Canada》2019,41(2):214-216
Background
Müllerian duct abnormalities are common and may be related to pregnancy complications. Few cases of ectopic pregnancy within an undescended Fallopian tube have been reported, and they present a diagnostic challenge.Case
A 32-year-old pregnant woman had three presentations to the emergency department for increasing left upper abdominal pain, chest pain, shortness of breath, and eventual hemodynamic instability in the setting of right unicornuate uterus and undiagnosed undescended left adnexa.Conclusion
This case presents a rare diagnosis in the differential diagnosis of chest pain and shortness of breath, as well as pregnancy of unknown location. If intraperitoneal hemorrhage is present in a woman with a positive pregnancy test but pregnancy is not detected within the pelvis, it is advisable to investigate the upper abdomen for ectopic pregnancy. 相似文献13.
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Payal Chaudhary Rahul Manchanda Vijay N. Patil 《Journal of obstetrics and gynaecology of India》2013,63(3):173-176
Purpose
To evaluate various laparoscopic methods for management of tubal ectopic pregnancy and study the incidence of ectopic pregnancy including the incidence of cornual ectopic pregnancy and conversion to laparotomy during laparoscopic procedure.Methods
A retrospective study was conducted in North Point Hospital, Delhi, on all laparoscopies conducted in 4 years, i.e., from January 2008 to December 2011.Results
Incidence of ectopic pregnancy was 4.62 % (out of all laparoscopic surgeries over 4 years) and that for cornual pregnancy was 4.65 % (out of all ectopic pregnancies); no laparotomy was done for the management of ectopic pregnancy. The site of ectopic pregnancy in the tubal pregnancy varied, with 76.75 % in the ampullary region, 16.27 % isthumic, 2.33 % fimbrial, and 4.65 % in the cornual region. Salpingectomy was done in 53.5 % cases and 46.5 % of patients underwent a conservative approach in the form of salpingostomy.Conclusion
The laparoscopic management of ectopic pregnancy is a safe and effective option with greatly reduced morbidity. 相似文献15.
目的:探讨异位妊娠腹腔内大出血诊断、抢救与预后的关系。方法:回顾性分析2004年1月至2013年12月在湖北省嘉鱼县人民医院和潜江市中心医院收治的150例异位妊娠腹腔内大出血的病例资料。结果:异位妊娠致腹腔内大出血150例均成功实施手术,手术成功率100%。术中证实输卵管间质部妊娠破裂27例(18.0%),行子宫角部楔形切除及输卵管切除术;卵巢妊娠破裂5例(3.3%),行卵巢楔形切除加卵巢修补术;输卵管峡部妊娠破裂51例(34.0%),行患侧输卵管峡部切除术;输卵管壶腹部妊娠破裂43例(28.7%),行患侧输卵管切除术;输卵管壶腹部妊娠流产22例(14.7%),17例无生育要求,行患侧输卵管切除,5例有生育要求,行输卵管切开取胚胎术;腹腔妊娠1例(0.7%),行病灶切除术;输卵管伞部妊娠流产1例(0.7%),行患侧输卵管切除术。150例中148例经过积极抢救并及时手术治疗恢复良好,1例患者术后出现暂时性尿崩症经治疗后好转,1例患者因休克时间长,于术后18天患者家属放弃治疗死亡。结论:异位妊娠腹腔内大出血应及时确诊,迅速抢救,有效的抗休克治疗和输血,积极手术切除异位妊娠灶,可挽救患者生命,减少不良结局的发生。 相似文献
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异丙酚与氯胺酮联合麻醉用于异位妊娠腹腔镜手术68例分析 总被引：1，自引：0，他引：1
目的:探讨氯胺酮与异丙酚静脉全身麻醉用于异位妊娠腹腔镜治疗的安全性。方法:对68例异位妊娠腹腔镜治疗患者选择氯胺酮与异丙酚静脉麻醉,观察生命体征、麻醉效果、副反应、苏醒时间等。结果:注射氯胺酮后8例患者MAP升高达到25%;注射异丙酚后25例RR<12/min,16例SpO2<0.93,6例HR<60/min;气腹5分钟时5例RR<12/min、但SpO2维持正常;气腹10分钟和气腹15分钟时,HR、MAP、RR、SpO2均在正常标准范围内;术毕意识恢复时间10.9±2.8分钟,定向力恢复时间12.6±3.1分钟,无躁动、谵妄、恶心呕吐、尿潴留等。结论:氯胺酮与异丙酚静脉麻醉是短时间异位妊娠腹腔镜治疗的可选择的一种麻醉方式,可达到安全、微创、经济等目的。 相似文献
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目的:分析近5年输卵管间质部妊娠的临床特点变化情况。方法:采用回顾性分析方法对90例输卵管间质部妊娠(间质部妊娠组)的临床特点进行分析,并选择同期收治的壶腹部妊娠组(120例)及峡部妊娠组(100例)患者的临床资料进行对照分析。结果:间质部妊娠组临床表现以阴道流血、伴或不伴腹痛为主要症状(60例,66.7%),无症状表现者14例(15.6%),出现单纯腹痛者(16例,17.8%),平均停经天数48.9±10.4天,为间质部妊娠组出现症状时,停经时间最短者。间质部妊娠组患者在停经8周内确诊59例(65.6%),8～12周内确诊27例(30.0%),与壶腹部妊娠组相比差异无统计学意义(P>0.05)。间质部妊娠组术前通过B超检查结合血β-HCG检测提示为间质部妊娠者37例(41.1%),血β-HCG在就诊时平均12579±9548U/L,明显高于壶腹部妊娠组(2132±567U/L)及峡部妊娠组(2079±607U/L),3组比较,差异有统计学意义(P<0.05)。结论:随着检测水平及检测手段的提高,输卵管间质部妊娠发现及诊断时间并不比其他类型的异位妊娠时间晚,输卵管间质部妊娠可以早期发现、早期诊断、早期治疗。 相似文献
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Laurentiu Pirtea Oana Balint Cristina Secosan Dorin Grigoras Razvan Ilina 《Journal of minimally invasive gynecology》2019,26(3):399-400
Study Objective
To present a case of a cesarean scar ectopic pregnancy treated by laparoscopic resection followed by isthmocele repair.Design
A case report.Settings
The University Gynecology Clinic of the Emergency Clinical City Hospital Timi?oara, Timi?oara, România.Background
Cesarean scar pregnancy is a rare form of ectopic pregnancy. In recent years, its prevalence has risen because of the increasing number of cesarean sections. An early diagnosis can lead to early management, decreasing the risk of life-threatening complications such as uterine rupture and massive hemorrhage. Many therapeutic options are available, medical and surgical, but the current literature suggests that the laparoscopic approach with ectopic pregnancy resection is the best option.Case Report
We present the case of a 30-year-old woman with a previous cesarean section in 2012 who was diagnosed by transvaginal ultrasound with a 6-week live pregnancy implanted at the level of the cesarean scar. The initial management was the administration of a 2-dose methotrexate protocol, but after 72 hours the transvaginal ultrasound showed an embryo with cardiac activity still present associated with an increased beta human chorionic gonadotropin level. We decided on laparoscopic surgical treatment, aiming to extract the pregnancy and repair the scar defect. A similar case was presented by Mahgoub et al [1], but their case had a different evolution, with decreasing levels of hCG.Interventions
In order to reduce the blood loss, the anterior trunks of the hypogastric arteries were clipped. The side wall peritoneum was cut bilaterally, and the ureters and the hypogastric arteries were dissected. Next, we performed the dissection of the vesicouterine space. Because of the previous cesarean section, the identification of the correct dissection plane was difficult. A uterine manipulator was used to facilitate the dissection. The exact location of the gestational sac was demonstrated using intraoperative transvaginal ultrasound. To reduce the bleeding, Glypressin (Ferring GmbH, Saint Prex, Switzerland) was injected at the level of the uterine scar. The cesarean scar was cut using a monopolar knife. The gestation sac was reached easily and then extracted from the abdominal cavity with the use of an endobag. In order to obtain proper healing, the margins of the scar were resected using cold scissors. The hysterotomy was closed using a double-layered suture with 2.0 Vicryl (Ethicon Inc., Cincinnati, OH). We used methylene blue to verify the tightness of the suture. The final step was the removal of the clips.Measurements and Main Results
The operative time was 85 minutes with minimal blood loss of about 20 mL. The patient recovered well and was discharged 2 days after the procedure. A transvaginal ultrasound was performed 1 month after the surgery showing good healing of the anterior uterine wall.Conclusion
The laparoscopic approach with excision and repair of the uterine wall represents a safe and efficient therapeutic option for the treatment of the cesarean scar ectopic pregnancy. 相似文献19.
OBJECTIVE: The molecular mechanisms underlying ectopic implantation have not been well characterized. Here we investigate HOXA10 gene expression at the site of ectopic implantation as compared with the endometrium and with the normal fallopian tube. STUDY DESIGN: Northern blot analysis was used to evaluate HOXA10 gene messenger RNA level in various segments of normal pregnant and nonpregnant human fallopian tube, ectopic pregnancy, and endometrium. RESULTS: Normal human fallopian tube expressed minimal levels of HOXA10 gene messenger RNA in the nonpregnant state. A trend toward a greater expression of HOXA10 gene was observed in the normal fallopian tube during pregnancy, but the difference was not statistically significant (P =.075). HOXA10 gene messenger RNA expression was up-regulated significantly at the site of implantation in ectopic pregnancy (P <.001), and its expression approached that of the endometrium during normal pregnancy (P =.33). CONCLUSION: HOXA10 gene expression is up-regulated at the ectopic implantation site in the fallopian tube, approaching that of the endometrium in normal intrauterine gestation. Inherently increased HOXA10 gene expression in the fallopian tube or dysregulation of HOXA10 gene expression by an abnormally implanting blastocyst may play a role in ectopic implantation. 相似文献
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异位妊娠相关的高危因素 总被引：1，自引：0，他引：1
徐虹 《国外医学:妇产科学分册》2009,(5):394-397
异位妊娠是早期妊娠妇女死亡的首要原因,近几十年发病率有上升趋势。对异位妊娠相关高危因素的认识有助于早期诊断、治疗及预防该病的发生。国内外对其相关高危因素的研究主要包括：盆腔炎性疾病、腹部手术史、吸烟、既往异位妊娠史、不孕史、辅助生育技术、避孕方法失败、流产和年龄等。其中盆腔炎性疾病,输卵管手术史及吸烟为异位妊娠的三大主要高危因素。异位妊娠往往是一种或多种高危因素同时作用的结果。 相似文献