自发宫内宫外同时妊娠并发输卵管破裂出血术后足月分娩1例报告

[摘要]目的强调宫内孕合并急腹症时发生自发宫内宫外同时妊娠（HP）的风险。方法和结果报道1例自发HP患者,有继发性不孕高危因素。在孕13周时因宫内孕合并输卵管妊娠破裂,出现失血性休克,行开腹患侧输卵管切除术。术后宫内胎儿孕期情况平稳,孕37+2周时因前置胎盘经剖宫产分娩一健康婴儿。结论HP多发生于接受辅助生殖技术的妇女,但当有高危因素存在时,也可发生于自然受孕人群。尽管宫内孕合并宫外输卵管妊娠破裂、失血性休克,如能积极抢救、加强支持治疗,仍能获得满意的结局。

Full-term delivery after surgical management of tubal rupture combined with heterotopic pregnancy: a case report

[Abstract]Objective To understand the risk of heterotopic pregnancy when intrauterine pregnancy and abdominal pain co-exist. Methods and resultsWe report a patient with heterotopic pregnancy in a naturally occurring pregnancy; she also had high risks for secondary infertility. At gestational week 13 she had hemorrhagic shock due to intrauterine pregnancy complicated with rupture of tubal pregnancy; salpingectomy was performed via open operation. The intrauterine pregnancy was uneventful after operation, and a healthy baby was delivered through cesarean section at 37+2 weeks due to placental previa. MethodsHeterotopic pregnancy usually occurs in women receiving assisted reproductive technology, but it can also happen in natural conception when there are high risk factors. Satisfactory outcome can be obtained in patients with heterotopic pregnancy, rupture of tubal pregnancy, and hemorrhagic shock, if prompt measures and supporting treatment can be given.