腹腔鏡用超音波プローブが有用であった卵管間質部妊娠の一例

概要

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Interstitial pregnancy is rare, accounting for 2%-4% of ectopic pregnancies. Massive intra-abdominal bleeding from uterine rupture may be fatal, so early detection and treatment are crucial. We report here a case of interstitial pregnancy detected early via laparoscopic surgical ultrasound probe. The patient, a 39-year-old female, presented at 5 weeks and 2 days of gestation, according to last menses. The initial serum human chorionic gonadotropin level of 2599 mIU/ml climbed to 4498.6 mIU/ml after two days. With a clinical diagnosis of ectopic pregnancy, emergency laparoscopic exploration was performed, disclosing a swollen left uterine cornu. Passage of an ultrasound probe enabled imaging of left cornual implantation and guided surgical extraction of the gestational sac. The limited uterine defect was easily repaired with negligible total blood loss. Laparoscopic diagnosis and treatment of this interstitial pregnancy was thus expedited through the use of an ultrasound probe.
日本産科婦人科内視鏡学会の論文
2010-12-01