孕晚期宫角妊娠破裂1例分析报道  

Angular pregnancy rupture in the third trimester: a case report

作　　者：李建安 Li Jianan(Fangchengcheng District Maternal and Child Health Hospital,Fangchenggang 538021,Guangxi,China)

机构地区：[1]防城港市防城区妇幼保健院妇产科,广西防城港538021

出　　处：《实用妇科内分泌电子杂志》2021年第19期80-82,共3页Electronic Journal of Practical Gynecological Endocrinology

摘　　要：目的 研究1例孕晚期子宫角妊娠临床特征与诊治方式。方法 回顾分析2021年5月22日本院收治的1例孕晚期子宫角妊娠患者临床资料,观察患者临床特征、诊治方式。结果 本例患者术后诊断为:孕8产1孕33+1周剖宫产;左侧宫角妊娠并子宫破裂;胎盘植入;左侧宫角楔形切除术后;脐带缠绕(绕颈2周);乙肝病毒携带者。治疗:入院后予以抑制宫缩及促胎肺成熟治疗,在局麻+强化麻醉下行紧急剖宫产,术中给予左侧子宫角部楔形切除术,术后给予抗感染、促进宫缩治疗后,术后第2d拔除引流管;第3d查腹部B超:宫腔分离条索;第7d拆除伤口缝线后给予出院处理。新生儿在儿科观察,存活较佳。结论 在孕期应加强检查,在发现宫角妊娠后立即采取相应的处理措施,若孕期漏诊,妊娠至孕晚期出现胎盘植入、子宫破裂就诊时,应立即启动急救措施,保障孕产妇及胎儿生命安全,促进其预后恢复,加快其产后康复速度。Objective To study the clinical characteristics, diagnosis and treatment of a case of horn pregnancy in the third trimester. Methods The clinical data of a patient with horn pregnancy in the third trimester admitted to Japanese hospital on May 22, 2021 were retrospectively analyzed, and the clinical characteristics, diagnosis and treatment of the patient were observed.Results The postoperative diagnosis of this case was: Cesarean section at 8 gestation and 33+1 week gestation;Left cornual pregnancy with uterine rupture;Placenta implantation;Left cornual wedge resection;Umbilical cord wrapping(around neck for 2 times);Hepatitis B virus carriers. Treatment: After admission, uterine contractions were inhibited and fetal lung maturation was promoted. Emergency cesarean section was performed under local anesthesia and enhanced anesthesia, and left uterine corner wedge resection was performed during the operation. After anti-infection and promotion of uterine contractions, drainage tube was removed 2d after surgery. 3d abdominal ultrasonography: Intrauterine separation strip shuttle;On 7th day, the wound was removed and sutures were removed. Neonates in the pediatric observation, the survival rate is better. Conclusion The examination should be strengthened during pregnancy, and the corresponding treatment measures should be taken immediately after the discovery of angular pregnancy. If the diagnosis is missed during pregnancy, the first aid measures should be immediately started in the case of placenta implantation and uterine rupture during the third trimester of pregnancy, so as to ensure the life safety of pregnant women and the fetus, promote their prognosis and speed up their postpartum recovery.

关 键 词：孕晚期 宫角妊娠 左侧子宫角部楔形切除术 

分 类 号：R714.22[医药卫生—妇产科学]