诊断学理论与实践 ›› 2023, Vol. 22 ›› Issue (01): 64-67.doi: 10.16150/j.1671-2870.2023.01.010

• 病例报告 • 上一篇    下一篇

超声动态监测宫角妊娠足月分娩1例报道

孙芳璨, 周金华, 顾欣贤, 陈友国, 孙倩茹, 韩冰()   

  1. 苏州大学附属第一医院妇产科,江苏 苏州 215006
  • 收稿日期:2021-07-07 出版日期:2023-02-25 发布日期:2023-07-06
  • 通讯作者: 韩冰 E-mail:hanbing@suda.edu.cn
  • 基金资助:
    苏州大学附属第一医院自然科学基金博习培育计划(BXQN202222)

Ultrasound dynamic monitoring of a full-term angular pregnancy: a case report

SUN Fangcan, ZHOU Jinhua, GU Xinxian, CHEN Youguo, SUN Qianru, HAN Bing()   

  1. Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
  • Received:2021-07-07 Online:2023-02-25 Published:2023-07-06
  • Contact: HAN Bing E-mail:hanbing@suda.edu.cn

摘要:

国内外对宫角妊娠定义不一,诊断较为困难,一次检查结果可能不足以诊断,有时也会存在一定的误导。所以动态监测对于宫角妊娠诊断以及后续患者的管理十分重要,而超声检查相比于盆腔MRI或腹腔镜检查具有更经济、方便、省时、操作性强等优势。本文报道了1例继续妊娠意愿非常强烈的宫角妊娠患者。利用超声技术对患者进行动态监测,观察其孕囊的大小、位置、与子宫内膜的关联、宫角部肌层的厚度等,后期随访超声检查均提示为偏心的宫内妊娠,最终患者成功足月分娩。本病例提示可以利用超声对这类患者进行动态监测,但应由经验丰富的医师进行标准化检查以尽早明确诊断,必要时还可采用三维超声、盆腔MRI及腹腔镜检查协助诊断。宫角妊娠需建立多学科、全方位、全程规范化的患者管理方案,以改善母婴结局。

关键词: 宫角妊娠, 超声, 动态监测

Abstract:

The definition of angular pregnancy is different, and the diagnosis is difficult. At the same time, the results of a single examination may not be enough to diagnose, and sometimes there will be misleading. Therefore, dynamic monitoring is very important for diagnosis and follow-up management. Compared with pelvic MRI or laparoscopy, ultrasound has the advantages of economy, convenience, time saving and strong operability. This paper reported a case of angular pregnancy with a strong desire to continue pregnancy. Ultrasound was used for dynamic monitoring, such as observing the size and position of the gestational sac, its association with the endometrium, and the thickness of the muscular layer of the uterine corner. Ultrasound follow-up showed that she had an eccentric intrauterine pregnancy and delivered to term successfully. This case suggests that ultrasound can be used for dynamic monitoring of such patients, but it is better to confirm early diagnosis with standardized examination by an experienced physician. If necessary, three-dimensional ultrasound, pelvic MRI and laparoscopy can be used to assist diagnosis. In addition, it is also necessary to pay attention to multi-discip-linary, all-round and full-process standardized management to avoid blindly giving up and improve maternal and infant outcomes.

Key words: Angular pregnancy, Ultrasound, Dynamic monitoring

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