Cesarean scar ectopic dichorionic twins pregnancy with right ovarian serous papillary cystadenoma: a case report and literature review
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摘要: 剖宫产术子宫瘢痕妊娠是指受精卵着床于前次剖宫产子宫切口瘢痕处的一种异位妊娠，子宫破裂是其众所周知的并发症，可危及生命，而出现子宫瘢痕双胞胎妊娠的病例实属罕见，本文报道1例子宫瘢痕双绒毛膜双胞胎妊娠合并右侧卵巢浆液性乳头状囊腺瘤更是临床上难得一见的病例，现结合文献复习，探讨子宫瘢痕妊娠合并卵巢浆液性乳头状囊腺瘤的临床诊断与鉴别诊断，若能在妊娠早期行常规规范盆腔妇检，并选择经阴道彩色多谱勒超声检查，有助于早期诊断，可避免延误诊治而导致相关风险。
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关键词:
- 剖宫产 /
- 子宫瘢痕妊娠 /
- 双绒毛膜双胞胎 /
- 卵巢浆液性乳头状囊腺瘤 /
- 经阴道彩色多普勒超声 /
- 早期诊断
Abstract: Cesarean scar ectopic pregnancy is defined as the fetus implantes on the previous uterine scar. As a life-threatening disease,cesarean scar ectopic pregnancy is easy to complicated with uterine rupture and bleeding. There were few studied on cesarean scar ectopic dichorionic twins pregnancy worldwide. Here we reported one extremely case with cesarean scar ectopic dichorionic twins pregnancy. We discussed clinical diagnosis and differential diagnosis of cesarean scar ectopic pregnancy with ovarian serous papillary cystadenoma by reviewing the literatures. Early detection of cesarean scar ectopic pregnancy is essential for providing important diagnostic information for correct diagnosis and treatments. In the early stage of pregnancy, conventional transvaginal color Doppler ultrasound scan is helpful to detect cesarean scar ectopic pregnancy and reduce the risk of uterine rupture and bleeding. -
[1] 中华医学会妇产科学分会计划生育学组. 剖宫产术后瘢痕妊娠诊治专家共识[J]. 中华妇产科杂志, 2016, 51(8): 568-72. doi: 10.3760/cma.j.issn.0529-567x.2016.08.003 [2] Litwicka K, Greco E. Caesarean scar pregnancy: a review of management options[J]. Curr Opin Obstet Gynecol, 2013, 25(6): 456-61. doi: 10.1097/GCO.0000000000000023 [3] 余 萍, 刘 娟. 剖宫产术后子宫疤痕处妊娠18例临床分析[J]. 中国妇幼保健, 2013, 28(6): 920-1, 927. doi: 10.7620/zgfybj.j.issn.1001-4411.2013.06.08 [4] Rehan M, Ri az. Cesarean scar ectopic pregnancy: imaging features, current treatment options, and clinical outcomes[J]. Abdom Imaging, 2015, 40(7): 2589-99. doi: 10.1007/s00261-015-0472-2 [5] 周逸雪, 林 英, 李云云. 子宫瘢痕部位妊娠诊治现状及研究进展[J]. 中国妇幼保健, 2018, 33(12): 2869-73. [6] 余瀚洋, 李翠兰. 妊娠合并卵巢肿瘤的诊疗进展[J]. 中国临床医生杂志, 2016, 44(9): 19-21, 22. doi: 10.3969/j.issn.2095-8552.2016.09.008 [7] 余贵媛, 李秋霞, 张 蕾, 等. 425例妊娠合并卵巢肿瘤患者的诊治分析[J]. 国际妇产科学杂志, 2018, 45(2): 231-5. doi: 10.3969/j.issn.1674-1870.2018.02.027 [8] 谢 幸, 苟文丽. 妇产科学[M]. 第8版. 北京: 人民卫生出版社, 2013: 321-33. -
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