罕见子宫畸形合并宫颈妊娠1例并相关文献复习

Rare Uterine Malformation Complicated with Cervical Pregnancy: A Case Report and Review of Related Literature

摘要: 目的：探讨宫颈妊娠的病因及诊疗。方法：回顾分析我院收治的一例双宫颈不全纵隔子宫畸形合并宫颈妊娠患者的临床资料，对诊治过程进行报道，并结合文献复习。结果：B超及MRI提示宫颈妊娠。入院后在双侧子宫动脉栓塞术后行超声引导下人工流产负压吸引术 + 宫腔镜下妊娠组织清除术。术后病理符合妊娠改变，术后辅助药物治疗，随访血清β-hCG降至正常，治疗成功。结论：宫颈妊娠临床罕见，B超及MRI可辅助诊断。子宫动脉栓塞可明显改善治疗与预后，避免大出血切除子宫的结局。宫腔镜下妊娠组织清除术能够可视化评估宫颈妊娠植入部位，避免盲目操作引起的大出血等并发症，有利于更彻底地清除妊娠组织，缩短治疗时间。

Abstract: Objective: To explore the etiology, diagnosis and treatment of cervical pregnancy. Method: Retro-spectively analyze the clinical data of a case of double cervical incomplete mediastinal uterine mal-formation combined with cervical pregnancy admitted to our hospital and review relevant litera-ture. Results: Cervical pregnancy can be diagnosed by ultrasound and MRI. Ultrasound-guided vac-uum aspiration for induced abortion and hysteroscopic removal of pregnancy tissue were per-formed after bilateral uterine artery embolization. The pathological diagnosis was pregnancy tissue. Adjuvant drug therapy was given after surgery, and serum β-hCG decreased to normal during fol-low-up. The treatment was successful. Conclusion: Cervical pregnancy is rare in clinic. Ultrasound and MRI can assist in diagnosis of cervical pregnancy. Uterine artery embolization can significantly improve the treatment and prognosis, and avoid the outcome of massive hemorrhage and hyster-ectomy. Hysteroscopic removal of pregnancy tissue can visually evaluate the implantation site of cervical pregnancy, avoid bleeding and other complications caused by blind operation, which is conducive to more thorough removal of pregnancy tissue and shorten the treatment time.