Abstract:Objective To analyze the clinical features,diagnosis and treatment of residual horn uterine pregnancy,and to reduce the misdiagnosis rate.Methods The clinical data of 5013 cases with ectopic pregnancy admitted to our hospital from July 1,1993 to December 31,2016 were retrospectively analyzed,and the related literature was reviewed.Results During 23 years,10 cases of residual horn uterine pregnancy accounted for 0.20%of ectopic pregnancy patients at the same period,3 cases of residual horn uterine cavity connected with normal uterine cavity,7 cases of non-communicating residual horn uterus(70%).Four cases of intrauterine pregnancy were indicated by B-mode ultrasonography.Among them,2 cases had no villus after induced abortion,1 case had stillbirth after 3-month pregnancy clinic treatment,and 1 case had mid-pregnancy and intrauterine live fetus because of abdominal pain clinic B-mode ultrasonography.The other 6 cases were not examined and were first visited in our hospital.Among them,1 case was ruptured uterine remnant horn pregnancy,1 case was diagnosed uterine remnant horn pregnancy by ultrasound before rupture,accounting for 10%.3 cases were admitted to hospital with ectopic pregnancy,1 case had obvious anemia,shock and abdominal distension in 5 months of pregnancy,and the suspected intestinal obstruction was transferred to superior hospital.All the 10 patients underwent laparotomy,2 cases without rupture underwent elective operation,the remaining 8 cases underwent emergency operation,and 3 cases of fetus and placenta were discharged into abdominal cavity or blocked the rupture.The residual horn uterus was located on the right in 6 cases,on the left in 4 cases,on the opposite side of the corpus luteum in 3 cases,and on the umbrella end of the fallopian tube in 3 cases.Surgical methods included residual horn hysterectomy plus salpingectomy on the affected side in 5 cases,simple residual horn hysterectomy in 5 cases,and circular ligament suture and fixation in 3 cases.One patient died(10%).Conclusions Residual horn uterine pregnancy is very rare,often occurs in the second trimester of pregnancy uterine rupture,because there is no specific clinical manifestations,it is very easy to misdiagnose.Attention to early pregnancy examination,careful and accurate analysis of clinical data and ultrasound examination can help to reduce the rate of misdiagnosis;early operation should be carried out after diagnosis,and minimal invasive treatment should be advocated.
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LU Jie;WANG Xiao-min. Analysis of the clinical diagnosis and treatment of residual horn uterine pregnancy. 中国当代医药, 2019, 26(2): 113-116.
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