残角子宫妊娠的临床诊治分析

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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.

Key words： Residual horn uterine pregnancy Misdiagnosis Diagnosis Therapy

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	LU Jie
	WANG Xiao-min

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LU Jie,WANG Xiao-min. Analysis of the clinical diagnosis and treatment of residual horn uterine pregnancy[J]. 中国当代医药, 2019, 26(2): 113-116.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2019/V26/I2/113

[6]	吴淑道，刘智.早孕期残角子宫妊娠的超声表现附14例分析[J].肿瘤影像学，2017，26（2）：141-144.
[7]	郑亮慧，陈素清，刘照贞，等.残角子宫妊娠6例临床分析[J].福建医药杂志，2014，36（1）：37-40.
[11]	张多多，朱兰，郎景和.残角子宫妊娠的临床特点[J].中华妇产科杂志，2018，53（4）：274-277.
[12]	曹泽毅.中华妇产科学[M].3版.北京：人民卫生出版社，2014：1288.
[1]	Kadan Y，Romano S.Rudimentary horn pregnancy diagnosed by ultrasound and treated by laparoscopy-a case report and review of the literature[J].J Minim Invasive Gynecol，2008，15（5）：527-530.
[2]	Iyoke C，Okafor C，Ugwu G，et al.Live Birth following a term pregnancy in a non-communicating rudimentary horn of a unicornuate uterus[J].Ann Med Health Sci Res，2014，4（1）：126-128.
[3]	Arslan T，Bilgi E，Senturk MB，et al.Rudimentary uterine horn pregnancy:a mystery diagnosis[J].Fertil Steril，2009，92（6）：2037.
[4]	Cheng C，Tang W，ZhangL，et al.Unruptured pregnancy in a noncommunicating rudimentary horn at 37 weeks with a live fetus:a case report[J].J Biomed Res，2015，29（1）：83-86.
[5]	Samuels TA，Awonuga A.Second-trimester rudimentary uterine horn pregnancy:rupture aftea labor induction with misoprostol[J].Obstet Gynecol，2005，106（5 Pt 2）：1160-1162.
[8]	Tsafrir A，Rojansky N，Sela HY，et al.Rudimentary horn pregnancy:first-trimester prerupture sonographic diagnosis and confirmation by magnetic resonance imaging[J].J Ultrasound Med，2005，24（2）：219-223.
[9]	Grimbizis GF，Campo R.Clinical approach for the classification of congenital uterine malformations[J].Gynecol Surg，2012，9（2）：119-129.
[10]	Nahum GG.Rudimentary uterine horn pregnancy.The 20thcentury worldwide experience of 588 cases[J].J Reprod Med，2002，47（2）：151-163.
[13]	Shahid A，Olowu O，Kandasamy G，et al.Laparoscopic management of a 16-week ruptured rudimentary horn pregnancy:a case and literature review[J].Arch Gynecol Obstet，2010，282（2）：121-125.
[14]	Park JK，Dominguez CE.Combined medical and surgical management of rudimentary uterine horn pregnancy[J].JSLS，2007，11（1）：119-122.
[15]	Lennox G，Pantazi S，Keunen J，et al.Minimally invasive surgical management of a second trimester pregnancy in a rudimentaryuterine horn[J].J Obstet Gynaecol Can，2013，35（5）：468-472.
[16]	程文俊．腹腔镜手术治疗残角子宫的手术技巧及并发症防治[J]．实用妇产科杂志，2010，26（5）：326-329．
[17]	吴小肄，姜伟.155例残角子宫合并单角子宫临床病例分析[J].现代妇产科进展，2016，25（12）：920-923.
[18]	许华，朱瑾.4例残角子宫妊娠临床报道[J].复旦学报（医学版），2010，37（1）：100-102.