Successful therapy for intramural pregnancy with combination of hysteroscopy and laparoscopy: a case report and literature review

doi:10.3877/cma.j.issn.1674-6899.2019.04.014

Abstract

Abstract:

Objective

To investigate the clinicopathological characteristics, diagnosis and differentiated diagnosis, and the regimens of intramural pregnancy (IMP).

Methods

A case of IMP was analyzed for the clinical manifestation, auxiliary assesses, clinical therapy, results of biopsy and pathology, with related literatures reviewed.

Results

The patient was diagnosed with IMP in uterine horn and underwent the hysteroscopy combined with laparoscopy, by which the lesion was successfully removed, with the uterine retained.

Conclusions

Due to the difficulty of intramural pregnancy diagnosis and lack of treatment experience, we should consider this disease when the patients had a history of induced abortion or endometriosis, as well as those who had a history of embryo transplantation.

Key words: Intramural pregnancy, Ectopic pregnancy, Hysteroscopy, Laparoscopy

Maofang Hua, Yuan Wang, Jun Yao. Successful therapy for intramural pregnancy with combination of hysteroscopy and laparoscopy: a case report and literature review[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2019, 12(04): 250-252.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhqjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6899.2019.04.014

https://zhqjwkzz.cma-cmc.com.cn/EN/Y2019/V12/I04/250

Figures/Tables 2

References 19

1	Ginsburg KA, Quereshi F, Thomas M, et al. Intramural ectopic pregnancy implanting in adenomyosis [J]. Fertility and sterility, 1989, 51(2):354-356.
2	Bernstein HB, Thrall MM, Clark WB. Expectant management of intramural ectopic pregnancy [J]. Obstetrics and gynecology, 2001, 97(5):826-827.
3	Ong C, Su LL, Chia D, et al. Sonographic diagnosis and successful medical management of an intramural ectopic pregnancy [J]. Journal of clinical ultrasound : JCU, 2010, 38(6):32032-32034.
4	ACOG Practice Bulletin No. 191: Tubal Ectopic Pregnancy [J]. Obstetrics and gynecology, 2018, 131(2):65-77.
5	Mcgowan L. Intramural Pregnancy[J]. Jama, 1965, 192(7):637-638.
6	Chida H, Kikuchi A, Murai M, et al. Intramural pregnancy implanted into a myometrial defect caused by curettage: diagnosis with transvaginal sonography and preconception and postconception magnetic resonance imaging[J]. Journal of ultrasound in medicine：official journal of the American Institute of Ultrasound in Medicine, 2016, 35(9):2066-2067.
7	Choi D, Kwon HY, Kim J. Intramural pregnancy associated with adenomyosis after in vitro fertilization and embryo transfer: a case report[J]. Journal of Reproductive Medicine, 2009, 54(4):255-258.
8	Lee GS, Hur SY, Kown I, et al. Diagnosis of early intramural ectopic pregnancy[J]. Journal of clinical ultrasound : JCU, 2005, 33(4):190-192.
9	Memtsa M, Jamil A, Sebire N, et al. Diagnosis and management of intramural ectopic pregnancy [J]. Ultrasound Obstet Gynecol, 2013, 42(3):359-362.
10	Liu NN, Han XS, Guo XJ, et al. Ultrasound diagnosis of intramural pregnancy [J]. The journal of obstetrics and gynaecology research, 2017, 43(6):1071-1075.
11	张敏. 孕早期宫角妊娠与子宫肌层妊娠的声像图特征[J]. 安徽医学，2012, 33(1):68-70.
12	Glass T, Smith P, Hodges R, et al. Intramural pregnancy presenting in a patient with tuberous sclerosis[J]. Journal of clinical ultrasound : JCU, 2010, 38(7):393-396.
13	Ko HS, Lee Y, Lee HJ, et al. Sonographic and MR findings in 2 cases of intramural pregnancy treated conservatively [J]. Journal of clinical ultrasound : JCU, 2006, 34(7):356-360.
14	Su S, Chavan D, Song K, et al. Distinguishing between intramural pregnancy and choriocarcinoma: a case report [J]. Oncology letters, 2017, 13(4):2129-2132.
15	Jin H, Zhou J, Yu Y, et al. Intramural pregnancy: a report of 2 cases [J]. The Journal of reproductive medicine, 2004, 49(7):569-572.
16	Wu PJ, Han CM, Wang CJ, et al. Early detection and minimally invasive management of intramural pregnancy [J]. Journal of minimally invasive gynecology, 2013, 20(1):123-126.
17	Wang S, Dong Y, Meng X. Intramural ectopic pregnancy: treatment using uterine artery embolization [J]. Journal of minimally invasive gynecology, 2013, 20(2):241-243.
18	刘亚滨，耿洁恩，吴蕊，等．宫腔介入治疗子宫肌壁间妊娠三例临床分析[J]．中华妇产科杂志，2005，40(12):851-852.
19	Verghese T, Wahba K, Shah A. An interesting case of intramyometrial pregnancy [J]. BMJ case reports, 2012, 2012(1):1-5.

[1]	Shihai Zhou, Hong Chen, Jing Zhang, Hongzhi Luo, Chunzai Feng, Hao Sun, Siquan Zhong. Natural orifice specimen extraction in colorectal tumor surgery: analysis of 67 cases [J]. Chinese Archives of General Surgery(Electronic Edition), 2021, 15(05): 340-343.
[2]	Jiawei Wang, Qingjun You, Xiaolin Li, Yifei Jia, Chao Duan. Clinical value of laparoscopic surgery based on CT three-layer quartet for the treatment of gastroesophageal junction tumor [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2021, 15(04): 400-403.
[3]	Song Chen, Yuzhe Tang, Meng Fu, Boxing Su, Yubao Liu, Bo Xiao, Weiguo Hu, Jianxing Li. Treatment of benign ureteral stenosis: retrospective analysis of 90 cases in single-center [J]. Chinese Journal of Endourology(Electronic Edition), 2021, 15(04): 313-316.
[4]	Hao Zhang, Yuanjun Jiang, Tao Liu. Experiences of anterograde laparoscopic inguinal lymph node dissection of 14 penile cancer patients [J]. Chinese Journal of Endourology(Electronic Edition), 2021, 15(04): 317-320.
[5]	Guangxu Liu, Tao Liu. Application of 3D laparoscopy in nephron sparing surgery [J]. Chinese Journal of Endourology(Electronic Edition), 2021, 15(04): 330-333.
[6]	Yangbai Lu, Wei Li, Yongxin Zhang, Yaqiang Huang, Bin Cao, Gang Luo, Runqiang Yuan, Hongxing Huang. The effectiveness and safety of "one scalpel and one scissors" method to establish laparoscopic observation access for transperitoneal laparoscopic surgery [J]. Chinese Journal of Endourology(Electronic Edition), 2021, 15(03): 192-197.
[7]	Xinghao Li, Zheng Liu, Jieying Wu, Tengcheng Li, Maoyin Li, Youqiang Fang. Comparison of transperitoneal and retroperitoneal laparoscopic adrenalectomy under preoperative CT-assisted program: report of 509 cases [J]. Chinese Journal of Endourology(Electronic Edition), 2021, 15(03): 215-220.
[8]	Fangming Wang, Guiming Zhang, Yong Liu, Lijiang Sun. Characteristics of central adrenal vein anatomy and variability in retroperitoneal laparoscopic right adrenalectomy [J]. Chinese Journal of Endourology(Electronic Edition), 2021, 15(03): 221-225.
[9]	Fang Li, Junfeng Wang. Meta-analysis of clinical efficacy and safety of laparoscopic transabdominal preperitoneal hernioplasty for recurrent inguinal hernia [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2021, 15(04): 401-409.
[10]	Ruijuan Huang, Xiangying Ma, Weidong Du, Jin Zhao. Effect on anti-reflux effect and quality of life in patients with GERD complicated with hiatus herniausing lansoprazole combined with itopride assisted laparoscopic repair of esophageal hiatus hernia [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2021, 15(03): 272-275.
[11]	Hui Zhou, Zhiyong Zhong, Suolin Li, Baojun Shi, Xiaofeng Yang. Application of ultrasonic knife combined with microwave hemostatic separator in laparoscopic resection of pediatric liver mass [J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2021, 14(04): 226-230.
[12]	Xiaogang Xu, Jixiao Zeng, Fei Liu, Menglong Lan, Boyuan Tao, Yuzhen Lin. Natural orifice transumbilical single-port three-dimensional laparoscopic hepojejunostomy for congenital choledochal cyst in children [J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2021, 14(03): 172-176.
[13]	Peng Hu, Wenquan Liang, Kecheng Zhang, Hongqing Xi, Jianxin Cui, Lin Chen. Short-term and quality of life outcomes of laparoscopy-assisted versus totally laparoscopic distal gastrectomy for gastric cancer: a single-center retrospective cohort study [J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2021, 14(03): 141-148.
[14]	Jian Sun, Hongyan Xin, Mingxu Ding. Application of carotid atherosclerosis ultrasonography in the diagnosis and treatment of cerebral infarction [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2021, 11(05): 211-214.
[15]	Sugui Wang, Lu Zhang, Fujin Jiang, Qiang Li, Ziyu Wu, Xianyun Zhang. Clinical value of diameter-axial-polar scoring system in retroperitoneal laparoscopic partial nephrectomy for renal cell carcinoma [J]. Chinese Journal of Clinicians(Electronic Edition), 2021, 15(04): 255-259.

Please choose a citation manager

Content to export