国际生殖健康/计划生育杂志 ›› 2024, Vol. 43 ›› Issue (2): 118-120.doi: 10.12280/gjszjk.20230272

• 病例报告 • 上一篇    下一篇

双子宫合并卵巢妊娠一例

谷旭照, 沈豪飞, 高敏, 刘阿慧, 王娜, 杨雯景, 张学红()   

  1. 730000 兰州大学第一临床医学院(谷旭照,沈豪飞,高敏,刘阿慧,王娜,杨雯景); 兰州大学第一医院(张学红)
  • 收稿日期:2023-07-04 出版日期:2024-03-15 发布日期:2024-03-22
  • 通讯作者: 张学红 E-mail:zhangxueh@lzu.edu.cn

Didelphic Uterus Combined with Ovarian Pregnancy:A Case Report

GU Xu-zhao, SHEN Hao-fei, GAO Min, LIU A-hui, WANG Na, YANG Wen-jing, ZHANG Xue-hong()   

  1. The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China (GU Xu-zhao, SHEN Hao-fei, GAO Min, LIU A-hui, WANG Na, YANG Wen-jing); The First Hospital of Lanzhou University, Lanzhou 730000, China (ZHANG Xue-hong)
  • Received:2023-07-04 Published:2024-03-15 Online:2024-03-22
  • Contact: ZHANG Xue-hong E-mail:zhangxueh@lzu.edu.cn

摘要:

双子宫(didelphic uterus)是米勒管融合失败导致的,最终形成了两个子宫腔,是最罕见的子宫畸形之一。米勒管发育异常的女性,可能增加围产期母婴并发症和不良妊娠结局的发生率。如果在妊娠期发现孕妇存在米勒管发育异常,应及时识别其异常类型,评估对母亲和胎儿的影响,并适当增加产前护理的频率。卵巢妊娠少见且术前通常很难诊断,与双子宫无逻辑性的关系。宫内节育器、辅助生殖技术(assisted reproductive technology,ART)和宫腔手术都是卵巢妊娠的高危因素。回顾1例双子宫妇女在ART助孕后发生卵巢妊娠的病例,总结分析卵巢妊娠发生的可能原因。单胚胎移植是双子宫患者最佳的移植策略。育龄妇女在进行ART助孕前应进行全面的盆腔检查,以便对先天性子宫异常进行早期诊断和适当管理。

关键词: 妊娠,卵巢, 体外受精, 单胚胎移植, 泌尿生殖系统畸形, 双子宫, 米勒管发育异常

Abstract:

Didelphic uterus are caused by Müllerian tube fusion failure that eventually form two uterine cavities, which is one of the rarest uterine malformations. Women with Müllerian anomalies may increase the incidence of perinatal complications and adverse outcomes of pregnancy. If Müllerian anomalies are found during pregnancy, the type of abnormality should be identified promptly, the impact on the mother and fetus should be assessed, and the frequency of prenatal care should be appropriately increased. Ovarian pregnancy as a rare ectopic gestation is often difficult to diagnose before surgery. Ovarian pregnancy seemingly has no logical relationship with the didelphic uterus. The high risk factors of ovarian pregnancy may include intrauterine device, assisted reproductive technology (ART) and intrauterine surgery history. A case of ovarian pregnancy in a woman with didelphic uterus after ART was reviewed, and the possible causes of ovarian pregnancy were summarized and analyzed. Single embryo transfer should be considered as the best transplantation strategy for those patients with didelphic uterus. Women of childbearing age should undergo a thorough pelvic examination before ART in order to make early diagnosis and proper management of congenital uterine abnormalities.

Key words: Pregnancy, ovarian, Fertilization in vitro, Single embryo transfer, Urogenital abnormalities, Didelphic uterus, Müllerian anomalies