当科で全腹腔鏡下子宮摘出術を施行した子宮頸管妊娠の2症例

抄録

Introduction: Cervical pregnancy is a rare form of ectopic pregnancy; it has an incidence of 1 in 10,000 to 95,000 pregnancies. Recently, preservation of fertility has become possible for this condition through various efforts of conservative treatment, including pharmacotherapy and uterine artery embolism. Nonetheless, a standard protocol has not been established to date. In this report, we present two cases of uterine cervical pregnancy successfully treated with total laparoscopic hysterectomy in our hospital.

Case 1 presented to our hospital due to continuous vaginal bleeding. Transvaginal ultrasonography and magnetic resonance imaging (MRI) findings showed a gestational sac of 15 mm in diameter in the cervical canal, and a cervical pregnancy was diagnosed. The serum human chorionic gonadotropin (hCG) level was 2063 mIU/mL; the pregnancy was unwanted. We performed total laparoscopic hysterectomy (TLH) for this patient. She was discharged on day 5 without any severe adverse effects.

Case 2 was referred to our hospital due to continuous genital bleeding following polypectomy. Transvaginal ultrasonography and MRI findings showed a gestational sac of 12 mm in diameter in the cervical canal, and a diagnosis of cervical pregnancy was made. The serum hCG level was 18,180 mIU/mL; the pregnancy was unwanted. We performed TLH on this patient. She was discharged on day 5 without any severe adverse effects.

Conclusion: It is suggested that TLH might be an effective treatment choice for patients with this form of ectopic pregnancy, and who desire pregnancy interruption, considering that the clinical stay is short and the procedure is safe with no severe side effects.