術前診断し腹腔鏡下に切除した副角妊娠の1例

抄録

  Rudimentary horn pregnancy (RHP) is a rare disease, the frequency of which is reported as 1/76,000 to 1/150,000 of pregnancies. The preoperative diagnosis is reportedly difficult, and the diagnostic yield is 16%. Some RHP cases are determined during the operation for ectopic pregnancy diagnosed, preoperatively, as tubal pregnancy. We present a case of RHP diagnosed by ultrasound and treated with laparoscopic surgery. A 35-year-old woman (gravida: 2, para: 1) presented to our department with suspected ectopic pregnancy at 6-weeks gestation.

  Vaginal ultrasound revealed a gestational sac covered with a thick myometrium on the left side of the uterus and a fetal heart beat within. Communication between the endometrium of the uterus and the gestational sac was undetected. Magnetic resonance imaging (MRI) showed the same findings as those of ultrasonography and a diagnosis of pregnancy with non-communicating rudimentary horn was established. On laparoscopy, we resected the rudimentary uterine horn including the fetus. This case demonstrates that laparoscopic resection of pregnant rudimentary horn is safe and feasible in the surgical management of unruptured RHP.