腹腔鏡下手術で診断した子宮漿膜妊娠の1例

抄録

  We report a case of uterine serosa pregnancy after in vitro fertilization. A 32-year-old woman, gravida 1 para 0, had abdominal pain. She was transferred to our hospital because of shock, which was judged by assessment of vital signs at a nearby clinic. The pregnancy test was positive, and computer tomography revealed an enhancing tumor in the uterine serosa; a large amount of blood was found in the peritoneal cavity. Emergency laparoscopy was performed. We collected 1400 ml of blood from the abdominopelvic cavity and found that she had a uterine serosa pregnancy with active bleeding. We removed the gestational tissue, but active bleeding remained at the excision margin of the uterine surface. We sutured the myometrium, which stopped the bleeding. Villi were confirmed histopathologically. After the surgery, serum hCG promptly decreased. If ectopic pregnancy is suspected, a peritoneal and or uterine serosa pregnancy should be considered.