腹腔鏡下手術を施行した副角妊娠の1例

抄録

　Pregnancy in the rudimentary uterine horn is an extremely rare condition (incidence: from 1:76,000 to 1:150,000). We report a case of rudimentary horn pregnancy that was treated with laparoscopic surgery. A 21-year-old primigravida female visited a clinic complaining of abnormal genital bleeding, and a left tubal pregnancy was suspected. Therefore she was referred to our hospital. Transvaginal ultrasonography showed an empty uterine cavity and a gestational sac, which exhibited a live fetal shadow, in a left adnexal lesion. Her serum human chorionic gonadotropin level was 21,557 mIU/ml. We suspected a left tubal pregnancy and performed emergency laparoscopic surgery. During a pelvic evaluation, we found that the rudimentary horn was connected to the right unicornuate uterus and left fallopian tube, which was dark red in color and thumb tip-sized. We diagnosed the patient with a rudimentary horn pregnancy. We removed the left rudimentary horn and left fallopian tube. A histopathological examination showed villi and fetal components in the rudimentary horn, which were surrounded by smooth muscle. The patient's postoperative course was uneventful, and she was discharged on the 3rd postoperative day.

　Since rudimentary horn pregnancies can cause uterine rupture and induce massive bleeding, which can lead to maternal death, we need to treat this rare condition carefully.