胎児心拍陽性の膀胱子宮窩腹膜妊娠に対する腹腔鏡下手術において,NBI(narrow band imaging)による観察とバゾプレッシンの局所投与が有効であった1例

抄録

  A 31-year-old woman was referred to our hospital for ectopic pregnancy. Transvaginal ultrasonography revealed a fetus in the right adnexal region (crown–rump length 7.1 mm with positive heartbeats). The gestational sac (GS) was implanted on the vesicouterine pouch near the right round ligament; however, no major bleeding was observed. Narrow band imaging (NBI) confirmed superficial neovascularization and avascular lesions. We performed subperitoneal injection of diluted vasopressin (0.2 U/mL) around the lesion, to prevent major bleeding, and excised the GS and villi using forceps, without any significant bleeding.

Conclusion: NBI-guided endoscopy can confirm the growth of vessels around the ectopic pregnancy, and injection of diluted vasopressin prevents severe bleeding and facilitates complete laparoscopic removal of the ectopic tissue.