子宮頸管妊娠に対して腹腔鏡下子宮動脈クリッピング併用子宮鏡下子宮内容除去術にて治療し、術後１年後に無事生児を得た１例

抄録

　No effective treatment for cervical pregnancy has been established thus far. Here we report successfully treating a patient with cervical pregnancy using a hysteroscopic approach with laparoscopic uterine artery clipping (LUAC). A 38-year-old woman, gravida 2, parity 1, presented with painless vaginal bleeding and was diagnosed with cervical ectopic pregnancy. As she had a desire for fertility preservation, a hysteroscopic approach with LUAC was used. The surgical procedure was performed by laparoscopically clipping the bilateral uterine arteries with a vascular clip, removing the gestational sac in the uterine cervix using a hysteroscopic approach, and finally unclipping the bilateral uterine arteries, all without active bleeding. The patient progressed favorably after the surgery, without any complications such as massive rebleeding or retention of the gestational sac. Natural menstruation reoccurred on postoperative day 23, and the human chorionic gonadotropin level was negative on day 32. Five months after the operation, she conceived naturally and delivered at full term. This case indicates that LUAC and hysteroscopic resection are a highly effective combination for treating cervical pregnancy while preserving fertility.