子宮内外同時妊娠に対して単孔式腹腔鏡下手術で治療し、生児を得られた１例

抄録

Introduction: Although heterotopic pregnancies are extremely rare, their incidence has been rising in recent years with the increased use of assisted reproductive technologies. We experienced a case in which a live birth was achieved after single-site laparoscopic surgery for a heterotopic pregnancy.

Case: A 35-year-old woman, G1P0, became pregnant using clomiphene and timing therapy. At 7 weeks 2 days of pregnancy, she experienced genital bleeding and lower abdominal pain, and visited a hospital. A fetal heartbeat was detected, but a blood clot was found in the pelvis, and the woman was admitted to another hospital with a diagnosis of threatened miscarriage. At 8 weeks 2 days of pregnancy, she was referred to our hospital due to increasing lower abdominal pain and progressive anemia. Ovarian bleeding or heterotopic pregnancy was suspected on the basis of blood retention around the right adnexa and worsening anemia, and single-site laparoscopic surgery was performed. The presence of an enlarged right fallopian tube led to the diagnosis of heterotopic pregnancy. The woman’s postoperative course was good, and a baby boy weighing 2,926 g was born spontaneously at 40 weeks 0 days of pregnancy.

Conclusion: Heterotopic pregnancies are easily missed, and are difficult to diagnose and treat. Even if an intrauterine pregnancy is identified, the possibility of heterotopic pregnancy must be kept in mind, with single-site laparoscopic surgery as a potential treatment option.