| Objective:Interstitial ectopic pregnancy is a special type of ectopic pregnancy,and the laparoscopic salpingectomy with corneal resection is the primary treatment.More and more patients after the surgery have fertility requirements while the risk of uterine rupture after surgery will increase.The aim of the following paper is to summarize the clinical features of uterine rupture after laparoscopic surgery for interstitial ectopic pregnancy so that it can provide reference for clinical diagnosis and treatmentMethods:We analyzed retrospectively the clinical data of 4 cases treated in our hospital between 1999 and 2016.Summary the risk factors,clinical features,treatment and prognosis of uterine rupture after laparoscopic surgery for interstitial ectopic pregnancy with review of the literature.Results:From November 1999 to October 2016,there are a total of 283 cases of uterine rupture in our hospital,including 4 cases of uterine rupture after laparoscopic surgery for interstitial pregnancy.Of the 4 cases we reported,they are all of reproductive age from 28-42.And they all have a history of pregnancy loss and unilateral or bilateral salpingectomy because of tubal ectopic pregnancy.The last pregnancies of 4 cases were interstitial pregnancy which resulted to cornual resection by laparoscopy.Only 1 of their next pregnancy after surgery is natural pregnancy while the rest are assisted reproductive pregnancy.The interpregnancy interval ranges from 0.52-2.25 years.The gestational age of 4 cases ranges from 17 weeks to 37+1 weeks with 2 cases of twin pregnancy,2 cases of fetal malpresentation.And the tears of 4 patients for uterine rupture were found in the uterine cornua at the scar site from the previous surgery.At the same time,half of the patients showed no obvious discomfort while 1 case found by B ultrasound and the other by operative exploration;1 of them only had mild abdominal pain while the other complained persistent severe abdominal pain with nausea and diarrhea,which was misdiagnosed as gastrointestinal diseases.Finally,4 patients all underwent uterine repair,and there were 2 cases of fatal death.They all recovered and discharged smoothly,only 1 patient has fertility requirement.Conclusion:The risk of uterine rupture will increase after the laparoscopic surgery for interstitial ectopic pregnancy.Though with low incidence,it may be associated with serious maternal and fetal complications while the clinical manifestations are not obvious which may be easily misdiagnosed.Therefore,it is significant to enhance the monitoring and be aware of the clinical features of uterine rupture in next pregnancy,and terminate pregnancy by cesarean if necessary. |
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