| Objectives: This conclusion can be used to improve the understanding of the rudimentary uterine horn pregnancy,from the analysis and summary of the epidemiological characteristics,clinical features,diagnosis and treatment of the rudimentary uterine horn pregnancy.Methods: The clinical data during January 2008 and December 2017 in our hospital who had been diagnosis of the rudimentary uterine horn pregnancy,and the data published in domestic and overseas during January 2008 and December 2017.Results:1 We analysed 156 cases: Among 156 patients,the mean age was 25.90,ranging from 18 to 42;145 cases had clear diagnosis before surgery,15 cases belongs ⅡA-1a type(10.34%),130 cases belongs ⅡA-1b type(89.66%);101 cases(64.74%)of rudimentary uterine horn pregnancy were located on the right side of the normal uterus,and 55 cases(35.26%)were on the left.2 61 cases(39.11%)were in early pregnancy,68 cases(43.59%)were in middle pregnancy;12 cases(7.69%)were in late pregnancy but not term pregnancy;11 cases(7.05%)were in term pregnancy;2 cases(2.90%)were in postterm pregnancy;Patients were admitted to the hospital for different complaints,69 cases(44.23%)with the lower abdominal pain,38 cases(24.36%)with failure of abortion and induced abortion,10 cases(6.41%)were found in the abdominal mass,11 cases(7.05%)were found during the examination,9 cases(5.77%)were found in cesarean section,12 cases(7.69%)due to the reduction or disappearance of fetal movement,only 6 patients(3.85%)showed with symptoms of vaginal bleeding,and only 1case showed with dizziness and weak.There were 14 cases(22.95%)of the lower abdominal pain and 25 cases(40.98%)with failure of abortion who found rudimentary uterine horn pregnancy during the period of pregnancy in early pregnancy,47 cases(68.12%)of the lower abdominal pain and 14 cases(22.95%) with failure of induced abortion who found rudimentary uterine horn pregnancy in middle pregnancy,8 cases(61.53%)were found during the operation who found rudimentary uterine horn pregnancy in late pregnancy but not term pregnancy,1 case(50%)were found during the operation who found rudimentary uterine horn pregnancy in in postterm pregnancy;During the operation,77 patients(49.36%)were found to rupture,The rupture of rudimentary uterine horn pregnancy was associated with menopause month,and the uterine rupture was more likely to occur in middle pregnancy(χ2=31.913,P=0.000).52 cases(33.33%)had the history of pregnancy,and42 had at least one child(26.92%).3 Only 50 cases(32.05%)were confirmed before surgery,42 cases(26.93%)were considered as tubal pregnancy before surgery,and 23 cases(14.74%)were considered as bicornuate uterine pregnancy.145(92.95%)patients only underwent gynecologic ultrasonography,of which 39(26.90%)were diagnosed by gynecologic ultrasonography.11 cases were used gynecologic ultrasonography combined with hysterosalpingography and/or pelvic MRI,and all had been diagnosed(100%)preoperatively.The accuracy of preoperative diagnosis of gynecologic ultrasound combined with hysterosalpingography and/or pelvic MRI was significantly higher than that of single gynecologic ultrasound.The difference was statistically significant(χ2=21.845,P=0.000).4 There were 156 cases(100%)of patients treated with surgery,one patient died of excessive blood loss during surgery.Laparotomies were performed in 119 patients,laparoscopes used in 10 cases and 10 cases used hysteroscopes,there were 4 cases used laparoscopes and hysteroscopes.According to the surgical classification,there were 1 case(0.64%)did subtotal hysterectomy;13 cases(8.39%)did full-term cesarean section and also removed the rudimentary uterine horn;141 cases(90.97%)removed the rudimentary uterine horn,of which 115 cases(81.56%)had laparotomy,22 cases(15.60%)had laparoscopic resection and 4 cases(2.8%)used hysteroscopy combined with laparoscopic surgery.5 155 patients recovered well after surgery,and only one patient died.Conclusion:1 The majority of patients with rudimentary uterine horn pregnancy is found in childbearing age,and is ⅡA-1b type,There is no significant difference in the age of onset of different types of residual uterine horn pregnancy.Most of them on the right side of the uterus.2 In the early stage of pregnancy,there were no symptoms,and the number of patients with the lower abdominal pain and failure of abortion and induced abortion was large.The occurrence of rudimentary uterine horn pregnancy rupture in patients was associated with menopause month,and the proportion of uterine rupture was higher in middle pregnancy.Only a few patients were able to have a full term pregnancy.Late pregnancy was more often found when obstetric complications were found during caesarean section.Remnants of uterus pregnancy have a history of poor pregnancy,only a small number of patients delivered the fetus.3 At present,the rate of medical treatment with misdiagnosed is high.Ultrasonography is the most widespread used method for the diagnosis of uterine pregnancy,but only a few patients can be diagnosed,gynecologic ultrasonography combined with hysterosalpingography and/or pelvic MRI can significantly improve the diagnosis rate of the disease.4 The main type of therapy for rudimentary uterine horn pregnancy should be operation.Most of the surgical were removal of rudimentary uterine horn.5 Most patients had a good prognosis after treatment. |
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