- 期刊
Diagnosis of an Angular Pregnancy in the First Trimester Using Three-dimensional Ultrasound
利用立體超音波在懷孕初期診斷Angular Pregnancy
摘要
目的：Angular pregnancy是一種罕見的子宮內懷孕，雖然有高解析度的經陰道超音波幫忙，但它與interstitial Pregnancy的鑑別診斷仍非常困難。在此我們將探討一例在懷孕初期以立體超音波確定診斷的angular Pregnancy。病例報告：一位三十一歲懷孕七週的婦女，因懷疑interstitial Pregnancy轉診至本院。平面超音波無法分辨胚胎植床在子宮腔內或外，透過立體超音波的冠面顯影及立體影像重組，我們可以清晰地看到胚胎植床在左子宮角及部分伸延至子宮間部。病人選擇了吸引式子宮搔括術來代替其它較侵犯性的手術終止懷孕，過程順利。 結論：對於angular pregnancy及interstitial pregnancy的鑑別診斷，立體超音波是一大利器。透過立體超音波的幫忙，我們可以在更早期以非侵犯性的檢查方式診斷出angular pregnancy，及選擇適當的治療方法，以避免不必要的侵犯性手術及併發症的發生。
並列摘要
Objective: Angular pregnancy is a rare type of intrauterine pregnancy. However, its differentiation from an interstitial pregnancy is often confusing in spite of use of high-resolution transvaginal sonography. This report discusses a case of angular pregnancy, which was confirmed using 3D ultrasound at 7 weeks and 2 days of gestation. Case Report(s): A 31-year-old woman, gravida 3, para 2, was referred to our hospital with a suspected interstitial pregnancy at 7 weeks of gestation. We could not determine whether the gestational sac was located within or outside the uterine cavity by 2D sonography. A gestational sac lying at the left uterine angle and partially protruding into the interstitial part of the tube was clearly demonstrated by 3D transvaginal sonography. Suctional dilatation and curettage (D&C) was chosen by the patient. Conclusion(s): Three-dimensional ultrasound is a helpful diagnostic tool in women with suspected angular or interstitial pregnancies. The use of 3D ultrasound permits an early non-invasive diagnosis of an angular pregnancy, and allows appropriate management which can avoid an invasive procedure.
延伸閱讀
- 柯滄銘（1989）。懷孕初期的超音波檢查。健康世界，(159)，34-36。https://doi.org/10.6454/HW.198903.0034
- 郭鴻璋、葉麗麗、張峰銘、劉志鴻（1991）。胎兒先天性心臟病的診斷和治療－產科超音波的應用。慈濟醫學雜誌，3(4)，349-353。https://doi.org/10.6440/TZUCMJ.199112.0349
- 陳明（2003）。婦產科：胎兒先天異常之超音波輔助子宮內治療。台灣醫學，7(5)，813-815。https://doi.org/10.6320/FJM.2003.7(5).20
- 邱宗鴻（2013）。胎兒解剖學與形態學之超音波評估檢查。台北市醫師公會會刊，57(3)，32-34。https://www.airitilibrary.com/Article/Detail?DocID=P20110322001-201303-201304120032-201304120032-32-34
- 周雨樺、余玉眉、蔣欣欣、謝豐舟、蕭伃伶（2001）。探討初胎孕婦透過立體超音波檢查對胎兒影像的認知行為。新臺北護理期刊，3(2)，51-62。https://doi.org/10.6540/NTJN.2001.2.005