Corneal pregnancy

Introduction to Gongjiao Pregnancy Gongjiao pregnancy refers to the implantation of fertilized eggs at the corners of the uterus. The uterine horn pregnancy is different from the tubal interstitial pregnancy. Although the patients with uterine horn pregnancy have severe abdominal pain, most cases can be delivered naturally. This is completely different from the interstitial pregnancy, which must be treated surgically. The fertilized egg is attached to the proximal uterine cavity of the oviduct, and the embryo develops to the uterine cavity rather than to the interstitial. basic knowledge The proportion of sickness: 0.01% Susceptible people: good for pregnant women Mode of infection: non-infectious Complications: miscarriage uterine rupture

Cause of uterine horn pregnancy

The uterine horn pregnancy refers to the implantation and development of the uterus in the fertilized egg uterus, which occurs mostly in primipara. In addition to the normal uterus, there is still a small uterus, and the intima line is sometimes seen in the uterine cavity. The main causes of cervical pregnancy are as follows. The uterine residual angle is a congenital malformation, which is an abnormality in the process of embryonic Müllerian tube reunion and leads to the end of the Müllerian tube.

Inflammation (23%):

Cervicitis causes the cilia on the surface of the cervical endometrial cells to lose motor function, and causes local pathological changes such as local stenosis of the cervix, so that the fertilized egg is blocked in the stenosis, leading to the occurrence of uterine horn pregnancy.

Intrauterine device (12%):

Whether the intrauterine device increases the incidence of uterine horn pregnancy is not yet easy to draw conclusions. It may be related to the type, population and observation methods of intrauterine devices. But clinically, IUD can indeed cause uterine horn pregnancy.

Sex hormone effects (10%):

Under normal circumstances, the proportion of estrogen and progesterone is appropriate, and the synergistic effect can make the pregnant egg can be sent into the uterine cavity by the normal endometrial ciliary movement and muscle peristalsis. If the balance of estrogen and progesterone is destroyed, it can cause the uterine horn pregnancy.

In vitro fertilization (17%):

It may be that the embryo is injected into the cervix or the embryo from the uterine cavity to the cervix occasionally, and the cervix has some lesions that cannot return the embryo to the uterine cavity. In addition, cervical feeding gametes are also prone to uterine horn pregnancy. Therefore, the incidence of uterine horn pregnancy is higher than that of natural pregnancy.

Other (20%):

Loss of cervical lesions (such as cervical erosion) or congenital malformations of the cervix (excessive length, diverticulum, etc.), premature or delayed ovulation can cause uterine horn pregnancy. If abortion does not occur early in pregnancy, these symptoms disappear into the mid-pregnancy. In fact, there is no absolute limit in anatomy for uterine horn pregnancy and normal pregnancy. Therefore, the incidence of uterine horn pregnancy will be further examined according to the patient's very mild symptoms during early pregnancy. Patients with uterine horn pregnancy (ectopic pregnancy) often complain of severe abdominal pain at or around 12 weeks of gestation, with or without vaginal bleeding, and asymmetry in the uterus.

Cervical pregnancy prevention

1, in order to prevent uterine horn pregnancy, pregnant women should be able to taste all kinds of food, chicken, duck and fish should be appropriate, more fruits and vegetables, but also with some coarse grains.

Cervical pregnancy complications Complications abortion uterine rupture

Gongjiao pregnancy can cause various complications, usually abortion, uterine rupture and placental retention. Uterine rupture is the most serious complication. In the uterine horn pregnancy, due to abnormal placenta attachment, abortion or childbirth, placenta retention is likely to occur, difficulty in peeling, curettage can not stop bleeding, laparotomy is the only way to remove the uterine horn. The differentiation of the uterine horn pregnancy and the tubal interstitial pregnancy is located at the uterine horn. It is the junction of the fallopian tube to the uterus. It is surrounded by uterine muscle tissue and has a total length of about 2.0cm. The fertilized egg is planted in this part, which forms Interstitial pregnancy. Because the pregnant egg is implanted and developed outside the uterine cavity on the fallopian tube at the opening of the fallopian tube of the uterus, it belongs to the category of ectopic pregnancy. Laparoscopy or laparotomy can be distinguished from the interstitial pregnancy of the tubal according to the relationship between the ligament of the round ligament and the protruding mass. If the round ligament is located on the outer side of the protruding mass, it is a uterine horn pregnancy, such as the round ligament located on the inner side of the protruding mass for the interstitial pregnancy of the fallopian tube.

If the treatment of uterine horn pregnancy is abortion type, it is feasible to clear the uterus or B-ultrasound and laparoscopy. If necessary, follow the HCG quantitative follow-up review. Once it is ruptured, it is one of the acute abdomen that seriously endangers women's life. Therefore, surgery must be performed immediately. Replenish blood volume to ensure blood supply to important organs. If the blood pressure can not rise immediately, you should fight against shock and fight for time. The corner of the uterus is the junction of the fallopian tube to the uterus. It is surrounded by uterine muscle tissue. It is the meeting place where the uterus and ovarian arteries meet. The blood vessels are rich. The fertilized egg is implanted here to form the uterine horn pregnancy, which belongs to the ectopic pregnancy. Rare. Clinical manifestations often have a history of menopause and early pregnancy. Compared with other ectopic pregnancy, due to muscle tissue around the official horn, the rupture time is later, even up to 16 to 18 weeks of gestation. Once ruptured, the condition is dangerous, if not Timely rescue can lead to death. It is difficult to distinguish between uterine horn pregnancy and intrauterine pregnancy before 8 weeks of gestation. The uterus enlargement is consistent with the number of menopause days, but the uterine horn is obviously softer. B-ultrasound can clearly identify the uterus and uterus. Increase, a prominent point, which can be seen in the pregnancy ring or embryo, no pregnancy in the uterine cavity. Only by carefully excluding the uterine horn pregnancy before abortion treatment, can we avoid the tragedy of artificially causing rupture of ectopic pregnancy and even death.

Gongjiao pregnancy symptoms Common symptoms Vaginal bleeding During pregnancy, persistent abdomen... Nausea abdominal pain Anal bulge

A small number of patients in the early pregnancy symptoms are not obvious and B-ultrasound can not find the fetal sac, can be through the vaginal four-dimensional color Doppler ultrasound and blood HCG, if necessary, laparoscopic exploration. This type of ectopic pregnancy is not easy to be detected early because it is not bleeding, and it is easy to be misdiagnosed by B-ultrasound. It usually breaks down after 3 months of menopause. Once it breaks, it will cause massive internal bleeding, shock, and death. In many cases, the pregnancy uterus is asymmetrically enlarged, and it is often delivered smoothly in the third trimester.

After the baby is delivered, the placenta often remains in the corner of the uterus and needs to be artificially stripped. The closer the fertilized egg is planted to the inner mouth of the fallopian tube, the more obvious the asymmetrical shape of the uterus, and the symptoms such as abdominal pain are also more obvious. Ectopic pregnancy shows women of childbearing age, menstrual period, sometimes accompanied by anorexia, nausea and other early pregnancy reactions, suggesting that they are pregnant but suddenly have abdominal pain, persistent or recurrent, may be accompanied by nausea, vomiting, anal fall and other discomfort, severe patient face Pale, cold sweat, cold limbs, even syncope, shock. Some patients have irregular vaginal bleeding, usually less than menstrual flow (note that you should not mistake this for menstruation). Therefore, the typical symptoms of ectopic pregnancy can be summarized into three major symptoms, namely: menopause, abdominal pain, vaginal bleeding.

Examination of uterine horn pregnancy

Gongjiao pregnancy (ectopic pregnancy) examination and treatment of the key 3 steps

1, early vaginal four-dimensional color Doppler ultrasound to determine the position of the gestational sac.

2. Once the laparoscopic combined operation is found, the uterine cavity is taken by the laparoscopic approach of the uterine cavity, and the laparoscopic fenestration is taken from the uterine cavity to open the window and the tube is sutured.

3, once ruptured, laparoscopic surgery can not repair the rupture, recovery of blood return.

Diagnosis of uterine horn pregnancy

Diagnostic criteria

The diagnostic criteria for uterine horn pregnancy are not yet uniform. The diagnostic criteria proposed by Jansen et al. are: abdominal pain accompanied by increased uterine asymmetry, followed by abortion or rupture; under the direct vision, the side of the uterine horn is enlarged, accompanied by the lateral ligament Displacement; the placenta is retained in the uterine horn. Those who meet the above criteria may be considered for a uterine horn pregnancy. Ultrasound imaging diagnostic criteria: the gestational sac is located at the uterine horn and is continuous with the endometrial line, and the intact muscle wall layer is seen around it. Vascular intervening therapy is less common in patients with uterine horn pregnancy, and its treatment is similar to cervical pregnancy.

Differential diagnosis

Gastroenteritis: This disease has abdominal pain, nausea, vomiting, diarrhea and other symptoms, and similar to ectopic pregnancy.

Acute appendicitis: Appendicitis is also a pain in the lower abdomen. The nature of the pain is severe and it is gradually increasing.

Threatened abortion or early pregnancy: threatened abortion, abdominal pain is more serious, sometimes vomiting, especially in the history of trauma, easy to diagnose the disease and prevent miscarriage.

Irregular menstruation: If the local tissue is less bleeding, the course of the disease is slightly longer, often vaginal bleeding, abdominal pain, but the menstruation treatment is invalid.

Luteal rupture: This disease also has the same risk of ectopic pregnancy, severe abdominal pain, shock and other manifestations, but this disease occurs in the mid-menstrual period, most of which occurs after sexual life, no amenorrhea and early pregnancy reaction, and no vaginal bleeding.

Ovarian cyst pedicle torsion: often have abdominal mass, no early pregnancy reaction, no history of menopause, and different from ectopic pregnancy.

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