Trudnoća u rogu maternice

master's thesis

• Title (english): Cornual pregnancy
• Author: Dunja Lukačević
• Mentor: Ratko Matijević (mentor)
• Committee member: Željko Duić (predsjednik povjerenstva)
• Committee member: Dinka Pavičić-Baldani (član povjerenstva)
• Committee member: Ratko Matijević (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2016-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Kornualna trudnoća, koju još zovemo i intersticijska trudnoća ili trudnoća u rogu maternice, vrsta je ektopične trudnoće koja je smještena u proksimalnom dijelu jajovoda unutar mišićnog materničnog zida. Rizični čimbenici za razvoj kornualne trudnoće su: upalna bolest zdjelice, anomalije maternice, starija životna dob trudnice, prethodna ektopična trudnoća i in vitro fertilizacija, dok je unilateralna salpingektomija jedinstveni predisponirajući rizični faktor. Kod kornualne trudnoće je vrlo... More važna rana dijagnostika, budući da je to stanje koje zbog mogućnosti obilnog krvarenja potencijalno može ugroziti život pacijentice. Dijagnozu je moguće postaviti putem ultrazvuka (UZV), magnetne rezonance (MR) i laparoskopije. U kliničkoj slici pacijentice koja ima kornualnu trudnoću, najčešće nema puno simptoma. Ultrazvukom se uočava gestacijska vreća na specifičnom mjestu roga maternice, test na trudnoću je pozitivan, kavum maternice je prazan, te inicijalno nema slobodne tekućine u trbuhu. Ako su simptomi kornualne trudnoće prisutni, onda uključuju bol u donjem abdomenu, te vaginalno krvarenje. Jedna od najvećih i najtežih komplikacija kornualne trudnoće je ruptura roga maternice koja na kraju, uz obilno krvarenje vodi u hipovolemički šok i moguću smrt pacijentice. Liječenje kornualne trudnoće može biti konzervativno ili kirurško. Konzervativno liječenje podrazumijeva liječenje metotreksatom, s jednom dozom ili više doza, dok se kirurški liječi ekscizijom kornualne trudnoće, najčešće laparoskopskom tehnikom, ali i laparotomijom. Kod izbora liječenja važna je hemodinamska stabilnost i trajanje trudnoće. Ishodi liječenja ovise o vrsti liječenja i stanju pacijentice prije početka liječenja. Less

Abstract (english)

Cornual pregnancy is type of ectopic pregnancy localized in proximal tubar segment of inner myometrial uterine wall. Risk factors for developing cornual pregnancy are: pelvic inflammatory disease, uterine anomalies, advanced maternal age, previous ectopic pregnancy, assisted reproductive techniques (ART), while unilateral salpingectomy is unique predisposed risk factor. Early recognition and diagnosis is very important in management of cornual pregnancy as this is a condition that in the... More case of its rupture and heavy bleeding threatens woman's life. Diagnose is possible with sonography, magnetic resonance or laparoscopy. Typical appearance of cornual pregnancy is just few symptoms or no symptoms at all, gestational sac by UZV is seen within its specific location, pregnancy test is positive, uterus is empty in expected location of gestational sac and there is no free fluid in abdomen. If symptoms exist, commonly they include vaginal bleeding and pain. The most important cornual pregnancy complication is uterine rupture, which ultimately leads to haemorrhagic shock and may cause maternal death. Treatment is conservative or surgical. Conservative treatment includes metotrexat therapy, single dose or multidose therapy, while surgical method is most often laparoscopy but sometimes laparotomy may be necessary. Treatment depends of patient hemodynamic stability and duration of pregancy. Treatment outcome depends of type of treatment and patient's condition before treatment. Less

• Keywords: kornualna trudnoća; in vitro fertilizacija; unilateralna salpingektomija; ruptura roga maternice; rana dijagnostika; laparoskopska tehnika
• Keywords (english): cornual pregnancy; in vitro fertilization; unilateral salpingectomy; uterine rupture; diagnosis; treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:105:675366
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-06-16 09:47:47