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CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2020; 80(07): 686-701
DOI: 10.1055/a-1181-8641
DOI: 10.1055/a-1181-8641
GebFra Science
Review/Übersicht
Seltene extrauterine Schwangerschaften – eine Literaturübersicht 2007 – 2019 zu Lokalisationen außerhalb von Uterus und Tuben
Artikel in mehreren Sprachen: English | deutsch
Zusammenfassung
Das Gros extrauteriner Schwangerschaften (EUG) sind Tubargraviditäten, doch auch andere Implantationsstellen außerhalb des Uterus und der Adnexe kommen vor. Diese seltenen Lokalisationen einer EUG stellen eine besondere diagnostische und therapeutische Herausforderung dar. Anhand einer systematischen Analyse von Fallberichten wird eine Übersicht zu möglichen sehr seltenen Lokalisationen ektoper Schwangerschaften, deren Symptomatik, Diagnostik und Therapie gegeben. Dazu wurde eine Literaturrecherche in den Datenbanken PubMed, Livivo und Google Scholar für den Zeitraum 2007 bis 2019 durchgeführt. Insgesamt wurden 113 Publikationen eingeschlossen. Diese Studien beschrieben EUG-Implantationen im Douglas-Raum, an der Uterusserosa und dem uterinen Bandapparat, im Bereich nahezu aller intraperitonealer Organe, der Bauchwand sowie retroperitoneale Lokalisationen. Das häufigste Symptom war der variabel lokalisierte abdominale Schmerz. Die diagnostischen Maßnahmen umfassten unterschiedliche Bildgebungsverfahren und/oder explorative Operationen in verschieden weit fortgeschrittenem Schwangerschaftsalter. Als häufigste Therapieoption wurde die operative Befundsanierung per laparotomiam gewählt. Die Plazenta konnte in der Mehrheit der Fälle erfolgreich reseziert werden. Eine EUG seltener Lokalisation sollte als mögliche Differenzialdiagnose bei Patientinnen im reproduktionsfähigen Alter mit abdominellen Beschwerden bedacht werden.
Publikationsverlauf
Eingereicht: 12. August 2019
Angenommen nach Revision: 19. Mai 2020
Artikel online veröffentlicht:
14. Juli 2020
© .
Georg Thieme Verlag KG
Stuttgart · New York
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