임신 25주에 조기 분만이 발생된 자궁내각임신
Angular pregnancy complicated with preterm labor at 25 gestational weeks of pregnancy
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자궁내각임신 (angular pregnancy)은 태낭이 자궁강 외각부위의 난관 자궁구의 내측에 착상된 경우로 태낭이 난관의 근층에 착상된 자궁벽자궁관 임신 (interstitial pregnancy)과 구별된다. 자궁내각임신은 자궁내 임신으로 자궁벽자궁관 임신에 비해 예후가 좋은 것으로 알려져 있다. 그러나 자궁내각임신과 관련되어 유산, 태반잔류, 유착태반, 천공태반과 같은 합병증도 보고되고 있다. 본 증례 보고에서는 임신 25주의 조산과 유착태반, 산후 자궁내막염이 합병된 자궁내각임신 1예를 문헌 고찰과 함께 보고하고자 한다. 본 증례를 통해 자궁내각임신은 불량한 임신 예후의 가능성 때문에 정상 자궁내 임신과 구별할 필요가 있음을 강조한다.
Abstract
Angular pregnancy refers to implantation of the embryo just medial to uterotubal junction in the lateral angle of the uterine cavity. This is differentiated from interstitial pregnancy in which the gestational sac is located within intramural portion of the tube. Angular pregnancy is categorized as intrauterine pregnancy and the outcome is known favorable. However, there have been few reports about adverse perinatal complications such as abortion, retained placenta, placenta accreta, placenta percreta and uterine rupture. We report a case of angular pregnancy complicated with preterm labor at 25 gestational weeks, placenta accreta and postpartum endometritis. This case suggests that angular pregnancy should be differentiated from normal intrauterine pregnancy because of its potential risk of adverse outcome.
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