Uspešno histeroskopsko rešavanje dva slučaja intersticijalne trudnoće
Sažetak
Uvod. Intersticijalna trudnoća (IT) je najređa forma tubarne trudnoće koja ima visoku stopu rupture i često ostaje asimp-tomatska u prvih 10–12 nedelja gestacije. Stoga, vreme kada se postavi dijagnoza je ključno za uspešno lečenje. Prikaz bolesnika. Kod dve pacijentkinje, starosti 28 i 22 godine, ul-trazvučno je dijagnostikovana IT. Obe pacijentkinje bile su bez simptoma, a koncentracije njihovog serumskog βhCG-a iznosile su 6 664 odnosno 4 641 mIU/mL. S obzirom na to da su odbile lečenje metotreksatom i imale želju da sačuvaju svoju fertilnost, podvrgnute su histeroskopskoj resekciji i evakuaciji gestacijskog tkiva. Operativne procedure su prošle bez komplikacija. Nakon operacija, značajno su snižene kon-centracije βhCG-a u serumu i pacijentkinje su otpuštene trećeg, odnosno četvrtog postoperativnog dana. Zaključak. Primenom histeroskopske resekcije uspešno smo rešili IT kod dve pacijentkinje bez simptoma, sa IT gestacijske starosti kraće od 10 nedelja i nivoima serumskih βhCG-a nižim od 7 000 mIU/mL. S obzirom na izuzetno retku pojavu IT, ali i mnogobrojne prednosti histeroskopije, neophodne su obimne, multicentrične studije, da bi se ispitali mesto i značaj tog pristupa u rešavanju IT. Obrasci i posledice uočeni tokom COVID-19 pandemije su u korelaciji sa značajem pravovremene dijagnostike ektopičnih trudnoća, minimalno invazivnim pristupom u njihovom rešavanju i epidemiološki opravdanom kraćom hospitalizacijom.
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