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子宮内外同時妊娠

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子宮内外同時妊娠
Ꮚᐑෆእྠ᫬ዷፎ
デ⒪ࡶ⤊ࢃࡾࠊᖐᏯࡋࡼ࠺࡜╔᭰࠼࡚࠸ࡿ࡜ࡇࢁ࡬⥭ᛴධ㝔ࡢሗ࿌ࠋᡤぢ࡛ࡣࠊ㉸㡢Ἴデ᩿࡛⫾ඣࡀ
ㄆࡵࡽࢀࠊᚰᢿࡶ☜ㄆࡉࢀ࡚࠸ࡓࠋ
࡜ࡇࢁࡀࠊ⭡⭍ෆ࡟኱㔞ࡢ⾑ᾮ㈓␃ࡀぢࡽࢀࡿࡓࡵࠊ⥭ᛴᡭ⾡ࡀᚲせ࡜㌿㏦ࡉࢀ࡚᮶ࡓࠋධ㝔᫬ࠊᝈ
⪅ࡉࢇࡣୗ⭡③ࢆッ࠼ࠊ㢦㠃ࡣ⵬ⓑࠊ┤ࡕ࡟ᡭ⾡ࡀ᪋ࡉࢀࠊ⭡⭍ෆ࡟⣙㸯㸵㸮㸮࣭ࡢจ⾑࡜⾑ᾮࡀࡳࡽ
ࢀࠊྑ༸⟶ࡢ୍㒊ࡀ㦵┙ቨࡢ⭡⭷࡜࠿ࡍ࠿࡟⒵╔㸦ࡺࡕࡷࡃ㸧ࡋ࡚࠸ࡓࠋࡋ࠿ࡋ኱㔞ฟ⾑ࡢཎᅉ࡜࡞ࡿ
ࡼ࠺࡞␗ᖖᡤぢࡣ௚࡟ㄆࡵࡽࢀࡎࠊ⒵╔ࡋ࡚࠸ࡓ༸⟶ࢆ๤㞳㸦ࡣࡃࡾ㸧ࡋࠊฟ⾑ࡋ࡚࠸ࡿ༸⟶ࢆ୍㒊ษ
㝖ࡋ࡚ᡭ⾡ࢆ⤊࠼ࡓࠋ
⾡ᚋࡢ⤒㐣ࡣ㡰ㄪ࡛ࠊὶ⏘ᚩೃࡶぢࡽࢀ࡞࠿ࡗࡓࠋ୙ᛮ㆟࡞ᛮ࠸࡛ᩘ᪥ࡀ㐣ࡂࡓࡀࠊ⑓⌮⤌⧊᳨ᰝ࡛ࠊ
㺀ษ㝖ࡋࡓ༸⟶࡟⫾ඣ⤌⧊ࡢ⤧ẟࡀㄆࡵࡽࢀࡿ㺁࡜ࡢሗ࿌ࢆཷࡅࠊึࡵ࡚Ꮚᐑෆእྠ᫬ዷፎ࡛ࠊྑ༸⟶ࡢ
Ꮚᐑእዷፎࡀ኱㔞ฟ⾑ࡢཎᅉࡔ࡜⪃࠼ࡽࢀࡓࡢ࡛࠶ࡿࠋ
ᩘ᪥๓ࠊ᪂₲኱Ꮫ⑓㝔࡛୙ዷᝈ⪅ࡉࢇࡀࠊࡸࡗ࡜ዷፎࡋࡓࡢࡣࡼ࠿ࡗࡓࡀ㉸㡢Ἴデ᩿࡛ෆእྠ᫬ዷፎ
࡜デ᩿ࡉࢀࠊᑐᛂ࡟ⱞ៖ࡋ࡚࠸ࡿࡀࠊᏊᐑእዷፎࡢ⮫ᗋ⑕≧ࡀ↓࠸ࡢ࡛⮬↛࡟⤒㐣ࢆࡳ࡚࠸ࡿ࡜⪺࠿ࡉ
ࢀࡓࡤ࠿ࡾ࡛࠶ࡗࡓࠋࡋ࠿ࡋࠊ⤒㦂ࡶ↓࠸ࡇ࡜࡞ࡢ࡛༙ಙ༙␲ࡢẼᣢࡕ࡛ࠊ௒ᚋ࡝࠺ᢅ࠺࡭ࡁ࠿኱Ꮫࡢ
ඛ⏕᪉࡜᳨ウࡋࡓࡔࡅ࡛࠸ࡓࠋ
᪥ᖖデ⒪࡟࠾࠸࡚ࡣࠊ㉸㡢Ἴデ᩿࡛Ꮚᐑෆ࡟ṇᖖዷፎ࡜デ᩿ࡉࢀ࡚࠸ࢀࡤࠊᏊᐑእዷፎࡀྠ᫬࡟Ꮡᅾ
ࡍࡿ➼࡜࠸࠺ࡇ࡜ࡣ୰ࠎᛮ࠸ᾋ࠿ࡪࡶࡢ࡛ࡣ࡞࠸࡜ᛮ࠺ࠋࡴࡋࢁ㉸㡢Ἴデ᩿⿦⨨ࡀࡲࡔᬑཬࡋ࡚࠸࡞࠿
ࡗࡓ㡭ࡣࠊᏊᐑእዷፎ࡛ᡭ⾡ࡋࡓᝈ⪅ࡉࢇࡀࠊᩘ᪥๓࡟ேᕤዷፎ୰⤯ࢆཷࡅ࡚࠸ࡓࡾࠊὶ⏘ࡢ἞⒪ࢆཷ
ࡅ࡚࠸ࡿࡼ࠺࡞ሙྜ࡟ࠊⱞࡋࡲࡂࢀ࡟ෆእྠ᫬ዷፎ࡜࠸࠺ゝⴥࢆཱྀ࡟ࡍࡿ⛬ᗘ࡛࠶ࡗࡓࠋᏊᐑෆእྠ᫬
ዷፎ࡜࠸࠺ࢣ࣮ࢫࡣࠊ⏘፬ே⛉་࡛ࡶ୍⏕࡟⤒㦂ࡍࡿ࠿ྰ࠿࡜࠸࠺ࡃࡽ࠸㠀ᖖ࡟⛥࡞⑌ᝈ࡛࠶ࡾࠊ㸱୓
౛࡟㸯౛࡜࠸ࢃࢀ࡚࠸ࡿࠋ
ࡋ࠿ࡋࠊࡇࡢࡼ࠺࡟⌧ᐇ࡟㸰౛⥆ࡅ࡚⤒㦂ࡍࡿ࡜ࠊᐇ㝿࡟ࡣሗ࿌ࡀ↓࠸ࡔࡅ࡛ᮏᙜࡣࡶࡗ࡜ከࡃぢࡽ
ࢀࡿ࠿ࡶࡋࢀ࡞࠸࡜ࡶᛮ࠺ࠋ
ఱ୓౛࡟㸯౛࡜࠸࠺⛥࡞⑓Ẽ࡛ࡶࠊᝈ⪅ࡉࢇ࡟ࡣ⏕Ṛ࡟࠿࠿ࢃࡿ஦ࡶ࠶ࡾࠊᛁࡋ࠸୰࡟࠶ࡗ࡚ࡶ㸺ᛮ
࠸㎸ࡳ἞⒪㸼ࢆࡋ࡞࠸ࡼ࠺࡟ὀពࡋ࡞ࡀࡽᝈ⪅ࡉࢇࡢ๓࡟❧ࡗ࡚࠸ࡿࠋ
኱Ꮫ⑓㝔ࡢ⑕౛ࡣࠊᏊᐑእዷፎࡢ᪉ࡣ⮬↛࡟ᾘ⁛ࡋ྾཰ࡉࢀ࡚ࡋࡲ࠸ࠊᏊᐑእዷፎᡭ⾡ࢆࡍࡿࡇ࡜࡞
ࡃࠊ↓஦࡟⏕ඣࢆᚓࡽࢀࡓ࡜⪺࠸࡚࠸ࡿࠋ
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