Rivlin Michel E, Carroll C Shannon, Morrison John C
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216-4505, USA.
J Reprod Med. 2003 Sep;48(9):687-91.
To establish the clinical features of patients with necrosis of the uterine incision after cesarean delivery because of the paucity of modern reports in the literature.
Over a 4-year period, the records of 6 patients with this complication were reviewed.
Three patients presented within 48-72 hours of delivery with clinical features very similar to those of bowel perforation. One patient had fascial dehiscence on day 5 after delivery. Two cases presented 2 and 6 weeks after delivery with postpartum hemorrhage without peritoneal findings. Diagnosis was not made prior to surgery in any case. All patients recovered after hysterectomy.
While the major risks with this uncommon but important complication are serious infectious morbidity and mortality, in our patients these risks were avoided but at the cost of hysterectomy in a group of young women of low parity. More data in the future might establish a basis for rational management, possibly including conservative surgery in selected cases.
鉴于文献中现代报道较少，本研究旨在明确剖宫产术后子宫切口坏死患者的临床特征。
回顾了4年间6例出现该并发症患者的记录。
3例患者在分娩后48 - 72小时内出现，临床特征与肠穿孔极为相似。1例患者在分娩后第5天出现筋膜裂开。2例患者在分娩后2周和6周出现产后出血，无腹膜相关表现。所有病例术前均未确诊。所有患者在子宫切除术后均康复。
虽然这种罕见但重要的并发症的主要风险是严重的感染性发病和死亡，但在我们的患者中这些风险得以避免，不过代价是一组低生育次数的年轻女性接受了子宫切除术。未来更多的数据可能为合理管理奠定基础，可能包括在特定病例中采用保守手术。
Zotero 插件