Matsuo Koji, Shimoya Koichiro, Shinkai Tsuneo, Ohashi Hiroshi, Koyama Masayasu, Yamasaki Masato, Murata Yuji
Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan.
J Obstet Gynaecol Res. 2004 Feb;30(1):34-6. doi: 10.1111/j.1341-8076.2004.00152.x.
We report the case of a 31-year-old Japanese female diagnosed by transvaginal ultrasonography to have a spontaneous uterine rupture in the first trimester. Her condition was complicated by diabetes mellitus type 1. Her previous pregnancy had resulted in an emergency cesarean section by transverse incision of the lower uterine segment with single-layer suture at 37(+4) weeks of gestation. Transvaginal ultrasonography displayed both a gestational sac located in the anterior lower uterine segment and a defect in the uterine wall located at the site of the previous cesarean delivery scar. Pelvic magnetic resonance imaging showed that the uterine muscle layer was discontinuous and the gestational sac was almost outside the uterine cavity, accompanied by mild hemorrhaging within the endometrial cavity. The defect in the lower uterine wall was round in shape and was 3 cm in diameter. Since uterine ruptures can occur during all gestational periods, it is important to pay attention to the uterine wall where any cesarean incision was previously made.
我们报告了一例31岁的日本女性病例，经经阴道超声检查诊断为孕早期自发性子宫破裂。她患有1型糖尿病，病情较为复杂。她之前的妊娠在孕37（+4）周时通过子宫下段横切口单层缝合进行了急诊剖宫产。经阴道超声检查显示妊娠囊位于子宫下段前壁，子宫壁缺损位于既往剖宫产瘢痕处。盆腔磁共振成像显示子宫肌层连续性中断，妊娠囊几乎位于子宫腔外，子宫内膜腔内伴有轻度出血。子宫下段壁缺损呈圆形，直径为3厘米。由于子宫破裂可发生在整个妊娠期，因此关注既往有剖宫产切口的子宫壁非常重要。
