Mazzone Michael E, Woolever Jonathan
Department of Family and Community Medicine, Medical College of Wisconsin, USA.
WMJ. 2006 Mar;105(2):64-6.
Uterine rupture is a true obstetrical emergency. We present a case of a multigravid woman who had a spontaneous uterine rupture after induction with misoprostol and oxytocin, followed by a general discussion of uterine ruptures with a special emphasis on an unscarred uterus. Risk factors for uterine rupture in an unscarred uterus include grand multiparity, induction with misoprostol or oxytocin, malpresentation, or previous surgical abortion. Most cases present with maternal tachycardia, signs of fetal distress, and bleeding. The treatment for intrapartum uterine rupture includes fluid resuscitation and emergency laporotomy. Postpartum counseling regarding the risk of rerupture with subsequent pregnancies is an important piece of the management of these patients.
子宫破裂是一种真正的产科急症。我们报告一例经产妇,在使用米索前列醇和缩宫素引产之后发生自发性子宫破裂,随后对子宫破裂进行了全面讨论,特别强调了未瘢痕化子宫。未瘢痕化子宫发生子宫破裂的危险因素包括多产、使用米索前列醇或缩宫素引产、胎位异常或既往人工流产。大多数病例表现为母体心动过速、胎儿窘迫体征和出血。产时子宫破裂的治疗包括液体复苏和急诊剖腹手术。对这些患者进行产后关于后续妊娠子宫再破裂风险的咨询是管理的重要环节。