Wang Yeou-Lih, Su Tsung-Hsien
Department of Obstetrics and Gynecology, Mackay Memorial Hospital, and Mackay Medicine, Nursing, and Management College, Taipei, Taiwan.
Gynecol Obstet Invest. 2006;62(3):131-5. doi: 10.1159/000093031. Epub 2006 May 2.
Rupture of the unscarred uterus is a rare and potentially catastrophic event. We retrospectively reviewed the records of patients with this condition to analyze their obstetric and gynecologic history and evaluate maternal and perinatal morbidity and mortality.
A total of 11 cases of rupture of the unscarred gravid uterus were managed at Mackay Memorial Hospital from January 1984 to September 2003. Data extracted from the records included the use of uterine stimulants, instrumental delivery, and prior abortion by instrumentation, clinical features, treatment, and maternal and fetal morbidity and mortality.
The incidence of unscarred uterine rupture is 0.009% during the 20-year study period. The most common contributing factors were prior abortion by instrumentation and the use of uterotonic agents, in three cases respectively. Fetal distress occurred in six cases and postpartum hemorrhage in two. There was no maternal death, but in two cases, there was intrauterine fetal demise or perinatal death.
Though unexpected in a woman with an unscarred uterus, rupture should be considered as a possible cause of fetal distress or unusual pain or hypotension in the mother.
未瘢痕化子宫破裂是一种罕见且可能具有灾难性的事件。我们回顾性分析了患有这种疾病的患者记录，以分析其妇产科病史，并评估孕产妇和围产儿的发病率及死亡率。
1984年1月至2003年9月期间，麦凯纪念医院共处理了11例未瘢痕化妊娠子宫破裂病例。从记录中提取的数据包括子宫收缩剂的使用、器械助产以及既往器械流产史、临床特征、治疗方法以及孕产妇和胎儿的发病率及死亡率。
在20年的研究期间，未瘢痕化子宫破裂的发生率为0.009%。最常见的促成因素分别是既往器械流产史和子宫收缩剂的使用，各有3例。6例出现胎儿窘迫，2例出现产后出血。没有孕产妇死亡，但有2例发生了宫内胎儿死亡或围产儿死亡。
虽然在未瘢痕化子宫的女性中这种情况出乎意料，但子宫破裂应被视为胎儿窘迫、母亲异常疼痛或低血压的可能原因。
