Fiori Olivia, Prugnolles Hervé, Darai Emile, Uzan Serge, Berkane Nadia
Service of Gynecology and Obstetrics and Reproductive Medicine, Hôpital Tenon, Paris, France.
J Reprod Med. 2007 Jul;52(7):657-8.
Spontaneous rupture of uterine vessels during pregnancy is rare and usually involves uteroovarian veins. Presenting symptoms include acute-onset abdominal pain and maternal hypovolemic collapse due to hemoperitoneum. An atypical case of subacute uterine artery rupture at 27 weeks of gestation occurred in a woman with sickle cell disease.
A 28-year-old, nulliparous woman with sickle cell disease was admitted at 27 weeks of gestation for sharp abdominal pain radiating to the right flank. The first diagnosis included acute renal colic and a sickling vasoocclusive crisis. One week after admission the patient experienced paroxysmal, diffuse abdominal pain associated with acute fetal distress requiring an emergency cesarean section. Laparotomy revealed an 800-mL hemoperitoneum. Active bleeding from a ruptured uterine artery was observed and successfully treated by selective suture.
Spontaneous rupture of the uterine artery during pregnancy may present as a 2-step process.
孕期子宫血管自发性破裂罕见，通常累及子宫卵巢静脉。临床表现为急性腹痛和因腹腔积血导致的母体低血容量性休克。一名患有镰状细胞病的女性在妊娠27周时发生了非典型的子宫动脉亚急性破裂。
一名28岁未生育的镰状细胞病女性在妊娠27周时因突发锐痛放射至右下腹入院。初步诊断包括急性肾绞痛和镰状细胞血管阻塞危象。入院一周后，患者出现阵发性弥漫性腹痛并伴有急性胎儿窘迫，需紧急剖宫产。剖腹探查发现腹腔积血800毫升。观察到子宫动脉破裂处有活动性出血，通过选择性缝合成功止血。
孕期子宫动脉自发性破裂可能表现为一个两步过程。
