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宫腔镜子宫纵隔切除术后再次妊娠29周时发生子宫破裂。

Uterine rupture at the 29th week of subsequent pregnancy after hysteroscopic resection of uterine septum.

作者信息

Satiroğlu Mustafa Hakan, Gözüküçük Murat, Cetinkaya Serife Esra, Aydinuraz Batu, Kahraman Korhan

机构信息

Department of Obstetrics and Gynecology, Ankara University Medical Faculty, Ankara, Turkey.

出版信息

Fertil Steril. 2009 Mar;91(3):934.e1-3. doi: 10.1016/j.fertnstert.2008.08.075. Epub 2008 Dec 4.

Abstract

OBJECTIVE

To describe a patient with uterine rupture in the subsequent pregnancy after hysteroscopic resection of a uterine septum.

DESIGN

Case report.

SETTING

University hospital.

PATIENT(S): A 30-year-old nulliparous woman, with a history of a first trimester spontaneous abortion, hysteroscopic uterine septum resection by cutting diathermy using the operating hysteroscope, and a second hysteroscopic procedure for a residual septum, was admitted to our clinic with symptoms of hemodynamic shock at the 29th week of gestation.

INTERVENTION(S): Immediate laparotomy was performed.

MAIN OUTCOME MEASURE(S): Uterine rupture in the second trimester of the subsequent pregnancy with fetal loss.

RESULT(S): Midfundal complete uterine rupture was observed at the site of the resected uterine septum, accompanied by an extrauterine exanimate fetus.

CONCLUSION(S): Uterine rupture may occur in pregnancies after hysteroscopic resection of the uterine septum. Clinicians who perform this procedure, especially in the cases with repeated procedures using cutting diathermy, must warn and inform their patients about the risks of their later pregnancies.

摘要

目的

描述一例子宫纵隔宫腔镜切除术后再次妊娠发生子宫破裂的患者。

设计

病例报告。

地点

大学医院。

患者

一名30岁未生育女性,有孕早期自然流产史,曾使用手术宫腔镜通过电切术进行子宫纵隔宫腔镜切除术,后因残留纵隔进行了第二次宫腔镜手术,在妊娠第29周因血流动力学休克症状入住我院。

干预措施

立即进行剖腹探查术。

主要观察指标

再次妊娠中期发生子宫破裂并导致胎儿丢失。

结果

在切除子宫纵隔的部位观察到子宫底部完全破裂,伴有宫外已死亡胎儿。

结论

子宫纵隔宫腔镜切除术后妊娠可能发生子宫破裂。实施该手术的临床医生,尤其是在使用电切术进行重复手术的情况下,必须向患者告知其后续妊娠的风险。

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