Kurdoglu Mertihan, Kolusari Ali, Yildizhan Recep, Adali Ertan, Sahin Hanim Guler
Department of Obstetrics and Gynecology, Yuzuncu Yil University School of Medicine Van Turkey.
Cases J. 2009 Jun 3;2:7966. doi: 10.1186/1757-1626-2-7966.
Although rare, rupture of an unscarred uterus is one of the most dangerous obstetric complications, resulting in maternal and fetal jeopardy.
A 30-year-old grand multiparous Turkish woman without any history of uterine surgery gave birth vaginally at 37 weeks of gestation with fundal pressure applied in the second stage of labor. Transabdominal sonography performed 32 hours after delivery due to postural hypotension and a drop in hemoglobin values in the postpartum period revealed massive intra-abdominal free fluid. On emergency laparotomy, serosal rupture of the uterus on the left posterior side was observed. She underwent a subtotal hysterectomy and did well postoperatively.
Postural hypotension in postpartum patients without any evident vaginal bleeding may be an early sign of possible uterine rupture, even if the vital signs are stable. Early diagnosis is important if maternal morbidity and mortality are to be decreased.
尽管未瘢痕化子宫破裂罕见，但它是最危险的产科并发症之一，可导致母婴危险。
一名30岁的土耳其经产妇，无子宫手术史，在妊娠37周时经阴道分娩，第二产程使用了腹部加压。产后因体位性低血压和血红蛋白值下降，于产后32小时行经腹超声检查，发现腹腔内大量游离液体。急诊剖腹探查时，观察到子宫左后侧浆膜破裂。她接受了次全子宫切除术，术后恢复良好。
产后无明显阴道出血的患者出现体位性低血压，即使生命体征稳定，也可能是子宫破裂的早期迹象。若要降低孕产妇发病率和死亡率，早期诊断很重要。
