Larue L, Marpeau L, Percque M, Castiel J, Guettier X, Maghioracos P, Barrat J
Clinique Universitaire de Gynécologie-Obstétrique, Hôpital Saint-Antoine, Paris.
J Gynecol Obstet Biol Reprod (Paris). 1991;20(2):269-72.
The authors report one case of uterine rupture in a non scarred uterus when an analogue of prostaglandin E2 was being transfused. It was Sulprostone used to terminate a pregnancy because of fetal death in utero after 27 weeks of amenorrhea. This case history and an analysis of the literature makes it possible to point out the need to reach the diagnosis before signs become too severe and to show that pharmacological knowledge of the drug has to be improved as well as the ways of administering prostaglandin analogue. This is to be conducted together with improving the ways of terminating pregnancies in the second trimester. It shows that mechanical accidents can occur even where there are no obvious risk factors. In this case, pain continued from the time of the rupture under epidural anaesthesia. The physiopathology is reviewed. Finally, conservative treatment of the uterus should be carried out whenever possible in order to allow a new pregnancy to occur and to lessen the morbidity of the operation.
作者报告了1例在输注前列腺素E2类似物时非瘢痕子宫发生子宫破裂的病例。该病例使用的是硫前列酮,用于因停经27周后胎儿宫内死亡而终止妊娠。该病例报告及文献分析指出,在体征变得过于严重之前作出诊断很有必要,还表明必须完善药物的药理学知识以及前列腺素类似物的给药方式。这应与改进孕中期终止妊娠的方式一并进行。该病例表明,即使没有明显的危险因素,也可能发生机械性意外。在本病例中,自破裂时起在硬膜外麻醉下疼痛持续存在。文中对病理生理学进行了回顾。最后,应尽可能对子宫进行保守治疗,以便能再次妊娠并降低手术的发病率。