Jayaprakash Sheela, Muralidhar Lakshmidevi, Sampathkumar G, Sexsena Rajivkumar
Obstetrics and Gynaecology Department, Vydehi Institute of Medical Sciences, Bangalore, Karnataka, India.
BMJ Case Rep. 2011 Oct 28;2011:bcr0820114633. doi: 10.1136/bcr.08.2011.4633.
A primigravida aged 20 years was referred to Vydehi Institute of Medical Sciences with diagnosis of 30 weeks of period of gestation with eclampsia and failure to respond to induction with misoprostol and she was on Pritchard regimen for the treatment of eclampsia and there was no response to induction of labour and emergency ultrasound was taken and it showed an extrauterine gestation of 30 weeks gestation with fetal demise and free fluid in peritoneum. A tentative diagnosis of secondary abdominal pregnancy with eclampsia was made and she was taken for emergency laprotomy. Intra operative findings showed haemoperitoneum, fetus with placenta and membranes in the peritoneal cavity, there was bicornuate uterus and right horn was ruptured from the fundus to about 8 cm down in the posterior aspect and ruptured part was sutured in two layers. After securing perfect haemostasis, abdomen was closed. This paper illustrates a case report of uterine anomaly with 30 weeks period of gestation and eclampsia and rupture following induction with prostaglandins.
一名20岁的初产妇因妊娠30周伴子痫且对米索前列醇引产无反应，被转诊至维迪希医学科学研究所。她正在接受普里查德方案治疗子痫，但引产无反应，遂进行了急诊超声检查，结果显示为妊娠30周的宫外妊娠伴胎儿死亡及腹腔内游离液体。初步诊断为继发性腹腔妊娠伴子痫，随后她接受了急诊剖腹手术。术中发现腹腔积血，胎儿及其胎盘和胎膜位于腹腔内，子宫为双角子宫，右角从底部向后破裂至约8厘米处，破裂部位分两层缝合。确保完全止血后，关闭腹腔。本文阐述了一例妊娠30周合并子痫且在前列腺素引产后宫角破裂的子宫异常病例报告。
