Tsankova M, Nikolov A, Bosev D, Pirnareva E
Akush Ginekol (Sofiia). 2012;51(5):50-3.
Uterine rupture is one of the most serious complications of pregnancy, causing maternal and perinatal death. An increased risk of uterine rupture is associated with uterine scars caused by previous cesarean section, myomectomy, hysteroscopic procedures and ART treatment. We report a case of 35-year-old nulliparous woman with a twin pregnancy who experienced a spontaneous uterine rupture at 30 weeks' gestation. She had a previous history of one opened myomectomy, two laporoscopic procedures for extrauterine pregnancy and myomectomy in the left uterine corn. Her pregnancy was established with in vitro fertilization 14 months after the laparoscopic myomectomy. The uterine rupture was heralded by a sudden onset of severe abdominal pain while she was having a routine exam. This case reinforces that pregnancy after myomectomy should be closely monitored with respect to uterine rupture.
子宫破裂是妊娠最严重的并发症之一，可导致孕产妇和围产儿死亡。子宫破裂风险增加与既往剖宫产、子宫肌瘤切除术、宫腔镜手术及辅助生殖技术治疗所致的子宫瘢痕有关。我们报告一例35岁未生育的双胎妊娠女性，在妊娠30周时发生自发性子宫破裂。她既往有一次子宫肌瘤切除术、两次腹腔镜宫外孕手术及左侧子宫角肌瘤切除术史。腹腔镜子宫肌瘤切除术后14个月通过体外受精受孕。子宫破裂发生在她进行常规检查时突然出现的剧烈腹痛之后。该病例强化了子宫肌瘤切除术后妊娠应密切监测子宫破裂的观点。
