孕中期早期未瘢痕化子宫自发性破裂：一例胎盘植入病例报告
Spontaneous rupture of unscarred uterus in the early second trimester: a case report of placenta percreta.
作者信息
Pierzynski Piotr, Laudanski Piotr, Lemancewicz Adam, Sulkowski Stanislaw, Laudanski Tadeusz
机构信息
Department of Reproductive Medicine and Gynaecological Endocrinology, Medical University of Bialystok, Poland.
出版信息
Ginekol Pol. 2012 Aug;83(8):626-9.
BACKGROUND
Prevalence of uterine rupture at delivery has been recently estimated at less than 1 in 2500 deliveries. Spontaneous uterine rupture in the early mid-trimester (16 weeks gestation or less), is far less frequent. We report a case of uterine rupture due to placenta percreta in otherwise uncomplicated pregnancy
CASE
A 35-year-old, gravida 5, para 5, at 15wk 2d gestation (menstrual age) with negative history of uterine scarring suddenly developed symptoms of incipient hypovolemic shock while being hospitalized for imminent miscarriage. On exploratory laparotomy we found a midline uterine rupture infiltrated by the placenta. Supracervical hysterectomy was performed. Postoperative lab analysis confirmed the elevated serum AFP levels.
CONCLUSION
Abnormal placentation and subsequent uterine rupture should be taken into consideration also in women in the second trimester who have no history of uterine instrumentation.
背景
近期估计分娩时子宫破裂的发生率低于2500分之一。妊娠中期早期（妊娠16周或更早）的自发性子宫破裂则更为罕见。我们报告一例在无其他并发症的妊娠中因胎盘植入穿透子宫肌层导致子宫破裂的病例。
病例
一名35岁、孕5产5的女性，妊娠15周2天（月经龄），无子宫瘢痕史，因即将流产住院期间突然出现早期低血容量性休克症状。在剖腹探查术中，我们发现子宫中线破裂，胎盘侵入。行次全子宫切除术。术后实验室分析证实血清甲胎蛋白水平升高。
结论
对于无子宫手术史的妊娠中期女性，也应考虑异常胎盘植入及随后的子宫破裂。
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