Sugaya S, Yahata T, Nishikawa N, Arinami Y, Maruhashi T, Takakuwa K, Tanaka K
Department of Obstetrics and Gynecology, Joetsu General Hospital, Joetsu City, Japan.
Clin Exp Obstet Gynecol. 2012;39(4):547-9.
Although severe Asherman's syndrome is a disease that may cause infertility, pregnancy and childbirth are possible by performing hysteroscopic surgery. However, the obstetrical outcome is not always satisfactory. We report a case where severe Asherman's syndrome occurred following a cesarean section. Hysteroscopic surgery was performed due to secondary infertility, and pregnancy was achieved through a subsequent intracytoplasmic sperm injection. At 23 weeks of gestation, the patient was hospitalized due to the threat of premature labor, and a cesarean section was performed at 29 weeks of gestation after pregnancy-induced hypertension occurred. It was determined to be abnormal adherent placentation such as placenta increta through intraoperative findings, and a cesarean hysterectomy was performed. The pathological diagnosis of the uterus was placenta increta. Due to the risk of complications from placenta increta in pregnancies following hysteroscopic surgery in patients with severe Asherman's syndrome, it is important to realize the high risk involved in such cases during the pregnancy course, and careful perinatal management should be required.
虽然重度阿谢曼综合征是一种可能导致不孕的疾病,但通过宫腔镜手术可实现妊娠和分娩。然而,产科结局并不总是令人满意。我们报告一例剖宫产术后发生重度阿谢曼综合征的病例。因继发性不孕行宫腔镜手术,并通过随后的卵胞浆内单精子注射实现妊娠。妊娠23周时,患者因早产威胁住院,妊娠高血压发生后于妊娠29周行剖宫产。术中发现为胎盘植入异常,如胎盘植入,遂行剖宫产子宫切除术。子宫病理诊断为胎盘植入。由于重度阿谢曼综合征患者宫腔镜手术后妊娠发生胎盘植入并发症的风险,在妊娠过程中认识到此类病例的高风险很重要,需要进行仔细的围产期管理。