Department of Gynaecology and Obstetrics, Kyoto University, Kyoto, Japan.
Eur J Obstet Gynecol Reprod Biol. 2013 Sep;170(1):20-4. doi: 10.1016/j.ejogrb.2013.04.018. Epub 2013 Jun 10.
An increasing number of women with severe endometriosis have conceived through assisted reproductive technology, but endometriosis can cause life-threatening complications for both the mother and baby during pregnancy. We describe a case of endometriosis-induced spontaneous ileal perforation in pregnancy with massive intestinal haemorrhage that required caesarean section, right hemicolectomy and terminal ileum resection at 33 weeks of gestation. Spontaneous perforation associated with intestinal endometriosis in pregnancy is a rare complication, and only seven cases have been reported in the English literature. To the best of our knowledge, this is the first report of spontaneous ileal perforation due to endometriosis. Moreover, this is probably the first case of massive intestinal haemorrhage in pregnancy that resulted from intestinal endometriosis. These risks must be explained to couples suffering from endometriosis-related infertility prior to conception by assisted reproductive technology, and multidisciplinary management may be mandatory for women with severe endometriosis in pregnancy.
越来越多患有严重子宫内膜异位症的女性通过辅助生殖技术怀孕，但子宫内膜异位症在怀孕期间可能会给母亲和婴儿带来危及生命的并发症。我们描述了一例妊娠合并子宫内膜异位症导致自发性回肠穿孔并大量肠出血的病例，该病例在妊娠 33 周时需要行剖宫产术、右半结肠切除术和回肠末端切除术。妊娠合并肠子宫内膜异位症相关自发性穿孔是一种罕见的并发症，在英文文献中仅报道了 7 例。据我们所知，这是首例因子宫内膜异位症导致的自发性回肠穿孔的报告。此外，这可能是首例因肠子宫内膜异位症导致的妊娠大量肠出血的病例。在通过辅助生殖技术受孕之前，必须向患有子宫内膜异位症相关不孕的夫妇解释这些风险，对于患有严重子宫内膜异位症的孕妇，可能需要多学科管理。
