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孕晚期非临产子宫自发性完全破裂:超声漏诊

Spontaneous Complete Uterine Rupture in a Nonlaboring, Early Third-trimester Uterus: Missed Diagnosis by Ultrasound.

作者信息

Dixon Luke, Carlan S J, O'Leary T D, Perez Jose

机构信息

Department of Obstetrics and Gynecology, Winnie Palmer Hospital, Orlando Regional Healthcare, Orlando, Florida.

出版信息

AJP Rep. 2013 Oct;3(2):79-82. doi: 10.1055/s-0033-1341575. Epub 2013 Mar 19.

Abstract

Objective Describe potential consequences and remedy for not intermittently auscultating fetal heart tones during travel to the imaging department and misdiagnosing a ruptured uterus on ultrasound as a synechiae. Study Design Retrospective chart review of case. Results Spontaneous uterine rupture in pregnancy is a rare and catastrophic event. Fetal monitoring is an important component for diagnosis, but fetal heart auscultation is usually discontinued while the patient is receiving imaging. We present a ruptured uterus at 28 weeks with delayed diagnosis secondary to interrupted fetal heart tone auscultation and a misdiagnosis of a rupture as a synechiae resulting in a seriously compromised newborn at delivery. Conclusion Intermittent fetal heart tone auscultation is a possible method of monitoring when the patient is off continuous fetal monitoring.

摘要

目的

描述在前往影像科途中未间断听诊胎心音以及超声将子宫破裂误诊为粘连的潜在后果及补救措施。研究设计:病例回顾性图表分析。结果:妊娠期间自发性子宫破裂是一种罕见且灾难性的事件。胎儿监测是诊断的重要组成部分,但在患者接受影像检查时通常会停止胎心听诊。我们报告一例28周子宫破裂病例,因胎心听诊中断导致诊断延迟,且破裂被误诊为粘连,致使新生儿出生时严重受损。结论:当患者脱离持续胎儿监测时,间断听诊胎心音是一种可行的监测方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53cb/3799716/2834a3f494d5/10-1055-s-0033-1341575-i13r0005-1.jpg

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本文引用的文献

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Rupture of the uterus in a primigravida: a case report.
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Fertil Steril. 2008 Apr;89(4):759-79. doi: 10.1016/j.fertnstert.2008.02.096.
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Rupture of the primigravid uterus: a review of the literature.初产妇子宫破裂:文献综述
Obstet Gynecol Surv. 2007 May;62(5):327-34; quiz 353-4. doi: 10.1097/01.ogx.0000261643.11301.56.
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