Bharatnur Sunanda, Hebbar Shripad, Shyamala G
Department of OBG, Manipal University, Manipal, Karnataka, India.
BMJ Case Rep. 2013 Dec 10;2013:bcr2013200960. doi: 10.1136/bcr-2013-200960.
Spontaneous uterine scar rupture can be lethal in pregnant women. A spontaneous uterine scar rupture in the early mid-trimester is rare and difficult to diagnose. This is a case of a 30-year-old woman (G2P1L1) at 19 weeks of gestation and having undergone a previous caesarean section presented with acute abdomen in shock. Laparotomy revealed a uterine scar rupture, which was resutured after evacuation of products of conception. This case merits that the uterine rupture should be considered as a differential diagnosis in pregnant women presenting with acute abdomen. In this case, although there was uterine rupture in the second trimester and a complete placental separation, fetus was alive which is quite unusual in patients presenting with rupture uterus.
自发性子宫瘢痕破裂对孕妇来说可能是致命的。妊娠中早期的自发性子宫瘢痕破裂很罕见且难以诊断。这是一名30岁女性(G2P1L1),妊娠19周,既往有剖宫产史,因急性腹痛伴休克就诊。剖腹探查发现子宫瘢痕破裂,在清除妊娠产物后进行了缝合。该病例提示,对于出现急性腹痛的孕妇,应将子宫破裂作为鉴别诊断之一。在本病例中,尽管孕中期发生子宫破裂且胎盘完全剥离,但胎儿存活,这在子宫破裂患者中相当罕见。