Ergenoğlu Ahmet Mete, Yeniel Ahmet Özgür, Ulukuş Murat, Aşkar Niyazi
Department of Obstetrics and Gynecology, Faculty of Medicine, Ege University, İzmir, Turkey.
J Turk Ger Gynecol Assoc. 2010 Sep 1;11(3):160-2. doi: 10.5152/jtgga.2010.26. eCollection 2010.
Pulmonary embolus is a rare and serious complication of myoma uteri in the puerperium that resulted in late postpartum hysterectomy A 38-year-old, multiparous woman with a large myoma located on the left lateral wall of the uterus underwent emergency cesarean section due to fetal distres at 28 weeks. During the operation, a 15 cm sized intramural myoma was left without any intervention. On the 40(th) day postpartum the patient returned to the clinic with sepsis and pulmonary embolus because of obstruction of lochia drainage by the sloughed off myoma. The patient underwent hysterectomy and medical therapy for pulmonary embolus. We presented an unusual complication of uterine leiomyoma in the late postpartum period after cesarean section. Whatever the mode of sloughing off of the myoma, the results of the obstruction of lochia drainage may be devastating as in our case. To avoid these complications, clinicians must be aware of these symptoms and prompt intervention is essential.
肺栓塞是产褥期子宫肌瘤罕见且严重的并发症,可导致晚期产后子宫切除术。一名38岁的经产妇,子宫左侧壁有一个大肌瘤,因28周时胎儿窘迫行急诊剖宫产。手术过程中,未对一个15厘米大小的壁间肌瘤进行任何干预。产后第40天,患者因脱落的肌瘤阻塞恶露引流,出现败血症和肺栓塞,返回诊所。患者接受了子宫切除术及肺栓塞的药物治疗。我们报告了剖宫产术后晚期产后子宫平滑肌瘤的一种不寻常并发症。无论肌瘤脱落方式如何,如我们病例中所见,恶露引流受阻的后果可能是灾难性的。为避免这些并发症,临床医生必须了解这些症状,及时干预至关重要。