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一例罕见的产科急症:孕32周急性子宫扭转

A rare obstetric emergency: acute uterine torsion in a 32-week pregnancy.

作者信息

Moores Karen Louise, Wood Matthew G, Foon Richard P

机构信息

Department of Maternity, Royal Shrewsbury Hospital, Shrewsbury, UK.

出版信息

BMJ Case Rep. 2014 Apr 11;2014:bcr2013202974. doi: 10.1136/bcr-2013-202974.

Abstract

Uterine torsion is rare in pregnancy and the cause in most cases is unknown. It is associated with fetal compromise, with perinatal mortality reported to be around 12%. Our case describes an acute torsion, presenting in pregnancy with severe abdominal pain and vomiting with a viable 32-week gestation. Emergency caesarean section was performed and the 180° uterine torsion was diagnosed intraoperatively. Posterior hysterotomy was required for delivery prior to detorsion of the uterus. This report describes that prompt recognition and intraoperative vigilance can achieve a successful maternal and fetal outcome in this rare and difficult obstetric scenario.

摘要

子宫扭转在妊娠中较为罕见,多数情况下病因不明。它与胎儿窘迫相关,据报道围产期死亡率约为12%。我们的病例描述了一例急性扭转,发生在妊娠期间,伴有严重腹痛和呕吐,孕32周胎儿存活。实施了急诊剖宫产,术中诊断为子宫180°扭转。在子宫复位前需要通过后路子宫切开术来娩出胎儿。本报告表明,在这种罕见且困难的产科情况下,及时识别和术中保持警惕可实现母婴成功结局。

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