Pieh-Holder Kelly L, Bell Heidi, Hall Tana, DeVente James E
Department of Obstetrics and Gynecology, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA.
Case Rep Obstet Gynecol. 2014;2014:435101. doi: 10.1155/2014/435101. Epub 2014 Oct 14.
Background. Uterine inversion is a rare, but life threatening, obstetrical emergency which occurs when the uterine fundus collapses into the endometrial cavity. Various conservative and surgical therapies have been outlined in the literature for the management of uterine inversions. Case. We present a case of a chronic, recurrent uterine inversion, which was diagnosed following spontaneous vaginal delivery and recurred seven weeks later. The uterine inversion was likely due to a leiomyoma. This late-presenting, chronic, recurring uterine inversion was treated with a vaginal hysterectomy. Conclusion. Uterine inversions can occur in both acute and chronic phases. Persistent vaginal bleeding with the appearance of a prolapsing fibroid should prompt further investigation for uterine inversion and may require surgical therapy. A vaginal hysterectomy may be an appropriate management option in select populations and may be considered in women who do not desire to maintain reproductive function.
背景。子宫内翻是一种罕见但危及生命的产科急症,发生于子宫底陷入子宫内膜腔时。文献中已概述了多种用于治疗子宫内翻的保守和手术疗法。病例。我们报告一例慢性复发性子宫内翻病例,该病例在自然阴道分娩后被诊断出,并在七周后复发。子宫内翻可能是由平滑肌瘤引起的。这种迟发性、慢性、复发性子宫内翻通过阴道子宫切除术进行治疗。结论。子宫内翻可发生在急性和慢性阶段。出现脱垂肌瘤并伴有持续阴道出血时,应促使进一步检查是否存在子宫内翻,且可能需要手术治疗。阴道子宫切除术在特定人群中可能是一种合适的治疗选择,对于不希望保留生殖功能的女性可予以考虑。