F Abdulwahab Dalia, Ismail Hamizah, Nusee Zalina
Department of Obstetrics & Gynaecology, Kulliyyah of Medicine, International Islamic University Malaysia, Jalan Hospital Campus, 25150 Kuantan, Pahang, Malaysia.
Malays J Med Sci. 2014 Jul;21(4):61-5.
Uterine rupture is a rare life-threatening complication. It mainly occurs in the third trimester of pregnancy and is rarely seen during the first or second trimesters. Our centre experienced three important cases of uterine rupture.
spontaneous uterine rupture at 14 weeks of pregnancy, which was diagnosed at autopsy. It was misled by the ultrasound finding of an intrauterine pregnancy, and searching for other non-gynaecological causes delayed the urgent obstetric surgical management.
ruptured uterus at 24 weeks following medical termination due to foetal anomaly. It was diagnosed only at laparotomy indicated for failed medical termination and chorioamnionitis. Third case: uterine rupture at 21 weeks of pregnancy in a patient with gastroenterology symptoms. In these reports, we have discussed the various risk factors, presentations, course of events and difficulties in diagnosing uterine rupture. The study concludes that the clinical presentation of uterine ruptures varies. It occurs regardless of gestational age. Ultrasound findings of intrauterine pregnancy with free fluid do not exclude uterine rupture or ectopic pregnancy. Searching for non-gynaecological causes in such clinical presentations might delay crucial surgical intervention, which leads to unnecessary morbidity, mortality or loss of obstetrics function.
子宫破裂是一种罕见的危及生命的并发症。它主要发生在妊娠晚期，在妊娠早期或中期很少见。我们中心经历了三例重要的子宫破裂病例。
妊娠14周时自发性子宫破裂，尸检时确诊。超声检查发现宫内妊娠导致误诊，寻找其他非妇科原因延误了紧急产科手术治疗。
因胎儿畸形在药物流产后24周子宫破裂。仅在因药物流产失败和绒毛膜羊膜炎而进行剖腹探查时才确诊。第三例：一名有胃肠病症状的患者在妊娠21周时子宫破裂。在这些报告中，我们讨论了子宫破裂的各种危险因素、表现、事件过程及诊断困难。研究得出结论，子宫破裂的临床表现各不相同。它在任何孕周均可发生。超声检查发现宫内妊娠伴有游离液体并不能排除子宫破裂或异位妊娠。在此类临床表现中寻找非妇科原因可能会延误关键的手术干预，从而导致不必要的发病、死亡或产科功能丧失。
