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妊娠期子宫破裂:两例病例报告及文献综述

Uterine rupture in pregnancy: two case reports and review of literature.

作者信息

Pontis A, Prasciolu C, Litta P, Angioni S

出版信息

Clin Exp Obstet Gynecol. 2016;43(2):304-9.

Abstract

Rupture of a gravid uterus is an obstetric emergency. Risks factors include a scarred uterus but also spontaneous rupture of an un- scarred uterus during pregnancy is possible. The authors present two cases of a spontaneous complete uterine rupture during pregnancy. The first case had only a past history of dilatation and curettage for abortion; the second case had a past history of dilatation and curettage for abortion and a monolateral laparoscopic salpingectomy for ectopic pregnancy. They presented with abdominal pain and after ultrasound scan, uterine ruptures were diagnosed. These cases show that there should be a high index of suspicious of uterine rupture in a gravid woman with a history of curettage for the possible presence of misunderstood uterine scar and in women with a past history of salpingectomy with or without corneal resection. Appropriate counseling and close follow-up might help to avoid such obstetrical catastrophes. To provide more insight into the possible risk factors for prelabor uterine rupture in pregnancy, a literature review was performed.

摘要

妊娠子宫破裂是一种产科急症。危险因素包括子宫瘢痕,但妊娠期间未瘢痕化子宫也可能发生自发性破裂。作者介绍了两例妊娠期间自发性完全子宫破裂的病例。第一例仅有既往人工流产刮宫史;第二例有既往人工流产刮宫史及单侧腹腔镜输卵管切除术治疗宫外孕史。她们均因腹痛就诊,经超声检查后诊断为子宫破裂。这些病例表明,对于有刮宫史的孕妇,应高度怀疑存在未被认识的子宫瘢痕,对于有或无输卵管间质部切除史的输卵管切除术史的女性,也应高度怀疑子宫破裂。适当的咨询和密切随访可能有助于避免此类产科灾难。为了更深入了解妊娠晚期子宫破裂的可能危险因素,进行了一项文献综述。

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