膀胱外翻和子宫脱垂患者经迪尔森切口后的阴道分娩
Vaginal Delivery After Dührssen Incisions in a Patient With Bladder Exstrophy and Uterine Prolapse.
作者信息
Lachica Ruben, Chan Yen, Uquillas Kristen R, Lee Richard H
机构信息
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Southern California, Los Angeles, California.
出版信息
Obstet Gynecol. 2017 Apr;129(4):689-692. doi: 10.1097/AOG.0000000000001938.
BACKGROUND
Bladder exstrophy is a rare congenital anomaly affecting the lower abdominal wall, pelvis, and genitourinary structures. Pregnant women with bladder exstrophy present a unique challenge to the obstetrician.
CASE
The patient is a 35-year old pregnant woman with bladder exstrophy, an extensive surgical history, and uterine prolapse with an abnormal, rubbery consistency to her cervix. Prenatally, she was counseled on the potential use of Dührssen incisions to facilitate vaginal delivery. Labor was induced at 36 4/7 weeks of gestation after her pregnancy was complicated by recurrent pyelonephritis. Vaginal delivery was achieved 8 minutes after the creation of Dührssen incisions.
CONCLUSION
The care of pregnant women with bladder exstrophy requires multidisciplinary management and careful delivery planning. Successful vaginal delivery can be attained in these patients.
背景
膀胱外翻是一种罕见的先天性异常，影响下腹部壁、骨盆和泌尿生殖结构。患有膀胱外翻的孕妇给产科医生带来了独特的挑战。
病例
该患者是一名35岁的孕妇，患有膀胱外翻，有广泛的手术史，子宫脱垂，宫颈质地异常、呈橡胶样。产前，她接受了关于可能使用杜尔森切口以促进阴道分娩的咨询。在她的妊娠因复发性肾盂肾炎而复杂化后，于妊娠36 4/7周时引产。在做出杜尔森切口8分钟后实现了阴道分娩。
结论
患有膀胱外翻的孕妇的护理需要多学科管理和仔细的分娩计划。这些患者可以成功实现阴道分娩。
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