Kirbas Ayse, Daglar Korkut, Kara Ozgur, Sucak Ayhan, Caglar Turhan
Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
J Exp Ther Oncol. 2016 Jul;11(3):221-223.
Uterine leiomyomas are the most common benign tumor of the female reproductive tract. Their incidence during pregnancy is approximately 2 percent and they are associated with some complications such as preterm labor, placental abruption, fetal malpresentation, obstructed labor, cesarean delivery, and postpartum hemorrhage. They may develop anywhere within the muscular wall of the uterus, including submucosal, intramural, or subserosal areas. Some of the submucous myomas may be pedunculated and eventually may protrude through the cervical canal to the vagina. They later become necrotic and sometimes infected. Vaginal myomectomy is recommended as the initial treatment of choice for a prolapsed, pedunculated myoma except when other indications require an abdominal procedure. Inversion is a condition in which the uterus turns inside out with prolapse of the fundus through the cervix. It is seen in acute and chronic forms. Chronic inversion may follow an incomplete obstetric inversion unnoticed or left uncared. Herein, we present, a case of infected non-puerperal uterine inversion due to submucous leiomyoma that was originating from fundus and the diagnostic dilemma it presents in the after puerperal stage.
子宫平滑肌瘤是女性生殖道最常见的良性肿瘤。其在孕期的发生率约为2%,且与一些并发症相关,如早产、胎盘早剥、胎位异常、产程梗阻、剖宫产及产后出血。它们可发生于子宫肌壁内的任何部位,包括黏膜下、肌壁间或浆膜下区域。一些黏膜下肌瘤可能有蒂,最终可能经宫颈管突出至阴道。它们随后会发生坏死,有时还会感染。对于脱垂的有蒂肌瘤,除其他指征需要行腹部手术外,建议首选经阴道肌瘤切除术。子宫内翻是一种子宫底经宫颈脱垂而致子宫翻出的情况。有急性和慢性两种形式。慢性子宫内翻可能继发于未被注意或未得到处理的不完全产时子宫内翻。在此,我们报告一例因起源于子宫底的黏膜下平滑肌瘤导致的非产褥期感染性子宫内翻病例及其在产后阶段所呈现的诊断难题。