Fukutani Riho, Hasegawa Junichi, Arakaki Tatsuya, Oba Tomohiro, Nakamura Masamitsu, Sekizawa Akihiko
Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan.
Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan.
J Obstet Gynaecol Res. 2017 Jul;43(7):1209-1211. doi: 10.1111/jog.13339. Epub 2017 Jun 14.
We present a rare asymptomatic case in which intestinal adhesions covered and occluded a site of uterine rupture, which was found during cesarean section. The patient had undergone laparoscopic myomectomy 5 years previously. However, detailed antenatal ultrasound and magnetic resonance imaging examinations revealed no uterine or placental abnormalities. It is thought that uterine rupture was not detected due to intestinal adhesions, which had occurred following the previous surgery. The present case suggests that women who conceive after laparoscopic myomectomy may be at risk of silent uterine rupture. However, detection of the silent uterine rupture during pregnancy may be limited, even with detailed imaging.
我们报告了一例罕见的无症状病例，该病例中肠道粘连覆盖并阻塞了子宫破裂部位，此情况在剖宫产术中被发现。患者5年前接受了腹腔镜子宫肌瘤切除术。然而，详细的产前超声和磁共振成像检查均未发现子宫或胎盘异常。据认为，由于先前手术后发生的肠道粘连，子宫破裂未被检测到。本病例提示，腹腔镜子宫肌瘤切除术后怀孕的女性可能有隐匿性子宫破裂的风险。然而，即使进行详细的影像学检查，孕期隐匿性子宫破裂的检测可能也存在局限性。
