Sharma Jai Bhagwan, Kriplani Alka, Gupta Monica, Seenu Vathulru
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.
Department of Surgery, All India Institute of Medical Sciences, New Delhi, India.
BMJ Case Rep. 2017 Oct 24;2017:bcr-2017-221954. doi: 10.1136/bcr-2017-221954.
A 30-year-old second gravida with history of laparoscopic myomectomy and one previous caesarean section was admitted at 31 weeks and 2 days period of gestation (POG) with a diagnosis of diffuse abdominopelvic leiomyomatosis and moderate anaemia. After correction of anaemia with intravenous iron and erythropoietin, laparotomy was performed at 37 weeks POG. A healthy female baby weighing 2.9 kg was delivered by classical caesarean section followed by hysterectomy in view of multiple fibroid uterus with uncontrolled bleeding. Debulking surgery was performed, and multiple large intraperitoneal leiomyomata with encasing blood vessels were removed. There was another 15×15 cm leiomyoma arising from the diaphragm which was excised. She received 4 units of packed red blood cells and fresh frozen plasma intraoperatively. The postoperative course was uneventful, both mother and baby were healthy and discharged 7 days after surgery.
一名30岁的经产妇，有腹腔镜子宫肌瘤切除术史和一次剖宫产史，在妊娠31周零2天时因诊断为弥漫性腹腔盆腔平滑肌瘤病和中度贫血入院。经静脉补铁和促红细胞生成素纠正贫血后，于妊娠37周时行剖腹手术。通过古典式剖宫产分娩出一名体重2.9千克的健康女婴，鉴于多发性子宫肌瘤且出血难以控制，随后进行了子宫切除术。进行了减瘤手术，切除了多个包裹血管的腹腔内大平滑肌瘤。还有一个起源于膈肌的15×15厘米平滑肌瘤也被切除。术中她接受了4单位的浓缩红细胞和新鲜冰冻血浆。术后过程顺利，母婴均健康，术后7天出院。
