Graafmans Lysanne D C, Dijksterhuis Marja G K, Vos Louwerens D, van Bavel Jeroen
Education Center, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands.
Gynaecology, Amphia Ziekenhuis Locatie Langendijk, Breda, The Netherlands.
BMJ Case Rep. 2017 Dec 2;2017:bcr-2017-221149. doi: 10.1136/bcr-2017-221149.
Rupture of the vaginal wall in unobstructed labour is a rare entity in the developed world. This case report describes rupture of the posterior cul-de-sac in a healthy 34-year-old multiparous woman attempting trial of labour after caesarean section. The woman presented to the labour ward at term with spontaneous onset of contractions. In the second stage of labour, the woman experienced sudden severe abdominal pain, different in character from the contraction pain. Therefore, the baby was delivered by ventouse extraction. As the woman continued to experience severe immobilising abdominal pain during the hospital stay, a CT scan was performed which revealed a haematoma and free fluid at the right side of the uterus. A laparotomy was performed 3 days postdelivery, during which a rupture of the posterior cul-de-sac was found and closed with a continuous suture. The woman was discharged 3 days after laparotomy in good clinical condition.
在发达国家，产道无梗阻情况下的阴道壁破裂是一种罕见情况。本病例报告描述了一名健康的34岁经产妇在剖宫产术后尝试阴道试产时发生后穹窿破裂的情况。该名妇女足月时因宫缩自发发作而被送至产房。在第二产程中，该名妇女突然感到剧烈腹痛，其性质与宫缩痛不同。因此，通过胎头吸引术娩出婴儿。在住院期间，该名妇女持续感到严重的、导致活动受限的腹痛，于是进行了CT扫描，结果显示子宫右侧有血肿和游离液体。产后3天进行了剖腹探查术，术中发现后穹窿破裂，并用连续缝合线进行了缝合。剖腹探查术后3天，该名妇女临床状况良好，顺利出院。
