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一名16岁女孩妊娠17周时非交通性残角子宫扭转破裂:经验教训

Torsion and rupture of a non-communicating rudimentary horn in a 17-week gestation in a 16-year-old girl: lessons learnt.

作者信息

Kumar Namrata, Das Vinita, Pandey Amita, Agrawal Smriti

机构信息

Department of Obstetrics and Gynecology, King George's Medical University, Lucknow, Uttar Pradesh, India.

Department of Obstetrics and Gynecology, King George's Medical University, Lucknow, India.

出版信息

BMJ Case Rep. 2018 Jan 13;2018:bcr-2017-222073. doi: 10.1136/bcr-2017-222073.

Abstract

A unicornuate uterus with non-communicating rudimentary horn has always been notorious and poses threat to continuation of pregnancy with dismal consequences. We are reporting an interesting case of uterine malformation with a 90° rotation of uterine axis which ultimately ruptured during termination of pregnancy. The rarity in our case was not only conception in non-communicating horn but also the complete twisting of axis which made the pregnant horn come in front of the non-gravid unicornuate uterus, mimicking normal pregnancy. The most important lesson learnt is that if induction does not lead to cervical changes and uterine contractions, one must consider atypical presentations of an anomalous uterus as a possible differential before proceeding further.

摘要

残角子宫合并单角子宫且残角子宫与单角子宫不相通一直以来都声名狼藉,对妊娠的持续构成威胁,后果往往很严重。我们报告了一例有趣的子宫畸形病例,子宫轴旋转了90°,最终在终止妊娠时发生破裂。我们这个病例的罕见之处不仅在于残角子宫受孕,还在于子宫轴完全扭转,使得妊娠的角部位于非妊娠的单角子宫前方,酷似正常妊娠。最重要的经验教训是,如果引产未导致宫颈变化和子宫收缩,在进一步处理之前,必须将子宫异常的非典型表现视为可能的鉴别诊断。

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本文引用的文献

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Rupture rudimentary horn pregnancy at 31 week.孕31周时残角子宫妊娠破裂。
Saudi Med J. 2017 Feb;38(2):201-203. doi: 10.15537/smj.2017.2.16016.
4
An unexpected near term pregnancy in a rudimentary uterine horn.残角子宫内意外的近期妊娠。
Case Rep Obstet Gynecol. 2013;2013:307828. doi: 10.1155/2013/307828. Epub 2013 Apr 27.
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Ruptured rudimentary horn at 22 weeks.孕22周时残角子宫破裂。
Niger Med J. 2012 Jul;53(3):175-7. doi: 10.4103/0300-1652.104391.
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Rare case of live birth in a ruptured rudimentary horn pregnancy.残角子宫妊娠破裂后活产的罕见病例。
J Obstet Gynaecol Res. 2011 Aug;37(8):1169-72. doi: 10.1111/j.1447-0756.2010.01497.x. Epub 2011 Apr 19.
9
Failure of prostaglandin induction labor in a Müllerian abnormality.先天性米勒管发育不全致前列腺素引产失败
Arch Gynecol Obstet. 2010 Aug;282(2):143-7. doi: 10.1007/s00404-010-1361-0. Epub 2010 Feb 25.

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