Hsu Po-Chao, Yu Mu-Hsien, Wang Chen-Yu, Wang Yu-Kuen, Wang Chun-Kai, Su Her-Young
Department of Obstetrics and Gynecology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
Department of Obstetrics and Gynecology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
Taiwan J Obstet Gynecol. 2018 Oct;57(5):745-749. doi: 10.1016/j.tjog.2018.08.025.
Incarcerated gravid uterus is a rare complication of pregnancy and can become a critical condition during delivery. For extremely uncommon cases that persist to the third trimester, correct diagnosis before delivery and appropriate management of the associated complications are important.
This was the first case of a full-term pregnancy with incarcerated gravid uterus, reported at a medical center. The condition was not diagnosed during pregnancy, which led to serious complications during the cesarean delivery; however, the prognosis was favorable because of the timely management.
Based on the previous case reports and clinical presentation of this case, early diagnosis with ultrasound and pelvic examination is the key to successful treatment. Vertical and more cephalad uterine incision reduces the risk of bladder perforation and injury to the cervix and vagina. A successful teamwork of obstetricians, gynecologists, urologists, and anesthesiologists can ensure favorable outcomes for both mother and fetus.
妊娠子宫嵌顿是一种罕见的妊娠并发症，在分娩期间可能会发展为危急情况。对于持续到孕晚期的极其罕见的病例，分娩前的正确诊断以及对相关并发症的适当处理至关重要。
这是一家医疗中心报告的首例足月妊娠合并妊娠子宫嵌顿的病例。该情况在孕期未被诊断出来，导致剖宫产时出现严重并发症；然而，由于处理及时，预后良好。
根据此前的病例报告及本病例的临床表现，超声检查及盆腔检查早期诊断是成功治疗的关键。垂直且位置更高的子宫切口可降低膀胱穿孔以及宫颈和阴道损伤的风险。产科医生、妇科医生、泌尿科医生和麻醉医生的成功协作可确保母婴获得良好结局。
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