Xu Yalan, Zhou Yuxiang, Xie Junshu, Yin Xiuju, Zhang Xiaohong
Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China.
Department of Obstetrics and Gynecology, Mentougou District Hospital, Beijing, China.
Medicine (Baltimore). 2019 Aug;98(35):e16300. doi: 10.1097/MD.0000000000016300.
We aim to investigate the diagnosis, treatment, and prognosis of intraperitoneal hemorrhage during pregnancy and parturition.Three cases with intraperitoneal hemorrhage during pregnancy and parturition admitted to our hospital from Jan. 2008 to Jan. 2018 were included in this study. One case showed fetal distress. Abdominal ultrasonography and abdominal CT showed pyoperitoneum in 2 cases. Abdominal puncture was performed in 2 patients, and noncoagulant blood was collected. The indications of emergency caesarean section in 3 cases were intraperitoneal hemorrhage. The etiology included rupture of posterior wall of uterus, rupture of blood vessel on uterine surface, and rupture of inflammatory vessel on uterine surface, respectively. The average volume of intraperitoneal bleeding was 2630 ml, and the average transfusion volume was 1530 ml. Caesarean section, and suture hemostasis were performed in 3 cases. The gestational age of delivery were 40 weeks, 40 weeks, and 25 weeks, respectively. There were 1 stillborn fetus and 2 live infants. All the puerperas were cured and discharged.Intraperitoneal hemorrhage in pregnancy is rare and is easily misdiagnosed. The mortality of pregnant women and perinatal infant is high. Therefore, early diagnosis, and timely operation is important.
我们旨在研究妊娠和分娩期间腹腔内出血的诊断、治疗及预后。本研究纳入了2008年1月至2018年1月期间我院收治的3例妊娠和分娩期间腹腔内出血的病例。1例出现胎儿窘迫。腹部超声和腹部CT检查显示2例有腹腔积脓。2例患者进行了腹腔穿刺，抽出不凝血。3例急诊剖宫产的指征均为腹腔内出血。病因分别为子宫后壁破裂、子宫表面血管破裂和子宫表面炎性血管破裂。腹腔内平均出血量为2630 ml，平均输血量为1530 ml。3例均行剖宫产及缝合止血。分娩孕周分别为40周、40周和25周。有1例死胎，2例活婴。所有产妇均治愈出院。妊娠期间腹腔内出血罕见，且易误诊。孕妇和围产儿死亡率高。因此，早期诊断和及时手术很重要。
