Hua Zhifen, Wu Minjun
Department of Obstetrics, Changning Maternity & Infant Health Hospital of Shanghai, Shanghai, China.
J Int Med Res. 2019 Oct;47(10):5328-5336. doi: 10.1177/0300060519874903. Epub 2019 Sep 26.
Laparoscopic salpingectomy (LPSC) is the main treatment for ectopic pregnancy, which leads to spontaneous uterine rupture (UR) during pregnancy. We report the characteristics of a woman who had spontaneous UR during pregnancy with a history of salpingectomy. We experienced a 31-year-old woman with a UR in pregnancy with a history of LPSC twice. The patient had a successful pregnancy. We also performed a literature review including cases with spontaneous UR after LPSC. Twenty-seven case reports of 48 women were included in our review. Thirty-five (83.33%, 35/42) women previously received LPSC and 15 (31.25%) developed interstitial pregnancies. The interval between pregnancy and the last surgery did not affect the frequency of interstitial pregnancy and gestational age. Fetal outcomes in patients with UR at the third trimester were better than those at the first and second trimesters. We suggest that close observation and timely treatment by experienced clinicians lead to good outcomes of pregnant women with suspected UR.
腹腔镜输卵管切除术(LPSC)是异位妊娠的主要治疗方法,该手术会导致孕期自发性子宫破裂(UR)。我们报告了一名有输卵管切除病史的女性在孕期发生自发性子宫破裂的病例特点。我们遇到一名31岁有两次LPSC病史的女性在孕期发生子宫破裂。该患者成功妊娠。我们还进行了文献综述,纳入了LPSC术后发生自发性子宫破裂的病例。我们的综述纳入了48名女性的27例病例报告。35名(占83.33%,35/42)女性之前接受过LPSC,其中15名(占31.25%)发生了间质部妊娠。妊娠与最后一次手术之间的间隔时间并不影响间质部妊娠的发生率和孕周。孕晚期发生子宫破裂患者的胎儿结局优于孕早期和孕中期。我们建议,经验丰富的临床医生进行密切观察并及时治疗,可使疑似子宫破裂的孕妇获得良好结局。