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输卵管切除术和羊膜囊突出作为附件囊肿导致的双角子宫破裂误诊的双胎妊娠:一例报告。

Misdiagnosis of a twin pregnancy with double-corner uterine rupture following salpingectomy and protrusion of the amniotic sac as an adnexal cyst: a case report.

机构信息

Department of Obstetrics and Gynecology, The Women and Children Hospital Affiliated to Jiaxing University, 2468 Middle Ring Eastern Road, Jiaxing City, 314000, Zhejiang, China.

出版信息

BMC Pregnancy Childbirth. 2020 Feb 3;20(1):71. doi: 10.1186/s12884-020-2773-x.

Abstract

BACKGROUND

Salpingectomy-associated uterine rupture during intrauterine pregnancy is rare in the clinic. We report a case of pregnancy with bilateral rupture of the uterine horns after bilateral salpingectomy.

CASE PRESENTATION

A 30-year-old woman of Han ethnicity presented with right epigastric pain at 28 weeks and 6 days of gestation. Examination by colour Doppler ultrasound showed the following: "Twin live births with normal foetal umbilical artery blood flow indexes and a 183 mm × 112 mm anechoic zone in the right front of the uterus". Initially, we made an incorrect judgement wherein we considered the amniotic sac that was protruding into the abdominal cavity to be an adnexal cyst. Fortunately, the diagnosis of uterine rupture was confirmed before the protruded amniotic sac broke. The mother did not bleed much, and the twin foetuses survived in our case.

CONCLUSION

A previous history of salpingectomy via laparoscopy could be a risk factor for uterine rupture in pregnant women. Attention should be paid to rare complications of pregnancy. To avoid adverse events, we should pay special attention to women with a history of laparoscopic salpingectomy who complain about abdominal discomfort and offer them a relevant ultrasound examination.

摘要

背景

在临床中,输卵管切除术相关的子宫破裂在妊娠期间较为罕见。我们报告了一例双侧输卵管切除术后子宫角双侧破裂的妊娠病例。

病例介绍

一名 30 岁汉族女性,在妊娠 28 周零 6 天时出现右上腹疼痛。彩色多普勒超声检查显示:“双活胎,胎儿脐动脉血流指数正常,子宫前右侧有 183mm×112mm 的无回声区”。最初,我们做出了错误的判断,认为突出到腹腔的羊膜囊是附件囊肿。幸运的是,在突出的羊膜囊破裂之前,我们确诊了子宫破裂。母亲没有大量出血,双胞胎胎儿在我们的病例中存活下来。

结论

腹腔镜输卵管切除术史可能是孕妇子宫破裂的危险因素。应注意妊娠的罕见并发症。为避免不良事件,我们应特别关注有腹腔镜输卵管切除术史且出现腹部不适的女性,并为其提供相关的超声检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ca0/6998286/ad435e406a43/12884_2020_2773_Fig1_HTML.jpg

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