Faguer C
A.C.C.A., Paris.
J Gynecol Obstet Biol Reprod (Paris). 1988;17(5):646-9.
Although early rupture of the uterus is rare, that does not mean that it should not be considered. The case reported here was of a patient in her third pregnancy who suddenly presented with internal haemorrhage requiring immediate laparotomy at the 22nd week of pregnancy. When a broad rupture at the fundus was discovered total hysterectomy had to be carried out. Immediately afterwards the patient collapsed and this required a further operation which showed that one of the cervico-vaginal pedicles had slipped away from its ligature. After this, recovery was uncomplicated. Histological examination made it clear that the cause of the rupture was a placenta increta which had grown on the fundus which itself contained a fibroid. Early ruptures of the uterus are very rare and usually occur in a uterus that has been weakened by an anterior scar, or an abnormal development during the pregnancy or a malformation of the uterus. It is rare for placenta increta to be the cause. We have reviewed the clinical and histological material. Hysterectomy is carried out in order to ensure haemostasis and the procedure is discussed.
虽然子宫早期破裂很少见，但这并不意味着不应予以考虑。此处报告的病例是一位第三次怀孕的患者，在怀孕第22周时突然出现内出血，需要立即进行剖腹手术。当发现子宫底部有广泛破裂时，不得不进行全子宫切除术。此后不久，患者出现虚脱，这需要进一步手术，结果显示宫颈阴道蒂之一从结扎处滑脱。在此之后，恢复过程顺利。组织学检查表明，破裂的原因是胎盘植入，其生长在子宫底部，而子宫底部本身有一个肌瘤。子宫早期破裂非常罕见，通常发生在因前次瘢痕、孕期异常发育或子宫畸形而变得薄弱的子宫中。胎盘植入作为病因很罕见。我们回顾了临床和组织学资料。进行全子宫切除术以确保止血，并对该手术进行了讨论。
