Tan Wen-Xi, Lv Xue-Jiao, Yang Rui-Qi, Zhao Ben-Zheng, Chen Jun-Yu, Wu Shan, Zhao Yan-Hui, Cui Man-Hua
Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun 130041, China.
Department of Respiratory, The Second Hospital of Jilin University, Changchun 130041, China.
Gland Surg. 2020 Apr;9(2):459-462. doi: 10.21037/gs.2020.02.16.
The spontaneous rupture of an unscarred uterus at 28 gestational weeks is an extremely rare event, particularly when associated with an intact amniotic sac extrusion and fetal leg entrapment, which has not been previously reported. A 27-year-old primigravid woman was referred to our department, due to perpetual abdominal pain, at 28 weeks and 5 days of gestation. The patient, G3p0, had previously undergone two induced abortions. At the time of admission, abdominal ultrasonography suggested a defect in the left uterine horn. An emergency laparotomy was subsequently performed and revealed an intact amniotic sac extrusion and fetal leg entrapment. Considering the risk of placental abruption, and the possibility of a secondary rupture if the gestation was not terminated, an emergency Cesarean section was recommended. Uterine rupture may be suspected whenever a patient complains of durative abdominal pain at 28 weeks and 5 days of gestation, even in the absence of an intra-abdominal hemorrhage or vaginal bleeding.
孕28周时无瘢痕子宫自发性破裂是极为罕见的事件，尤其是伴有完整羊膜囊突出和胎儿腿部嵌顿时，此前尚无相关报道。一名27岁初孕妇于孕28周零5天时因持续性腹痛转诊至我科。该患者为G3p0，既往有两次人工流产史。入院时，腹部超声提示子宫左角有缺损。随后进行了急诊剖腹探查，发现有完整羊膜囊突出和胎儿腿部嵌顿。考虑到胎盘早剥的风险以及如果不终止妊娠可能发生继发性破裂，建议行急诊剖宫产。无论患者在孕28周零5天时是否主诉持续性腹痛，即使没有腹腔内出血或阴道出血，都可能怀疑子宫破裂。
