剖宫产术后中期妊娠因胎儿异常行药物流产合并膀胱子宫破裂：一例报告
Combined vesicouterine rupture during second-trimester medical abortion for fetal abnormality after prior cesarean delivery: A case report.
作者信息
Caruso Giuseppe, Paladini Vanessa, D'ambrosio Valentina, Giancotti Antonella, Piccioni Maria Grazia, Palaia Innocenza, Di Donato Violante, Perniola Giorgia, Brunelli Roberto, Pecorini Francesco, Muzii Ludovico, Scudo Maria
机构信息
Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.
出版信息
Case Rep Womens Health. 2021 Oct 27;32:e00364. doi: 10.1016/j.crwh.2021.e00364. eCollection 2021 Oct.
INTRODUCTION
The use of mifepristone and misoprostol for the induction of a second-trimester abortion is common and effective. However, its safety in women with previous cesarean delivery is still controversial, given the potentially higher risk of uterine rupture.
CASE PRESENTATION
We present the case of a 30-year-old woman (G2P1) who experienced vesicouterine rupture with escape of the dead fetus into the bladder during second-trimester induced abortion after prior cesarean delivery. She was successfully managed with conservative surgery.
CONCLUSION
This case highlights the challenges of early diagnosis of vesicouterine rupture during second-trimester medical abortion. We argue that a close monitoring of patients with prior cesarean section is mandatory, particularly if uterine contractions suddenly stop or the fetal head fails to descend. A prompt conservative surgical approach allows preservation of fertility.
引言
米非司酮和米索前列醇用于中期妊娠引产是常见且有效的。然而，鉴于子宫破裂风险可能更高，其在有剖宫产史女性中的安全性仍存在争议。
病例报告
我们报告一例30岁女性（孕2产1）的病例，该女性在剖宫产术后中期妊娠引产期间发生膀胱子宫破裂，死胎掉入膀胱。她通过保守手术成功治疗。
结论
该病例突出了中期药物流产时膀胱子宫破裂早期诊断的挑战。我们认为，对有剖宫产史的患者进行密切监测是必要的，特别是在子宫收缩突然停止或胎头不降的情况下。及时采取保守手术方法可保留生育能力。
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