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双角单颈子宫自然双胎妊娠合并子痫前期:一例报告。

Spontaneous twin pregnancy in uterus bicornis unicollis complicated with preeclampsia: A case report.

作者信息

Chemlal Chaymae, El Amouri Imane, Tanouti Saloua, Taheri Hafsa, Saadi Hanane, Mimouni Ahmed

机构信息

Gynecology and Obstetrics Department, Mohammed VI University Hospital of Oujda, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco.

Gynecology and Obstetrics Department, Mohammed VI University Hospital of Oujda, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco.

出版信息

Int J Surg Case Rep. 2022 Mar;92:106899. doi: 10.1016/j.ijscr.2022.106899. Epub 2022 Mar 1.

Abstract

INTRODUCTION AND IMPORTANCE

Bicornuate uterus is a uterine malformation caused by abnormal Müllerian fusion, often leading to multiple obstetric complications. A twin pregnancy in this condition is extremely rare.

CASE PRESENTATION

A 27-year-old patient (Gravida 3, Para 0) with a previous history of two spontaneous early miscarriages was diagnosed with uterus bicornis unicollis (unicervical bicornuate uterus). She presented with spontaneous twin pregnancy complicated with preeclampsia at 34 weeks + 6 days. Thus, she underwent cesarean section with two separate lower-segment incisions. Consequently, healthy twins were delivered successfully.

CLINICAL DISCUSSION

Bicornuate uterus is a rare congenital uterine malformation, and only 16 cases of twin pregnancy associated with uterus bicornis unicollis have been reported worldwide. This uterine malformation can be discovered spontaneously in imaging or during obstetric complications such as spontaneous abortions, premature labor, premature rupture of membranes, malpresentations, and intrauterine growth restriction. In addition, the risk for preeclampsia in twin pregnancies is twice higher than singleton gestations.

CONCLUSION

Twin pregnancy in a bicornuate uterus is extremely rare; this phenomenon is yet to have guidelines for monitoring pregnancy and the mode of delivery.

摘要

引言与重要性

双角子宫是一种由苗勒管融合异常引起的子宫畸形,常导致多种产科并发症。这种情况下的双胎妊娠极为罕见。

病例介绍

一名27岁患者(孕3产0),既往有两次自然早期流产史,被诊断为单宫颈双角子宫。她在孕34周+6天时出现双胎妊娠并伴有子痫前期。因此,她通过两个独立的下段切口进行了剖宫产。最终,成功分娩出健康双胞胎。

临床讨论

双角子宫是一种罕见的先天性子宫畸形,全球仅报道了16例与单宫颈双角子宫相关的双胎妊娠病例。这种子宫畸形可在影像学检查中自发发现,或在产科并发症如自然流产、早产、胎膜早破、胎位异常和胎儿生长受限期间被发现。此外,双胎妊娠子痫前期的风险比单胎妊娠高两倍。

结论

双角子宫中的双胎妊娠极为罕见;目前尚无针对这种情况的孕期监测和分娩方式的指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16a8/8914195/f0cbb42daf5d/gr1.jpg

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