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成功保守治疗 18 周妊娠自发性子宫破裂出血

Successful conservative management of a spontaneous hemorrhagic uterine rupture at 18 weeks of gestation.

机构信息

Department of Obstetrics and Gynecology, DMU Santé des Femmes et des Nouveau-nés Antoine Béclère Hospital, Université Paris Saclay, AP-HP, Clamart, France.

Department of Obstetrics and Gynecology, Tam Anh Hospital, Hanoi City, Viet Nam.

出版信息

J Gynecol Obstet Hum Reprod. 2022 Jun;51(6):102396. doi: 10.1016/j.jogoh.2022.102396. Epub 2022 Apr 28.

Abstract

Prelabor uterine rupture is a very rare complication of pregnancy that in most cases occurs when there is a history of uterine surgery. Maternal and neonatal morbidity is significant. Most often, the pregnancy must be terminated to rescue both the mother and the newborn, if possible. We report the case of a patient who had a pre-labor uterine rupture at 18 weeks of gestation (WG) complicated by massive hemoperitoneum. Emergency surgery with conservative management allowed the pregnancy to continue until 32+3 WG. In very rare situations of uterine rupture at a very early term, conservative management appears to be an acceptable solution to allow the pregnancy to continue until a sufficient gestational age to limit complications related to prematurity.

摘要

产前子宫破裂是一种非常罕见的妊娠并发症,在大多数情况下发生于有子宫手术史的孕妇。母体和新生儿发病率很高。如果可能的话,大多数情况下,为了抢救母亲和新生儿,必须终止妊娠。我们报告了一例 18 孕周(WG)产前子宫破裂的患者,并发大量腹腔积血。急诊手术联合保守治疗使妊娠得以继续,直至 32+3 WG。在极早期子宫破裂的极少数情况下,保守治疗似乎是一种可以接受的解决方案,可使妊娠继续,直至达到足以限制与早产相关并发症的足够胎龄。

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