Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Program on Human Rights, Health and Conflict, Center for Public Health and Human Rights; Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
BMJ Case Rep. 2022 Jun 28;15(6):e246515. doi: 10.1136/bcr-2021-246515.
We review the case of an unstable gynaecological patient in the USA who presented with profuse vaginal bleeding after spontaneous miscarriage and was ultimately diagnosed with a uterine arteriovenous malformation managed with interventional radiology embolisation of her uterine artery. Her case was complicated by the presence of an ankle monitoring device which had been placed by US Immigration and Customs Enforcement as part of the Alternatives to Detention programme in which she was enrolled during her immigration proceedings. The device prompted important considerations regarding the potential use of cautery, MRI compatibility and device-related trauma, in addition to causing significant anxiety for the patient, who was concerned about how the team's actions could affect her immigration case. Discussion of her course and shared perspective highlights the unique clinical and medicolegal considerations presented by the expanded use of ankle monitoring devices for electronic surveillance (or 'e-carceration') of non-violent immigrants and others.
我们回顾了一位不稳定的妇科患者在美国的病例，该患者在自然流产后出现大量阴道出血，最终被诊断为子宫动静脉畸形，采用介入放射学子宫动脉栓塞治疗。她的病例很复杂，因为她有一个脚踝监测设备，这是美国移民和海关执法局作为替代拘留计划的一部分放置的，她在移民诉讼期间参加了该计划。该设备引发了一些重要的考虑，包括电凝的潜在用途、磁共振兼容性和与设备相关的创伤，此外还让患者感到非常焦虑，因为她担心团队的行动会如何影响她的移民案件。对她的病程和共同观点的讨论强调了脚踝监测设备在电子监控（或“电子监禁”）非暴力移民和其他人方面的广泛使用所带来的独特临床和医学法律方面的考虑。
