Eboh Stanley, Burghul Suna, Galloway Michael, Sanchez Asley, Ventolini Gary
Texas Tech University Health Sciences Center at the Permian Basin, Odessa, TX, USA.
Clin Med Insights Case Rep. 2022 Jul 12;15:11795476221112376. doi: 10.1177/11795476221112376. eCollection 2022.
Spontaneous uterine rupture is a catastrophic obstetric complication for both the mother and fetus. We highlight a case of a 32-year-old G2P1A0L1 Hispanic female at 36 weeks gestation who presented to the labor and delivery unit with minimal prenatal care, complaining of abdominal pains and vaginal bleeding. An abdominopelvic ultrasound confirmed an empty uterus and fetal demise in the abdominal cavity, leading to an exploratory laparotomy to evacuate the fetus. At surgery, a preterm sized fetus "en caul" with intact amnions was floating in the abdominal cavity and a hemostatic, complete rupture of the anterior uterine wall was discovered. Uterus was repaired and the patient recovered postoperatively without complications. Despite the best evidence suggesting that a history of low-transverse Cesarean section poses a low risk for spontaneous uterine rupture, this complication should always be considered and patients should be counseled regardless of the low risk should they desire a cesarean section.
自发性子宫破裂对母亲和胎儿来说都是一种灾难性的产科并发症。我们重点介绍一例36周妊娠的32岁西班牙裔女性，G2P1A0L1，产前检查极少，因腹痛和阴道出血就诊于分娩室。腹盆腔超声证实子宫内空虚，胎儿死于腹腔，遂行剖腹探查术以取出胎儿。手术中，一个胎膜完整的早产大小的“带胎膜”胎儿漂浮在腹腔内，发现子宫前壁有止血性、完全破裂。子宫得以修复，患者术后恢复良好，无并发症。尽管有充分证据表明低位横切口剖宫产史导致自发性子宫破裂的风险较低，但无论风险多低，只要患者希望剖宫产，都应始终考虑到这种并发症，并对患者进行咨询。
