与菌血症和产褥期发热相关的子宫肌瘤：病例报告。
Pyomyoma associated with bacteremia and puerperal pyrexia: A case report.
机构信息
Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei City, Taiwan.
Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei City, Taiwan.
出版信息
Taiwan J Obstet Gynecol. 2023 Jan;62(1):171-174. doi: 10.1016/j.tjog.2022.10.007.
OBJECTIVE
To report a case of pyomyoma, a serious complication of the uterine leiomyoma, in a postpartum woman. As the occurrence of pyomyoma in association with pregnancy is rather rare, a brief literature review of the condition in pregnant women is provided.
CASE REPORT
A 41-year-old woman was found to have pyomyoma following persistent fever during the postpartum period of a first-time vaginal delivery. Her pregnancy course was complicated by preterm labor, for which the patient had received tocolysis since 30-week gestation. The pyomyoma was promptly removed by myomectomy on day-6 postpartum.
CONCLUSION
Pyomyoma can occur in both pre- and post-menopausal women, and may even complicate pregnancies. Therefore, obstetricians and gynecologists should be wary of pyomyoma in postpartum women with histories of leiomyoma that present with sepsis of unknown focus that is refractory to standard antibiotics. Fertility may be preserved through timely diagnosis, followed by a prompt intervention.
目的
报告一例产后妇女发生的子宫肌瘤严重并发症——子宫肌瘤脓肿。由于妊娠合并子宫肌瘤脓肿的发生率相当罕见，故对妊娠妇女的该病情况进行简要文献复习。
病例报告
一名 41 岁女性，在首次阴道分娩的产后期间持续发热后被诊断为子宫肌瘤脓肿。她的妊娠过程复杂，有早产，自 30 孕周起患者接受了保胎治疗。产后第 6 天通过子宫肌瘤切除术迅速切除了子宫肌瘤脓肿。
结论
子宫肌瘤脓肿可发生于绝经前和绝经后妇女，甚至可能使妊娠复杂化。因此，妇产科医生应警惕有子宫肌瘤病史的产后女性出现原因不明的、对抗生素治疗无反应的败血症。及时诊断并迅速干预可保留生育能力。
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