Suzuki Toshifumi, Takeda Jun, Seyama Rie, Makino Shintaro, Takeda Satoru, Itakura Atsuo
Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan.
Department of Obstetrics and Gynecology, Keiai Hospital, Saitama, Japan.
Surg J (N Y). 2023 Feb 3;9(1):e36-e38. doi: 10.1055/s-0042-1749427. eCollection 2023 Jan.
Intrauterine balloon prolapse sometimes occurs, and the intrauterine balloon must be reinserted. Furthermore, intrauterine balloon tamponade (IBT) failure can necessitate additional invasive procedures. We report a case of cervical cerclage with IBT for placenta previa with a cervical dilation. In our case, emergency cesarean section was performed at 35 + 4 weeks of gestation because of persistent hemorrhage. During the operation, we performed IBT to prevent further postpartum hemorrhage. However, immediately after the operation, uterine cervical dilatation was 6 cm, which resulted in cervical dilation and prolapse of the intrauterine balloon. Therefore, we performed cervical cerclage using absorbable sutures with IBT and blood transfusion. We speculated that the intrauterine balloon might have induced cervical canal ripening during the operation. Our case suggested that cervical cerclage with IBT is a useful method to prevent intrauterine balloon prolapse in cases with cervical dilation.
宫内球囊脱垂有时会发生，必须重新插入宫内球囊。此外，宫内球囊填塞术（IBT）失败可能需要进行额外的侵入性手术。我们报告一例前置胎盘伴宫颈扩张行宫颈环扎术联合IBT的病例。在我们的病例中，由于持续出血，在妊娠35+4周时进行了急诊剖宫产。手术期间，我们进行了IBT以预防进一步的产后出血。然而，手术后立即发现宫颈扩张至6cm，导致宫颈扩张和宫内球囊脱垂。因此，我们使用可吸收缝线进行宫颈环扎术并联合IBT及输血治疗。我们推测术中宫内球囊可能导致了宫颈管成熟。我们的病例表明，宫颈环扎术联合IBT是预防宫颈扩张病例中宫内球囊脱垂的一种有用方法。
