疑似重症多形红斑患者胎儿死亡后行扩张刮宫术：一例报告
Dilation and evacuation for fetal demise in a patient with presumed erythema multiforme major: A case report.
作者信息
Frisse Ann, Jobarteh Ruth, Levitt Jacob, Bogaert Kelly, Gerber Sharon
机构信息
Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, 1176 5th Ave, KP 9th floor, Box 1170, New York, NY 10029, United States of America.
Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 E 98 St, New York, NY 10029, United States of America.
出版信息
Case Rep Womens Health. 2023 Feb 20;37:e00488. doi: 10.1016/j.crwh.2023.e00488. eCollection 2023 Mar.
BACKGROUND
Erythema multiforme is a rare dermatologic condition. There is limited data on the effects of erythema multiforme on the vulva, vagina, and pregnancy.
CASE
This case report describes a 32-year-old woman with erythema multiforme major with vulvovaginal involvement, found to have a fetal demise measuring 16 weeks' gestation. Dilation and evacuation was performed and was complicated by vaginal adhesions. The adhesions were lysed intraoperatively and managed postoperatively with vaginal dilators and topical corticosteroids for three months. At six weeks postoperatively, the vulvovaginal lesions had completely healed with no residual scarring or stenosis.
CONCLUSION
Erythema multiforme with vulvovaginal involvement can complicate obstetrical procedures and requires a multidisciplinary approach. In this instance, pain control, topical corticosteroids, and vaginal dilators produced favorable clinical outcomes.
背景
多形红斑是一种罕见的皮肤病。关于多形红斑对外阴、阴道及妊娠影响的数据有限。
病例
本病例报告描述了一名32岁患有重症多形红斑且累及外阴阴道的女性，发现其妊娠16周的胎儿已死亡。进行了扩张刮宫术，术后出现阴道粘连并发症。术中分离粘连，术后使用阴道扩张器和外用皮质类固醇治疗三个月。术后六周，外阴阴道病变完全愈合，无残留瘢痕或狭窄。
结论
累及外阴阴道的多形红斑可使产科手术复杂化，需要多学科方法处理。在此病例中，疼痛控制、外用皮质类固醇和阴道扩张器产生了良好的临床效果。
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