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双子宫非明显相通残角子宫过期臀位妊娠需行半子宫切除术

Post-dated Breech Pregnancy in a Non-obviously Communicating Rudimentary Horn of a Bicornuate Uterus Requiring Hemi-hysterectomy.

作者信息

Aminu Muhammad Baffah, Sania Iffat, Khairunnaesa Munni

机构信息

Department of Obstetrics & Gynaecology, Abubakar Tafawa Balewa University, Bauchi, Nigeria.

Department of Obstetrics & Gynaecology, Sadar Hospital, Cox's Bazaar, Bangladesh.

出版信息

J West Afr Coll Surg. 2023 Jan-Mar;13(1):111-113. doi: 10.4103/jwas.jwas_194_22. Epub 2023 Jan 18.

Abstract

Developmental anomalies of the Müllerian duct systems such as the bicornuate uterus are rare globally and hardly do term pregnancies occur in conjunction with these abnormalities. The occurrence of post-dated pregnancy is rarely associated with a bicornuate uterus. We present a 35-year-old un-booked multigravida with post-date pregnancy complicated by breech and intrauterine foetal death (IUFD) in a rudimentary uterine horn. She had caesarean delivery complicated by intractable postpartum haemorrhage (PPH). This together with the risks of poor uterine involution in the postpartum and obstetric outcome in the event that another pregnancy occurs in the same horn subsequently warranted a caesarean hemi-hysterectomy of the rudimentary uterine horn. Uterine bicornuate is an uncommon genital tract anomaly and a rare cause of post-date pregnancy. Postpartum bleeding warranting caesarean hemi-hysterectomy should be anticipated as the pregnant horn may not be responsive to conventional oxytocics.

摘要

苗勒管系统发育异常,如双角子宫,在全球范围内较为罕见,且与这些异常同时发生足月妊娠的情况几乎不存在。过期妊娠的发生很少与双角子宫相关。我们报告一例35岁未预约产检的经产妇,其过期妊娠并发臀位及残角子宫内胎儿宫内死亡(IUFD)。她接受了剖宫产,术后并发难治性产后出血(PPH)。鉴于产后子宫复旧不良的风险以及后续同一残角子宫再次妊娠时的产科结局,有必要对残角子宫行剖宫产半子宫切除术。双角子宫是一种不常见的生殖道异常,也是过期妊娠的罕见原因。由于妊娠的残角子宫可能对传统宫缩剂无反应,应预料到产后出血可能需要行剖宫产半子宫切除术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e442/10010583/784b44419f29/JWACS-13-111-g001.jpg

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