The Third Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China.
Department of Obstetrics and Gynecology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing Jiangsu, China.
Medicine (Baltimore). 2023 Jun 16;102(24):e33977. doi: 10.1097/MD.0000000000033977.
In most cases, uterine rupture occurs during the third trimester of pregnancy or during labor. Even fewer reports have been published about the occurrence of this condition without a gynecologic history of any surgical procedure. Due to their scarcity and variable clinical presentation, early diagnosis of uterine rupture may be difficult, and if the diagnosis is not timely, the condition may be life-threatening.
Herein, 3 cases of uterine rupture from a single institution are described. Three patients are at different gestational weeks and all have no history of uterine surgery. They came to the hospital due to acute abdominal pain, which is characterized by severe and persistent pain in the abdomen, with no apparent vaginal bleeding.
All 3 patients were diagnosed with uterine rupture during the operation.
One patient underwent uterine repair surgery; while the other 2 underwent subtotal hysterectomy due to persistent bleeding and pathological examination after surgery confirmed placenta implantation.
The patients recovered well after the operation, and no discomfort occurred in the follow-up.
Acute abdominal pain during pregnancy can pose both diagnostic and therapeutic challenges. It is important to consider the possibility of uterine rupture, even in cases where there is no history of prior uterine surgery. The key to the treatment of uterine rupture is to shorten the diagnosis time as much as possible, this potential complication should be carefully monitored for and promptly addressed to ensure the best possible outcomes for both the mother and the developing fetus.
大多数情况下，子宫破裂发生在妊娠晚期或分娩期间。但也有少数病例报告指出，即使没有任何妇科手术史，也可能发生这种情况。由于其罕见且临床表现多变，早期诊断可能具有挑战性，如果诊断不及时，可能会危及生命。
在此，描述了来自单一机构的 3 例子宫破裂病例。这 3 位患者处于不同的妊娠周数，且均无子宫手术史。她们因急性腹痛而就诊，其特征为腹痛剧烈且持续，无明显阴道出血。
所有 3 例患者均在术中诊断为子宫破裂。
1 例患者接受了子宫修复手术；而另外 2 例由于持续出血，术后行病理检查证实为胎盘植入，行次全子宫切除术。
患者术后恢复良好，随访中无不适。
妊娠期间的急性腹痛可能具有诊断和治疗方面的挑战。即使没有既往子宫手术史，也应考虑子宫破裂的可能性。子宫破裂治疗的关键是尽可能缩短诊断时间，应仔细监测这种潜在并发症，并及时处理，以确保母婴的最佳结局。
