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产后 7 年因严重贫血致慢性子宫全层外翻并再次妊娠成功:1 例报告。

Chronic uterine inversion presenting with severe anemia 7 years after a home delivery and the subsequent successful pregnancy: a case report.

机构信息

Madda Walabu University, Goba Referral Hospital, School of Medicine, Goba, Oromia, Ethiopia.

Department of Obstetrics and Gynecology, Madda Walabu University, Goba Referral Hospital, Goba, Oromia, Ethiopia.

出版信息

J Med Case Rep. 2023 Jul 4;17(1):278. doi: 10.1186/s13256-023-04012-x.

Abstract

BACKGROUND

Uterine inversion is a clinical condition characterized by the folding of the uterine fundus into the uterine cavity or beyond the cervix. Chronic uterine inversions that manifest seven years after delivery are extremely rare, despite the fact that both acute and chronic uterine inversions are infrequent. Unlike uterine inversion during parturition, which can be promptly managed, chronic uterine inversion poses a diagnostic and management challenge. We, herein, report a patient who was managed and followed at our institution for chronic uterine inversion.

CASE PRESENTATION

A 28-year-old African female who was referred to our institution with complaints of secondary infertility for seven years, abnormal vaginal bleeding, and lower abdominal pain for 12 months with a mass-like sensation in the vagina. At presentation, she had pale conjunctiva and a protruded, rubbery mass in the cervix with indistinguishable cervical OS on vaginal examination. The patient was resuscitated with intravenous fluids and three units of blood, after which Haultain's procedure was performed. After 16 months on a contraceptive, she was able to conceive and deliver a healthy neonate.

CONCLUSION

Severe anemia can rarely be a presenting symptom of chronic uterine inversion. Following a surgical procedure for chronic uterus inversion, a successful delivery is possible if thorough follow-up is carried out.

摘要

背景

子宫内翻是一种临床病症,其特征为子宫底部向子宫腔或宫颈内折叠。尽管急性和慢性子宫内翻都不常见,但在分娩后出现的长达 7 年的慢性子宫内翻极为罕见。与分娩时的子宫内翻不同,后者可以及时处理,慢性子宫内翻则存在诊断和管理上的挑战。在此,我们报告了一例在我院接受慢性子宫内翻治疗和随访的患者。

病例介绍

一位 28 岁的非洲女性,因继发性不孕 7 年、阴道异常出血、12 个月下腹疼痛和阴道内有肿块感就诊。就诊时,她结膜苍白,宫颈外口可见突出、有弹性的肿块,阴道检查无法辨认宫颈 OS。患者接受了静脉补液和 3 个单位的输血,随后进行了 Haultain 手术。避孕 16 个月后,她成功怀孕并分娩了一个健康的新生儿。

结论

严重贫血很少是慢性子宫内翻的首发症状。对于慢性子宫内翻的手术治疗,如果进行彻底的随访,那么成功分娩是可能的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d48/10318773/4f29e938301e/13256_2023_4012_Fig1_HTML.jpg

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