Rahman Luthfi, Praharsini Kania, Januajie Aditiyo, Anwar Ruswana
Department of Obstetrics and Gynecology, Hasan Sadikin General Hospital-Padjadjaran University, Bandung, Indonesia.
Int Med Case Rep J. 2024 Jan 22;17:51-55. doi: 10.2147/IMCRJ.S442687. eCollection 2024.
Uterine rupture is a rare obstetrical and surgical emergency but is often associated with a catastrophic obstetric complication. Traditionally, unscarred uteri without risk factors are considered immune to rupture and information about its risk factors is only few due to its rarity. Complementary and alternative medicine is commonly used in pregnant woman in southeast Asian countries such as Indonesia, however information regarding its toxicity due to irrational use is few. This case report presents a G2P1A0 35-year-old woman with acute abdomen with spontaneous unscarred uterine rupture >15 cm after continuously consuming herbal water made of Kacip Fatimah leaves in boiling water.
A 35-year-old pregnant woman was referred to hospital due to abdominal discomfort 3 hours before admission due to suspicion of intrauterine fetal death. She drank the extracted herbal water to help her when the labor comes, which was made from boiled water with rumput Fatimah from her neighbor's house. Then, she was diagnosed with G2P1A0 parturient aterm latent phase; acute abdomen due to suspicion of placentae abruption dd/ ruptur uteri; and Intrauterine Fetal Death. Exploratory laparotomy was decided due to acute abdominal pain, and during the procedure the operator decided to do subtotal hysterectomy on the patient. The operator found her uterine was already ruptured, approximately 15-18 cm and the placentae was located outside of the uterus.
This case suggest that rational usage of herbal medicine must be implemented to avoid unwanted complication.
子宫破裂是一种罕见的产科和外科急症，但常伴有灾难性的产科并发症。传统上，无危险因素的未瘢痕化子宫被认为不会发生破裂，且由于其罕见性，关于其危险因素的信息很少。在印度尼西亚等东南亚国家，孕妇常用补充和替代医学，但由于不合理使用导致的毒性信息很少。本病例报告介绍了一名35岁的G2P1A0妇女，在持续饮用由卡西普·法蒂玛叶制成的草药水后，出现急性腹痛，子宫自发性无瘢痕破裂超过15厘米。
一名35岁孕妇因入院前3小时腹部不适被转诊至医院，怀疑宫内胎儿死亡。她喝了从邻居家拿的用卡西普·法蒂玛叶煮的草药水，以为能在分娩时有所帮助。随后，她被诊断为G2P1A0过期妊娠产妇潜伏期；因怀疑胎盘早剥/子宫破裂导致急性腹痛；以及宫内胎儿死亡。由于急性腹痛决定进行剖腹探查术，术中手术医生决定对患者行子宫次全切除术。手术医生发现她的子宫已经破裂，约15 - 18厘米，胎盘位于子宫外。
该病例表明，必须合理使用草药以避免不良并发症。
