unicornuate uterus 子宫畸形 子宫单角妊娠孕晚期自发性子宫破裂伴羊膜囊突出 1 例报告
Spontaneous uterine rupture with amniotic sac protrusion during the third trimester of a unicornuate uterus pregnancy: A rate case report.
机构信息
Department of Ultrasound, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan, China.
Medical Imaging Department, Central Laboratory, Jinan Key Laboratory of Oral Tissue Regeneration, Jinan Stomatological Hospital, Jinan, China.
出版信息
Medicine (Baltimore). 2024 Mar 15;103(11):e37445. doi: 10.1097/MD.0000000000037445.
RATIONALE
Uterine rupture is an obstetrical emergency associated with severe maternal and fetal mortality. It is rare in the unscarred uterus of a primipara.
PATIENT CONCERNS
A 25-year-old woman in her 38th week of gestation presented with slight abdominal pain of sudden onset 10 hours before. An emergency cesarean section was done. After surgery, the patient and the infant survived.
DIAGNOSES
With slight abdominal pain of clinical signs, ultrasound examination showed that the amniotic sac was found in the peritoneal cavity with a rupture of the uterine fundus.
INTERVENTIONS
Uterine repair and right salpingectomy.
OUTCOMES
After surgery, the patient and the infant survived. The newborn weighed 2600 g and had an Apgar score of 10 points per minute. Forty-two days after delivery, the uterus recovered well.
LESSONS
Spontaneous uterine rupture should be considered in patients even without acute pain, regardless of gestational age, and pregnancy with abdominal cystic mass should consider the possibility of uterine rupture.
背景
子宫破裂是一种与严重母婴死亡率相关的产科急症，在初产妇未受损的子宫中很少见。
病例介绍
一位 25 岁的初产妇，妊娠 38 周，10 小时前突发轻微腹痛。行急诊剖宫产术，术后产妇和婴儿存活。
诊断
患者有轻微腹痛的临床表现，超声检查显示羊膜囊位于腹腔内，子宫底部破裂。
干预措施
子宫修补术和右侧输卵管切除术。
结果
术后，产妇和婴儿存活。新生儿体重 2600g，Apgar 评分 1 分钟时为 10 分。产后 42 天，子宫恢复良好。
教训
即使没有急性疼痛，无论妊娠周数如何，都应考虑患者是否存在自发性子宫破裂，对于有腹部囊性肿块的妊娠应考虑子宫破裂的可能性。
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