Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, China.
School of Basic Medical Sciences, Shandong Second Medical University, Weifang, China.
J Int Med Res. 2024 Sep;52(9):3000605241275006. doi: 10.1177/03000605241275006.
Incarceration of the gravid uterus is a rare and serious obstetric complication that can lead to severe complications. We present the case of a 32-year-old woman (gravida 5, para 2022) at 12 weeks and 5 days of gestation who presented with urinary retention and lower abdominal pain. Despite attempts at positional changes and manipulative repositioning under epidural anesthesia, the incarceration of the gravid uterus persisted. Subsequent intervention under general anesthesia involved partially reducing the uterine fundus into the abdominal cavity and using gauze strips in the posterior vaginal fornix to maintain traction. In addition, the bilateral round ligaments of the uterus were sutured to release the incarcerated uterus via laparoscopy. Vaginal gauze packing under general anesthesia may be a beneficial intervention for addressing cases of an incarcerated uterus, particularly in patients in whom passive maneuvers and manual pressure fail to resolve the condition.
子宫嵌顿是一种罕见且严重的产科并发症,可导致严重的并发症。我们报告了一例 32 岁的妇女(孕 5 产 2022),妊娠 12 周加 5 天,出现尿潴留和下腹痛。尽管尝试了体位改变和硬膜外麻醉下的手法复位,但仍持续存在子宫嵌顿。随后在全身麻醉下进行的干预包括部分将子宫底降低到腹腔,并在后阴道穹窿中使用纱布条维持牵引。此外,通过腹腔镜缝合子宫双侧圆韧带,以释放嵌顿的子宫。对于子宫嵌顿的病例,全身麻醉下的阴道纱布填塞可能是一种有益的干预措施,尤其是对于那些被动手法和手法复位无法解决问题的患者。