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孕中期创伤性子宫破裂:两个科室,两名患者,两名幸存者。

Traumatic Uterine Rupture in Second Trimester: Two Departments, Two Patients, Two Survivors.

作者信息

Kaggwa Henry, Deogratious Edemaga, Ndiwalana Billy Richard, Luweesi Henry, Kaduyu Paul

机构信息

Department of Obstetrics and Gynecology, Mengo Hospital, Kampala, Uganda.

Department of Surgery, Mengo Hospital, Kampala, Uganda.

出版信息

Int J Womens Health. 2025 Jan 28;17:185-188. doi: 10.2147/IJWH.S501521. eCollection 2025.

Abstract

Uterine rupture is defined as the complete division of all three layers of the uterus: the endometrium, myometrium, and perimetrium. Uterine rupture due to trauma often results from high-impact blunt abdominal trauma such as motor vehicle accidents, falls and domestic violence, and it is most common in the third trimester. Prompt diagnosis is necessary to treat this emergency, given its quick onset and progression, to prevent potentially life-threatening complications to the mother and fetus, notably fetal death, which commonly occurs in such cases. Here, we present a case of a 33-year-old female, Gravida 3 Para 2+0, with two previous uterine scars who sustained a traumatic uterine rupture at gestation of 18 weeks due to blunt abdominal trauma after a bathroom fall. The uterine rupture was surgically repaired, allowing continuation of pregnancy and delivery of a live baby 20 weeks later. We demonstrate a timely multidisciplinary approach to managing a pregnant trauma patient by surgical and obstetric teams to optimize outcomes for both the fetus and the mother.

摘要

子宫破裂的定义为子宫三层结构(子宫内膜、肌层和浆膜层)的完全断裂。创伤性子宫破裂通常由高冲击力钝性腹部创伤引起,如机动车事故、跌倒和家庭暴力,且在妊娠晚期最为常见。鉴于其发病迅速且进展快,为防止对母亲和胎儿产生潜在的危及生命的并发症,尤其是胎儿死亡(此类情况中常见),及时诊断对于治疗这一急症至关重要。在此,我们报告一例33岁女性病例,孕3产2 + 0,有两次子宫瘢痕史,因浴室跌倒后钝性腹部创伤,在妊娠18周时发生创伤性子宫破裂。子宫破裂通过手术修复,使妊娠得以继续,并在20周后分娩出一名活婴。我们展示了外科和产科团队对妊娠创伤患者进行及时多学科管理的方法,以优化胎儿和母亲的结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf0b/11786786/d0bca34c5e9c/IJWH-17-185-g0001.jpg

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