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既往超声引导下经皮微波消融子宫肌瘤后分娩时子宫破裂:一例报告

Uterine rupture in labor after prior ultrasound-guided percutaneous microwave ablation of uterine fibroids: A case report.

作者信息

Zeng Yucui, Wang Yanlan, Guang Xiaoyan

机构信息

Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China.

出版信息

Case Rep Womens Health. 2025 Mar 14;46:e00702. doi: 10.1016/j.crwh.2025.e00702. eCollection 2025 Jun.

Abstract

Ultrasound-guided percutaneous microwave ablation for the treatment of uterine fibroids has gained widespread clinical application due to its efficacy. However, reports on fertility outcomes and pregnancy complications following this treatment remain scarce. This report presents the case of a 31-year-old woman who underwent ultrasound-guided percutaneous microwave ablation for uterine fibroids. Regular postoperative follow-up revealed a significant reduction in the size of the uterine fibroids. Six months later, the patient successfully achieved natural conception, and her pregnancy progressed without any abnormalities. Given her strong preference for vaginal delivery, she was admitted to hospital at 40 weeks of gestation for monitoring when she began to exhibit signs of labor. However, uterine rupture occurred without any apparent warning during the labor. Following emergency surgical intervention, the neonate and the patient had a favorable outcome. This case underscores the efficacy of percutaneous microwave ablation for uterine fibroids but also emphasizes the need for postoperative follow-up to promptly identify any complications during the third trimester of pregnancy.

摘要

超声引导下经皮微波消融治疗子宫肌瘤因其疗效已在临床上广泛应用。然而,关于该治疗后生育结局和妊娠并发症的报道仍然很少。本报告介绍了一名31岁女性接受超声引导下经皮微波消融治疗子宫肌瘤的病例。术后定期随访显示子宫肌瘤大小显著缩小。六个月后,患者成功自然受孕,孕期进展顺利,无任何异常。鉴于她强烈倾向于阴道分娩,在妊娠40周开始出现临产迹象时入院监测。然而,分娩过程中子宫无明显预警地发生了破裂。经过紧急手术干预,新生儿和患者均预后良好。该病例强调了经皮微波消融治疗子宫肌瘤的疗效,但也强调了术后随访以在妊娠晚期及时发现任何并发症的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fae1/11984988/d05e0381a06e/gr1.jpg

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