Zhou Qian, Yu Yi, Liu Juntao, Gao Jinsong, Song Yijun, Sun Yin, Guo Qi
Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric and Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Matern Fetal Med. 2024 Oct 11;6(4):249-252. doi: 10.1097/FM9.0000000000000239. eCollection 2024 Oct.
In this article, we report a case of spontaneous ruptured pyomyoma during pregnancy with successful delivery after myomectomy. A 35-year-old pregnant female (27 weeks of gestation) presented with lower abdominal pain. The patient had a history of uterine fibroids. Ultrasound, computed tomography, and magnetic resonance imaging confirmed a spontaneous ruptured pyomyoma (maximum diameter: 12.6 cm). Myomectomy was performed, and her abdominal distension and pain were significantly improved within 1 day; the condition of the fetus was normal. One month after surgery, severe tenderness was detected in the lower right side of the uterus. Considering the higher risk of uterine rupture and associated complications, a cesarean section was performed. The mother and neonate were discharged 3 and 42 days after delivery, respectively, in good condition. Myomectomy for spontaneous ruptured pyomyoma during pregnancy may be feasible and extend gestational age to improve outcomes for the mother and neonate.
在本文中,我们报告了一例妊娠期自发性脓性子宫肌瘤破裂病例,患者在肌瘤切除术后成功分娩。一名35岁的孕妇(妊娠27周)出现下腹痛。该患者有子宫肌瘤病史。超声、计算机断层扫描和磁共振成像证实为自发性脓性子宫肌瘤破裂(最大直径:12.6厘米)。进行了肌瘤切除术,术后1天内她的腹胀和疼痛明显改善;胎儿状况正常。术后1个月,子宫右下方检测到严重压痛。考虑到子宫破裂及相关并发症的风险较高,遂进行了剖宫产。母亲和新生儿分别在分娩后3天和42天出院,情况良好。妊娠期自发性脓性子宫肌瘤破裂行肌瘤切除术可能是可行的,可延长孕周,改善母婴结局。