Devasia Jaice M, Rafi Reshma
Obstetrics and Gynaecology, Whittington Health National Health Service (NHS) Trust, London, GBR.
Cureus. 2025 Aug 3;17(8):e89288. doi: 10.7759/cureus.89288. eCollection 2025 Aug.
Hematometra is an uncommon and delayed complication following the surgical management of miscarriage. When it occurs in the early postoperative period, it is sometimes referred to as "Redo syndrome". We present the case of a 39-year-old woman who developed this rare condition following a suction and evacuation procedure performed for a missed miscarriage. Within 48 hours of the procedure, the patient presented with acute lower abdominal pain, low-grade fever, dysuria, and pain during defecation. Despite her symptoms, her vital signs remained stable. However, laboratory investigations revealed an elevated C-reactive protein (CRP) level, indicating inflammation. She was started on broad-spectrum antibiotics. A transvaginal ultrasound revealed the presence of hematometra, a collection of blood within the uterine cavity. The patient underwent a repeat uterine evacuation under ultrasound guidance, during which approximately 50 mL of dark blood clots were removed. She recovered well post-procedure and was discharged the following day in a stable condition. Follow-up scan done after two weeks was normal. This case highlights the importance of considering hematometra, or Redo Syndrome, in patients presenting with abdominal pain and systemic symptoms shortly after surgical miscarriage management. Early recognition and prompt intervention are essential to prevent further complications and to ensure patient recovery.
子宫积血是流产手术治疗后一种罕见且延迟出现的并发症。当它发生在术后早期时,有时被称为“再次手术综合征”。我们报告一例39岁女性的病例,该患者在因稽留流产行吸宫术后出现了这种罕见情况。术后48小时内,患者出现急性下腹痛、低热、排尿困难及排便时疼痛。尽管有这些症状,但其生命体征仍保持稳定。然而,实验室检查显示C反应蛋白(CRP)水平升高,提示存在炎症。于是开始给予她广谱抗生素治疗。经阴道超声检查发现子宫积血,即子宫腔内有血液积聚。患者在超声引导下再次进行了清宫术,术中清除了约50毫升暗红色血凝块。术后她恢复良好,第二天病情稳定后出院。两周后进行的随访扫描结果正常。该病例强调了对于流产手术治疗后不久出现腹痛和全身症状的患者,考虑子宫积血或再次手术综合征的重要性。早期识别和及时干预对于预防进一步并发症及确保患者康复至关重要。