Shaw F M, Reinus J F, Leikin E L, Tejani N
Department of Obstetrics and Gynecology, Westchester County Medical Center, New York Medical College, Valhalla, USA.
Obstet Gynecol. 1995 Oct;86(4 Pt 2):639-41. doi: 10.1016/0029-7844(95)00125-b.
Chorioamnionitis, a common cause of second-trimester abortion, is usually secondary to an ascending infection. Recurrent chorioamnionitis with second-trimester abortion secondary to an occult enterouterine fistula has not been reported previously.
A 26-year-old Indian woman, para 0-0-2-0, presented with two spontaneous second-trimester losses. Her third pregnancy carried to 24 weeks, but she delivered after the development of pneumonia, bacteremia, preterm labor, and chorioamnionitis. The patient passed melena containing blood clots after the delivery. After the last pregnancy, laparoscopy and laparotomy revealed an ileal-uterine fistula and a foreign body (necrotic cartilage). The blind loop of bowel was resected and the fistulous tract excised.
Our patient's recurrent pregnancy wastage was caused by chorioamnionitis secondary to an enterouterine fistula resulting from foreign body ingestion. A complete reversal of this problem is anticipated.
绒毛膜羊膜炎是孕中期流产的常见原因，通常继发于上行性感染。既往未见因隐匿性肠子宫瘘继发复发性绒毛膜羊膜炎伴孕中期流产的报道。
一名26岁的印度女性，孕0产0流2存0，出现两次孕中期自然流产。她的第三次妊娠持续到24周，但在发生肺炎、菌血症、早产和绒毛膜羊膜炎后分娩。患者产后排出含血凝块的黑便。最后一次妊娠后，腹腔镜检查和剖腹手术发现回肠子宫瘘和一个异物（坏死软骨）。切除了肠盲袢并切除了瘘管。
我们的患者反复妊娠失败是由异物摄入导致肠子宫瘘继发绒毛膜羊膜炎引起的。预计这一问题可完全逆转。
