Wang P H, Pang Y P, Chao H T, Lai C R, Juang C M, Yuan C C, Ng H T
Department of Obstetrics and Gynecology, Veterans General Hospital-Taipei, Taiwan, ROC.
Zhonghua Yi Xue Za Zhi (Taipei). 1998 Aug;61(8):492-5.
Adenomyosis of the uterus is a serious problem for women of reproductive age because of its possible consequence of infertility. We present the case of a woman who had adenomyosis of the uterus, a successful spontaneous pregnancy, and delayed and tenacious postpartum hemorrhage that did not respond to conservative treatment. The 26-year-old woman, gravida 1, para 1, suffered from fulminating vaginal bleeding and associated shock 20 days after the delivery of a 3,450-g female by Cesarean section. Conservative treatment included uterine compression and massage, blood transfusion, intravenous administration of high-dosage estrogen, oxytocin and sulprostone (prostaglandin E analogue), and gauze packing from the vagina into the uterine cavity. Despite treatment, the patient went into shock due to persistent vaginal bleeding. Emergency exploratoric assessment laparotomy was performed, followed by a stotal hysterectomy. Pathology revealed extensive adenomyosis of the uterus without other significant abnormality. The potential dangers of adenomyosis in pregnancy should not be overlooked when patients seek treatment for infertility.
子宫腺肌病对育龄女性来说是个严重问题，因为它可能导致不孕。我们报告一例患有子宫腺肌病的女性病例，该患者成功自然受孕，但产后出血延迟且顽固，保守治疗无效。这位26岁经产妇，剖宫产分娩一名3450克女婴后20天，出现大量阴道出血并伴有休克。保守治疗包括子宫压迫和按摩、输血、静脉注射高剂量雌激素、催产素和硫前列酮（前列腺素E类似物），以及从阴道向子宫腔填塞纱布。尽管进行了治疗，患者仍因持续阴道出血而休克。遂进行急诊探查性剖腹术，随后行全子宫切除术。病理检查显示子宫广泛腺肌病，无其他明显异常。当患者因不孕寻求治疗时，不应忽视子宫腺肌病在妊娠中的潜在危险。
