Fung T Y, Yim S F, Fung H Y
Department of Obstetrics and Gynaecology, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong.
J Reprod Med. 1998 Nov;43(11):1002-4.
Intramyometrial abscess in pregnancy is a rare event. Little information is available on the presentations and potential complications.
Two asymptomatic patients underwent complications with failed instrumental delivery in the second stage of labor. Intramyometrial abscesses were found during lower segment cesarean section. In the first case, incision and drainage was done, and the culture of the pus revealed multiple organisms, including Escherichia coli, group B Streptococcus and Klebsiella species. The patient was successfully treated with antibiotics, while the infant did not show any evidence of infection. In the second case, removal of the abscess was performed, and pathology showed evidence of chronic abscess, but the culture did not reveal any organisms. The patient was treated with prophylactic antibiotics. The infant was treated with antibiotics for clinical sepsis, but no organism was revealed.
Intramyometrial abscess complicating pregnancy can be asymptomatic. Obstructed labor can be a potential complication when the abscesses are located in the lower uterine segment. Antibiotics, together with incision and drainage or removal of the abscess, is the first choice for treatment.
妊娠子宫肌层内脓肿是一种罕见的情况。关于其临床表现和潜在并发症的信息很少。
两名无症状患者在第二产程中因器械助产失败而出现并发症。在低位剖宫产术中发现子宫肌层内脓肿。第一例患者进行了切开引流，脓液培养显示有多种微生物，包括大肠杆菌、B族链球菌和克雷伯菌属。患者经抗生素治疗成功，而婴儿未显示任何感染迹象。第二例患者进行了脓肿切除，病理显示为慢性脓肿，但培养未发现任何微生物。患者接受了预防性抗生素治疗。婴儿因临床败血症接受抗生素治疗，但未发现任何微生物。
妊娠合并子宫肌层内脓肿可能无症状。当脓肿位于子宫下段时，产程受阻可能是一种潜在并发症。抗生素联合切开引流或脓肿切除是治疗的首选方法。
