Inner myometrial laceration – an unusual presentation of antepartum and postpartum hemorrhage: case reports and review of the literature
Inner myometrial laceration – an unusual presentation of antepartum and postpartum hemorrhage: case reports and review of the literature
复制标题
子宫肌层内部撕裂——产前和产后出血的异常表现：病例报告和文献综述
DOI：
10.3109/14767058.2015.1094795
复制
发表时间：
2015
期刊：
影响因子：
--
通讯作者：
B. Dilbaz
中科院分区：
文献类型：
--
作者：
M. Kaplanoğlu;D. Kaplanoglu;M. Bulbul;B. Dilbaz
摘要目的：本研究的目的是评估诊断标准，治疗方案和进展的情况下，产前或产后出血的子宫肌层内裂伤（IML），并审查文献。研究设计：回顾性评价了2012年8月至2015年7月期间诊断为IML的8例患者的档案。结果如下：患者组包括4名因分娩期间大出血而进行紧急剖腹产的患者和4名因阴道分娩后不受控制的出血而进行紧急剖腹产的患者，在评估患者的4T体征（创伤、组织滞留、子宫紧张和Trombin）后。一期缝合是所有患者的一线治疗。在两名患者中，在规定的外科手术未能成功控制出血后进行了子宫切除术。结论：本病例系列是一项开创性研究，描述了IM，这是一种定义不清的产后出血原因，是分娩期间出血的原因。一期缝合是第一步，可能需要进一步的手术来治疗这种危及生命的疾病，并且应该根据患者的年龄和生育状况做出决定。
Abstract Objective: The aim of this study is to evaluate the diagnostic criteria, treatment options and progression of cases who have antenatal or postpartum hemorrhage due to internal myometrial laceration (IML) and to review the literature. Study design: The files of eight patients who were diagnosed to have IML between August 2012 and July 2015 were evaluated retrospectively. Results: The patient group consisted of four patients who had an emergency c-section due to massive bleeding during labor and four patients who had an emergency laparotomy due to uncontrolled bleeding after vaginal delivery after evaluation of the patient for signs of 4Ts (trauma, tissue retention, uterine tonus, and trombin). Primary suturation was the first-line treatment in all patients. In two of the patients, hysterectomy was performed after the defined surgical procedures were not successful in controling the bleeding. Conclusion: The presented case series is a pioneering study that describes IM which is a poorly defined reason of postpartum hemorrhage, as the cause of bleeding during labor. Primary suturation is the first-step, further surgery might be required in order to treat this life-threathening condition and the decision should be based on the age and the fertility status of the patient.