Spontaneous Unscarred Uterine Rupture at 15 Weeks of Pregnancy: A Case Report.
Spontaneous Unscarred Uterine Rupture at 15 Weeks of Pregnancy: A Case Report.
复制标题
怀孕 15 周自发性无疤痕子宫破裂：病例报告。
DOI：
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
I. Noci
中科院分区：
文献类型：
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作者：
L. Mannini;F. Sorbi;Viola Ghizzoni;G. Masini;M. Fambrini;I. Noci
背景
妊娠期间子宫破裂是一种严重的产科并发症。先前有子宫疤痕是最重要的危险因素，而无疤痕子宫破裂则是罕见事件。
病例报告
一位34岁女性，妊娠3-1岁，在妊娠15周时突然出现急性下腹疼痛。患者没有剖腹产病史。超声扫描显示空的子宫内膜腔直接进入主要在子宫外发育的羊膜囊。由于超声检查的结果和患者进行性贫血，进行了腹腔镜检查，发现大量的腹膜积血是由于宫底破裂和大部分羊膜囊外置引起的。中转开腹，摘除妊娠，修复子宫裂伤。
结论
子宫破裂的早期诊断和及时治疗可明显改善预后。这种严重的产科并发症应该被考虑，即使在妊娠早期和在没有已知危险因素的情况下也是如此。
BACKGROUND
Uterine rupture during pregnancy is a serious obstetric complication. The presence of a previous uterine scar is the most important risk factor, whereas rupture in an unscarred uterus is a rare event.
CASE REPORT
A 34-year-old woman, gravida 3 para 1, presented with sudden acute hypogastric pain at 15 weeks of gestation. The patient had no history of cesarean delivery. Ultrasound scans showed an empty endometrial cavity continuing directly into the amniotic sac that developed mainly outside the uterus. Because of the ultrasound findings and the patient's progressive anemia, a laparoscopy was performed that revealed a massive hemoperitoneum caused by the rupture of the uterine fundus with exteriorization of most of the amniotic sac. Laparoscopy was converted to laparotomy, the pregnancy was removed, and the uterine disruption was repaired.
CONCLUSION
Early diagnosis and prompt treatment of uterine rupture may significantly improve prognosis. This severe obstetric complication should be considered even in early gestational age pregnancies and in the absence of known risk factors.