Hemoperitoneum in a patient with spontaneous rupture of the posterior wall of an unscarred uterus in the second trimester of pregnancy.
Hemoperitoneum in a patient with spontaneous rupture of the posterior wall of an unscarred uterus in the second trimester of pregnancy.
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DOI：
10.1186/s13104-015-1575-0
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发表时间：
2015-10-24
影响因子：
1.8
通讯作者：
Sawicki W
中科院分区：
文献类型：
--
作者：
Abdalla N;Reinholz-Jaskolska M;Bachanek M;Cendrowski K;Stanczak R;Sawicki W
无疤痕子宫破裂引起的腹膜积血是一种罕见的情况。在没有明显危险因素的患者中，子宫破裂与非特异性体征和症状有关，这可能会延误诊断。本文报告妊娠中期子宫后壁自发性破裂，表现为腹内出血。在此，我们报告一例31岁高加索经产妇(妊娠3例，第1段)，在妊娠28周时突然出现腹痛。患者没有剖腹产病史。由于患者的临床情况恶化，进行了剖腹探查，超声结果怀疑是腹膜积血。子宫后壁破裂并有活动性的缺损处出血被证实。进行了剖腹产，生下了一名体重1000克、阿普加评分为3分的活体女婴。在剖宫产术中进行了子宫切除术。诊断困难源于疾病的罕见，临床表现不具特异性，以及缺乏主要危险因素。子宫无疤痕患者的腹膜积血的鉴别诊断中应考虑子宫破裂。
Hemoperitoneum resulting from a rupture of an unscarred uterus is a rare condition. Uterine rupture in patients without evident risk factors is associated with non-specific signs and symptoms that can delay the diagnosis. This is a report of spontaneous rupture of posterior wall of the uterus in the second trimester of pregnancy presented as intra-abdominal bleeding. Here, we report the case of a 31-year-old Caucasian multiparous female (gravida 3, para 1) who had a sudden onset of abdominal pain at 28 weeks of gestation. The patient had no history of caesarean section. Exploratory laparotomy was performed due to deterioration of the patient’s clinical condition, and ultrasound results were suspicious for hemoperitoneum. Uterine rupture in the posterior wall with active bleeding from the defect was confirmed. A caesarean section was performed, and a live female infant weighing 1000 g, with an Apgar score of three, was delivered. A hysterectomy was performed during the caesarean section. Diagnostic difficulties arise from the rarity of the disease, a nonspecific clinical picture and the absence of the main risk factors. Uterine rupture should be considered in the differential diagnosis of hemoperitoneum in patients with an unscarred uterus.