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首页> 外文期刊>American Journal of Case Reports >Posterior uterine wall rupture of an unscarred gravid uterus at 37 weeks of gestation: Experience of a rare case with a review of the literature
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Posterior uterine wall rupture of an unscarred gravid uterus at 37 weeks of gestation: Experience of a rare case with a review of the literature

机译：妊娠37周时未瘢痕状妊娠子宫的子宫后壁破裂：罕见病例的经验并文献复习

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Background: Uterine perforation is an uncommon but serious and life-threatening event, and the diagnosis is difficult in an unscarred gravid uterus.Case Report: A 44-year-old woman, gravida 5, para 2, with a history of two first-trimester elective suction abortions, presented at the 37th week of her gestation with spontaneous rupture of membranes. During labor induction with intravenous oxytocin using a standard protocol, the woman complained of sudden abdominal pain and profound fetal bradycardia occurred. During an emergency laparotomy, free blood in the abdomen was found and the fetus and the placenta were completely exteriorized from the uterus. A stillborn male infant weighing 3400 g was removed from the abdomen. The placenta was removed manually from the abdomen and the free blood was irrigated. The uterus was exteriorized for examination and a 7-cm longitudinal defect at the posterior surface of the uterus from the fundus to the supracervical area was identified as the source of the rupture. A hysterectomy was performed because hemostasis was not achieved.Conclusions: Spontaneous uterine rupture is a rare but serious and catastrophic event. Sudden abdominal pain and fetal distress during active labor in association with multigravidity should always prompt consideration of uterine rupture as a possible cause in cases of unexplained anomalies in an unscarred gravid uterus. A history of possible myometrial damage should be taken in consideration as well.
机译：背景：子宫穿孔是罕见的但严重且危及生命的事件，在无疤痕的妊娠子宫中很难诊断。病例报告：一名44岁的孕妇，gravida 5，第2段，有两个先发史，妊娠第37周时出现的择期抽吸性流产，伴有自发性膜破裂。在使用标准方案通过静脉催产素引产的过程中，该妇女抱怨突然出现腹痛，并发生了严重的胎儿心动过缓。在紧急剖腹手术中，发现腹部有游离血，胎儿和胎盘完全脱离了子宫。从腹部取出体重3400g的死产男婴。从腹部手动除去胎盘，并冲洗游离血液。将子宫外部化以进行检查，从眼底到颈上区域的子宫后表面的7厘米纵向缺损被确定为破裂源。子宫切除术是由于未能实现止血而进行的。结论：自发性子宫破裂是一种罕见的但严重的灾难性事件。在活动劳动期间突然腹部疼痛和胎儿窘迫以及多重重力，应始终提示考虑子宫破裂，这是在无疤痕妊娠的子宫中出现无法解释的异常情况下的可能原因。还应考虑可能的子宫肌层损害的病史。

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