孕晚期子宫右前壁血管自发性破裂一例
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摘要
孕晚期子宫血管自发性破裂是由于各种原因导致子宫动、静脉出现的自然破裂,由于孕晚期子宫血供极其丰富,一旦发生子宫血管破裂容易造成孕妇腹腔出血、休克、胎死宫内等不良事件。孕晚期子宫血管自发性破裂发病率低,但凶险性极高,诊断不及时或者漏诊将严重危害母儿安全。为提高对孕晚期子宫血管自发性破裂的认识,现回顾分析1例孕晚期子宫右前壁血管自发性破裂患者的临床资料,并复习相关文献,进一步分析其发病机制、辅助检查及临床表现,以加深临床医生对该病的认识,提高诊断和治疗水平。
Various reasons can contribute to induce spontaneous rupture of uterine vessels in late pregnancy including arteries and veins. Due to the abundant blood supply of uterus in the late pregnancy, it is very easy to cause abdominal hemorrhage, shock and intrauterine fetal death in pregnant women once uterine vessel rupture occurs. The incidence of spontaneous rupture of uterine vessels in late pregnancy is low, but it is extremely dangerous, and if the diagnosis is not timely or missed, it will seriously endanger the safety of the mother and the children. Now, in order to improve the understanding of spontaneous rupture of uterine vessels in late pregnancy, the clinical data of a patient with spontaneous rupture of uterine right anterior wall in late pregnancy was retrospectively analyzed, and the related literature was reviewed to further analyze its pathogenesis, auxiliary examination and clinical manifestations, so as to deepen the understanding of the disease by clinicians and improve the level of diagnosis and treatment.
Various reasons can contribute to induce spontaneous rupture of uterine vessels in late pregnancy including arteries and veins. Due to the abundant blood supply of uterus in the late pregnancy, it is very easy to cause abdominal hemorrhage, shock and intrauterine fetal death in pregnant women once uterine vessel rupture occurs. The incidence of spontaneous rupture of uterine vessels in late pregnancy is low, but it is extremely dangerous, and if the diagnosis is not timely or missed, it will seriously endanger the safety of the mother and the children. Now, in order to improve the understanding of spontaneous rupture of uterine vessels in late pregnancy, the clinical data of a patient with spontaneous rupture of uterine right anterior wall in late pregnancy was retrospectively analyzed, and the related literature was reviewed to further analyze its pathogenesis, auxiliary examination and clinical manifestations, so as to deepen the understanding of the disease by clinicians and improve the level of diagnosis and treatment.
引文
[1]GloserováP,Hensel G,Kostál’M.Spontaneous rupture of the uterine artery in connection with pregnancy[J].Ceska Gynekol,2018,83(2):127-132.
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[8]Liu SY,Zeng B,Deng JB.Massive retroperitoneal hemorrhage secondary to femoral artery puncture:A case report and review of literature[J].Medicine(Baltimore),2017,96(50):e8724.
[9]Zhang N,Lou WH,Zhang XB,et al.Antepartum hemorrhage from previous-cesarean-sectioned uterus as a potential sign of uterine artery pseudoaneurysm[J].J Zhejiang Univ Sci B,2017,18(5):441-444.
[10]Tracy BM,O′Neal CM,Clayton E,et al.Seat Belt Sign as a Predictor of Placental Abruption[J].Am Surg,2017,83(11):e452-e454.
[11]Ahmed DM,Mengistu TS,Endalamaw AG.Incidence and factors associated with outcomes of uterine rupture among women delivered at Felegehiwot referral hospital,Bahir Dar,Ethiopia:cross sectional study[J].BMC Pregnancy Childbirth,2018,18(1):447.
[12]Langhe R,Shah UF,Alfathil A,et al.Silent uterine rupture in scarred uterus[J].BMJ Case Rep,2017,2017:bcr-2016-218189.
[13]Thakur M,Adekola HO,Asaad R,et al.Secondary Postpartum Hemorrhage due to Spontaneous Uterine Artery Rupture after Normal Vaginal Delivery Managed by Selective Arterial Embolization[J].AJP Rep,2016,6(4):e442-e444.
[14]de Carvalho JP,Severo LA,de Carvalho MH,et al.Spontaneous Rupture of Uterine Artery in a 14-Week Pregnant Woman[J].Case Rep Obstet Gynecol,2016,2016:9524250.
[15]Habek D.Intraoperative Spontaneous Rupture of Uterine Varicose Vein[J].Acta Clin Croat,2017,56(4):821-822.
[2]Jang JH,Kyeong KS,Lee S,et al.A case of spontaneous hemoperitoneum by uterine vessel rupture in pregnancy[J].Obstet Gynecol Sci,2016,59(6):530-534.
[3]Hardin N,Delozier A,Torabi A,et al.Spontaneous Rupture of the Uterine Artery in an Otherwise Normal Pregnancy[J].J Radiol Case Rep,2017,11(1):7-13.
[4]Dias B,Raimond E,Pelissier A,et al.Spontaneous uterine artery rupture during pregnancy:About two cases[J].Eur J Obstet Gynecol Reprod Biol,2017,212:194-195.
[5]Becker R,Kowalsky BL,Hatzmann W.Rupture of the uterine artery after spontaneous delivery with unusual course in childbed[J].ZGeburtshilfe Neonatol,2002,206(3):107-113.
[6]Lim PS,Ng SP,Shafiee MN,et al.Spontaneous rupture of uterine varicose veins:a rare cause for obstetric shock[J].J Obstet Gynaecol Res,2014,40(6):1791-1794.
[7]代桂珍,杜辰.妊娠晚期子宫浆膜下血管自发性破裂5例[J].中国妇产科临床杂志,2013,14(4):348-350.
[8]Liu SY,Zeng B,Deng JB.Massive retroperitoneal hemorrhage secondary to femoral artery puncture:A case report and review of literature[J].Medicine(Baltimore),2017,96(50):e8724.
[9]Zhang N,Lou WH,Zhang XB,et al.Antepartum hemorrhage from previous-cesarean-sectioned uterus as a potential sign of uterine artery pseudoaneurysm[J].J Zhejiang Univ Sci B,2017,18(5):441-444.
[10]Tracy BM,O′Neal CM,Clayton E,et al.Seat Belt Sign as a Predictor of Placental Abruption[J].Am Surg,2017,83(11):e452-e454.
[11]Ahmed DM,Mengistu TS,Endalamaw AG.Incidence and factors associated with outcomes of uterine rupture among women delivered at Felegehiwot referral hospital,Bahir Dar,Ethiopia:cross sectional study[J].BMC Pregnancy Childbirth,2018,18(1):447.
[12]Langhe R,Shah UF,Alfathil A,et al.Silent uterine rupture in scarred uterus[J].BMJ Case Rep,2017,2017:bcr-2016-218189.
[13]Thakur M,Adekola HO,Asaad R,et al.Secondary Postpartum Hemorrhage due to Spontaneous Uterine Artery Rupture after Normal Vaginal Delivery Managed by Selective Arterial Embolization[J].AJP Rep,2016,6(4):e442-e444.
[14]de Carvalho JP,Severo LA,de Carvalho MH,et al.Spontaneous Rupture of Uterine Artery in a 14-Week Pregnant Woman[J].Case Rep Obstet Gynecol,2016,2016:9524250.
[15]Habek D.Intraoperative Spontaneous Rupture of Uterine Varicose Vein[J].Acta Clin Croat,2017,56(4):821-822.