PDF(Pubmed)
Abstract：
BACKGROUND: Uterine rupture is extremely hazardous to both mothers and infants. Diagnosing silent uterine rupture in pregnant women without uterine contractions is challenging due to the presence of nonspecific symptoms, signs, and laboratory indicators. Therefore, it is crucial to identify the elevated risks associated with silent uterine rupture.
METHODS: on admission, case 1 was at 37 gestational weeks, having undergo laparoscopic transabdominal cerclage 8 months prior to the in vitro fertilization embryo transfer procedure, case 2 was at 38 4/7 gestational weeks with a history of 5 previous artificial abortion and 2 previous vaginal deliveries, case 3 was at 37 6/7 gestational weeks with a history of laparoscopic myomectomy.
METHODS: The diagnosis of silent uterine rupture was based on clinical findings from cesarean delivery or laparoscopic exploration.
METHODS: Case 1 underwent emergent cesarean delivery, revealing a 0.25 cm × 0.25 cm narrow concave area above the Ring Ties with active and bright amniotic fluid flowing from the tear. Case 2 underwent vaginal delivery, and on the 12th postpartum day, ultrasound imaging and magnetic resonance imaging revealed a 5.8 cm × 3.3 cm × 2.3 cm lesion on the lower left posterior wall of the uterus, and 15th postpartum day, laparoscopic exploration confirmed the presence of an old rupture of uterus. Case 3 underwent elective cesarean delivery, revealing a 3.0 cm × 2.0 cm uterine rupture without active bleeding at the bottom of the uterus.
RESULTS: The volumes of antenatal bleeding for the 3 patients were approximately 500 mL, 320 mL, and 400 mL, respectively. After silent uterine ruptures were detected, the uterine tear was routinely repaired. No maternal or neonatal complications were reported.
CONCLUSIONS: Obstetricians should give particular consideration to the risk factors for silent uterine rupture, including a history of uterine surgery, such as laparoscopic transabdominal cerclage, laparoscopic myomectomy, and induced abortion.
METHODS: on admission, case 1 was at 37 gestational weeks, having undergo laparoscopic transabdominal cerclage 8 months prior to the in vitro fertilization embryo transfer procedure, case 2 was at 38 4/7 gestational weeks with a history of 5 previous artificial abortion and 2 previous vaginal deliveries, case 3 was at 37 6/7 gestational weeks with a history of laparoscopic myomectomy.
METHODS: The diagnosis of silent uterine rupture was based on clinical findings from cesarean delivery or laparoscopic exploration.
METHODS: Case 1 underwent emergent cesarean delivery, revealing a 0.25 cm × 0.25 cm narrow concave area above the Ring Ties with active and bright amniotic fluid flowing from the tear. Case 2 underwent vaginal delivery, and on the 12th postpartum day, ultrasound imaging and magnetic resonance imaging revealed a 5.8 cm × 3.3 cm × 2.3 cm lesion on the lower left posterior wall of the uterus, and 15th postpartum day, laparoscopic exploration confirmed the presence of an old rupture of uterus. Case 3 underwent elective cesarean delivery, revealing a 3.0 cm × 2.0 cm uterine rupture without active bleeding at the bottom of the uterus.
RESULTS: The volumes of antenatal bleeding for the 3 patients were approximately 500 mL, 320 mL, and 400 mL, respectively. After silent uterine ruptures were detected, the uterine tear was routinely repaired. No maternal or neonatal complications were reported.
CONCLUSIONS: Obstetricians should give particular consideration to the risk factors for silent uterine rupture, including a history of uterine surgery, such as laparoscopic transabdominal cerclage, laparoscopic myomectomy, and induced abortion.
摘要：
背景：子宫破裂对母亲和婴儿都是极其危险的。由于存在非特异性症状，在没有子宫收缩的孕妇中诊断无症状子宫破裂具有挑战性。标志,实验室指标。因此,确定与无症状子宫破裂相关的风险升高是至关重要的。
方法：关于入学，病例1是在37孕周，在体外受精胚胎移植手术前8个月接受腹腔镜经腹环扎术，病例2在384/7孕周，有5次先前的人工流产和2次先前的阴道分娩史，病例3为376/7孕周，有腹腔镜子宫肌瘤切除术史。
方法：无症状子宫破裂的诊断基于剖宫产或腹腔镜探查的临床表现。
方法：病例1行紧急剖宫产，揭示了一个0.25厘米×0.25厘米的狭窄的凹陷区域，从泪液中流出活跃而明亮的羊水。病例2经阴道分娩,在产后第12天，超声成像和磁共振成像显示子宫左下后壁有5.8cm×3.3cm×2.3cm的病变，产后第15天，腹腔镜探查证实存在旧的子宫破裂。病例3接受选择性剖宫产，显示3.0cm×2.0cm子宫破裂，子宫底部无活动性出血。
结果：3例患者的产前出血量约为500mL，320毫升,400毫升，分别。在检测到无症状的子宫破裂后，常规修复子宫撕裂。未报告产妇或新生儿并发症。
结论：产科医生应特别考虑无症状子宫破裂的危险因素，包括子宫手术史,如腹腔镜经腹环扎术，腹腔镜子宫肌瘤切除术,和人工流产。
方法：关于入学，病例1是在37孕周，在体外受精胚胎移植手术前8个月接受腹腔镜经腹环扎术，病例2在384/7孕周，有5次先前的人工流产和2次先前的阴道分娩史，病例3为376/7孕周，有腹腔镜子宫肌瘤切除术史。
方法：无症状子宫破裂的诊断基于剖宫产或腹腔镜探查的临床表现。
方法：病例1行紧急剖宫产，揭示了一个0.25厘米×0.25厘米的狭窄的凹陷区域，从泪液中流出活跃而明亮的羊水。病例2经阴道分娩,在产后第12天，超声成像和磁共振成像显示子宫左下后壁有5.8cm×3.3cm×2.3cm的病变，产后第15天，腹腔镜探查证实存在旧的子宫破裂。病例3接受选择性剖宫产，显示3.0cm×2.0cm子宫破裂，子宫底部无活动性出血。
结果：3例患者的产前出血量约为500mL，320毫升,400毫升，分别。在检测到无症状的子宫破裂后，常规修复子宫撕裂。未报告产妇或新生儿并发症。
结论：产科医生应特别考虑无症状子宫破裂的危险因素，包括子宫手术史,如腹腔镜经腹环扎术，腹腔镜子宫肌瘤切除术,和人工流产。
