PDF(Pubmed)
Abstract：
Spontaneous uterine rupture in unscarred uteri complicated by pulmonary emboli is a rare event with major maternal morbidity and mortality. This is a case of a 32-year-old woman, G1P0, at term, with no pertinent past medical/surgical history, who underwent an emergency cesarean delivery for failed induction of labor complicated by uterine rupture. Post-operatively, the patient was tachycardic and hypoxic. CT arteriogram revealed massive bilateral pulmonary emboli, and she was transferred for specialist care. An emergency pulmonary embolectomy and implantation of an extracorporeal right ventricular assist device were performed. Once the patient was clinically stable, an evaluation for thrombophilias and collagen disorders was done, and was positive for a variant of unknown significance in the ELN gene (c.205G > C). This case report highlights a potential connection between uterine ruptures, hemorrhage, and multiple, large pulmonary emboli. The authors propose a multidisciplinary discussion and evaluation to identify risk factors and biologic causes for these rare but life-threatening complications.
摘要：
无疤痕子宫自发性子宫破裂并发肺栓塞是罕见的事件，具有主要的孕产妇发病率和死亡率。这是一个32岁的女人的案子,G1P0，任期内，没有相关的既往医疗/手术史，因引产失败并发子宫破裂而接受紧急剖宫产。术后,患者为心动过速和缺氧。CT动脉造影显示巨大的双侧肺栓塞，她被转院接受专科护理.进行了紧急肺栓塞切除术和体外右心室辅助装置的植入。一旦病人临床稳定,对血栓形成和胶原紊乱进行了评估，并且对ELN基因中未知意义的变异呈阳性（c.205G>C）。此病例报告强调了子宫破裂之间的潜在联系，出血,和多个，大肺栓塞.作者提出了多学科的讨论和评估，以确定这些罕见但危及生命的并发症的危险因素和生物学原因。
