无瘢痕子宫的自发性子宫破裂非常罕见。在体外受精后发现是罕见的。如果不及时诊断和治疗,它与显着的发病率和死亡率有关。
■结婚11年后体外受精后双胎妊娠的33岁女性在妊娠36周3天时因下腹疼痛被送往急诊科,并计划紧急剖腹产用于分娩中的珍贵双胎妊娠。
■她非常稳定,触诊腹部,有普遍的温柔伴随着守卫。所有调查都在正常范围内。
■在蛛网膜下腔阻滞下进行紧急剖腹产,发现子宫底破裂6×2cm,无活动性出血,分层修复。用子宫下段切口摘除婴儿。第一对双胞胎出生后立即哭泣,而第二对双胞胎由于围产期窒息而需要复苏和机械通气。
■即使在以前没有疤痕的子宫中很少见,子宫破裂可以以不同的形式出现,需要对患者进行警惕的评估,并及时进行干预,以避免严重的孕产妇或胎儿发病率和死亡率。
Spontaneous uterine rupture in an unscarred uterus is very rare. It is found to be rarer after in-vitro fertilization. It is associated with significant morbidity and mortality if not diagnosed and treated promptly.
UNASSIGNED: Thirty three years female with twin pregnancy following in-vitro fertilization after 11 years of marriage presented to emergency department with lower abdominal pain at 36 weeks 3 days of gestation and was planned for emergency caesarean section for precious twin pregnancy in labour.
UNASSIGNED: She was vitally stable and on palpation of abdomen, there was generalized tenderness along with guarding. All the investigations were within normal limits.
UNASSIGNED: Emergency caesarean section was performed under subarachnoid block which revealed a 6×2 cm fundal uterine rupture with no active bleeding which was repaired in layers. The babies were extracted with a lower uterine segment incision. First twin cried immediately after birth while the second one needed resuscitation and mechanical ventilation due to perinatal asphyxia.
UNASSIGNED: Even though rare in a previously unscarred uterus, uterine rupture can present in different forms and thus, requires vigilant evaluation of the patient and prompt intervention to avoid significant maternal or foetal morbidity and mortality.