[1]曹京红,于飞,翟建军*.妇科手术后妊娠子宫破裂4例临床分析及文献复习[J].中国计划生育和妇产科,2020,(4):84-88.
　CAO Jing hong,YU Fei,ZHAI Jian jun*.Uterine rupture in pregnancy after gynaecologic surgery： clinical analysis of 4 cases and literature review[J].Chinese Journal of Family Planning & Gynecotokology,2020,(4):84-88.
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妇科手术后妊娠子宫破裂4例临床分析及文献复习
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2020年4期
页码:
84-88
栏目:
论著与临床
出版日期:
2020-04-25

文章信息/Info

Title:
Uterine rupture in pregnancy after gynaecologic surgery： clinical analysis of 4 cases and literature review
作者:
曹京红; 于飞; 翟建军*
首都医科大学附属北京同仁医院妇产科
Author(s):
CAO Jinghong;  YU Fei;  ZHAI Jianjun*
Department of Obstetrics and Gynecology, Beijing Tongren Hospital, Capital Medical University，Beijing 100730,P.R.China
关键词:
妇科手术; 瘢痕子宫; 妊娠子宫破裂
Keywords:
gynaecologic surgery;  scar uterus;  uterine rupture in pregnancy
分类号:
R 71446
摘要:
目的 探讨妇科手术后瘢痕子宫患者发生妊娠子宫破裂的特点，与手术之间的关系，以减少妇科手术后妊娠子宫破裂风险。方法 回顾性分析2011年6月至2016年8月首都医科大学附属北京同仁医院妇产科收治的4例有妇科手术史的妊娠子宫破裂患者的病例资料，了解其临床表现、妊娠结局及相关手术情况。结果 4例妊娠子宫破裂患者中2例曾行腹腔镜子宫肌瘤剔除术，1例曾行腹腔镜异位妊娠手术，1例有人工流产术后持续腹痛病史。4例患者来院时均呈休克状态，均已胎死宫内。结论 任何造成子宫瘢痕的手术均可能发生妊娠子宫破裂的远期并发症，应将此类患者作为妊娠子宫破裂的高危人群加以重视。
Abstract:
ObjectiveTo investigate the characteristics of uterine rupture (UR) during pregnancy in patients with scar uterus following a history of gynaecologic surgery, and its relationship with gynaecologic surgery, so as to reduce the risk of UR. MethodsRetrospectively reviewed the medical data of 4 patients who developed UR in pregnancy following a history of gynaecologic surgery admitted in Beijing Tongren Hospital, Capital Medical University from June 2011 to August 2016. To understand clinical manifestations, pregnancy outcomes and relevant gynaecologic surgeries of these 4 cases. ResultsAmong 4 patients with UR, 2 had undergone laparoscopic myomectomy, 1 had undergone laparoscopy of ectopic pregnancy, 1 had a history of persistent abdominal pain after induced abortion. These 4 patients were all in shock and with fetal die in uterus when admitted to hospital. ConclusionAny surgery which results in uterus scar may cause longterm complications of UR in pregnancy. We need to regard these patients as group with high risk of UR.

参考文献/References:

［1］赫英东, 时春艳, 杨慧霞.围产期非剖宫产瘢痕子宫破裂5例临床分析 ［J］.中华围产医学杂志, 2016, 19（9）：681683. ［2］李玲, 于昕, 郎景和, 等.妊娠子宫破裂25例临床分析 ［J］.生殖医学杂志,2015,24（2）:138142. ［3］Mettler L, Schollmeyer T, Tinelli A, et al.Complications of uterine fibroids and their management, surgical management of fibroids, laparoscopy and hysteroscopy versus hysterectomy, haemorrhage, adhesions, and complications ［J］.Obstet Gynecol Int，2012,2012:18. ［4］周应芳.注重子宫微创手术技巧，预防妊娠期子宫破裂 ［J］.中华妇产科杂志, 2016,51（11）：832834. ［5］Xiaoyi Wu, Wei Jiang, Huan Xu, et al.Characteristics of uterine rupture after laparoscopic surgery of the uterus: clinical analysis of 10 cases and literature review ［J］.Journal of International Medical Research, 2018, 46（9）: 36303639. ［6］Kolankaya A, Arici A.Myomas and assisted reproductive technologies: When and how to act? ［J］.Obstet Gynecol Clin North Am,2006,33（1）:145152. ［7］赫敏, 尉楠.关注腹腔镜下子宫肌瘤切除手术后子宫破裂的问题 ［J］.中国妇产科临床杂志, 2012, 13（2）：136139. ［8］Antonella Vimercati, Vittoria Del Vecchio, Annarosa Chincoli, et al.Uterine rupture after laparoscopic myomectomy in two cases: real complication or malpractice［J］.Case Reports in Obstetrics and Gynecology,2017,2017: 1404815. ［9］Koo YJ, Lee JK, Lee YK, et al.Pregnancy otcomes and risk factors for uterine rupture after laparoscopic myomectomy: A singlecenter experience and literature review［J］.J Minim Invasive Gynecol, 2015,22（6）: 10221028. ［10］Claeys J, Hellendoorn I, Hamerlynck T, et al.The risk of uterine rupture after myomectomy: a systematic review of the literature and metaanalysis ［J］.Gynecol Surg,2014,11（3）:197206. ［11］Parker WH, Einarsson J, Istre O, et al.Risk factors for uterine rupture after laparoscopic myomectomy［J］.J Minim Invasive Gynecol，2010,17（5）: 551554. ［12］Kumakiri J,Kikuchi I,Kitade M, et al.Evaluation of factors contributing to uterine scar formation after laparoscopic myomectomy［J］.Acta Obstet Gyn Scan, 2010, 89（8）: 10781083. ［13］Pistofidis G, Makrakis E, Balinakos P, et al.Report of 7 uterine rupture cases after laparoscopic myomectomy: Update of the literature ［J］.Journal of Minimally Invasive Gynecology, 2012,19（6）:762767. ［14］Paul PG, Koshy AK,Thomas T.Pregnancy outcomes following laparoscopic myomectomy and singlelayer myometrial closure ［J］.Hum Reprod, 2006,21（12）: 32783281. ［15］Kiseli M, Artas H, Armagan F, et al.Spontaneous rupture of uterus in midtrimester pregnancy due to increased uterine pressure with previous laparoscopic myomectomy［J］.Int J Fertil Steril, 2013, 7（3）: 239242. ［16］Torbe′ A, MikofajekBedner W, Kafuzynski W, et al.Uterine rupture in the second trimester of pregnancy as an iatrogenic complication of laparoscopic myomectomy ［J］.Medicina （Kaunas），2012,48（4）: 182185. ［17］Tsuji S, Takahashi K, Imaoka I, et al.MRI evaluation of the uterine structure after myomectomy［J］.Gynecol Obstet Invest, 2006,61（2）:106110. ［18］Sutton C, Standen P, Acton J, et al.Spontaneous uterine rupture in a preterm pregnancy following myomectomy ［J］.Case Rep Obstet Gynecol, 2016,2016: 6195621. ［19］刘洪莉, 李俊男, 黎洪波, 等.腹腔镜下子宫肌瘤剔除术后妊娠中期子宫破裂2例报告及文献复习 ［J］.中国实用妇科与产科杂志, 2015, 31（12）：11741176. ［20］Mol F, van Mello NM, Strandell A, et al.Salpingotomy versus salpingectomy in women with tubal pregnancy （ESEP study）: an openlabel, multicentre, randomised controlled trial［J］.Lancet, 2014, 383（9927）:14831489. ［21］Liao CY, Tse J, Sung SY, et al.Cornual wedge resection for interstitial pregnancy and postoperative outcome［J］.Aust N Z J Obstet Gynaecol, 2017, 57（3）:342345. ［22］Wang J, Huang D, Lin X, et al.Incidence of interstitial pregnancy after in vitro fertilization/embryo transfer and the outcome of a consecutive series of 38 cases managed by laparoscopic cornuostomy or cornual repair ［J］.J Minim Invasive Gynecol, 2016, 23（5）:739747. ［23］高梦怡,郑飞云.腹腔镜治疗宫内合并输卵管间质部妊娠21例效果分析 ［J］.实用妇产科杂志, 2019,35（3）: 234236. ［24］薛凤霞, 魏丽坤.重视育龄期女性输卵管疾病的管理预防妊娠期子宫破裂的发生［J］.中华妇产科杂志, 2018,53（4）：239242. ［25］夏恩兰.宫腔镜手术并发症的过往及现状 ［J］.中华妇幼临床医学杂志（电子版），2016, 12（3）： 249254． ［26］Sentilhes L, Sergent F, Berthier A, et al．Uterine rupture following 0perative hysteroscopy ［J］． Gynecol Obstet Fertil, 2006,34（11）：10641070. ［27］Sahin Zetero glu, Melisa Aslan, Bertan Akar, et al.Uterine rupture in pregnancy subsequent to hysteroscopic surgery: A case series［J］.Turk J Obstet Gynecol,2017，14（4）: 252255. ［28］Kayatas S， Meseci E， Tosun 0A，et al． Experience of hysteroscopy indications and compIications in 5 474 cases ［J］． Clin Exp 0bstet Gynecol，2014，41（4）：451454. ［29］Baggish MS．Complications of hysteroscopic surgery∥Llaggish MS，Valle RF，Gued H．Hysteroseopy visual perspectives of uterine anatomy，physiology and pathology［M］．3rd ed．Philadelphia： Lippincott Williams，2007：471472．

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更新日期/Last Update: 2020-04-25