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首页> 外文期刊>Journal of Medical Case Reports >Total and acute uterine inversion after delivery: a case report
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Total and acute uterine inversion after delivery: a case report

机译:分娩后全子宫和急性子宫内翻:一例报告

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Introduction Uterine inversion is a rare obstetric emergency that can lead to hypovolemic shock or even maternal death. There are many management strategies, but they are poorly described and dispersed in the medical literature. The purpose of this article is to describe a case of complete acute uterine inversion and a review of the literature. Case presentation The authors describe a case of complete uterine inversion after a normal delivery with fundal placenta and without cord traction, in a 33-year-old Caucasian woman. After the diagnosis was made and after several attempts of manual correction of the inversion, the patient was taken immediately to the operating room and a laparotomy was performed. With opposing pressures in the cervical ring through the abdominal cavity and on the uterus fundus through her vagina, the inversion was resolved. An incision on the cervical ring was unnecessary. Due to incomplete detachment of the placenta the bleeding was mild. She recovered without complications and the histological examination of placenta was unremarkable. In this case, the only risk factor for uterine inversion was the fundal implantation of the placenta. Conclusions The low incidence of uterine inversion leads to sparse experience in resolving this obstetrical emergency. The best prognosis occurs in situations where the diagnosis and maneuvers for uterine reversal are made at an early stage. The authors concluded that opposing pressures in the cervical ring through the abdominal cavity and on the uterus fundus through the vagina can resolve the inversion without the need of other surgical techniques. It is essential to keep in mind this diagnosis, and be updated about the strategies required to solve this complication.
机译:简介子宫内翻是一种罕见的产科急症,可导致低血容量性休克甚至产妇死亡。有许多管理策略,但是在医学文献中很少对其进行描述和分散。本文的目的是描述一种完全急性子宫内翻的病例并进行文献复习。病例介绍作者描述了一名33岁的白人妇女,正常分娩后有胎盘胎盘且无脐带牵拉后完全子宫内翻的情况。在做出诊断后,并尝试了几次人工矫正内翻后,立即将患者带到手术室并进行了剖腹手术。通过腹腔的宫颈环和通过阴道的子宫底受到相反的压力,内翻得以解决。不需要在颈环上切开切口。由于胎盘剥离不完全,出血轻微。她康复无并发症,胎盘组织学检查无异常。在这种情况下,子宫内翻的唯一危险因素是胎盘的基底植入。结论子宫内翻的发生率低导致解决这种产科急症的经验稀少。最好的预后发生在早期进行子宫逆转的诊断和手术的情况下。作者得出的结论是,不需要其他外科技术,通过腹腔的宫颈环和通过阴道的子宫底对立的压力就可以解决内翻。重要的是要牢记这一诊断,并及时更新解决该并发症所需的策略。

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