瘢痕子宫行乳酸依沙吖啶引产致子宫破裂的病例报告及文献复习
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南京市妇幼保健院

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江苏省卫生健康委科研项目 H2019014


Uterine rupture induced by ethacridine lactate in scarred uterus: 7 cases report and review of cases
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Wang Xinyan

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    摘要:

    目的: 通过对剖宫产术后瘢痕子宫孕妇行乳酸依沙吖啶羊膜腔内注射引产致子宫破裂的临床资料分析,探索此类孕妇发生子宫破裂时的临床特点。 方法: 回顾性分析2015年12月至2021年12月在南京医科大学附属妇产医院行乳酸依沙吖啶羊膜腔内注射引产导致子宫破裂孕妇的临床资料,并对2000年1月1日至2022年1月1日在中国知网、万方数据库、维普、Sinomed数据库期刊上收录的相关文献进行汇总分析。结果: 六年间我院一共有7例乳酸依沙吖啶羊膜腔内注射引产后发生子宫破裂,均为剖宫产术后瘢痕子宫孕妇,6例破裂口位于原瘢痕部位,1例位于子宫下段近宫颈内口处;3例于分娩后发现,4例于分娩前发现,临床症状以腹痛、失血性休克为主。检索所得12例行羊膜腔内乳酸依沙吖啶注射引产后发生子宫破裂的瘢痕子宫孕妇中有2例于流产后发现,10例于流产前发现,临床症状以剧烈腹痛,失血性休克为主。结论: 瘢痕子宫行乳酸依沙吖啶羊膜腔内注射引产时发生子宫破裂的风险高,应谨慎、个体化选择引产方法,引产过程中密切注意孕妇腹痛、生命体征等情况,必要时可行腹腔穿刺及影像学检查。

    Abstract:

    Objective: To explore the clinical characteristics of pregnant women with scarred uterus who have occurred uterine rupture induced by intraamniotic injection of ethacridine lactate through analyzing their clinical data. Methods: Retrospective analyze the clinical data of pregnant women with uterine rupture induced by intraamniotic injection of ethacridine lactate and delivered in Women’s Hospital of Nanjing Medical University from December 2015 to December 2021. The relevant literature collected in CNKI, Wanfang database, VIP, Sinomed database from January 1, 2000 to January 1, 2022 were summarized and analyzed. Results: During the past six years, there were 7 cases of pregnant women with uterine rupture after induction of labor by intraamniotic injection of ethacridine lactate in our hospital. All of them were pregnant women with scar uterus after cesarean section. There are 6 cases whose rupture was located at the original scar site, and 1 case located at the lower uterine segment near the inner cervical orifice. Three cases were found after delivery and 4 cases before delivery. The main clinical symptoms were abdominal pain and hemorrhagic shock. Among the retrieved 12 cases of uterine rupture, two cases were found after abortion and 10 cases were found before abortion. The main clinical symptoms were severe abdominal pain and hemorrhagic shock. Conclusion: There is a high risk of uterine rupture for pregnant women with scarred uterus induced by intraamniotic injection of ethacridine lactate. When clinical workers are dealing with such pregnant women, choice of labor induction method should be carefully and individually selected, close attention should be paid to the abdominal pain and vital signs during induction of labor, and laparotomy and imaging are feasible when necessary.

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  • 收稿日期:2022-11-11
  • 最后修改日期:2023-01-09
  • 录用日期:2023-03-02
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