腹腔镜子宫颈环扎术后妊娠晚期环扎线处子宫破裂1例报道  

A case report on uterine rupture in the third-trimester after laparoscopic transabdominal cervical cerclage

作　　者：于燕[1] 张锐[1] 朱元方[1] 张建平[2] YU Yan;ZHANG Rui;ZHU Yuan-fang;ZHANG Jian-ping(Department of Obstetrics,Bao＇an Maternity and Child Health Hospital,Shenzhen,Guangdong 518133;Department of Obstetrics and Gynecology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,Guangdong 510102,China)

机构地区：[1]深圳市宝安区妇幼保健院产科,广东深圳518133 [2]中山大学孙逸仙纪念医院妇产科,广东广州510102

出　　处：《热带医学杂志》2018年第8期1119-1122,共4页Journal of Tropical Medicine

摘　　要：目的探讨腹腔镜子宫颈环扎术后妊娠晚期环扎线处子宫破裂的临床表现和经验教训。方法对诊治的1例腹腔镜子宫颈环扎术后妊娠晚期环扎线处子宫破裂的孕妇进行病例分析和相关文献复习。结果孕妇,38岁,行体外受精-胚胎移植(IVF-ET)妊娠,孕9+周因"宫颈机能不全"行腹腔镜下高位宫颈环扎术,孕25周再次行经阴道宫颈环扎术,孕29+2周早产临产,拟行急诊剖宫产术,术前孕妇出现休克表现,紧急剖腹探查见子宫后壁下段沿环扎线处横行破裂,裂至双侧阔韧带。结论腹腔镜子宫颈环扎术后妊娠晚期环扎线处子宫破裂极为罕见,多次行IVF-ET可能增加子宫破裂风险。Objective To explore clinical manifestation, diagnosis and treatment of uterine rupture in the third-trimester after laparoscopic transabdominal cervical cerclage. Methods A case with uterus rupture in the ligation thread after lateterm cervical cerclage under laparoscope was reported and the related literature reviewed. Results A pregnant woman（38 years old）suffering from cervical incompetence was undergoing in vitro fertilization and embryo transfer（IVF-ET）. She was treated with high position ligation of the cervix under laparoscope in pregnant 9 weeks due to cervical incompetence, and did another transvaginal cervical cerclage at 25 weeks of pregnancy. At 29＋2 weeks, emergency caesarean section was planned to taken because of preterm labor, however, pregnant woman showed the manifestation of shock, exploratory laparotomy found that the posterior segment of the posterior wall of the uterus ruptures along the cerclage line and cleft to the bilateral broad ligaments. Conclusion Uterine rupture in the third-trimester after laparoscopic transabdominal cervical cerclage without any high-risk factor is extremely rare, the IVF-ET will increase the risk of uterine rupture.

关 键 词：宫颈机能不全 宫颈环扎术 子宫破裂 IVF-ET 

分 类 号：R714.4[医药卫生—妇产科学]