妊娠子宫嵌顿的超声诊断及结局分析  

Utrasonographic diagnosis and outcome analysis for incarceration of the gravid uterus during pregnancy

作　　者：李洁[1] 常明兰 李涵 栗河舟[1] 张红彬[1] 朱功升[1] LI Jie;CHANG Ming-lan;LI Han;LI He-zhou;ZHANG Hong-bin;ZHU Gong-sheng(The Third Afiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院,河南郑州450052

出　　处：《中国临床医学影像杂志》2023年第3期189-191,195,共4页Journal of China Clinic Medical Imaging

基　　金：河南省医学适宜技术推广项目(SYJS2020080)。

摘　　要：目的:总结妊娠子宫嵌顿的超声特征、诊断经验及妊娠结局。方法:回顾性收集我院10例产前超声检查提示妊娠子宫嵌顿的孕妇资料,分析其临床资料、超声特征、妊娠结局等。结果:6例在早孕期诊断,4例在中孕期诊断;10例中2例合并子宫肌瘤,7例既往有腹部或盆腔手术史,4例为辅助生殖技术受孕;8例临床表现为尿道梗阻症状,3例表现为直肠压迫症状,4例表现为其他非特异性症状;9例宫颈受压变薄拉长,长约3.9~7.3 cm;10例均采取手法复位和(或)膝胸卧位复位,其中1例接受手术复位;最终8例足月娩出活产儿,1例孕24周胎儿停止发育,1例目前孕26周+6无异常表现。结论:早期诊断对于产科管理和临床干预至关重要,亦有助于成功释放嵌顿的子宫;应注重对宫底、宫体与宫颈位置关系以及子宫与周边脏器关系的扫查。Objective:To summarize the ultrasound features,diagnostic experience and pregnancy outcome of incarceration of the gravid uterus during pregnancy.Methods:The data of 10 pregnant women with incarcerated gravid uterus indicated by prenatal ultrasound were collected retrospectively,and the data of pregnancy diagnosis,inducing clinical data,ultrasound features and pregnancy outcome were analyzed.Results:Six cases of incarcerated gravid uterus were diagnosed in the first trimester and 4 cases of incarcerated gravid uterus were diagnosed in the second trimester.Among the 10 cases,2 cases were complicated with uterine fibroids,7 cases had previous abdominal or pelvic surgeries,and 4 cases underwent assisted reproductive technology.The clinical manifestations of urethral obstruction were in 8 cases,rectal compression in 3 cases and other nonspecific symptoms in 4 cases.In 9 cases,the cervix was thinned and elongated by compression with the length about 3.9~7.3 cm.Ten cases were treated with manual reduction and/or knee-chest position reduction,among which 1 case underwent surgical reduction.Eventually,8 full-term live births were delivered,1 case stopped developing at 24 weeks,and 1 case has no abnormal appearance so far at 26+6 weeks.Conclusion:Early diagnosis is essential for vital importance for obstetric management and clinical intervention,and helpful to successfully release incarcerated gravid uterus.Attention should be paid to scanning the overall position relationship between uterine fundus,uterine body and cervix and relationship of uterus and peripheral viscera.

关 键 词：妊娠并发症 超声检查 产前 

分 类 号：R714.25[医药卫生—妇产科学] R445.1[医药卫生—临床医学]