妊娠子宫嵌顿的超声表现及临床分析  

Ultrasound Characteristics and Clinical Analysis of Incarcerated Gravid Uterus

作　　者：刘迎凤[1] 李培培 烟娟 未占艳 梁丽华[1] Liu Yingfeng;Li Peipei;Yan Juan;Wei Zhanyan;Liang Lihua(Department of Ultrasound,The Fourth Hospital of Shijiazhuang,Shijiazhuang 050000,China)

机构地区：[1]石家庄市第四医院超声科,石家庄市050011

出　　处：《中国超声医学杂志》2024年第2期219-221,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨妊娠子宫嵌顿(IGU)的超声表现及临床诊断。方法回顾性分析9例IGU的超声图像、临床表现及妊娠结局,并结合既往文献进行讨论。结果9例IGU超声图像均表现为:宫颈不同程度拉长前移,子宫后倾后屈位,宫底位于直肠子宫陷凹内。其中5例孕早期诊断,4例孕中期诊断。临床表现:4例为排尿困难及下腹胀痛,1例为便秘及排尿不畅,1例为阴道少量出血,3例无特殊临床症状;发病的高危因素:3例为盆腔粘连,2例为子宫肌瘤,1例为子宫畸形,3例无明显高危因素。9例IGU孕妇中:4例为辅助生殖技术受孕,5例采取手法复位或膝胸卧位复位,4例在妊娠晚期仍未复位;1例25+6周胎死宫内,行剖宫取胎术,1例双胎34+3周剖宫产,1例合并胎盘植入34+5周剖宫产,3例足月剖宫产,3例足月经阴道顺娩。结论超声是诊断的首选方法,超声表现具有一定的特征,可为临床诊断提供依据。Objective To investigate the ultrasound manifestations,diagnosis and treatment for incarcerated gravid uterus(IGU).Methods The ultrasound images,clinical manifestations and pregnancy outcomes of 9 patients with IGU were retrospectively analyzed and investigated in combination with previous literature.Results Ultrasound images of 9 patients with IGU showed that the cervix was elongated and moved forward,the uterus was retroflexed,and the uterine fundus was located in the uterine-rectal depression.5 cases were diagnosed in the first trimester and 4 in the second trimester.The clinical manifestations of 4 cases were dysuria and abdominal pain,1 showed constipation and poor urination,1 showed a small amount of vaginal bleeding,and the other 3 had no special clinical symptoms.Pelvic adhesions stood for the high-risk factors in 3 cases,uterine fibroids in 2 cases,uterine malformation in 1 case,and no obvious high-risk factor was found in 3 cases.Among the 9 patients with IGU,4 cases were conceived by assisted reproductive technology,5 cases were reduced by manual reduction or knee-chest lying position,and 4 cases were not reduced in the third trimester.1 case on day 6 of week 25 experienced intrauterine fetal death and received cesarean section,1 case of twins with double cashmere and double sheep underwent cesarean section on day 3 of week 34,1 case received cesarean section at day 5 of week 34 with placenta implantation,3 cases underwent cesarean section at full-term,and 3 vaginal deliveries at full-term.Conclusions Ultrasound is the preferred method for diagnosing IGU.Ultrasound manifestations have certain characteristics and can provide evidence for the clinical diagnosis of gestational uterine incarceration.

关 键 词：妊娠子宫嵌顿 超声 宫颈 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.2[医药卫生—诊断学]