复杂双子宫妊娠产后大出血介入栓塞治疗1例并文献复习

Interventional Embolization for Massive Postpartum Hemorrhage of Sophisticated Uterus Didelphys with Twin Pregnancy:Case Report and Review of the Literature

目的探讨双子宫妊娠的特点、产后出血发生及治疗方法。方法结合1例双子宫妊娠产后出血的处理经过并进行相关文献复习。结果本例双子宫,单阴道单宫颈,双胎妊娠,在妊娠35+6周时存在重度子痫前期及先兆早产,行剖宫产后出现产后大出血,行双侧子宫动脉栓塞术后,出血反复,最终进行了双子宫切除术。结论双子宫畸形双胎妊娠,产后出血行双子宫动脉栓塞后出血可能反复,提示子宫供血动脉可能较正常人复杂。

Objective To study the characters, postpartum hemorrhage and its therapy of uterus didelphys with pregnancy. Methods This case of uterus didelphys with single commom vagina and cervix, who was twin pregnancy complicating with serious eclampsism and threatened premature labor at 35＋6- week of gestation. Uterine-incision delivery was performed and massive postpartum hemorrhage occurred, which was treated by bilateral uterine artery einbolization （UAE）. Bilateral hysterectomy was performed ultimately due to repeated hemorrhage. Conclusion UAE may be incredulous for postpartum hemorrhage in patients with uterus didelphys with twin pregnancy due to sophisticated uterine blood supply.