妊娠晚期子宫血管自然破裂出血1例

Spontaneous rupture of superficial uterine vessels with hemorrhage in late pregnancy:a case report

本文报告了1例妊娠晚期子宫血管自然破裂出血的病例。患者因妊娠晚期不规律腹痛入院,考虑有活动性腹腔内出血,行开腹探查术+剖宫产术。术中见近子宫下段右侧壁表面2根血管破裂。先行子宫下段剖宫产术娩出一活婴,新生儿生后1、5和10 min Apgar评分分别为7、9、9分。新生儿娩出后,缝扎子宫表面破裂血管,探查腹腔未见其他异常,清理盆腹腔未再见活动性出血,腹腔内出血共1600 ml。术后诊断为子宫表面血管破裂出血、腹腔内出血、子宫多发性平滑肌瘤。术后母儿恢复良好。

This paper reports a case of spontaneous rupture of uterine vessels with hemorrhage in the third trimester.A patient with irregular abdominal pain during late pregnancy was admitted to the hospital.Due to the consideration of active intraperitoneal hemorrhage,an exploratory laparotomy was performed,and it was found that two right-sided superficial blood vessels near the lower uterine segment were ruptured.Meanwhile,a lower uterine segment cesarean section was performed to deliver a live infant with an Apgar score of 7-9-9 at one,five and ten minutes after birth.The ruptured uterus vessels were sutured.No other abnormalities were revealed in the abdominal cavity,and no active bleeding was found after abdominopelvic cavity cleansing.The total intraabdominal hemorrhage was 1600 ml.The patient was diagnosed with superficial uterine vessel rupture,intraabdominal hemorrhage,and multiple uterine leiomyomas after the surgery.Both the mother and child recovered well.