非瘢痕子宫破裂误诊为胎盘早剥一例并文献复习

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1、非瘢痕子宫破裂误诊为胎盘早剥一例并文献复习王华1张晓霏2刘艳秋3江苏大学附属医院江苏镇江212001【摘要】目的：探讨非瘢痕妊娠子宫破裂的临床特点并分析误诊原因。方法：结合相关文献对我院收治的一例非瘢痕妊娠子宫破裂的临床资料进行回顾性分析。结果：产妇于孕41周在当地社区医院予缩宫素引产，引产过程中突发腹痛、阴道流血，疑胎盘早剥，急诊转入我院，抗休克同时积极行子宫下段剖宫产术，术中发现确诊为子宫体部纵形裂开。结论：非瘢痕子宫破裂临床罕见，易误诊为胎盘早剥。详细询问病史、仔细查体，尽早明确诊治，有助于改善预后。【关键词】非瘢痕子宫；子宫破裂;

2、胎盘早剥；误诊Spontaneousuterineruptureofanunscarreduterusmisdiagnosedasplacentalabruption:casereportandreviewoftheliteratureWangHuaiZhangXiaofei2LiuYanqiu3(AffiliatedHospitalofJiangsuUniversityZhenjiangJiangsu212001)[Abstract]ObjectiveToexploreclinicalcharacteristicofspontaneou

3、suterineruptureofanunscarreduterusandanalyzethemisdiagnosiscauses.MethodsClinicaldataofapatientwithspontaneousuterineruptureofanunscarreduterusinourhospitalwasretrospectivelyanalyzed,andrelatedliteraturewasreviewed.ResultsThepatientwasa37-year-oldwomenGravida1para1at41wee

4、k’gestationwithnopasthistoryofuterinesurgery.Thelocalhospitaluseoxytocintoinducelabor.Duringoxytocinintravenousdripping,thepatientfeltspontaneouspelvicpainandsufferedvaginalbleedingsoon.Thepatientwasdiagnosedasplacentalabruptionandsendtoourhospital.Anti-shocktherapy

5、wasgivenandcesareansectionwasperformedatonce.Duringtheoperation,wefoundthattheuterusbodywasrupturedvertically.ConclusionThediagnosisofspontaneousuterineruptureisdifficultinanunscarreduterus,andmaybeeasilymisdiagnosedasplacentalabruption.Cliniciansshouldaskmedicalhistoryan

6、dgivephysicalexaminationcarefully.Theearlierdiagnosisandtreatmentaretaken,thebettertheprognosiswillbe.［KeyWords】Unscarreduterus;Spontaneousuterusrupture;PlacentalAbruption;Misdiagnosis【中图分类号】R714.25【文献标识码】B【文章编号】2096-0867(2015)-08-117-03子宫体部或子宫下段在妊娠期或分娩期发生破裂称为子宫破裂，如未及时诊断与

7、治疗，常引起母儿死亡，文献报道的子宫破裂发生率为0.07‰S右⑴。子宫破裂的症状和体征主要取决于发生吋间的长短、破裂位置及损伤程度；但子宫破裂最初的症状和体征并无特异性［2］。我院收治非瘢痕子宫破裂一例，病初误诊为胎盘早剥，现总结分析如下。1.病例资料女，37岁，孕2产1。因“孕足月，腹痛、阴道流血40分钟”急诊入院。因“孕41周，无产兆”入住当地社区医院，予小剂量缩宫素引产3天，第三天缩宫素静滴中突感腹痛，伴阴道多量流血，色鲜红，胎心听不清，拟诊“胎盘早剥”，立即予左侧卧位，吸氧，停缩宫素静滴，换用平衡液500ml静滴；测

8、血压90/70mmHg,脉搏84次/分，予贺斯500ml静滴；急诊转入我院。入院查体：一般情况差，神志淡漠。皮肤苍白，肢体湿冷。脉搏138次/分，呼吸26次/分，血压未测及。专科情况：宫底扪不