گزارش دو مورد پارگی رحم فراموش شده به‌دنبال زایمان طبیعی بدون اسکار قبلی

نوع مقاله : گزارش مورد

نویسندگان

1 رزیدنت طب اورژانس، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 رزیدنت طب اورژانس، دانشکده پزشکی، دانشگاه علوم پزشکی ایران، تهران، ایران.

3 دانشیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

4 کارشناس کتابداری پزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: پارگی رحم هنگام بارداری، یک عارضه کشنده بودهیا باعوارض شدید مادری و جنین همراه است.در برخی موارد به علت عدم تشخیص به‌موقع پارگی رحم، بیمار با حال عمومی بد مراجعه خواهد کرد که در صورت تشخیص زودرس، مداخله سریع‌تری قابل انجام است.
معرفی بیمار: در این گزارش، دو مورد پارگی رحم معرفی شد که مورد اول پارگی رحم به دنبال ترومای موتور و مرگ جنین و زایمان اتفاق افتاده و بیمار با هرنی امنتوم به داخل رحم و علائم متریت مراجعه کرده است و مورد دوم، پارگی رحم به علت فشار بر فوندوس هنگام زایمان در بیمار بدون اسکار شده که به‌صورت دیررس به علت هرنیه شدن روده‌ها به داخل رحم با علائم انسدادی شکم حاد مراجعه کرد.
نتیجه‌گیری: توصیه می‌شود در بیماران با ترومای شکمی و به‌خصوص همراه با مرگ جنین و در بیمارانی که نوزاد به خون آغشته است، به‌دنبال زایمان، علی‌رغم کامل بودن جفت و نداشتن خونریزی، ارزیابی داخل رحم از نظر پارگی رحم با دست انجام شود تا در صورت تشخیص پارگی رحم، مداخله سریع‌تری صورت گیرد.

کلیدواژه‌ها

عنوان مقاله [English]

Report of two cases of missed uterus rupture after normal vaginal delivery without previous scar

نویسندگان [English]

  • Kosar Deldar 1
  • Seyed Saleh Seyedein 2
  • Marzieh Lotfalizadeh 3
  • Mansoureh Mohammadnezhad 4
1 Resident, Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Resident, Department of Emergency Medicine, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
3 Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4 B.Sc. of Medical Library, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: Uterus rupture during pregnancy is a fatal complication or is associated with severe maternal and fetal complications. In some cases, due to the lack of timely diagnosis of uterus rupture, the patient will refer with bad state that in the case of early diagnosis, faster intervention can be performed
Case Report: In this report, two cases of uterine rupture were introduced; the first case of uterine rupture occurred following motor trauma and fetal death and vaginal delivery, and the patient referred with metrite symptom and omentom herniation to ruptured uterus, and the second case, rupture of the uterus was due to pressure on the fundus during delivery in the patient without uterine scar, which referred as delayed due to the intestinal herniation to the uterus with acute abdomen obstructive symptoms.
Conclusion: It is recommended that in patients with abdominal trauma, especially with fetal death, and in patients who have infant infected with blood, after delivery, despite the completeness of the placenta and absence of bleeding, an intrauterine assessment in terms of uterus rupture be performed with hand, and faster intervention be done in the case of diagnosing rupture uterus.

کلیدواژه‌ها [English]

  • Intestinal hernia
  • Missed uterus rupture
  • Omental hernia
  • Pregnancy trauma

مراجع

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مجله زنان، مامایی و نازایی ایران
دوره 21، شماره 11
بهمن 1397
صفحه 91-95

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