| 195 | 1 | 111 |
| 下载次数 | 被引频次 | 阅读次数 |
目的 研究妊娠期子宫嵌顿的总体特征及保守治疗嵌顿子宫复位的影响因素，探讨子宫复位对妊娠结局的影响。方法 报道1例我院收治的妊娠期子宫嵌顿患者，并在中国期刊全文数据库、万方数据知识服务平台、维普资讯、PubMed数据库上，检索各数据库从成立至2024年1月1日期间发表的所有有关于妊娠期子宫嵌顿的病例报道，回顾性分析子宫嵌顿总体的临床特征及子宫嵌顿保守治疗嵌顿子宫成功与失败两组患者之间差异及妊娠结局。结果 包括本院的1例患者，一共纳入了179例患者，保守治疗嵌顿子宫复位成功组103例、失败组76例。保守治疗嵌顿子宫时，与复位成功组相比，复位失败组中有风险因素的比例更多、症状更少、发现子宫嵌顿的时间更晚、终止妊娠的时间更早、剖宫产率更高、剖宫产术中并发症更多，差异均有统计学意义(P<0.05),两组间孕妇年龄、人种、孕产次、受孕方式、此次妊娠胎儿个数、检查结果等比较均无统计学差异(P>0.05)。结论 我们需及时发现并复位妊娠嵌顿子宫，避免不良妊娠结局的发生。
Abstract：Objective:To study the general characteristics of incarcerated gravity uterus, the influencing factor of conservation treatment, in order to discuss the effect of uterine reduction on pregnancy outcomes.Methods:A case of incarcerated gravid uterus admitted to our hospital was reported, and all the case reports about incarcerated gravid uterus published in various databases including China National Knowledge Infrastructure(CNKI),Wanfang Data, China Science and Technology Journal Database and PubMed from its establishment to January 1,2024 were searched on. The overall clinical characteristics of incarcerated gravity uterus, the differences between successful and failed conservative treatment of incarcerated gravity uterus as well as pregnancy outcomes were analyzed retrospectively.Results:Including one patient in Affiliated Hospital of Guangdong Medical University, a total of 179 patients were recruited. There were 103 cases in the successful reduction group and 76 cases in the failed group. Compared with the successful reduction group, the failure group of conservative treatment for the reduction of incarcerated gravity uterus had more risk factors, fewer symptoms, later diagnosis of incarcerated gravity uterus, earlier termination of pregnancy, higher cesarean section rate and more complications during cesarean section, showing significant differences(P<0.05). There were no statistically significant differences in the age, race, pregnancy and childbirth times, the conception mode, the number of fetuses in this pregnancy and examination results between the two groups(P>0.05).Conclusions:We need to find and reduce the incarcerated gravity uterus in time so as to avoid the occurrence of adverse pregnancy outcomes.
[1] Fidan U,Keskin U,Ulubay M,et al.Value of vaginal cervical position in estimating uterine anatomy[J].Clin Anat,2017,30:404-408.
[2] Takami M,Hasegawa Y,Seki K,et al.Spontaneous reduction of an incarcerated gravid uterus in the third trimester[J].Clin Case Rep,2016,4:605-610.
[3] Pina Moreno JM,Ruiz Minaya M,Fraile López A,et al.Importance of the early diagnosis of incarcerated gravid uterus:case report and systematic review[J].Int J Gynaecol Obstet,2023,162:193-201.
[4] Li H,Wu Q,Wei W,et al.Abnormal uterine position during pregnancy secondary to abdominal surgery:two case reports[J].Medicine(Baltimore),2022,101:e30914.
[5] 丁绍英.妊娠子宫嵌顿致膀胱自发性破裂一例[J].同济医科大学学报，1987,16:99.
[6] Dierickx I,Mesens T,Van Holsbeke C,et al.Recurrent incarceration and/or sacculation of the gravid uterus:a review[J].J Matern Fetal Neonatal Med,2010,23:776-780.
[7] Abel JS,Morgenstern B.Incarceration of a gravid uterus with massive placental enlargement and fetal triploidy at 19 weeks of gestation - a case report on the simultaneous presence of two rare conditions[J].Case Rep Womens Health,2023,40:e00564.
[8] Wu L,Zhang B,Xu J,et al.Anterior uterine incarceration complicated by placenta previa and placenta accreta spectrum disorder:a case report[J].Ann Transl Med,2023,11:139.
[9] Singh MN,Payappagoudar J,Lo J,et al.Incarcerated retroverted uterus in the third trimester complicated by postpartum pulmonary embolism[J].Obstet Gynecol,2007,109:498-501.
[10] 姚俊秀，郭欣，董旭东.无症状妊娠足月子宫嵌顿2例[J].中国临床案例成果数据库，2022,04:E03843.
[11] Narayanamoorthy S,Hillebrand A,Pendam R,et al.Incarcerated gravid uterus - a systematic review[J].Eur J Obstet Gynecol Reprod Biol X,2023,19:100227.
[12] Li HT,Luo S,Trasande L,et al.Geographic variations and temporal trends in cesarean delivery rates in China,2008-2014[J].JAMA,2017,317:69-76.
[13] 丁美平，陈菁，邹英，等.生育“二孩”或“三孩”高龄疤痕子宫孕妇再次剖宫产产后出血发生情况及危险因素分析[J].生殖医学杂志，2023,32:1879-1882.
[14] 彭娟，李蕾，李姝庆，等.妊娠期子宫嵌顿9例临床分析[J].中华妇产科杂志，2022,57:618-621.
[15] 朱晔，尹秀菊，张晓红.子宫前壁肌瘤导致妊娠子宫嵌顿1例病例报告[J].现代妇产科进展，2022,31:639-640.
[16] 牛小溪，公衍民，陶国伟，等.子宫畸形导致妊娠子宫嵌顿成功剖宫产分娩1例[J].现代妇产科进展，2023,32:880.
[17] Katopodis C,Menticoglou S,Logan A.Incarcerated fibroid uterus:the role of conservative management[J].J Obstet Gynaecol Can,2013,35:536-538.
[18] Tachibana D,Misugi T,Kitada K,et al.Incarcerated gravid uterus:spontaneous resolution is not rare[J].Diagnostics(Basel),2021,11:1544.
[19] 周广金，赵扬玉，王学举.磁共振成像在妊娠期子宫嵌顿诊治中的应用探讨[J].国际生殖健康/计划生育杂志，2021,40:298-302.
[20] Tanimura M,Sakiyama A,Yoshioka S.A new method for reduction of incarcerated gravid uterus[J].Eur J Obstet Gynecol Reprod Biol X,2023,18:100201.
[21] Gardner B,Kozakiewicz ML,Whitecar PW,et al.Novel approach to reduction of an incarcerated uterus[J].Obstet Gynecol,2018,132:1177-1179.
[22] Policiano C,Araújo C,Santo S,et al.Incarcerated gravid uterus:early manual reduction vs.late spontaneous resolution[J].Eur J Obstet Gynecol Reprod Biol,2014,180:201-202.
[23] Abelman SH,Jayakumaran JS,Sigdel M,et al.Incarcerated gravid uterus liberated by placement of a vaginal balloon[J].Obstet Gynecol,2022,140:898-900.
[24] Dierickx I,Delens F,Backaert T,et al.Case report:incarceration of the gravid uterus:a radiologic and obstetric challenge[J].J Radiol Case Rep,2014,8:28-36.
基本信息:
中图分类号:R714.2
引用信息:
[1]方菊丹,曹春燕,岳素如,等.妊娠期子宫嵌顿复位的重要性：病例报道及系统回顾[J].生殖医学杂志,2025,34(03):348-357.
2025-03-15
2025-03-15