Hemorrhaging Uterine Fibroid Leading to Emergent Early Term Cesarean Delivery: A Case Report.

IF 0.8 Q4 PEDIATRICS
AJP Reports Pub Date : 2024-10-22 eCollection Date: 2024-07-01 DOI:10.1055/a-2434-5650
Nicholas Racchi, Lisa Bird, Samantha Mullan, William Schnettler, Nanci Billock
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Abstract

Background  The incidence of uterine leiomyomas, or fibroids, affecting pregnant individuals is estimated to be 10%, but there are no guidelines or recommendations for fetal or maternal surveillance in pregnancies affected by them. Risks associated with fibroids during pregnancy include potential for pain, preterm birth, fetal growth restriction, higher cesarean delivery rate, fetal malpresentation, placenta abruption, and postpartum hemorrhage. Case Presentation  This case describes a 26-year-old gravida 1 para 0 who presented at early term for severe abdominal pain and was found to have acute abdomen accompanied by a nonreassuring fetal heart rate tracing. With emergent cesarean delivery, it was found that the patient was hemorrhaging from a ruptured vessel of a pedunculated fibroid and myomectomy was subsequently performed. Conclusion  While rare, hemorrhage from a uterine fibroid should be considered a part of the differential diagnosis of abdominal pain in pregnant patients with fibroids, particularly when accompanied by concurrent indicators such as free fluid, hypotension/tachycardia, or concerning changes in fetal heart rate, especially in a patient without risk factors for uterine rupture.

子宫肌瘤大出血导致紧急早产剖宫产:病例报告。
背景 据估计,妊娠期子宫良性肌瘤或子宫肌瘤的发病率为 10%,但目前还没有针对受其影响的妊娠期胎儿或孕产妇监测的指南或建议。妊娠期子宫肌瘤的相关风险包括潜在的疼痛、早产、胎儿生长受限、剖宫产率升高、胎位不正、胎盘早剥和产后出血。病例介绍 本病例描述的是一名 26 岁的孕妇,孕酮为 1.0,在早产时因剧烈腹痛而就诊,被发现患有急腹症,同时伴有不能保证的胎心率追踪。紧急剖宫产后发现,患者因有蒂肌瘤血管破裂而大出血,随后进行了肌瘤切除术。结论 子宫肌瘤出血虽然罕见,但应作为子宫肌瘤妊娠患者腹痛的鉴别诊断之一,尤其是同时伴有游离液体、低血压/心动过速或胎儿心率变化等指标时,特别是对于无子宫破裂危险因素的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
AJP Reports
AJP Reports PEDIATRICS-
CiteScore
2.20
自引率
0.00%
发文量
30
审稿时长
12 weeks
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