A Case of Preeclampsia with Uterine Necrosis after Uterine Artery Embolization for Postpartum Hemorrhage

IF 0.6 Q4 OBSTETRICS & GYNECOLOGY
Midori Yoshikawa, T. Seyama, T. Iriyama, S. Sayama, T. Fujii, Masatake Toshimitsu, Moto Nakaya, R. Kurokawa, Eisuke Shibata, T. Watadani, K. Kumasawa, T. Nagamatsu, K. Koga, Y. Osuga
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引用次数: 1

Abstract

Uterine necrosis is a rare complication in uterine artery embolization (UAE) for postpartum hemorrhage (PPH). Preeclampsia (PE) is a condition characterized with systemic endothelial damage and intravascular volume depletion. Whether a patient with PE is at high risk for uterine necrosis after UAE for PPH has been unknown. A 30-year-old primipara woman was diagnosed with PE based on hypertension and proteinuria during delivery. UAE was performed for PPH after forceps delivery. After UAE, the patient presented with pleural effusion and massive ascites as well as persistent fever unresponsive to antibiotics. Ultrasonography and contrast-enhanced magnetic resonance imaging (MRI) led to the diagnosis of uterine necrosis, for which we performed total laparoscopic hysterectomy. It should be kept in mind that patients with PE associated with massive ascites may be at high risk for uterine necrosis after UAE due to decreased uterine perfusion. Therefore, it is important to pay attention to persistent symptoms such as fever and abdominal pain after UAE to diagnose uterine necrosis.
子宫动脉栓塞治疗产后出血后子痫前期合并子宫坏死1例
子宫坏死是子宫动脉栓塞治疗产后出血(PPH)的一种罕见并发症。先兆子痫(PE)是一种以全身内皮损伤和血管内容量减少为特征的疾病。PE患者在PPH UAE后是否有子宫坏死的高风险尚不清楚。一位30岁初产妇在分娩时因高血压和蛋白尿被诊断为PE。产钳分娩后PPH行UAE。UAE后,患者出现胸腔积液和大量腹水以及持续发热,对抗生素无反应。超声检查和增强磁共振成像(MRI)导致子宫坏死的诊断,为此我们进行了全腹腔镜子宫切除术。需要注意的是,PE合并大量腹水的患者,由于子宫灌注减少,UAE后子宫坏死的风险较高。因此,要注意UAE后持续出现发热、腹痛等症状,以诊断子宫坏死。
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来源期刊
Case Reports in Obstetrics and Gynecology
Case Reports in Obstetrics and Gynecology Medicine-Obstetrics and Gynecology
CiteScore
1.30
自引率
0.00%
发文量
64
审稿时长
12 weeks
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