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应对和处理苗勒管异常中的意外妊娠:病例系列

Anticipating and Executing off Beat Pregnancies in Müllerian Duct Anomalies: A Case Series.

作者信息

Koya Satyasri, Radhakrishnan Krishnapriya, Ravikumar Sanjitha, Kaul Somika, Desai Archie

机构信息

Department of Obstetrics & Gynecology, KS Hegde Medical Academy (NITTE Deemed to be University) Mangalore, Karnataka, India.

Department of Obstetrics & Gynecology, Vydehi Institute of Medical Sciences & Research Center, Bangalore, Karnataka, India.

出版信息

J Family Reprod Health. 2024 Sep;18(3):200-205. doi: 10.18502/jfrh.v18i3.16663.

Abstract

OBJECTIVE

Müllerian duct Anomalies (MDA) are rare but well-known entity. Most of the MDAs are asymptomatic, and are undiagnosed; However, MDAs may present with infertility, bad obstetric history or other associated anomalies which further fuel the suspicion of MDAs. This case series comprises of 6 problem-pregnancies, their course and management.

CASE REPORT

Primigravida with bicornuate uterus presented at 23 weeks with hand prolapse, requiring hysterotomy. A G2P1L0 presented at 36 weeks with footling presentation, managed by a preterm CS. Primigravida presented at 24 weeks with Didelphys uterus with partial longitudinal vaginal septum, needing hysterotomy. Primigravida at 37 weeks presented with abruptio placenta, managed by CS.

CONCLUSION

Though the incidence of MDAs is low, but the outcomes can be rather distressing for both mother and fetus. Once identified, adverse outcomes must be anticipated and prepared for, and these are best managed at tertiary hospitals. Apart from counselling we should also meticulously document, improve awareness regarding MDAs and their outcomes. Early diagnosis and timely management can hit the jackpot in terms of pregnancy outcomes.

摘要

目的

苗勒管异常(MDA)较为罕见但广为人知。大多数MDA无症状且未被诊断;然而,MDA可能表现为不孕、不良产科病史或其他相关异常,这进一步引发了对MDA的怀疑。本病例系列包括6例妊娠问题及其病程和处理。

病例报告

初产妇,双角子宫,孕23周时出现手脱垂,需行子宫切开术。一名孕2产1未育孕妇,孕36周时出现足先露,行早产剖宫产。初产妇,孕24周时诊断为双子宫伴部分纵向阴道纵隔,需行子宫切开术。初产妇,孕37周时出现胎盘早剥,行剖宫产。

结论

尽管MDA的发生率较低,但对母亲和胎儿而言,其结局可能相当令人苦恼。一旦确诊,必须对不良结局进行预测并做好准备,最好在三级医院进行处理。除了提供咨询外,我们还应仔细记录,提高对MDA及其结局的认识。早期诊断和及时处理在妊娠结局方面可能会取得成功。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bef/11491699/013af1230829/JFRH-18-200-g001.jpg

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