Ohta Naomi, Hasegawa Keita, Suenaga Kaori, Mochimaru Yoshiyuki, Arase Toru
Department of Obstetrics and Gynecology, Keiyu Hospital, Yokohama, JPN.
Cureus. 2025 Jul 16;17(7):e88124. doi: 10.7759/cureus.88124. eCollection 2025 Jul.
Placental attachment spanning from the anterior to the posterior uterine wall, resulting in the formation of two uterine cavities, presents a diagnostic challenge in obstetrics. Differential diagnoses include placental abruption, multiple gestations, placental variations, and uterine anomalies. Accurate prenatal identification is often difficult, especially when anomalies are not detected during early pregnancy. We report a rare case of a 27-year-old primigravid Japanese woman with a placenta spanning from the anterior to the posterior uterine wall, creating two cavities. At 35 weeks of gestation, ultrasound suggested an unusual placental position, with fetal parts located in separate cavities. At 37 weeks and three days, a cesarean section was performed for breech presentation. Intraoperatively, a partial uterine septum was palpated postplacental removal, with a planar fundus and no retroplacental hematoma. Postoperative ultrasound confirmed the diagnosis of a partial septate uterus. Although septate uterus is the most common uterine anomaly, it often remains undiagnosed in women without infertility. This case highlights the importance of considering uterine anomalies when placental morphology is atypical, especially in the absence of a prior diagnosis, as early recognition is crucial for appropriate perinatal management.
胎盘附着横跨子宫前壁至后壁,导致形成两个子宫腔,这在产科诊断中是一项挑战。鉴别诊断包括胎盘早剥、多胎妊娠、胎盘变异和子宫畸形。准确的产前诊断往往很困难,尤其是在孕早期未检测到异常时。我们报告了一例罕见病例,一名27岁的初产妇日本女性,其胎盘横跨子宫前壁至后壁,形成两个腔隙。妊娠35周时,超声提示胎盘位置异常,胎儿部分位于不同腔隙。妊娠37周零三天时,因臀位行剖宫产术。术中,胎盘取出后可触及部分子宫纵隔,子宫底部平坦,无胎盘后血肿。术后超声确诊为部分纵隔子宫。虽然纵隔子宫是最常见的子宫畸形,但在无不孕的女性中往往未被诊断。该病例强调了在胎盘形态不典型时,尤其是在未事先诊断的情况下,考虑子宫畸形的重要性,因为早期识别对于适当的围产期管理至关重要。