Uncontrollable uterine atony after replacement of uterine inversion managed by hysterectomy: a case report.

説明

type:Journal Article

Background:Uterine inversion may cause massive hemorrhage, resulting in maternal deterioration and death. Replacement of the inverted uterus must be performed as soon as possible. As time passes, the inverted uterus becomes atonic and necrotic, and a surgical approach may be required.

Case presentation:A 27-year-old Japanese woman was admitted to our hospital 4 hours postpartum with increased hemorrhage after the replacement of an inverted uterus. Recurrent inversion was diagnosed, and though the atonic uterus was replaced again by the Johnson maneuver, hemorrhage persisted. Balloon tamponade was not successful in stopping the hemorrhage, and uterine artery embolization was performed. Bleeding resumed the next day on removal of the balloon, and hysterectomy was performed. Massive hemorrhage, coagulopathy, and uterine necrosis caused uterine atony, and the reperfused blood flow on replacement of the ischemic uterus increased hemorrhage.

Conclusions:Cases of uterine inversion with coagulopathy lasting for more than 4 hours may require a surgical intervention, and uterine replacement may have to be delayed until the maternal hemodynamic condition is stabilized. Uterine replacement under laparotomy may be also be considered due to the risk of increased hemorrhage.

source:http://www.ncbi.nlm.nih.gov/pmc/articles/pmc7542967/

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詳細情報 詳細情報について

  • CRID
    1050004953560489216
  • NII論文ID
    120006894399
  • Web Site
    http://hdl.handle.net/10422/00012826
  • 本文言語コード
    ja
  • 資料種別
    journal article
  • データソース種別
    • IRDB
    • CiNii Articles

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