国际妇产科学杂志 ›› 2025, Vol. 52 ›› Issue (4): 402-404.doi: 10.12280/gjfckx.20250155

• 产科生理及产科疾病:病例报告 • 上一篇    下一篇

非瘢痕子宫妊娠合并子宫、卵巢破裂一例

马玲, 李亚西, 赵敏, 王静(), 李红丽   

  1. 730000 兰州大学第一临床医学院(马玲,李亚西,赵敏); 兰州大学第一医院产科(王静,李红丽)
  • 收稿日期:2025-02-19 出版日期:2025-08-15 发布日期:2025-09-08
  • 通讯作者: 王静,E-mail:wjdyx2008@126.com

Non-Scarred Uterine Pregnancy with Concurrent Uterine and Ovarian Rupture: A Case Report

MA Ling, LI Ya-xi, ZHAO Min, WANG Jing(), LI Hong-li   

  1. The First School of Clinical Medicine of Lanzhou University, Lanzhou 730000, China (MA Ling, LI Ya-xi, ZHAO Min); Department of Obstetrics, The First Hospital of Lanzhou University, Lanzhou 730000, China (WANG Jing, LI Hong-li)
  • Received:2025-02-19 Published:2025-08-15 Online:2025-09-08
  • Contact: WANG Jing, E-mail: wjdyx2008@126.com

摘要:

子宫破裂是一种严重的产科急症,具有起病急、进展快、母婴病死率高等特点。子宫破裂最常见的因素是瘢痕子宫,既往无手术史却于妊娠晚期发生子宫、卵巢破裂极为罕见。报告1例高龄孕妇非瘢痕子宫妊娠合并子宫、卵巢破裂的诊治过程,强调了非瘢痕子宫、卵巢破裂的特殊机制,包括高龄妊娠、强直性脊柱炎病史及长期使用糖皮质激素等因素对子宫肌层的影响,同时突出了早期诊断和及时治疗是改善预后的关键,以及多学科协作在急诊处理中的重要性,为临床上非瘢痕子宫妊娠合并子宫、卵巢破裂患者的提早预判、合理治疗提供参考,避免不良妊娠结局的发生。

关键词: 妊娠并发症, 子宫破裂, 脊柱炎, 强直性, 病例报告, 非瘢痕妊娠, 卵巢破裂

Abstract:

Uterine rupture is a critical obstetric emergency characterized by sudden onset, rapid progression, and high maternal-fetal mortality. While the most common predisposing factor is a scarred uterus, spontaneous uterine and ovarian rupture in late pregnancy without prior surgical history is exceedingly rare. This report describes the diagnosis and management of a non-scarred uterine pregnancy with concurrent uterine and ovarian rupture in an advanced-age patient. The case highlights unique mechanisms of rupture in non-scarred uteri, including advanced maternal age, history of ankylosing spondylitis, and long-term glucocorticoid use, all of which may compromise uterine myometrial integrity. Early diagnosis and immediate intervention were pivotal in improving outcomes, underscoring the importance of multidisciplinary collaboration in emergency obstetric care. This case provides clinical insights into early risk stratification and optimal management of non-scarred uterine rupture to prevent adverse pregnancy outcomes.

Key words: Pregnancy complications, Uterine rupture, Spondylitis, ankylosing, Case reports, Non-scar pregnancy, Ovarian rupture