RESUMO
Post-partum haemorrhage (PPH) is a major cause of maternal mortality, according to the WHO. Early PPH occurs in 5% to 15% of births. In 80% of cases, uterine atonia is the cause. We describe a case of uterine necrosis following uterine artery embolization (UAE). due to PPH. The patient was a 37-year-old woman who had a normal delivery after her second pregnancy, but experienced haemorrhage due to uterine atonia that failed to respond to drugs. She underwent UAE with Spongostan® with no complications. The peri-partum period was normal. At 16 days, she consulted due to recurrence of fever. Magnetic resonance imaging confirm the diagnosis of uterine necrosis. Abdominal hysterectomy was performed.
Assuntos
Necrose , Hemorragia Pós-Parto/terapia , Embolização da Artéria Uterina/efeitos adversos , Útero/patologia , Adulto , Feminino , Humanos , Histerectomia , Imageamento por Ressonância Magnética , Hemorragia Pós-Parto/etiologia , Gravidez , Inércia UterinaAssuntos
Carcinossarcoma/diagnóstico , Neoplasias Peritoneais/diagnóstico , Dor Abdominal , Idoso , Carcinossarcoma/complicações , Carcinossarcoma/patologia , Colonoscopia , Evolução Fatal , Feminino , Gastroscopia , Humanos , Tumor Mulleriano Misto/diagnóstico , Tumor Mulleriano Misto/patologia , Neoplasias Peritoneais/complicações , Neoplasias Peritoneais/patologia , Embolia Pulmonar/complicações , Tomografia Computadorizada por Raios X , Trombose Venosa/complicaçõesRESUMO
Objetivo. Exponer el caso de una gestante que presentó un hematoma espontáneo de cordón umbilical, así como revisión de la literatura. Sujetos y métodos Primigesta, sin antecedentes de interés, con control gestacional normal, que ingresó por fase latente de parto. La MNE fue no satisfactoria, realizándose una cesárea de urgencia. Resultados. Nacimiento de una mujer de 3.050g, Apgar 1/3, que ingresó en la UCI y fue dada de alta con diagnóstico de encefalopatía hipóxico-isquémica. Conclusiones. La presencia de un patrón de monitorización fetal no satisfactorio debe alertar hacia la patología de cordón umbilical, debiéndose revisar este histológicamente (AU)
Objective. To present the case of a pregnant woman with a spontaneous umbilical cord hematoma and to provide a review of the literature. Subjects and methods. A primigravida, with no antecedents of interest and uneventful pregnancy, was admitted to our hospital in the latent phase of labor. Cardiotocography was unsatisfactory, and an urgent cesarean section was performed. Results. A 3050g girl was born, with an Apgar score of 1/3, and was admitted to the intensive care unit. The neonate was discharged with a diagnosis of hypoxic-ischemic encephalopathy. Conclusions. Umbilical cord abnormalities should be suspected when the results of fetal monitoring are unsatisfactory. Histological analysis of the umbilical cord should be performed (AU)
Assuntos
Humanos , Feminino , Gravidez , Adulto , Hematoma/complicações , Hematoma/diagnóstico , Cordão Umbilical/patologia , Cordão Umbilical , Hipóxia-Isquemia Encefálica/complicações , Hipóxia-Isquemia Encefálica/diagnóstico , Monitorização Fetal/instrumentação , Monitorização Fetal/métodos , Monitorização Fetal , Fatores de Risco , Hematoma , Hipóxia-Isquemia Encefálica/fisiopatologia , Hipóxia-Isquemia Encefálica , Monitorização Fetal/tendências , Cesárea/métodos , Corioamnionite/fisiopatologia , Corioamnionite , /instrumentaçãoRESUMO
La torsión uterina es un evento raro, más aún cuando se produce en ausencia de embarazo. Se define como una rotación de más de 45° sobre el eje longitudinal uterino, y habitualmente tiene lugar a lo largo de la transición entre cuerpo y cérvix. En 2 tercios de los casos se produce hacia el lado derecho. Normalmente, está causada por la presencia de una condición anormal o patología que afecta al útero y/o a las estructuras adyacentes. Las manifestaciones clínicas pueden ser agudas, crónicas, o incluso un cuadro asintomático, constituyendo entonces un hallazgo intraoperatorio. La confirmación diagnóstica se realiza únicamente durante la realización de la laparotomía. La congestión de vasos en el ligamento ancho y la colocación anterior de los ovarios, hacen que la histerotomía baja realizada habitualmente en la cesárea no pueda realizarse en determinadas situaciones, optando por una histerotomía clásica en la superficie posterior del útero (AU)
Uterine torsion is a rare event, especially in the absence of pregnancy. This complication is defined as a rotation of more than 45° around the long axis of the uterus and usually occurs along the transition between the body and the cervix. In two thirds of cases, the torsion is toward the right side. This event is usually caused by the presence of an abnormal condition that affects the uterus and/or the adjacent structures. Clinical manifestations may be acute or chronic, or even entirely absent, in which case the torsion is identified as an intraoperative finding. The diagnosis can only be confirmed during laparotomy. Because of vessel congestion in the broad ligament and the anterior position of the ovaries, low hysterotomy, usually performed at cesarean section, cannot be carried out in certain situations. Instead classical hysterotomy on the posterior surface of the uterus is performed (AU)
