Clinical Analysis of Uterine Rupture in Intrauterine Pregnancy after Laparoscopic Salpingectomy or Transection

YI Xiling; SUN Jianhua

doi:10.3969/j.issn.1672-7185.2019.01.017

Abstract：Objective To analyze the causes,clinical characteristics and prognosis of uterine rupture in intrauterine pregnancy after laparoscopic salpingectomy or transection,so as to provide reference for clinical diagnosis and treatment.Methods The clinical data of uterine rupture in intrauterine pregnancy after laparoscopic salpingectomy and transection from January 2000 to September 2018 were retrospectively analyzed.Results A total of 22 cases were collected,including 2 cases treated in our hospital and 20 cases retrieved from literature.15 cases had lower abdominal pain,1 case had anal swelling,2 cases had decreased amniotic fluid detected by ultrasonography,and the other 4 cases had no obvious clinical symptoms.Except 1 case did not describe the specific time interval of intrauterine pregnancy again,the other 21 cases were 3 weeks to 4 years after operation.Among them,13 cases occurred within one year after operation,5 cases occurred within one to two years after operation,and 3 cases occurred two years after operation.In previous operations,15 cases were treated with wound electrocoagulation hemostasis,2 cases were treated with electrocoagulation combined with local suture,and the other patients did not mention the specific treatment measures.Of the 22 cases,13 cases had intrauterine fetal death,3 cases had neonatal asphyxia,and the other neonates were in good condition.All cases had no maternal death.Conclusion The risk of uterine rupture is relatively high for women with intrauterine pregnancy again after laparoscopic salpingectomy or transection.Patients with fallopian tube diseases who need pregnancy should be well guided,carefully select the surgical methods,strengthen management during intrauterine pregnancy again,and be alert to the occurrence of uterine rupture.