Clinical features of ectopic decidua in term gestation
10.11659/jjssx.08E018030
- VernacularTitle:盆腔异位蜕膜在足月剖宫产术中的临床特征分析
- Author:
Bi-Hui BAO
1
;
Ling YANG
;
Shi-Yong LU
;
Fang HE
;
Li-Mei CHEN
;
Li-Li CAO
;
Chun-Dong LU
Author Information
1. 成都市青白江区妇幼保健院妇产科
- Keywords:
ectopic decidua;
caesarean section;
postpartum hemorrhage;
uterus
- From:
Journal of Regional Anatomy and Operative Surgery
2018;27(10):734-737
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the biological behavior and pathologic mechanism of ectopic decidua hemorrhage or acute postpartum hemorrhagic deciduosis caused by typical decidua tissue outside the uterine cavity under the influence of ovarian and placental hormones,and provide reference for accurate diagnosis and effective treatment. Methods From August 2017 to January 2018,there were 461 term-pregnant women undergoing ceasarian section in maternal and child health hospital of Qingbaijiang district,of whom 3 cases with ectopic deciduas were diagnosed.The clinical characteristics and microscopic features of 3 cases were retrospectively analyzed.The risk assessment to human health as well as effective control measures of ectopic deciduas were further elucidated along with the relevant references. Results Three patients with ectopic decidua generally had no obvious clinical symptoms or endometriosis,though dysmenorrheal and infertility might happen before pregnancy.Only an intraoperative incidentally finding of specific lesions varied from vacuolar plaques, hyperemia,vascular nodules, solid nodules and local hemorrhagic change.Under light microscope, the decidualized stroma revealed large polygonal cell aggregates, without nu-clear atypia.Due to the clinical features of abnormal angiogenesis and inflammatory reactions, ectopic decidua may cause severe cases such as acute postpartum hemorrhagic deciduosis,which could provide a basis for clinical comprehensive understanding and scientific prevention and treatment.Conclusion Ectopic decidua can happen in uterine seromuscular layers,ovary,great epiploon,cervix,vagina and so on,which is easy to be misdiagnosed or fails to be examined due to asymptom and nonspecific physical signs.It hasn’t been unequivocally clarified and widely recognized,nor earned extensively considered for rarely life-threatening haemorrhagic deciduosis in the prepartum and postpartum peri-od,which must be taken effective first-aid measures such as surgical intervention to protect maternal-fetal health.
