Incarceration of early gravid uterus with adenomyosis and myoma: report of two patients managed with uterine reduction.
10.5468/ogs.2018.61.5.621
- Author:
Hee Sun KIM
1
;
Ji Eun PARK
;
Seo Yeon KIM
;
Jung Eun KIM
;
Su Hyun CHAE
;
In Sook SOHN
;
Han Sung HWANG
;
Han Sung KWON
Author Information
1. Department of Obstetrics and Gynecology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
- Publication Type:Case Report
- Keywords:
Uterine disease;
Myoma;
Retroversion;
Pregnancy
- MeSH:
Adenomyosis*;
Adult;
Back Pain;
Dysuria;
Female;
Fetus;
Humans;
Infant;
Knee-Chest Position;
Myoma*;
Pelvic Pain;
Pessaries;
Pregnancy;
Pregnancy Trimester, Second;
Sensation;
Urinary Bladder;
Urinary Retention;
Uterine Diseases;
Uterus*
- From:Obstetrics & Gynecology Science
2018;61(5):621-625
- CountryRepublic of Korea
- Language:English
-
Abstract:
Although gravid uterine incarceration is typically diagnosed during the early second trimester, we encountered two unusual cases in early pregnancy. A 34-year-old multiparous woman with adenomyosis presented at 7 + 2 weeks of gestation with increased urinary frequency and a sensation of incomplete bladder emptying. The uterine incarceration was successfully reduced by manual reduction and pessary insertion, and she delivered a normal infant at term. In the second case, a 31-year-old nulliparous woman with a large myoma complained of dysuria, acute urinary retention, and intense back pain at 6 weeks of gestation. Manual reduction was successful in the knee-chest position. Subsequent pessary insertion failed; however, a slight reduction in pain was achieved. After a week, the fetus spontaneously aborted. In summary, gravid uterine incarceration is a rare but potentially fatal condition for the fetus, and a suspicion of this condition in patients with urinary symptoms, especially urinary retention and pelvic pain, is important in the early gestation period.
