Clinical analysis of massive intraperitoneal hemorrhagic shock in early pregnancy complicated with myoma caused by mifepristone
10.3760/cma.j.cn101441-20210903-00386
- VernacularTitle:对米非司酮致早孕合并子宫肌瘤患者腹腔内大出血休克病例临床分析
- Author:
Chunyan XUE
1
;
Hui WANG
;
Yun XU
;
Wenfeng YE
;
Zonghao ZHU
;
Chun QIU
;
Dan LUO
;
Hongyan GAO
Author Information
1. 苏州大学附属第三医院妇产科，常州 213003
- Publication Type:Journal Article
- Keywords:
Mifepristone;
Early pregnancy;
Giant uterine leiomyoma;
Hemorrhagic shock
- From:
Chinese Journal of Reproduction and Contraception
2022;42(12):1280-1283
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze and summarize the experience and shortcomings of this case in the process of abortion diagnosis and treatment of early pregnancy patients with hysteromyoma.Methods:A case of early pregnancy complicated with huge hysteromyoma was reported. The patient was planned to perform assisted uterine curettage after drug flow.Results:On the second day after taking mifepristone, the patient suddenly suffered from severe lower abdominal pain and less to moderate amount of ascites in the abdominal cavity. "Blood abdomen to be investigated: ectopic pregnancy? Spleen rupture? Hemorrhagic shock". The shock was corrected and exploratory laparotomy was performed at the same time. Repeated exploration of the pelvis and abdomen revealed no obvious bleeding point. During the operation, a small amount of blood was found in the vagina, and the villi were discharged automatically, so the uterus was cleared. The final consideration was that the bleeding was caused by the backflow of intrauterine bleeding to the abdominal cavity.Conclusion:Early pregnancy with hysteromyoma belongs to the category of high-risk abortion, especially hysteromyoma larger than 5 cm. Such patients need to strictly grasp the indications of drug abortion, and strengthen monitoring and management to avoid serious complications such as hemorrhagic shock.
