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題名 | 懷孕合併恥骨聯合分離=Separation of the Symphysis Pubis during Pregnancy |
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作者 | 黃敏毓; 黃達熾; 蔡鎰和; Huang, Min-yu; Huang, Ta-chih; Tsay, I-hor; |
期刊 | 國防醫學 |
出版日期 | 19990600 |
卷期 | 28:6 1999.06[民88.06] |
頁次 | 頁495-499 |
分類號 | 417.346 |
語文 | chi |
關鍵詞 | 產前恥骨聯合分離; 骨盆腔攝影; 生產; Peripartum symphyseal separation; Pelviography; Delivery; |
中文摘要 | 產前合併恥骨聯合分離的病例並不常見,其發生率從1/521到1/30000 都有文獻報告過,且大部分的病例都發生在妊娠末期或生產當時,黃體素及 弛緩素在妊娠末期分泌增加,促進恥骨聯合彈性以利生產,而有症狀的恥骨 聯合分離通常都大於10mm。發生的原因並不完全了解,相關的可能因素有 生產時快速下降的胎頭、產鉗的使用、胎頭骨盆不對稱、多胎、胎位不正及 先前受傷的骨盆腔。診斷主要是依據臨床症狀,骨盆腔攝影並非絕對必要但 可評估癒後。症狀可持續兩天到八個月不等,但大部分的病例可於八週內緩 解。非手術性保守治療對大多數的病例有效,生產方式則多所爭議。回溯過 去五年國軍左營醫院約4000個生產數�堶情A發現有四個產前恥骨聯合分離 的病例,發生率約1/1000。本文乃病例闡述及文獻回顧。 |
英文摘要 | Peripartum symphyseal separation is an unusual complication with a reported incidence varying between one in 521 to one in 30,000 deliveries. Most cases occurred in late pregnancy or during delivery. Progesterone and relaxin in the last trimester induce progressive relaxation and widening of the symphysis pubis, and symptomatic separation of symphysis bpbis was usually greater than 10mm. The underlying eitology of symptomatic symphyseal separation has not been fully elucidated. Associations with forceful descent of fetal head duing precipitious labor, traumatic forcep delivery, cephalopelvic disproportion, multiparity, abnormal presentation and pre-existing pelvic injury have been suggested as possible etiologies. The diagnosis is most commonly made on the basis of clinical finding. Pelviographic confirmation is not mandatory but may be helpful in assessing recovery. Discomfort may last from 2 days to 8 months, but the majority of cases weill resolve within 8 weeks. Conservative treatment without surgical closure appear to be very effective in all the cases. The management of future deliveries is debatable. A retrospective review of our experience with 4000 deliveries from last five years found 4 cases of peripartum symphyseal sparation, resulting in an incidence of 1 of 1000 deliveries. Details regarding this case series and a review of the literature are presented. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。