頁籤選單縮合
題名 | Cervical Incompetence: A Case Report=子宮頸閉鎖不全:病例報告 |
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作者姓名(中文) | 王如民; 黃千祝; 周松男; | 書刊名 | 中華民國婦產科醫學會會刊雜誌 |
卷期 | 38:2 1999.06[民88.06] |
頁次 | 頁57-62 |
分類號 | 417.3 |
關鍵詞 | 子宮頸閉鎖不全; 子宮頸環紮術; 麥當勞式環紮術; Cervical incompetence; Cervical cerclage; McDonald suture; |
語文 | 英文(English) |
中文摘要 | 背景:報告一個在初次妊娠診斷為子宮頸閉鎖不全經成功治療並足月生產之病例。 病例報告:一位二十四歲第一次懷孕的孕婦於妊娠第二十五週時被診斷為子宮頸閉鎖不 全,經絕對臥床休息一週後,在麻醉下施以行子宮頸環紮術,術後並給予安胎藥物使用。之 後產婦狀況穩定,並於妊娠第三十七週順利生產。 結論:對一位初次妊娠的產婦,詳細的病史問診,謹慎的骨盆腔內診,以及超音波檢查 對於診斷子宮頸閉鎖不全有很大的幫肋。完全臥床休息,小心施以子宮頸環紮術,並配合安 胎藥物的使用及定期的追蹤,可以得到最好的妊娠結果。 |
英文摘要 | Background: The occurrence of cervical incompetence in first parity is rare. The purpose of this article is to report on a primigravida woman with cervical incompetence that was diagnosed at 26 weeks of gestation and successfully treated using the McDonald suture. Case report: A 24-year-old, gravida-1-para-0 woman presented with vaginal spotting at 21 weeks of gestation. She visited a local hospital and transvaginal sonography revealed funneling of internal os. After complete bed rest, the symptoms improved. When she returned to a clinic at 25 weeks of gestation, however, the cervical os was dilated and fetal membranes had progressively protruded. She was then referred to our department for further evaluation and management. No evidence of preterm labor was encountered. Despite absolute bed rest in the Trendelenberg position, the dilated os and protruding membranes did not regress We preformed a McDonald suture for her with double-nylon sutures under sonar guidance at the gestational age of 26 weeks. The post-operative course was smooth. The suture was removed at 35 weeks and she delivered a viable female baby weighing 2818 gm via vaginal route at the gestational age of 37 weeks. Conclusion: The diagnosis of cervical incompetence relies on detailed review of the obstetric and gynecologic histories, appropriate physical examinations, and ultrasonography. In our patient, cervical incompetence occurred in the first pregnancy due to unknown etiology. Absolute bed rest, meticulous suture placement, aggressive tocolysis after cerclage may lead to a favorable outcome even in the presence of significantly dilated os and protruding membranes. |
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