Uterus rüptürü gelişen 3 olguda konservatif tedavi ve sonuçları ile birlikte literatür derlemesi

Year 2023, Volume: 6 Issue: 1, 81 - 89, 09.06.2023

İsa Kaplan

Abstract

2019-2021 Yılları arasında hastanemizde konservatif olarak tedavi edilen 3 uterus rüptürü olgusu sunulacaktır. Olgu 1 29 yaşında 5. Gebeliği olup daha önce 3 sezaryen öyküsü mevcuttur. Olgu 2 27 yaşında 4. Gebeliği olup daha önce 2 sezaryen öyküsü mevcuttur. Olgu 3 22 yaşında olup daha önce 1 sezaryen öyküsü mevcuttur. Her üç olgu komplet uterin rüptür meydana gelmiştir. Her üç olguda bebek batından çıkarılmıştır. 3 bebek canlı doğurtulmuş fakat bir bebek başka bir merkeze sevk edildikten sonra ex olmuştur. Anne ölümü olmamıştır. Olgu 1 hasta aile baskısı ile evde doğum denemiştir. Olgu 2 EDT nedeniyle takip edilirken aniden rüptür olmuştur. Olgu 3 hastaneye geldiği anda rüptür saptanmıştır. Olgu 1’ de ayrıca uterin rüptüre mesane rüptürüde eşlik etmektedir. Her üç olguya bilateral uterin arter ligasyonu, bilateral ovaryen arter ligasyonu, retroperitona ilerleyen hematomun stabillenmesi, primer uterin onarım ve peritonizasyon işlemleri yapılmıştır. Olgu 1’ de gelişen mesane hasarı primer onarılmış fakat sonrasında kaçak olması üzerine tekrar opere edilmiştir. Olgu 1’ de atoni olması üzerine uterin balon tamponad konulmuştur. Her üç olguda uterus korunmuş ve hastalar sağlıklı bir şekilde taburcu edilmiştir.

Keywords

Uterus Rüptürü, Sezaryen, Gebelikte Kanama, Obstetrik Acil

A literature review with conservative treatment and results in 3 cases of uterine rupture

Abstract

Three cases of uterine rupture conservatively treated in our hospital between 2019-2021 will be presented. Case 1 is 29 years old and has 5th pregnancy and has 3 previous cesarean sections. Case 2 is 27 years old and has 4th pregnancy. She has a history of 2 previous cesarean sections. Case 3 is 22 years old and has a previous cesarean section history. Complete uterine rupture occurred in all three cases. The baby was removed from the abdomen in all three cases. 3 babies were delivered live but one baby died after being transferred to another center. No maternal death occurred. Case 1 patient tried home delivery under family pressure. Case 2 suddenly ruptured while being followed up for EDT. Rupture was detected as soon as case 3 came to the hospital. In Case 1, uterine rupture is also accompanied by rupture of the bladder. Bilateral uterine artery ligation, bilateral ovarian artery ligation, stabilization of hematoma progressing to the retroperitoneum, primary uterine repair and peritonization procedures were performed in all three cases. The bladder damage that developed in Case 1 was primarily repaired, but it was re-operated due to leakage. In case 1, uterine balloon was placed due to atony. In all three cases, the uterus was preserved and the patients were discharged in good health.

Keywords

Uterine Rupture, Cesarean Section, Bleeding During Pregnancy, Obstetrics Emergency

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