Incarceration of early gravid uterus with adenomyosis and myoma: report of two patients managed with uterine reduction
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Although gravid uterine incarceration is typically diagnosed during the early second trimester, we encounteredtwo unusual cases in early pregnancy. A 34-year-old multiparous woman with adenomyosis presented at 7 + 2weeks of gestation with increased urinary frequency and a sensation of incomplete bladder emptying. The uterineincarceration was successfully reduced by manual reduction and pessary insertion, and she delivered a normal infantat term. In the second case, a 31-year-old nulliparous woman with a large myoma complained of dysuria, acuteurinary retention, and intense back pain at 6 weeks of gestation. Manual reduction was successful in the knee-chestposition. Subsequent pessary insertion failed; however, a slight reduction in pain was achieved. After a week, thefetus spontaneously aborted. In summary, gravid uterine incarceration is a rare but potentially fatal condition for thefetus, and a suspicion of this condition in patients with urinary symptoms, especially urinary retention and pelvic pain,is important in the early gestation period.
Abstract
Although gravid uterine incarceration is typically diagnosed during the early second trimester, we encounteredtwo unusual cases in early pregnancy. A 34-year-old multiparous woman with adenomyosis presented at 7 + 2weeks of gestation with increased urinary frequency and a sensation of incomplete bladder emptying. The uterineincarceration was successfully reduced by manual reduction and pessary insertion, and she delivered a normal infantat term. In the second case, a 31-year-old nulliparous woman with a large myoma complained of dysuria, acuteurinary retention, and intense back pain at 6 weeks of gestation. Manual reduction was successful in the knee-chestposition. Subsequent pessary insertion failed; however, a slight reduction in pain was achieved. After a week, thefetus spontaneously aborted. In summary, gravid uterine incarceration is a rare but potentially fatal condition for thefetus, and a suspicion of this condition in patients with urinary symptoms, especially urinary retention and pelvic pain,is important in the early gestation period.
참고문헌 (14)
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