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KMID : 1143220180610050621
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Obstetrics & Gynecology Science
2018 Volume.61 No. 5 p.621 ~ p.625
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Incarceration of early gravid uterus with adenomyosis and myoma: report of two patients managed with uterine reduction
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Kim Hee-Sun
Park Ji-Eun
Kim Seo-Yeon
Kim Jung-Eun
Chae Su-Hyun
Sohn In-Sook
Hwang Han-Sung
Kwon Han-Sung
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Abstract
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Although gravid uterine incarceration is typically diagnosed during the early second trimester, we encountered two unusual cases in early pregnancy. A 34-year-old multiparous woman with adenomyosis presented at 7 + 2 weeks of gestation with increased urinary frequency and a sensation of incomplete bladder emptying. The uterine incarceration was successfully reduced by manual reduction and pessary insertion, and she delivered a normal infant at term. In the second case, a 31-year-old nulliparous woman with a large myoma complained of dysuria, acute urinary retention, and intense back pain at 6 weeks of gestation. Manual reduction was successful in the knee-chest position. Subsequent pessary insertion failed; however, a slight reduction in pain was achieved. After a week, the fetus spontaneously aborted. In summary, gravid uterine incarceration is a rare but potentially fatal condition for the fetus, and a suspicion of this condition in patients with urinary symptoms, especially urinary retention and pelvic pain, is important in the early gestation period.
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KEYWORD
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Uterine disease, Myoma, Retroversion, Pregnancy
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