Hysterectomy with embryo in utero in a patient with pulmonary thromboembolism: report of a case


Authors

  • Angy Lorena Meneses Parra
  • Miguel Leonardo Arias Duarte UMNG
  • Jhaira Daniela Mosquera Fernández
  • Roberto Gallo Roa
  • José Andrés Valderrama Balaguera

DOI:

https://doi.org/10.22517/25395203.25522

Keywords:

Hysterectomy, Pregnancy, Leiomyomatosis, Indicators of Morbidity and Mortality, Pregnancy Reduction

Abstract

Background:  En bloc hysterectomy is defined as the removal of the pregnant uterus with its gestational content in situ. The indications for performing this en bloc surgery are neoplastic processes, as the most frequent cause; septic processes, trophoblastic disease and hemorrhage secondary to abnormal placental insertion, however, it is a controversial procedure, and with little updated literature.

Clinical case: 45-year-old patient with a pregnancy of 8 weeks and 5 days, with giant uterine myomatosis associated with pulmonary thromboembolism who decided to voluntarily terminate the pregnancy, and it was decided to perform en bloc hysterectomy.

Conclusions: En bloc hysterectomy is a surgery rarely performed at present, however, this surgical approach is a safe and effective option for the voluntary termination of pregnancy, and it should not be ruled out among the surgical treatment alternatives, always individualizing each patient.

Downloads

Download data is not yet available.

References

Ramos GR, Ramírez G, Hurtado G. Indicaciones de histerectomía obstétrica en el Hospital de Ginecología y Obstetricia del Instituto Materno Infantil del Estado del Estado de México del 2007 al 2008. Arch Inv Mat Inf 2010; II(1):11-14).

Tanjona RA, Romuald R, Mahefa R, Housni IA, Martial RA, Mahenina RJ, et al. Emergency peripartum hysterectomy in a tertiary hospital in Antananarivo, Madagascar. Int J Reprod Contracept Obstet Gynecol.[Internet] 2018 [citado 23 Feb 2023]; 7: 4752-7. Disponible en: http://dx.doi.org/10.18203/2320-1770.ijrcog20184542

Casas-Peña RL, Pérez-Varela IL, Chicangana-Figueroa GA. Frecuencia, indicaciones y complicaciones de la histerectomía obstétrica en el Hospital Universitario San José de Popayán, 2006-2010. Estudio de cohorte. Rev. colomb. obstet. ginecol. [Internet] 2013 [citado 28 de junio de 2023];64(2):121-5. Disponible en: https://doi.org/10.18597/rcog.119

Kallianidis AF, Rijntjes D, Brobbel C, Dekkers OM, Bloemenkamp KWM, van den Akker T. Incidence, Indications, Risk Factors, and Outcomes of Emergency Peripartum Hysterectomy Worldwide: A Systematic Review and Meta-analysis. Obstet Gynecol. 2023 Jan 1;141(1):35-48. doi: 10.1097/AOG.0000000000005022

Flood KM, Said S, Gear y M, et al. Changing trends in peripartum hysterectomy over the last 4 decades. Am J Obstet Gynecol. 2009; 200:632. e1-632.e6). https://doi.org/10.1016/j.ajog.2009.02.001

Ramírez B; Bolaños R; Argüelles M; Juárez L; Castelazo E. Histerectomía en bloque. Experiencia institucional de seis años. Ginecol. obstet. Méx; 65(6): 239-42, jun. 1997

Stanco M, Paul H, Mishell R. Emergency peripartum hysterectomy and associated risk factors. Am J Obstet Gynecol. 2003; 168:879-83. https://doi.org/10.1016/S0002-9378(12)90838-8

Bonfante Ramírez E, Bolaños Ancona R, Ambas Argüelles M, Juárez García L, Castelazo Morales E. Histerectomía en bloque. Experiencia institucional de seis años. Ginecol Obstet Mex [Internet]. 1997; 65:239–42.

Mercer LJ, Silver RI, Niemiec TR, Block BS, Hajj SN. Abortion hysterectomy for gynecologic pathology. Am J Obstet Gynecol. 1988 Nov;159(5):1149-53. doi: 10.1016/0002-9378(88)90434-6.

Hibbard LT. Sexual sterilization by elective hysterectomy. Am J Obstet Gynecol. 1972 Apr 15;112(8):1076-83. doi: 10.1016/0002-9378(72)90183-4.

Stumpf PG, Ballard CA, Lowensohn R. Abdominal hysterectomy for abortion-sterilization. A report of 500 consecutive cases. Am J Obstet Gynecol. 1980 Mar 15;136(6):714-20. doi: 10.1016/0002-9378(80)90446-9.

Espinosa Mejía A, Garay Serrano G. “Histerectomía obstétrica de emergencia: prevalencia, morbilidad y mortalidad materna en pacientes atendidas en el hospital de ginecología y obstetricia Imiem durante el periodo de marzo 2010 a febrero 2013”. Tesis de postgrado de Ginecología y Obstetricia. Universidad Central del Ecuador. Enero 2017; Disponible en: http://ri.uaemex.mx/handle/20.500.11799/14585.

Fruscio R, de Haan J, Van Calsteren K, et al. Cáncer de ovario en el embarazo. Best Pract Res Clin Obstet Gynaecol 2017; 41 :108–17. doi: 10.1016/j.bpobgyn.2016.09.013.

Bagot CN, et al. Virchow and his triad: a question of attribution. Br J Haemotol 2008t;143(2):180-90. https://doi.org/10.1111/j.1365-2141.2008.07323.x.

Fletcher H, et al. Venous thromboembolism as a complication of uterine fibroids: A retrospective descriptive study. J Obstet Gyneacol 2009;29(8):732-736. https://doi.org/10.3109/01443610903165545.

Rubinstein LM, Lebherz TB, Kleinkopf V. Sterilization and menstrual disturbances. JAMA. 1977 Oct 31;238(18):1913. doi: 10.1001/jama.1977.03280190015008.

Downloads

Published

2024-07-17

How to Cite

Meneses Parra, A. L. ., Arias Duarte, M. L., Mosquera Fernández , J. D. ., Gallo Roa, R. ., & Valderrama Balaguera, J. A. . (2024). Hysterectomy with embryo in utero in a patient with pulmonary thromboembolism: report of a case. Revista Médica De Risaralda, 30(1), 175–184. https://doi.org/10.22517/25395203.25522