Abstract:

In recent years, the incidence of uterine adhesion is on the rise. A case of full-term pregnancy with uterine cavity adhesion "wall" (about 2.5 cm thick) was reported. The patient was admitted to hospital for 36⁺² weeks of gestation and irregular abdominal pain for more than 3 hours. The patient had a history of 2 cesarean sections and 1 uterine curettage. Multiple ultrasound during pregnancy revealed heterogeneous echoes in the lower segment of the uterus, which had been diagnosed as placenta previa. After admission, cesarean section was performed due to scar uterus. During the operation, a cavity was found in the lower segment of the uterus, which was about 12 cm × 6 cm×4 cm. The top of the cavity was curved from right to left, which was muscular tissue, and no pregnancy was found in the cavity. After switching to the "inverted T" incision of the uterus and thoroughly cutting open the muscular tissue at the top of the lacuna, the amniotic sac of pregnancy was seen. After the fetus was removed, the placenta was found in the posterior wall of the uterus, covering the muscular tissue (adhesion "wall") down to the anterior wall. After artificial exfoliation of the placenta, the muscular adhesion "wall" was removed and the uterine anatomy was restored. The patient recovered well after operation. Through reviewing this case and summing up the experience, the understanding of uterine cavity adhesion will be strengthen for clinical and ultrasonic doctors.

Key words: Uterine diseases, Tissue adhesions, Pregnancy, Diagnosis, Ultrasonography, Case reports