Adenomyosis interna bei schwerster Blutung in der Nachgeburtsperiode und post partum

Alfred Szenes
In: Archiv für Gynäkologie · 1928 · vol. 134(3) , pp. 546–560 · doi:10.1007/bf01701608 · W1964437773
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A woman experiencing severe postpartum hemorrhage required a hysterectomy, revealing adenomyosis interna associated with significant decidual reaction and uterine atony.

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The paper describes a case report of a 40-year-old first-time mother who experienced severe bleeding in the placental period and postpartum, requiring blood transfusion and ultimately vaginal uterine extirpation. Pathological examination found a markedly enlarged, lax uterus with extensive adenomyosis interna at the placental site, penetrating about one-third of the uterine wall cross-section and accompanied by a strong, especially in deeper myometrial layers, decidual reaction. The authors link these findings to severe uterine atony as the presumed cause of the hemorrhage, while the major limitation is that the evidence is drawn from a single clinical case rather than a systematic study. Relevance to endometriosis: adenomyosis interna is not endometriosis per se, but it is directly about adenomyosis and therefore is centrally related to adenomyosis as discussed in the corpus.

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Zusammenfassung Bei einer 40 jährigen Erstgebärenden kam es im Anschluß an die Spontangeburt am normalen Ende der Schwangerschaft zu schwerster Blutung in der Nachgeburtsperiode und post partum, die nach Bluttransfusion die vaginale Exstirpation des Uterus nötig machte. In der Wand des überaus großen und schlaffen Uterus fand sich entsprechend der Plazentarstelle eine ausgebreitete, 1/3 des Querschnittes der Wand durchsetzende Adenomyosis interna mit starker, besonders in den tieferen Schichten der Muskulatur an Mächtigkeit zunehmender dezidualer Reaktion, eine Veränderung, mit der die schwere Atonie in Zusammenhang gebracht wird. Similar content being viewed by others Literaturverzeichnis Albrecht, H., Patholog. Anatomie und Klinik des Adenomyoms und der Adenomyosis. Handbuch Halban-Seitz. Bd. IV, S. 335. Amos, Zeitschr. f. Geburtsh. u. Gynäkol.54, 171, 1905. Aschheim, Zeitschr. f. Geburtsh. u. Gynäkol.86, 414 1923. Burg, E., Zeitschr. f. Geburtsh. u. Gynäkol.90, 642. 1927. Frankl, O., Patholog. Anatomie und Histologie der weiblichen Genitalorgane. Leipzig 1914; Zentralbl. f. Gynäkol. 1922, S. 241. Americ. journ. of obster. a gynecol10, 680. 1925. Josselin de Jong undde Snoo, Virchows Arch. f. pathol. Anat. u. Physiol.257, 23. 1925. Josselin de Jong, Virchows Arch. f. pathol. Anat. u. Physiol.262, 735. 1926. Katz, H., Wien. klin. Wochenschr. 1924, Nr. 48. Kitai, J., Arch. f. Gynäkol.124, 178. Lahm, W., Zeitschr. f. Geburtsh. u. Gynäkol.85, 292. 1923. Meyer, R., Zeitschr. f. Geburtsh. u. Gynäkol.54, 191. 1905. Opitz, E., Zeitschr. f. Geburtsh. u. Gynäkol.42, 1. 1900. Schäfer, P., Arch. f. Gynäkol.109, 284. 1918. Schiller, W., Arch. f. Gynäkol.127, 544. 1926;129, 425. 1927. Schugt, P., Zentralbl. f. Gynäkol. 1926, S. 1135. Unterberger, F., Monatsschr. f. Geburtsh. u. Gynäkol.55, 116, 1921. Author information Authors and Affiliations Additional information Mit 10 Textabbildungen. Rights and permissions About this article Cite this article Szenes, A. Adenomyosis interna bei schwerster Blutung in der Nachgeburtsperiode und post partum. Arch. Gynak. 134, 546–560 (1928). https://doi.org/10.1007/BF01701608 Issue date: DOI: https://doi.org/10.1007/BF01701608

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