scholarly journals Spontaneous rupture of an unscarred uterus during pregnancy: an interesting case report

2017 ◽  
Vol 6 (12) ◽  
pp. 5642
Author(s):  
Durga K.
Keyword(s):  
Uterine Rupture ◽  
Spontaneous Rupture ◽  
Past History ◽  
Abdominal Cavity ◽  
Interesting Case ◽  
Emergency Laparotomy ◽  
History Of ◽  
Uterine Curettage ◽  
Rupture Of Uterus ◽  
Uterine Scar

Uterine rupture in pregnancy is very rare and potentially catastrophic for both mother and foetus. The most common cause of uterine rupture is giving away of previous caesarean uterine scar. Spontaneous rupture of an unscarred uterus during pregnancy is a rare occurrence. We hereby present a rare case of a spontaneous complete uterine rupture in a non-labouring unscarred uterus of a 33-year-old nulliparous woman at 35 weeks of gestation. She presented with lower abdomen pain and decreased foetal movements at Institute of Obstetrics and Gynaecology, Chennai. Even before getting into labour, patient suddenly collapsed, and emergency laparotomy was proceeded in view of suspicious concealed abruption. There was frank hemoperitoneum along with a dead baby in the abdominal cavity. There was rupture of uterine fundus extending from one cornual end to the other and closure of uterine rent proceeded. Spontaneous rupture of uterus occurs when there is an upper segment uterine scar. She had a past history of eventful uterine curettage which was the risk factor for uterine rupture. 

scholarly journals RUPTURE OF UTERUS (FUNDUS)

2016 ◽  
Vol 23 (01) ◽  
pp. 114-117
Author(s):  
Mubasher Saeed Pansota ◽  
Aisha Ajmal ◽  
Bushra Sher Zaman
Keyword(s):  
Uterine Rupture ◽  
Past History ◽  
Sudden Onset ◽  
Gravid Uterus ◽  
History Of ◽  
Uterine Curettage ◽  
Rupture Of Uterus ◽  
Uterine Scar ◽  
Scarred Uterus ◽  
Uterine Fundus

Rupture of a gravid uterus is a surgical emergency. Predisposing factorsinclude a scarred uterus. Spontaneous rupture of an unscarred uterus during pregnancy is arare occurrence. We hereby present the case of a spontaneous complete uterine rupture at agestational age of 35 weeks 01 day in a 25 years old patient. The case was managed at theCivil Hospital Bahawalpur. She had past history of one uterine curettage for endometrial polypone year back. She presented with mild abdominal pains of sudden onset. After conservativemanagement for 10 hours in hospital she suddenly developed severe abdominal pains with P/Vbleeding. On ultrasound scan, uterine rupture was diagnosed and an emergency laparotomywas done. The ruptured amniotic sac with baby and placenta were found in the peritoneal cavitywith rupture of the uterine funds. Spontaneous uterine fundus rupture usually occurs whenthere is an upper segment uterine scar. This case report shows that past history of curettage isa risk factor for the presence of uterine scar.

scholarly journals Placenta Percreta: An Unusual Etiology for Spontaneous Rupture of Uterus Near Term

2014 ◽  
Vol 6 (3) ◽  
pp. 180-182
Author(s):  
Anupam Varshney ◽  
Neerja LNU ◽  
Manju Varma ◽  
RK Thakral
Keyword(s):  
Pregnant Women ◽  
Uterine Rupture ◽  
Spontaneous Rupture ◽  
Placenta Percreta ◽  
Emergency Laparotomy ◽  
Lower Segment Cesarean Section ◽  
Spontaneous Uterine Rupture ◽  
History Of ◽  
Rupture Of Uterus ◽  
Near Term

ABSTRACT Uterine rupture is a life-threatening complication in pregnancy with an incidence of 0.07%, out of which 80% are spontaneous rupture. Placenta percreta is the rarest form of placental implantation abnormalities, with an incidence 1 in 2500 pregnant women.1,2 Spontaneous uterine rupture due to placenta percreta is very rare, with an incidence of 1 in 4,366 pregnant women.3 It often occurs in patients with a history of scar in the uterus.4 Placenta percreta-induced spontaneous uterine rupture at term with previous lower segment cesarean section (LSCS) is difficult to diagnose. A 25-year-old pregnant woman, with history of one incomplete abortion treated by dilatation and curettage followed by a vaginal delivery with stillbirth and one LSCS again with stillbirth at term, was admitted in the emergency ward with history of approx 9 months amenorrhea, breathlessness, pain in abdomen (unable to lie down or even sit), vomiting and loss of fetal movements for last 24 hours. O/E: GC fair, afebrile, Pallor +++, pedal edema +, pulse 100/minutes regular, resp. rate; 40/minutes, thoracic, BP 110/70 mm Hg, lung fields clear with no abnormality detected in heart. On P/A: skin was stretched and a Pfannensteil scar healed by primary intention was present Abdomen tense, tender therefore fundal height could not be assessed. Fetal parts were not palpable and lie/presentation could not be made out. FHS were absent. On P/V; os closed with uneffaced cervix, presenting part could not be made out and was high. No bleeding or leaking per-vaginum was present. Hb 6.7 gm%, TLC 15600, DLC P90, L8, E2, M0. Ultrasound done on 27.5.12 (one month back) outside revealed 32.3 weeks gestation with normal scar thickness, placenta located in upper segment, grade I. No comment was made on the interface between placenta and myometrium in ultrasound report. Patient was subjected to emergency laparotomy, massive hemoperitoneum was found. Examination of uterus revealed an intact previous scar. A full term male stillborn baby was delivered by uterine scar (LSCS) on 21.6.2012, at 10.30 pm The placenta could not be delivered as there was no plain of cleavage between placenta and myometrium. Uterus was exteriorized and to surprise there was a rent of about 3 × 2 cm at left cornua, placental tissue peeping out on removing the clots. Subtotal hysterectomy was performed. Three units blood were transfused. Postoperative period was uneventful and the patient was discharged in satisfactory condition on 9th day. Histopathological examination of the uterine specimen revealed placenta percreta. To conclude uterine rupture should be considered in the differential diagnosis in pregnant women who present with acute abdomen with or without shock. How to cite this article Neerja, Varma M, Thakral RK, Varshney A. Placenta Percreta: An Unusual Etiology for Spontaneous Rupture of Uterus Near Term. J South Asian Feder Obst Gynae 2014;6(3):180-182.

scholarly journals A case report: spontaneous postpartum rupture of unscarred uterus

2018 ◽  
Vol 7 (8) ◽  
pp. 3420
Author(s):  
Swati Singh ◽  
Ravinder Ahlawat
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Unusual Case ◽  
Surgical Intervention ◽  
Emergency Laparotomy ◽  
Full Thickness ◽  
Uterine Incision ◽  
History Of ◽  
Rupture Of Uterus ◽  
Specific Symptoms

Rupture of uterus is characterized by a breach in the wall of the uterus involving its full thickness. An unscarred uterus rupture is uncommon. It has non-specific symptoms and presentation differs according to site and time of rupture. Authors report an unusual case of spontaneous rupture of unscarred uterus. A 32-year-old, pregnant woman, developed postpartum bleeding with no history of prior uterine incision. She was diagnosed as a case of rupture of uterus and emergency laparotomy was done. Early diagnosis and immediate surgical intervention may significantly improve the prognosis. Differential diagnosis of uterine rupture should always be kept in mind in all patients with or without risk factors.

scholarly journals Cornual Pregnancy

2012 ◽  
Vol 13 (2) ◽  
pp. 227-229
Author(s):  
F Wazed ◽  
N Sultana ◽  
S Ahamed ◽  
JH Khan ◽  
S Rouf ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Uterine Rupture ◽  
Abdominal Cavity ◽  
Correct Diagnosis ◽  
Emergency Laparotomy ◽  
Abdominal Pregnancy ◽  
Cornual Pregnancy ◽  
Rare Form ◽  
Therapeutic Challenge ◽  
Uterine Anomaly

Cornual pregnancy is rare form of ectopic pregnancy where implantation occurs in the cavity of a rudimentary horn of the uterus. It is the diagnostic and therapeutic challenge with potential sever consequence if uterine rupture occurs with massive intra abdominal haemorrhage .We report a case of misdiagnosed rupture cornual pregnancy occurring at 12 weeks gestation. First USG revealed intra uterine pregnancy. Repeat USG showed abdominal pregnancy sac but cornual pregnancy was not diagnosed and uterine anomaly was not detected. The correct diagnosis was made at emergency laparotomy. An intact pregnancy sac of 12weeks fetus was seen in abdominal cavity. Placenta and pregnancy sac was adherent to omentum and torn end of left cornu of the bicornuate uterus. Left sided cornu was resected keeping both the ovaries and tubes intact. DOI: http://dx.doi.org/10.3329/jom.v13i2.12763 J Medicine 2012; 13 : 227-229

scholarly journals Spontaneous uterine rupture in primigravida at 15 weeks

2017 ◽  
Vol 6 (3) ◽  
pp. 1138
Author(s):  
Mousumi Das Ghosh ◽  
Vinita Singh
Keyword(s):  
Acute Abdomen ◽  
Uterine Rupture ◽  
Interesting Case ◽  
Emergency Laparotomy ◽  
Intrauterine Pregnancy ◽  
Spontaneous Uterine Rupture ◽  
Operative Recovery

This is a very rare and interesting case of primigravida with sonographic evidence of intrauterine pregnancy presenting with acute abdomen at 15 weeks. With the diagnosis of uterine rupture, emergency laparotomy was done. The defect was repaired and post-operative recovery was good. This shows that spontaneous uterine rupture can occur in primigravida and should be kept in mind during diagnosis of acute abdomen.

scholarly journals Multigravid Women with Uterine Rupture: A Case Report

2021 ◽  
Vol 6 (2) ◽  
pp. 1353-1357
Author(s):  
Firmansyah Basir ◽  
Adnan Abadi ◽  
Abarham Martadiansyah ◽  
Cindy Kesty ◽  
Febi Stevi Aryani ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Antenatal Care ◽  
Peritoneal Cavity ◽  
Uterine Rupture ◽  
Abdominal Cavity ◽  
Mode Of Delivery ◽  
Positive Sign ◽  
Fetal Survival ◽  
Prompt Treatment ◽  
Uterine Scar

Introduction: Uterine rupture is the discontinuation of the uterine scar that creates connection between uterine and peritoneal cavity. The most common etiology for uterine rupture is dehiscence of uterine scar tissue from previous cesarean section. In patient with uterine rupture and fetal expulsion to the peritoneal cavity, fetal survival becomes extremely poor. Therefore, it is important for clinician to understand the uterine rupture and be able to give prompt treatment in order to prevent maternal and fetal morbidity and mortality. Case Presentation: A 34-year-old woman, G3P2A0 38 weeks of gestation complained that she had abdominal pain, couldn’t feel her baby movement, watery discharge since 10 hours before admission. Bloody discharge and trauma were all denied. Patient underwent twice cesarean section before. Patient only had four times antenatal care with obstetrician at 24, 28, 32, and 36 weeks of gestation. She was scheduled for caesarean section at 38 weeks of gestation. Patient looked alert with low blood pressure and tachycardia. On physical examination, we found that she was pale, fundal height could not be determined, and there was no fetal heart rate detected. Speculum examination showed livide portio, closed external orifice of uterus, and inactive blood. There was positive slinger sign and Douglas cavity was bulging. Ultrasound examination showed intrauterine fetal demise, complete uterine rupture on lower segment, and positive sign of free fluid on abdominal cavity. Patient underwent operation and we found the died male neonate was in the peritoneal cavity and the placenta was still attached in the uterine cavity. We delivered the baby and placenta completely. There was uterine rupture on the previous CS scar, the edge of the uterine wound was regular with no necrosis and extended to the right side of uterus. Then, we performed hysterorrhaphy in order to stop the bleeding and repair the uterus, and we also performed tubal ligation. The died neonate had maceration grade I. Conclusion: Uterine rupture causes poor fetal and maternal prognosis. Early diagnosis and prompt treatment is really important in uterine rupture. Prevention of uterine rupture could be done by meticulous antenatal care, especially visiting to obstetrician in order to review maternal and fetal condition and determine mode of delivery.

scholarly journals Volvulus of the liver with intrathoracic herniation

2014 ◽  
Vol 96 (7) ◽  
pp. e27-e29 ◽  
Author(s):  
G Moussa ◽  
PM Thomson ◽  
A Bohra
Keyword(s):  
Abdominal Pain ◽  
Transverse Colon ◽  
Abdominal Cavity ◽  
Liver Perfusion ◽  
Previous History ◽  
Interesting Case ◽  
Oval Window ◽  
Uneventful Recovery ◽  
Pericardial Window ◽  
History Of

Introduction We present a rare case of a liver volvulus, stomach and transverse colon herniating through the diaphragm. This scenario has not been reported previously. We discuss the presentation and management of this interesting case. Case history A 65-year-old woman with a history of sarcoidosis and recurrent pericardial effusions, treated previously with a subxiphoid pericardial oval window fenestration, presented with acute upper abdominal pain radiating to the chest. High contrast computed tomography showed a volvulus of the liver with consequent venous congestion, and herniation of the liver, stomach and transverse colon through an anterior diaphragmatic defect. With liver perfusion threatened, an urgent laparoscopic repair was performed. The stomach and transverse colon were reduced, and the twisted left lobe of the liver was unrotated and reduced into the abdominal cavity. A double-sided synthetic mesh was used to repair the defect. The patient made an uneventful recovery. Conclusions This is a novel complication of a patient presenting with abdominal pain with a previous history of pericardial window fenestration. A laparoscopic reduction and repair can be performed safely with excellent postoperative results.

Panperitonitis Caused by Gangrene of the Urinary Bladder: Report of a Successfully Treated Case

2008 ◽  
Vol 74 (4) ◽  
pp. 302-304
Author(s):  
Shozo Fujiwara ◽  
Tsuyoshi Noguchi ◽  
Takuya Noguchi ◽  
Akio Emoto ◽  
Yoshihisa Tasaki
Keyword(s):  
Past History ◽  
Abdominal Cavity ◽  
Antibiotic Administration ◽  
Urinary Frequency ◽  
Bladder Preservation ◽  
Abdominal Drainage ◽  
The Third ◽  
Total Hysterectomy ◽  
Neck Fracture ◽  
History Of

The patient was a 74-year-old woman with Parkinson's disease who had a past history of total hysterectomy for uterine myoma. She was admitted for a femoral neck fracture and treated conservatively. From the third day of the illness, the patient experienced increased urinary frequency and constant urge to urinate. On the seventh day, the patient developed peritonitis and underwent emergency surgery. Laparotomy confirmed a dark greenish malodorous abscess in the abdominal cavity. The bladder was necrotic and perforated, and the patient was accordingly diagnosed with panperitonitis caused by bladder gangrene. Because almost the entire bladder exhibited full-layer necrosis, it was determined that bladder preservation would not be possible, and total cystectomy, bilateral ureterocutaneostomy, and abdominal drainage were performed. Postoperatively, residual intra-abdominal abscess was present, but this resolved with drainage and antibiotic administration. Here, we present this patient who survived extremely rare pan-peritonitis caused by bladder gangrene.

scholarly journals Appendicovesical fistula presenting as hypokalaemic hyperchloraemic metabolic acidosis: a case report

2019 ◽  
Vol 101 (6) ◽  
pp. e131-e132
Author(s):  
S Keane ◽  
GD Tebala
Keyword(s):  
Urinary Tract ◽  
Past History ◽  
Iliac Fossa ◽  
Fistulous Tract ◽  
Emergency Laparotomy ◽  
Metabolic Derangement ◽  
History Of ◽  
Right Iliac Fossa Pain ◽  
Tract Infections

A 52-year-old man was admitted with diarrhoea and faecaluria and referred recurrent urinary tract infections for over 20 years. He also reported a two-week hospital admission more than 20 years ago for right iliac fossa pain, which was managed conservatively. Computed tomography showed a fistulous tract extending from the bladder with an unclear connection to the bowel. Cystoscopy confirmed the presence of a vesical fistula and biopsy of the tract confirmed colonic mucosa. Flexible sigmoidoscopy was negative. A cystogram was requested as an outpatient procedure and the patient was discharged after antibiotic treatment. A few days after discharge the patient was readmitted as an emergency to critical care for severe hyperchloraemic hypokalaemic acidosis and a Glasgow Coma Score of 6/15. He was intubated and ventilated and his metabolic derangement was treated. As soon as his conditions improved, he underwent emergency laparotomy, which revealed the presence of a fistula between the caecal fundus and the bladder. The fistula was repaired and the patient recovered swiftly and completely and was discharged on postoperative day 5. At 12-month follow up the patient was completely symptoms-free, his bowel habits were normal and he has not had any urinary infection. Appendicovesical fistula is a rare and potentially lethal condition due to its metabolic consequences. Past history of right iliac fossa pain treated conservatively, diarrhoea and recurrent urinary tract infection must raise suspicion.

scholarly journals Silent Spontaneous Uterine Rupture at 36 Weeks of Gestation

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
J. Y. Woo ◽  
L. Tate ◽  
S. Roth ◽  
A. C. Eke
Keyword(s):  
Cesarean Section ◽  
Uterine Rupture ◽  
Spontaneous Rupture ◽  
Neonatal Morbidity ◽  
Male Infant ◽  
Postoperative Recovery ◽  
Spontaneous Uterine Rupture ◽  
Good Imaging ◽  
History Of ◽  
High Index Of Suspicion

Introduction.Silent spontaneous rupture of the uterus before term, with extrusion of an intact amniotic sac and delivery of a healthy neonate, with no maternal or neonatal morbidity or mortality is very rare. Very few cases have been reported in literature.Case Presentation.We report a case of silent spontaneous uterine rupture, found during a scheduled repeat cesarean section at 36 weeks of gestation. Patient had history of two prior classical cesarean sections. She underwent cesarean section, with delivery of a healthy male infant. She had a good postoperative recovery and was discharged on postoperative day 3.Conclusion.Silent spontaneous rupture of the uterus before term with extrusion of an intact amniotic sac is rare. A high index of suspicion and good imaging during pregnancy are important in making this diagnosis.

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