scholarly journals Uterine rupture at the fundus during labor: A case report

2021 ◽  
Vol 8 (4) ◽  
pp. 577-579
Author(s):  
Sunita Yadav ◽  
Susheela Chaudhary ◽  
Vani Malhotra
Keyword(s):  
Uterine Rupture ◽  
Early Recognition ◽  
Abdominal Cavity ◽  
Shoulder Dystocia ◽  
Normal Vaginal Delivery ◽  
Maternal Complications ◽  
Predisposing Factor ◽  
Tertiary Hospitals ◽  
Scarred Uterus ◽  
Fundal Pressure

Uterine rupture is a rare but catastrophic complication seen in obstetrical practice. The most crucial predisposing factor is previous caesarean scar and it is generally being reported during labor in patients with scarred uterus. Although rare, rupture of an unscarred uterus is one of the most terrible obstetric complications, resulting in maternal and fetal jeopardy. Shoulder dystocia is one of the most difficult complications of labour that is unpredictable and therefore unpreventable. In neglected cases, grave maternal complications like obstructed labour and rupture of uterus can occur. Very rarely, the reverse, uterine rupture leading to shoulder dystocia can also occur. The present case is reported to emphasize the importance of early recognition of this condition. A 32 year old gravida 5 para 2 live 2 abortion 2 with 9 month period of gestation presented to labor room with shoulder dystocia, with history of fundal pressure. After delivery of head, pain subsided and the trunk failed to deliver. Her previous two deliveries were by normal vaginal delivery 8 years and 5 years back respectively. She had previous two abortions 6 years and 3 years back respectively. Both were spontaneous expulsion followed by dilatation and curettage. On examination, clinical diagnosis of rupture uterus was made and patient was taken up for laparotomy. On laparotomy, fetal body and limbs along with the placenta was seen lying in the abdominal cavity and head was in uterus. Baby of 2.34 kg was extracted as breech. A linear rupture of around 10-12 centimeter was present at fundo-posterior region. Uterus was repaired in 3 layers and bilateral tubal ligation was done. Patient was discharged on post- operative day 10 without any complications.In women with high risk for uterine rupture, delivery must be conducted at tertiary hospitals where facilities for emergency caesarean is available. In these patients, if shoulder dystocia occurs, rupture of the uterus must be suspected as an underlying cause. Assisted fundal pressure during delivery can result in trauma even to the unscarred uterus and cause traumatic uterine rupture. Early diagnosis is vital if maternal morbidity is to be reduced.

Role of Decapitation in Management of A Case of Complete Shoulder Dystocia with Rupture Uterus - A Case Report

2021 ◽  
Vol 15 (11) ◽  
pp. 3043-3044
Author(s):  
Nadia Zahid ◽  
Muntiha Sarosh ◽  
Rakhshsanda Toheed ◽  
Mohammad Saa ◽  
Kokab Zia
Keyword(s):  
Uterine Rupture ◽  
Maternal Education ◽  
Bladder Wall ◽  
Time Lapse ◽  
Shoulder Dystocia ◽  
Maternal Complications ◽  
Fetal Head ◽  
Obstructed Labor ◽  
Uterine Scar ◽  
Scarred Uterus

Complete Shoulder dystocia in the presence of scarred uterus is an acute obstetrical emergency and if not properly handled can lead to serious fetal and maternal complications. A G5P4AO previous II cesarean sections, presented in emergency after delivery of fetal head and impacted shoulders, at a small private clinic in a village, four hours back. On laparotomy, there was uterine rupture from the previous uterine scar along with posterior bladder wall rupture . The shoulder dystocia was relieved by decapitation and breech extraction abdominally. Subtotal hysterectomy and repair of the bladder wall was done. This case highlight the dilemma of lack of regular antenatal care and maternal education, malpractices by untrained health professionals and time lapse in referral system that is still a very serious and major issue in developing countries like Pakistan . Keywords: Shoulder dystocia, obstructed labor, and uterine rupture

Liver abscess in early infancy with no underlying risk factors: a case series

2020 ◽  
pp. 004947552095993
Author(s):  
Mugdha Anand ◽  
Puneet Kaur Sahi ◽  
Mukta Mantan
Keyword(s):  
Liver Abscess ◽  
Early Recognition ◽  
Case Series ◽  
Birth Asphyxia ◽  
Favourable Outcome ◽  
Early Infancy ◽  
Predisposing Factor ◽  
High Index Of Suspicion ◽  
Work Up ◽  
Umbilical Catheterisation

Liver abscess in early infancy is uncommon, needs a high index of suspicion for diagnosis and carries a high mortality. It presents most frequently by a fulminant course, generalised sepsis and multiple metastatic abscesses. An underlying predisposing factor is usually attributed in nearly all cases reported to date. These include prematurity, low birth weight, umbilical catheterisation (UC), administration of hypertonic dextrose or total parenteral nutrition via UC, exchange transfusion, blood culture proven sepsis, necrotising enterocolitis, antecedent abdominal surgery, birth asphyxia, omphalitis and underlying immunodeficiency. We present three cases of early infantile liver abscesses without any identifiable predisposing factor despite extensive work-up to search for such. Early recognition and management led to a favourable outcome in all our patients.

Congenital fetal lymphangioma causing shoulder dystocia and uterine rupture

2011 ◽  
Vol 112 (3) ◽  
pp. 248-248 ◽  
Author(s):  
Prabhat C. Mondal ◽  
Debdutta Ghosh ◽  
Anirban Mondal ◽  
Arup K. Majhi
Keyword(s):  
Uterine Rupture ◽  
Shoulder Dystocia

scholarly journals Rupture uterus: a prospective observational study of 25 consecutive cases in a tertiary referral centre in South India

2017 ◽  
Vol 6 (6) ◽  
pp. 2601 ◽  
Author(s):  
Rashmi S Desai ◽  
Amitha V Kamat
Keyword(s):  
Observational Study ◽  
Perinatal Mortality ◽  
Uterine Rupture ◽  
Maternal Morbidity ◽  
Prospective Observational Study ◽  
Demographic Data ◽  
Referral Centre ◽  
Tertiary Referral Centre ◽  
Predisposing Factor ◽  
Artery Ligation

Background: Uterine rupture in pregnancy is a rare though catastrophic complication with a high incidence of foetal and maternal morbidity. It appeared to be on the decline in recent times, prompting us to analyse the clinical picture now. The objective of the study was to study the risk factors, clinical profile and consequences of uterine rupture on maternal and perinatal outcome.Methods: A prospective observational study of 25 consecutive cases of uterine rupture was carried out between July 2013 and October 2015. All the cases of rupture uterus either referred or diagnosed after admission were included. Detailed demographic data, past and present obstetric events, time taken to reach the referral centre, the reasons for any delay, mode of presentation, type of rupture, management and maternal and foetal outcomes were analysed.Results: The incidence of rupture was 1 in 915 deliveries. Seventy-two per cent of them were referred cases. Average time to reach from referral centre was 4.3 hours, the common reasons for delay being patient factors (33%), transport problems (38%) and delayed referrals (22%). Previous caesarean section was the most common predisposing factor (56%). Sixty-four per cent of the ruptures were diagnosed clinically. Eighty-four per cent of the ruptures were complete. Sub-total hysterectomy was carried out in 14 (56%) patients. Internal iliac artery ligation (20%) and bladder repair (8%) were sometimes required. All women required blood transfusion.  Perinatal mortality was seen in 76%. There was no maternal mortality.Conclusions: Uterine rupture is a cause of severe acute maternal morbidity and very high perinatal mortality.  Delay in referral and diagnosis can lead to significant maternal morbidity and hysterectomy.

scholarly journals Successful pregnancy after previous uterine rupture

2021 ◽  
Vol 10 (2) ◽  
pp. 784
Author(s):  
Shamrao Ramjj Wakode ◽  
Varsha Narayana Bhat
Keyword(s):  
Uterine Rupture ◽  
Maternal Morbidity ◽  
Breech Presentation ◽  
Morbidity Rate ◽  
Emergency Laparotomy ◽  
Catastrophic Event ◽  
Successful Pregnancy ◽  
Male Baby ◽  
Spontaneous Uterine Rupture ◽  
Scarred Uterus

Uterine rupture is a rare and catastrophic event with high fetal and maternal morbidity rate. It is most commonly seen in scarred uterus. Here we present a case of 30 years old female, gravida 3 para 2 living 0 with previous spontaneous uterine rupture at 28-30 weeks with still birth 3 years ago. She underwent emergency laparotomy with repair. She conceived spontaneously, admitted at 20 weeks of gestational age and close antenatal surveillance was done throughout the pregnancy. Corticosteroids was administered. At 36 weeks elective caesarean was planned, delivering via breech presentation to a live male baby of 2.5 kg, Apgar score of 8/10,9/10 at 1 and 5 minutes.

scholarly journals Pregnancy Outcomes and Associated Factors for Uterine Rupture: An 8 Years Population-based Retrospective Study

2021 ◽  
Author(s):  
Sheng Wan ◽  
Mengnan Yang ◽  
Jindan Pei ◽  
Xiaobo Zhao ◽  
Chenchen Zhou ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Uterine Rupture ◽  
Obstetric Care ◽  
Developed Countries ◽  
Population Based ◽  
Fetal Heart Rate Monitoring ◽  
Fetal Complications ◽  
History Of ◽  
Scarred Uterus ◽  
Obstetrical Emergency

Abstract Background: Uterine rupture is an obstetrical emergency with serious undesired complications for laboring mothers resulting in fatal maternal and neonatal outcomes. The aim of this study was to assess the incidence of uterine rupture, its association with previous uterine surgery and vaginal birth after caesarean section (VBAC), and the maternal and perinatal implications. Methods: This is a population-based retrospective study. All pregnant women treated for ruptured uterus in one center between 2013 and 2020 were included. Their information retrieved from the medical records department were retrospectively reviewed.Results: A total of 209,112 deliveries were included and 41 cases of uterine rupture were identified. The incidence of uterine rupture was 1.96/10 000 births. 16 (39.0%) had maternal and fetal complications. There were no maternal deaths secondary to uterine rupture, while perinatal fatality related to uterine rupture was 7.3%. Among all case, 38 (92.7%) were scarred uterus and 3 (7.3%) were unscarred uterus. The most common cause of uterine rupture was previous cesarean section, while cases with a history of laparoscopic myomectomy were more likely to have serious adverse outcome. 24 (59%) of the ruptures occurred in anterior lower uterine segment. Fetal heart rate monitoring changes were the most reliable signs for rupture.Conclusions: Incidence of uterine rupture in the study area was consistent with developed countries. Further improvement in obstetric care and strong collaboration with referring health facilities was needed to ensure maternal and perinatal safety.

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 731. Puerperal Sepsis Among Women with In-facility Births in Western Tanzania

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S464-S464
Author(s):  
Rachel Smith ◽  
Alicia Ruiz ◽  
Matthew Westercamp ◽  
Godson Maro ◽  
Florina Serbanescu
Keyword(s):  
Early Recognition ◽  
Descriptive Analysis ◽  
Health Centers ◽  
Mortality Data ◽  
Free Text ◽  
Maternal Complications ◽  
Obstructed Labor ◽  
Puerperal Sepsis ◽  
Neonatal Deaths ◽  
Facility Births

Abstract Background Puerperal sepsis is an important cause of maternal mortality worldwide. As access to emergency obstetric services expands in resource-limited settings, rapid recognition and treatment of sepsis, and prevention of nosocomial infections that might lead to sepsis, is critical. We describe puerperal sepsis cases among women with in-facility births in the Kigoma region of Tanzania. Methods Demographic, obstetric history, pregnancy complication and outcome, as well as mortality data were collected for women who delivered in hospitals, health centers and dispensaries in the Kigoma region, Tanzania 2016 – 2018. Up to 3 maternal complications were recorded as free text. Puerperal sepsis included women where ‘sepsis’ was recorded as a complication during hospitalization. We calculated rates of puerperal sepsis and completed a descriptive analysis of patients. Results 203,604 women delivered infants in 197 participating facilities during the data collection period. Of these, 2228 (1.1%) had sepsis recorded, for an overall rate of 10.9 sepsis cases per 1000 deliveries. Although 48% of births occurred in dispensaries, sepsis complications were reported almost exclusively in hospitals and health centers (37.7 and 10.3 per 1000 deliveries, respectively). Sepsis rates varied across individual facilities, from 15.5 to 45.2 cases per 1000 deliveries in hospitals and 0 to 38.6 cases per 1000 deliveries in health centers. Women who developed sepsis had a median age of 25 (IQR 22 – 30) years and 1113 (56%) were nulliparous. 1763 (90%) of women who had sepsis delivered by caesarian delivery. Obstructed labor (827; 42%) was a common co-complication of sepsis; obstetric hemorrhage and uterine rupture were seen in 93 (5%) and 77 (4%) women with sepsis, respectively. 49 women with sepsis (3%) died prior to hospital discharge. Stillbirths and pre-discharge neonatal deaths complicated 107 (5%) and 74 (4%) deliveries to women with sepsis. Conclusion In the Kigoma region of Tanzania puerperal sepsis frequently occurs in women with obstructed labor and caesarian delivery. Further evaluation of both facility-level and individual factors that contribute to the incidence of sepsis in this population, particularly those related to invasive procedures, is critical for early recognition and prevention. issue Disclosures All Authors: No reported disclosures

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