Uterine Rupture in Subsequent Pregnancy in a Patient with Previous Uterine Manipulator Associated Uterine Perforation

<p>To report a case who experienced uterine rupture at 38th week of gestation and had a history of manipulator associated uterine rupture. <br />A 25 years old primigravid woman at 38 weeks of gestation was referred to our hospital with the signs of active labor. Heavy lower abdominal cramps and signs of acute abdomen suggested uterine rupture and emergent cesarean section was performed. A 3 cm in size and circular in shape uterin rupture at the fundus that was imitative of enlarged previous manipulator associated rupture was observed. <br />A manipulator associated uterine rupture should be repaired when encountered in reproductive ages in order to prevent a possible uterine perforation during subsequent pregnancy.</p>

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Spontaneous Rupture of an Unscarred Gravid Uterus in a Primigravid Woman at 32 Weeks of Gestation

Case Reports in Obstetrics and Gynecology ◽

10.1155/2014/209585 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 5

Author(s):

Etsuko Mizutamari ◽

Tomoko Honda ◽

Takashi Ohba ◽

Hidetaka Katabuchi

Keyword(s):

Cesarean Section ◽

Uterine Rupture ◽

Spontaneous Rupture ◽

Gravid Uterus ◽

Uterine Perforation ◽

Primigravid Woman ◽

Scarred Uterus ◽

Operative Findings ◽

The Right

Uterine rupture usually occurs in a scarred uterus, especially secondary to prior cesarean section. Antepartum uterine rupture in an unscarred uterus is extremely rare. We report a case of spontaneous rupture of an unscarred gravid uterus at 32 weeks of gestation in a primigravid woman. Ultrasonography and magnetic resonance imaging showed a bulging cystic lesion communicating with the intrauterine cavity. Operative findings during emergent cesarean section revealed uterine perforation in the right cornual area and a prolapsed, nonbleeding amniotic sac. The left cornual area was also focally thin. An arcuate uterus was suspected based on follow-up hysterosalpingography. Antepartum uterine rupture tends to occur in the uterine cornual area. In this case, Müllerian duct anomalies may have been associated with focal myometrial defects.

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Recurrent large uterine fundal dehiscence during cesarean section after hysteroscopic uterine septum resection with uterine perforation

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2015-0082 ◽

2016 ◽

Vol 5 (2) ◽

pp. 85-87

Author(s):

İbrahim Alanbay ◽

Mustafa Öztürk ◽

Mustafa Ulubay ◽

Uğur Keskin ◽

Emre Karaşahin

Keyword(s):

Cesarean Section ◽

Uterine Rupture ◽

Late Complication ◽

Uterine Wall ◽

Elective Cesarean Section ◽

Uterine Perforation ◽

Elective Cesarean ◽

Uterine Septum ◽

Uterine Fundus ◽

Previous Cesarean

Abstract Septum resection using hysterescopy is safe, rapid and efective, but some late complication of it may be seen as uterine rupture or dehiscence of uterine wall during pregnancy due to myometrial damage. We present a case of recurrent large uterine fundal dehiscence conscecutive to cesarean section in a patient who had previously undergone a uterine septum resection. The patient was a 35-year-old who presented at 39 weeks of gestation (Gravida 2, Parity 1) and was admitted for an elective cesarean section. Her reproductive history included a septum resection which resulted in uterine perforation, and one previous cesarean section in which a large fundal defect was found and repaired. Then the examination had shown an aproximately 5 cm large uterine fundus defect including all three layers of uterus which had been repaired. Perforation or excessively deep incision of uterine fundus during hysteroscopic metroplasty may cause chronic weakness of the uterine wall especially at fundal localization. Our case was an incidental uterine wall dehiscence during cesarean section. Patients with an uterine septum resection history should be followed up carefully for uterine rupture during pregnancy.

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Nationwide population-based cohort study of adverse obstetric outcomes in pregnancies with myoma or following myomectomy: Retrospective cohort study

10.21203/rs.3.rs-27382/v3 ◽

2020 ◽

Author(s):

Se Jin Lee ◽

Hyun Sun Ko ◽

Sunghun Na ◽

Jin Young Bae ◽

Won Joon Seong ◽

...

Keyword(s):

Cohort Study ◽

Cesarean Section ◽

Uterine Rupture ◽

Placenta Previa ◽

Multivariate Logistic Regression Analysis ◽

Population Based ◽

Obstetric Outcomes ◽

Nulliparous Women ◽

History Of ◽

Adverse Pregnancy

Abstract Background: Our objective was to evaluate risks of adverse obstetric outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy. Methods: We analyzed the national health insurance database, which covers almost the entire Korean population, between 2004 and 2015. The risks of adverse pregnancy outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy, compared to those in women without a diagnosed myoma, were analyzed in multivariate logistic regression analysis. Results: During the study period, 38,402 women with diagnosed myoma(s), 9,890 women with a history of myomectomy, and 740,675 women without a diagnosed myoma gave birth. Women with a history of diagnosed myoma(s) and women with a history of myomectomy had significantly higher risks of cesarean section (aOR 1.13, 95% CI 1.1-1.16 and aOR 7.46, 95% CI 6.97-7.98, respectively) and placenta previa (aOR 1.41, 95% CI 1.29-1.54 and aOR 1.58, 95% CI 1.35-1.83, respectively), compared to women without a diagnosed myoma. And the risk of uterine rupture was significantly higher in women with previous myomectomy (aOR 12.78, 95% CI 6.5-25.13), compared to women without a diagnosed myoma, which was much increased (aOR 41.35, 95% CI 16.18-105.69) in nulliparous women. The incidence of uterine rupture was the highest at delivery within one year after myomectomy and decreased over time after myomectomy. Conclusions: Women with a history of myomectomy had significantly higher risks of cesarean section and placenta previa compared to women without a diagnosed myoma.

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Nationwide population-based cohort study of adverse obstetric outcomes in pregnancies with myoma or following myomectomy: Retrospective cohort study

10.21203/rs.3.rs-27382/v2 ◽

2020 ◽

Author(s):

Se Jin Lee ◽

Hyun Sun Ko ◽

Sunghun Na ◽

Jin Young Bae ◽

Won Joon Seong ◽

...

Keyword(s):

Cohort Study ◽

Cesarean Section ◽

Uterine Rupture ◽

Placenta Previa ◽

Multivariate Logistic Regression Analysis ◽

Population Based ◽

Obstetric Outcomes ◽

Nulliparous Women ◽

History Of ◽

Adverse Pregnancy

Abstract Background: Our objective was to evaluate risks of adverse obstetric outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy.Methods: We analyzed the national health insurance database, which covers almost the entire Korean population, between 2004 and 2015. The risks of adverse pregnancy outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy, compared to those in women without a diagnosed myoma, were analyzed in multivariate logistic regression analysis.Results: During the study period, 38,402 women with diagnosed myoma(s), 9,890 women with a history of myomectomy, and 740,675 women without a diagnosed myoma gave birth. Women with a history of diagnosed myoma(s) and women with a history of myomectomy had significantly higher risks of cesarean section (aOR 1.13, 95% CI 1.1-1.16 and aOR 7.46, 95% CI 6.97-7.98, respectively) and placenta previa (aOR 1.41, 95% CI 1.29-1.54 and aOR 1.58, 95% CI 1.35-1.83, respectively), compared to women without a diagnosed myoma. And the risk of uterine rupture was significantly higher in women with previous myomectomy (aOR 12.78, 95% CI 6.5-25.13), compared to women without a diagnosed myoma, which was much increased (aOR 41.35, 95% CI 16.18-105.69) in nulliparous women. The incidence of uterine rupture was the highest at delivery within one year after myomectomy and decreased over time after myomectomy. Conclusions: Women with a history of myomectomy had significantly higher risks of cesarean section and placenta previa compared to women without a diagnosed myoma.

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Risk Analysis of Placenta Previa in Subsequent Pregnancy with History of Cesarean Section: A Case Control Study in Faridpur Medical College Hospital

Faridpur Medical College Journal ◽

10.3329/fmcj.v10i2.30270 ◽

2016 ◽

Vol 10 (2) ◽

pp. 52-54

Author(s):

Dilruba Zeba ◽

Shila Rani Das ◽

Swapan Kumar Biswas ◽

Rajib Kumar Roy ◽

Abul Fattah ◽

...

Keyword(s):

Cesarean Section ◽

Cesarean Delivery ◽

Placenta Previa ◽

Subsequent Pregnancy ◽

Medical College Hospital ◽

Bladder Injury ◽

College Hospital ◽

Medical College ◽

History Of ◽

Previous Cesarean

Placenta previa is a life threatening pregnancy complication where placenta partially or completely covers the internal cervical os causing serious adverse consequence for both mother and baby. History of cesarean delivery is an important risk factor for placenta previa. Which have a increased chance of cesarean hysterectomy and bladder injury because of an associated accrete syndrome. The objective of this study is to analyze the outcome of placenta previa with history of cesarean section. This is a prospective study done in Faridpur Medical College Hospital, Bangladesh from 01.01.2013 up to 31.12.14. Total 18 (study group) patients had undergone cesarean delivery with placenta previa and history of previous cesarean section. Among 18 patients maternal age range was 25- 40, parity 1-4, emergency hysterectomy was done in 11, average blood transfusion 2-8 and other morbidity like urinary bladder injury was 4. So we decided to conduct the study to evaluate the frequency of the placenta previa and morbidity related to number of previous cesarean deliveries.Faridpur Med. Coll. J. Jul 2015;10(2): 52-54

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Silent Spontaneous Uterine Rupture at 36 Weeks of Gestation

Case Reports in Obstetrics and Gynecology ◽

10.1155/2015/596826 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3 ◽

Cited By ~ 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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Classical Cesarean Section

The Surgery Journal ◽

10.1055/s-0039-3402072 ◽

2020 ◽

Vol 06 (S 02) ◽

pp. S98-S103

Author(s):

Amano Kan

Keyword(s):

Cesarean Section ◽

Uterine Rupture ◽

Preterm Labor ◽

Placenta Previa ◽

Subsequent Pregnancy ◽

Lower Uterine Segment ◽

Transverse Incision ◽

Dense Adhesion ◽

Trial Of Labor ◽

Vertical Incision

AbstractCesarean section is the most common surgery in obstetrics. Several techniques are proposed according to the indication and the degree of urgency. Usually laparotomy followed by hysterotomy with a low transverse incision is preferable. However, in cases in which it is difficult to access the lower uterine segment, such as that in preterm labor, dense adhesion, placenta previa/accrete a vertical hysterotomy (classical cesarean section) may be needed. Although a smooth and gentle delivery of the fetus is possible through the vertical incision, uterine closure is technically difficult. To decrease the risks of hemorrhage and adhesion, a speedy and skillful technique is mandatory. The most serious risk of vertical incision in the contractile corpus is uterine rupture in the subsequent pregnancy. Therefore, cases of prior classical cesarean section are contraindicated for trial of labor after cesarean section.

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Complications Associated with Insertion of Intrauterine Pressure Catheters: An Unusual Case of Uterine Hypertonicity and Uterine Perforation Resulting in Fetal Distress after Insertion of an Intrauterine Pressure Catheter

Case Reports in Obstetrics and Gynecology ◽

10.1155/2012/517461 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 3

Author(s):

Kara M. Rood

Keyword(s):

Cesarean Section ◽

Unusual Case ◽

Neonatal Morbidity ◽

Fetal Distress ◽

Adverse Outcomes ◽

Uterine Perforation ◽

Routine Procedure ◽

Intrauterine Pressure ◽

Emergent Cesarean Section ◽

Pressure Catheter

Insertion of intrauterine pressure catheters is a routine procedure performed in labor and delivery departments, with few associated complications. There are several reports of maternal and neonatal morbidity associated with the use of intrauterine pressure catheters and their rare adverse outcomes. We report an unusual case of uterine hypertonicity resulting in fetal distress, immediately after the placement of an intrauterine pressure catheter. An emergent Cesarean section was performed for fetal distress and revealed a 5 cm vertical rent in the posterior lower uterine segment. The uterine perforation was repaired intraoperatively. Mother and infant did well and were discharged home on postoperative day four.

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Case Report: Acute abdomen presentation revealing a metastatic invasive mole with uterine rupture

F1000Research ◽

10.12688/f1000research.74051.1 ◽

2021 ◽

Vol 10 ◽

pp. 1115

Author(s):

Fatma Dhieb ◽

Miriam Boumediene ◽

Armi Saoussem ◽

Garci Mariem ◽

Mathlouthi Nabil ◽

...

Keyword(s):

Acute Abdomen ◽

Uterine Rupture ◽

Pulmonary Nodules ◽

Gestational Trophoblastic Disease ◽

Molar Pregnancy ◽

Gestational Trophoblastic Neoplasia ◽

Trophoblastic Tumor ◽

Clinical Presentations ◽

History Of ◽

Invasive Mole

Gestational trophoblastic neoplasia refers to the aggressive subset of gestational trophoblastic disease, including invasive mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor. These tumors may have atypical clinical presentations that can mislead the diagnosis. The reported case is a 48-year-old woman in perimenopause, without any history of vaginal bleedings nor molar pregnancy, who presented to the Emergency Department with acute abdominal pain. Serum beta human chorionic gonadotropin (β-HCG) was highly elevated at 261 675.23 mIU/ml. A complicated invasive mole was suspected, and an abdominal computed tomography was performed, showing a moderate hemoperitoneum associated to complex cystic and solid uterine mass, with a common left iliac adenomegaly and multiple pulmonary nodules. MRI showed a multiloculated cystic uterine mass with zones of hemorrhage recalling an invasive mole with perforation of the posterior uterus wall, associated to a high abundance hemoperitoneum. The diagnosis of a metastatic invasive mole complicated of uterine rupture and hemoperitoneum was retained. A surgical intervention was decided immediately and a subtotal hysterectomy with bilateral annexectomy was done. Pathologic examination of the specimen was positive for an invasive mole. The patient was proposed for chemotherapy. This case study will increase awareness of unusual clinical presentations of gestational trophoblastic neoplasia We believe that our case will contribute to the literature not only because of the rarity of this entity in perimenopausal period, but also due the atypical clinical presentation as acute abdomen without vaginal bleeding nor history of molar pregnancy evacuation

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An example of Non-Cooperative patient attitude and legal implications

Annals of King Edward Medical University ◽

10.21649/akemu.v10i1.1166 ◽

2016 ◽

Vol 10 (1) ◽

Author(s):

Khurram Ahmad ◽

Tahira Bashir Solehria

Keyword(s):

Case Report ◽

Cesarean Section ◽

Uterine Rupture ◽

Mode Of Delivery ◽

Operative Delivery ◽

Clear Indication ◽

Multiple Hazards ◽

Legal Implications ◽

History Of ◽

Primary Management

Previous two Cesarean Section is a clear indication for C/section at term for safe mode of delivery. In earlier gestation if labour sets in and it fails to respond to tocolytics or in situations where tocolysis is contraindicated, even then operative delivery is safe mode. This is a case report of a patient with history of laparotomy for repair of uterine rupture followed by four cesarean section. In her last pregnancy she presented with premature preterm established labor obstetrician decided about cesarean section on failure of primary management with tocolytics and dexamethasone. But she refused to give consent for cesarean section. Although she went safe and sound along her baby after three days of delivery but exposed her self, her baby and the obstetrician to multiple hazards.

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