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 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 Second trimester rupture of an unscarred uterus following blunt trauma: a case report

2018 ◽  
Vol 7 (10) ◽  
pp. 4305
Author(s):  
Basil Mathews ◽  
Chitra T.
Keyword(s):  
Blood Transfusion ◽  
Acute Abdomen ◽  
Blunt Trauma ◽  
Uterine Rupture ◽  
Third Trimester ◽  
Increased Risk ◽  
Life Threatening ◽  
History Of ◽  
Rupture Of Uterus ◽  
Scarred Uterus

Uterine rupture is a life-threatening emergency in obstetrics carrying an increased risk of maternal and foetal morbidity and mortality. Often, uterus ruptures during labour; however, scarred uterus may rupture before the onset of contractions in the late third trimester. Uterine rupture in an unscarred uterus occurs extremely rare. Various aetiology has been described in literature from anomalous uterus, uterine manoeuvres, and abnormal placentation to congenital exposure to Diethylstilbestrol.  Maternal outcome depends greatly on the early diagnosis, prompt management and availability of emergency expert care and blood transfusion. However, the diagnosis is not always obvious with its varied non-specific presentation. Most common presentation of rupture uterus is acute abdomen, which is often mistaken for other causes like acute pancreatitis, appendicitis, cholecystitis, especially in the early pregnancy. Authors report a case of grand multipara at 19 weeks of gestation presented as acute abdomen. She was referred as incomplete abortion in need of blood transfusion, later diagnosed to be rupture of uterus. She had abdominal pain and vaginal bleeding for 14hours duration prior to admission. On further inquiry, history of blunt trauma to abdomen, the day prior was revealed.

Obsessive—Compulsive Disorder in Post-Streptococcal Infection

1998 ◽  
Vol 32 (4) ◽  
pp. 579-581
Author(s):  
Erik Monasterio ◽  
Roger T. Mulder ◽  
Thomas D. Marshall
Keyword(s):  
Streptococcal Infection ◽  
Past History ◽  
Sudden Onset ◽  
Autoimmune Response ◽  
Progressive Reduction ◽  
Obsessive Compulsive ◽  
Obsessive Compulsive Symptoms ◽  
Compulsive Disorder ◽  
History Of ◽  
Peritoneal Infection

Objective: We describe the sudden onset of obsessive—compulsive symptoms fol lowing a peritoneal infection with α-haemolytic streptococci. Clinical picture: A 35–year-old woman with no past history or family history of obsessions or compulsions developed these symptoms 2 weeks after a peritoneal infection. Treatment: The patient received 80 mg fluoxetine daily. Outcome: She responded to treatment with a progressive reduction in symptoms. Conclusions: It is suggested that these obsessions and compulsions may be related to an autoimmune response to the streptococcal infection.

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 A CASE REPORT -UTERINE RUPTURE AFTER PREVIOUS CAESAREAN SECTION

2021 ◽  
pp. 184-186
Author(s):  
Dr.Amrita Kishor Jeswani ◽  
Dr.Suman Saurabh Gupta ◽  
Dr.Rohit Kishor Jeswani
Keyword(s):  
Caesarean Section ◽  
Uterine Rupture ◽  
Rare Complication ◽  
Signs And Symptoms ◽  
Gravid Uterus ◽  
Previous Caesarean Section ◽  
Risk Of Rupture ◽  
Life Threatening ◽  
Rupture Of Uterus ◽  
Present Case Study

Uterine rupture though a rare complication is life threatening for mother as well as baby. The commonest cause for rupture of a gravid uterus is previous caesarean section. It is important that the risk of rupture of uterus is explained to the pregnant female who has undergone previous caesarean section. The symptoms with which the patient presents can be subjective and vague like pain in abdomen or of acute abdomen. The patient can also come with objective findings like non-reassuring fetal status and loss of fetal station. With previous caesarean section it is important to be vigilant throughout the pregnancy especially in third trimester. It is also imperative that the patient should be educated about the signs and symptoms of rupture uterus so that timely intervention can be done to save the life of mother and the baby. In the present case study, the USG scan revealed that the placenta had shifted and was covering the internal os from fundo-posterior position along with the shift of baby from cephalic presentation to transverse lie. Hence these case was a suspicious of rupture uterus which causes change in lie as well as presentation of baby.

scholarly journals Analyzing uterine rupture: A study from tertiary care centre of western Nepal

2017 ◽  
Vol 4 (3) ◽  
pp. 95-99
Author(s):  
Junu Shrestha ◽  
Rami Shrestha
Keyword(s):  
Uterine Rupture ◽  
Tertiary Care ◽  
Operative Management ◽  
Demographic Variables ◽  
Bladder Injury ◽  
Tertiary Care Centre ◽  
Microsoft Excel ◽  
Cross Sectional ◽  
Uterine Scar ◽  
Scarred Uterus

Background: Rupture uterus is a serious obstetric complication which if diagnosed and managed early improves foetomaternal outcome.Objectives: To determine the frequency, causes, management aspects and foeto-maternal outcome of uterine rupture.Methods: This is a cross sectional observational study conducted in Department of Obstetrics and Gynaecology of Manipal Teaching Hospital from July 2012 to June 2015. All cases of rupture uterus, both complete as well as incomplete, diagnosed during surgery were included. Patient’s demographic variables, clinical presentation, risk factors for rupture were studied. Factors related to rupture like the type, nature and site of uterine rupture were noted. The operative management, maternal and neonatal outcome of the patients was reviewed. All the information was entered in the Microsoft Excel chart sheet. Data was analyzed using simple frequencies and percentages.Results: There were 22 cases of uterine rupture and 7987 deliveries during that period giving frequency of 2.8 rupture uterus in every 1000 deliveries. Uterine scar following previous cesarean section was the commonest (72.7%) cause for rupture uterus. Repair was the commonest (86.4%) surgical treatment done. There was no maternal mortality. Blood transfusion was needed two-third of the cases. Other complications were bladder injury (9.1%), paralytic ileus (9.1%), acute renal failure (4.5%) and pneumonia (4.5%). The perinatal mortality was 45.5%.Conclusion: Uterine rupture is a grave obstetric event with maternal and perinatal morbidity and commonly follows pregnancies with scarred uterus.

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 Risk factors and outcomes of uterine rupture in Singapore: Emerging trends

2021 ◽  
Vol 50 (1) ◽  
pp. 5-15 ◽  
Author(s):  
Shu Qi Tan ◽  
Li Houng Chen ◽  
Dhilshad Muhd Abdul Qadir ◽  
Bernard SM Chern ◽  
George SH Yeo
Keyword(s):  
Uterine Rupture ◽  
Clinical Presentation ◽  
Past History ◽  
Common Factor ◽  
Laparoscopic Myomectomy ◽  
Contributing Factors ◽  
Antenatal Period ◽  
Lower Segment Caesarean Section ◽  
Emerging Trends ◽  
Scarred Uterus

ABSTRACT Introduction: Uterine rupture is uncommon but has catastrophic implications on the pregnancy. A scarred uterus and abnormal placentation are known contributory factors. The aim of our study was to review the contributing factors, clinical presentation, complications and management of uterine rupture in our population in light of the changing nature of modern obstetric practices. Methods: A retrospective observational study was conducted at KK Women’s and Children’s Hospital by studying proven cases of uterine rupture in the period between January 2003 and December 2014. These cases were analysed according to their past history, clinical presentation, complications, management and outcome. Results: A total of 48 cases of proven uterine rupture were identified. The incidence of uterine rupture was 1 in 3,062 deliveries. The ratio of scarred uterus rupture to unscarred uterus rupture was approximately 3:1. The most common factor was previous lower segment caesarean section for the scarred group, followed by a history of laparoscopic myomectomy. Abdominal pain was the common clinical presentation in the antenatal period, while abnormal cardiotocography findings were the most common presentation in intrapartum rupture. Conclusion: There is a notable shift in the trend of uterine rupture cases given the increasing use of laparoscopic myomectomy and elective caesarean sections. While ruptures from these cases were few, their presentation in the antenatal period calls for diligent monitoring with informed patient involvement in their pregnancy care. Keywords: Antenatal, laparoscopic myomectomy, birth after caesarean, rupture, VBAC

scholarly journals Is Foley Catheter Use during a Trial of Labor after Cesarean Associated with Uterine Rupture?

2019 ◽  
Vol 36 (14) ◽  
pp. 1431-1436
Author(s):  
Jennifer L. Katz Eriksen ◽  
Suchitra Chandrasekaran ◽  
Shani S. Delaney
Keyword(s):  
Uterine Rupture ◽  
Multinomial Logistic Regression ◽  
Foley Catheter ◽  
Secondary Analysis ◽  
Cervical Ripening ◽  
Trial Of Labor ◽  
Increased Risk ◽  
History Of ◽  
Observational Cohort ◽  
Uterine Scar

Objective We sought to assess the safety of transcervical Foley catheter (TCF) placement for cervical ripening in women undergoing induction of labor (IOL) after prior cesarean by evaluating the risk of uterine rupture. Study Design We performed a secondary analysis of the Maternal-Fetal Medicine Unit's Cesarean Section Registry, a prospective observational cohort study. We included women with a history of ≤2 low-transverse cesarean deliveries who underwent IOL at ≥24 weeks of gestational age with a live singleton fetus without major anomalies. We excluded those who received prostaglandins or laminaria. We performed multinomial logistic regression to calculate adjusted odds ratios (aORs) for uterine rupture and dehiscence. Relevant confounders included prior vaginal delivery, pregnancy-induced hypertension, chorioamnionitis, and cervical effacement and dilation on admission. Results A total of 2,564 women were eligible. Unadjusted analysis demonstrated no increased risk of uterine rupture with TCF (1.9 vs. 0.9%; p = 0.10) but an increased risk of uterine dehiscence (1.9 vs. 0.6%; p = 0.02). After adjustment, TCF was not associated with an increased risk of uterine rupture (aOR: 2.02; 95% confidence interval [CI]: 0.71–5.78) or uterine scar dehiscence (aOR: 1.32; 95% CI: 0.37–4.72). Conclusion Foley catheter is a safe tool for mechanical dilation in women undergoing IOL after prior cesarean.

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

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
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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