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.

Non-penetrating uterine rupture along the scar after cesarean section and dehiscence/aneurysm of the uterine scar in the second half of pregnancy and during childbirth

2021 ◽  
Vol 6_2021 ◽  
pp. 66-72
Author(s):  
Savelyeva G.M. Savelyeva ◽  
Kurtser M.A. Kurtser ◽  
Breslav I Breslav ◽  
Yu. Yu ◽  
Karaganova E.Ya. Karaganova ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Uterine Rupture ◽  
Uterine Scar

scholarly journals Can third-trimester assessment of uterine scar in women with prior Cesarean section predict uterine rupture?

2016 ◽  
Vol 47 (4) ◽  
pp. 410-414 ◽  
Author(s):  
N. Jastrow ◽  
O. Vikhareva ◽  
R. J. Gauthier ◽  
O. Irion ◽  
M. Boulvain ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Uterine Rupture ◽  
Third Trimester ◽  
Uterine Scar ◽  
Prior Cesarean Section

scholarly journals Emergency obstetric hysterectomy: experience at a tertiary care centre in Central India

2019 ◽  
Vol 8 (8) ◽  
pp. 3280
Author(s):  
Jayashree Mulik ◽  
Tanvi Vibhute
Keyword(s):  
Cesarean Section ◽  
Uterine Rupture ◽  
Placenta Previa ◽  
Post Partum ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Central India ◽  
Tertiary Care Centre ◽  
Study Centre ◽  
Labour Room

Background: Obstetric hysterectomy is an important procedure in modern obstetrics and its proper indications, risks and complications need to be studied for judicious usage and improvement in outcome.Methods: A retrospective, record-based study was carried out over one and a half years at a tertiary care government hospital. All the patients who underwent emergency obstetric hysterectomy at the study centre during study period were studied. Labour room register, operation room register for emergency and elective cases, case records, referral slips and mortality register data were reviewed for the same and outcomes analysed.Results: Total 33 patients underwent emergency obstetric hysterectomy, with the incidence observed at 0.21%. The most common indications were atonic post-partum hemorrhage (42.4%), uterine rupture (33.3%) and morbidly adherent placenta (18.1%). Prior cesarean section (36.4%) and placenta previa (15.1%) were the commonest predisposing factors associated with PPH and uterine rupture. Subtotal hysterectomy (66.7%) was observed to be the preferred type of surgery. Out of total 7 maternal deaths that occurred, 4 (57%) were because of disseminated intravascular coagulation.Conclusions: There is increasing trend in the rate of obstetric hysterectomy along with rise in rate of previous LSCS, emphasizing the importance of the mode of delivery. Measures to reduce the rate of primary cesarean section are advisable.

scholarly journals A case of scarred uterine rupture at 11 weeks of gestation having a uterine scar places induced by in vitro fertilization-embryo transfer

2018 ◽  
Author(s):  
Akiko Takashima ◽  
Naoki Takeshita ◽  
Toshihiko Kinoshita
Keyword(s):  
In Vitro Fertilization ◽  
Cesarean Section ◽  
Uterine Rupture ◽  
Early Recognition ◽  
Placenta Previa ◽  
Lower Abdominal Pain ◽  
Vitro Fertilization ◽  
Increased Risk ◽  
Uterine Scar

Having a uterine scar places a woman at increased risk of complications, such as Cesarean scar pregnancy (CSP), uterine rupture, placenta previa, and placenta accreta, in subsequent pregnancies. We report a case of uterine rupture at 11 weeks of gestation in a woman with a previous Cesarean section. A 43-year-old woman with a history of abdominal myomectomy and Cesarean section had her pregnancy induced by in vitro fertilization with donor eggs. The exact location of the gestational sac was identified on her first day of hospitalization, and her pregnancy was suspected to be a CSP. The following day, the patient complained of sudden lower abdominal pain. A uterine scar rupture was diagnosed, and an emergency surgery was required. It may be that first-trimester screening could allow the early recognition of patients at risk for these perinatal complications.

scholarly journals An example of Non-Cooperative patient attitude and legal implications

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.

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 Characteristics of clinical progress of vaginal delivery after cesarean section

2012 ◽  
Vol 61 (6) ◽  
pp. 41-47
Author(s):  
Lyudmila Evgenyevna Petrova ◽  
Tatyana Ulyanovna Kuzminykh ◽  
Igor Uryevich Kogan ◽  
Ekaterina Vasilyevna Mikhalchenko
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Uterine Cervix ◽  
Uterine Rupture ◽  
Induction Of Labor ◽  
Clinical Criterion ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Uterine Scar ◽  
Labor Onset

The 982 cases of women with uterine scar after cesarean section were analyzed. Clinical criterion of uterine scar consistency is the “maturity” uterine cervix and greater response of uterine cervix to the delivery preparation. Characteristics of vaginal delivery after cesarean section clinical progress are the following: spontaneous labor onset (95,5 %), abnormal labor (11,9 %), premature rupture of membranes (46,4 %). Induction of labor caused increased the frequency of dystocia by a factor of 2, whereas risk of repeated cesarean section increased 2.3. Frequency of the uterine rupture in these labor cases was 0,73 %.

scholarly journals Algorithm for the management of patients with incompetence of postoperative uterine scar after a cesarean section, our clinical experience

2018 ◽  
Vol 9 (3) ◽  
pp. 38-43
Author(s):  
O. M. Kogan ◽  
N. B. Voytenko ◽  
E. A. Zosimova ◽  
E. N. Martynova ◽  
D. M. Nersesayn ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Clinical Experience ◽  
Reconstructive Surgery ◽  
Uterine Rupture ◽  
Premature Labor ◽  
Uterine Scar

The growth of the cesarean section frequency has created a new healthcare problem – follow up of pregnancy in women with a uterine scar. The pregnancy course in the case of an incompetent uterine scar poses risks of not only a premature labor, but also of a uterine rupture during the entire gestation. Currently, the issues of the diagnostics and reconstructive surgery for an incompetent uterine scar after a cesarean section when planning a pregnancy remain understudied.

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