scholarly journals An Exceptional Case of Uterine Rupture on a Scarred Uterus Discovered Following a Late Abortion

2021 ◽  
pp. 1-3
Author(s):  
M Serraj andaloussi ◽  
Keyword(s):  
Uterine Rupture ◽  
Case Reports ◽  
First Trimester ◽  
Exceptional Case ◽  
True Incidence ◽  
Small Series ◽  
Life Threatening ◽  
History Of ◽  
Late Abortion ◽  
Scarred Uterus

Uterine rupture (UR) is a life-threatening peripartum complication with a high incidence of maternal morbidity and mortality. It is quite common in the third trimester of pregnancy ranging from 1 / 8,000 to 1 / 15,000 pregnancies. Its true incidence in the first trimester is unknown as most of the reports are case reports or small series of cases. We report an exceptional case of uterine rupture at 13 weeks of amenorrhea in a 34-year-old patient with a history of a cesarean delivery 2 years ago, discovered following a late abortion due to persistent bleeding and failure of aspiration. Through this observation we would like to draw the attention of practitioners to this diagnosis, which is often overlooked in the first trimester.

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.

scholarly journals First Trimester Uterine Rupture: A Case Report and Literature Review

2020 ◽  
Vol 17 (8) ◽  
pp. 2976
Author(s):  
Fabiana Cecchini ◽  
Alice Tassi ◽  
Ambrogio P. Londero ◽  
Giovanni Baccarini ◽  
Lorenza Driul ◽  
...  
Keyword(s):  
Uterine Rupture ◽  
Case Reports ◽  
Good Condition ◽  
First Trimester ◽  
Emergency Laparotomy ◽  
Cesarean Scar Pregnancy ◽  
Spontaneous Uterine Rupture ◽  
History Of ◽  
Group A ◽  
English Articles

The aim is to report a case of spontaneous uterine rupture in the first trimester of pregnancy and to review the literature on the topic. Methods: A literature search was performed using PubMed and Scopus. Relevant English articles were identified without any time or study limitations. The data were aggregated, and a summary statistic was calculated. Results: A 35-year-old gravida 5, para 2 was admitted at our department because of fainting and abdominal pain. The woman had a first-trimester twin pregnancy and a history of two previous cesarean sections (CSs). Suspecting a uterine rupture, an emergency laparotomy was performed. The two sacs were completely removed, and the uterine rupture site was closed with a double-layer suture. The patient was discharged from hospital four days later in good condition. On the basis of this experience, a total of 76 case reports were extracted from PubMed and included in the review. Fifty-three patients out of 76 (69.74%) underwent previous surgery on the uterus. Most women (67.92%) had a CS, and in this group a cesarean scar pregnancy (CSP) or a placenta accreta spectrum (PAS) disorder was found to be the etiology in 77.78% of cases. Furthermore, 35.85% of the women had hysterectomy after uterine rupture. Twenty-three patients out of 76 (30.26%) had an unscarred uterus. Of this group, most women presented a uterine anomaly (43.48%). Moreover, 17.39% of these women had a hysterectomy. Conclusion: According to the literature, the current pandemic use of CS explains most cases of first-trimester uterine rupture.

scholarly journals Sirenomelia: two case reports

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Asiyeh Shojaee ◽  
Firooze Ronnasian ◽  
Mahdiyeh Behnam ◽  
Mansoor Salehi
Keyword(s):  
Case Reports ◽  
Three Dimensional ◽  
First Trimester ◽  
Mendelian Inheritance ◽  
Lower Limbs ◽  
Congenital Deformity ◽  
White Family ◽  
Her Family ◽  
Caudal Regression ◽  
History Of

AbstractBackgroundSirenomelia, also called mermaid syndrome, is a rare lethal multi-system congenital deformity with an incidence of one in 60,000–70,000 pregnancies. Sirenomelia is mainly characterized by the fusion of lower limbs and is widely associated with severe urogenital and gastrointestinal malformations. The presence of a single umbilical artery derived from the vitelline artery is the main anatomical feature distinguishing sirenomelia from caudal regression syndrome. First-trimester diagnosis of this disorder and induced abortion may be the safest medical option. In this report, two cases of sirenomelia that occurred in an white family will be discussed.Case presentationWe report two white cases of sirenomelia occurring in a 31-year-old multigravid pregnant woman. In the first pregnancy (18 weeks of gestation) abortion was performed, but in the third pregnancy (32 weeks) the stillborn baby was delivered by spontaneous vaginal birth. In the second and fourth pregnancies, however, she gave birth to normal babies. Three-dimensional ultrasound imaging showed fusion of the lower limbs. Neither she nor any member of her family had a history of diabetes. In terms of other risk factors, she had no history of exposure to teratogenic agents during her pregnancy. Also, her marriage was non-consanguineous.ConclusionThis report suggests the existence of a genetic background in this mother with a Mendelian inheritance pattern of 50% second-generation incidence in her offspring.

scholarly journals Spontaneous rupture of an unscarred uterus in early pregnancy: a rare but life-threatening emergency

2019 ◽  
Vol 12 (5) ◽  
pp. e228493 ◽  
Author(s):  
Bedayah Amro ◽  
Ghassan Lotfi
Keyword(s):  
Early Pregnancy ◽  
Uterine Rupture ◽  
Laparoscopic Approach ◽  
First Trimester ◽  
Rare Occurrence ◽  
Spontaneous Uterine Rupture ◽  
First Case ◽  
Life Threatening ◽  
First Trimester Of Pregnancy ◽  
Underlying Risk

Spontaneous uterine rupture during early pregnancy is an extremely rare occurrence and may vary in presentation and course of events, hence the clinical diagnosis is often challenging. We present our experience with two such cases of spontaneous uterine rupture in the first trimester of pregnancy without any identifiable underlying risk factors. The first case was at 12 weeks of gestation and the second case was at 6 weeks gestational age (GA). Both cases were diagnosed and managed by the laparoscopic approach. We are reporting the earliest documented GA in which spontaneous uterine rupture occurred. So far, the earliest GA reported in the literature according to our knowledge was at 7+3 weeks. Access to a laparoscopic facility is crucial in the early definitive diagnosis and prompt management of these cases, since this may significantly reduce the risk of severe morbidity and mortality.

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 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 Carcinosarcoma of the Bladder: A Case Report and Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Doğan Atılgan ◽  
Yusuf Gençten
Keyword(s):  
Case Report ◽  
Urinary Bladder ◽  
Transurethral Resection ◽  
Tumor Recurrence ◽  
Case Reports ◽  
Sarcomatoid Carcinoma ◽  
Review Of The Literature ◽  
Biological Behaviour ◽  
Small Series ◽  
History Of

Carcinosarcoma of the urinary bladder is a rare neoplasm that is composed of malignant epithelial and mesenchymal components. In these tumors, histogenesis and biological behaviour remain controversial. Approximately 70 cases have been reported in the literature, usually as case reports or a small series. A series of 221 cases using the Surveillance, Epidemiology and End Results (SEER) Program database has been reported recently. Optimal treatment is uncertain. Herein, we report a case of sarcomatoid carcinoma of urinary bladder of a farmer aged 84 years old with a year history of hematuria and dysuria. A transurethral resection of the tumor (TUR-T) revealed a carcinosarcoma. The patient underwent radical cystectomy, and there is no tumor recurrence for 15 months after treatments.

scholarly journals A rare case of unruptured tubal pregnancy at ten weeks of gestation

2014 ◽  
Vol 2 (3) ◽  
pp. 148-151
Author(s):  
Shreyashi Aryal ◽  
Meena Thapa ◽  
Chanda Karki
Keyword(s):  
Average Duration ◽  
Case Reports ◽  
Tubal Pregnancy ◽  
Crown Rump Length ◽  
Medical College ◽  
Foot Length ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Gestational Sac

Ectopic pregnancy is a life threatening condition and can present itself in diverse ways. This case reports a 23 years primigravida, admitted with history of amenorrhoea of ten weeks and right sided unruptured tubal pregnancy diagnosed on routine ultrasonography. On laparoscopy, there was an unruptured tubal pregnancy with gestational sac measuring around 6 × 5 cm. The foetus had crown rump length of 32 mm and foot length of 5 mm; both of which correspond probably to 10 to 11 weeks size. Segmental resection of the affected part of the fallopian tube was done laparoscopically. Rarely tubal pregnancy can remain asymptomatic and unruptured for longer duration of gestation than the usual scenario. The reported average duration of diagnosis of unruptured tubal pregnancy is of nine weeks and this case explores the possibility of removing an intact foetus at longer gestational age through laparoscopy.Journal of Kathmandu Medical College Vol. 2, No. 3, Issue 5, Jul.-Sep., 2013 Page: 148-151DOI: http://dx.doi.org/10.3126/jkmc.v2i3.9966Uploaded date : 3/4/2014

scholarly journals Uterine Rupture at a Site Distant From Old Scar: An Unusual Presentation

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Poonam Shakya ◽  
Sonam Jindal ◽  
Avir Sarkar ◽  
Ankita Yadav ◽  
Jagadish Chandra Sharma
Keyword(s):  
Uterine Rupture ◽  
Index Case ◽  
Neonatal Morbidity ◽  
Fetal Demise ◽  
Area Index ◽  
Surgical Incision ◽  
Caesarean Scar ◽  
Life Threatening ◽  
Scarred Uterus ◽  
A Site

Uterine rupture is a rare life threatening emergency with severe obstetric consequences. Most ruptures occur in a scarred uterus at the site of previous transmyometrial surgical incision. However, rupture on site distant from previous scar is a very rare entity. It is associated with major maternal and neonatal morbidity than rupture at a scarred area. Index case describes a scenario where uterine rupture occurred at the fundal region, far away from previous caesarean scar site leading to fetal demise. Till now, only a very few cases with uterine rupture away from the site of previous caesarean scar have been reported. Keywords: uterine rupture, unscarred uterus, acute abdomen, hemoperitoneum

scholarly journals Life-threatening events in patients with pheochromocytoma

2015 ◽  
Vol 173 (6) ◽  
pp. 757-764 ◽  
Author(s):  
Anna Riester ◽  
Dirk Weismann ◽  
Marcus Quinkler ◽  
Urs D Lichtenauer ◽  
Sandra Sommerey ◽  
...  
Keyword(s):  
Case Reports ◽  
Hypertensive Crisis ◽  
Hospital Treatment ◽  
Lung Edema ◽  
Tumor Diameter ◽  
Small Series ◽  
Life Threatening ◽  
Threatening Situation ◽  
Cerebrovascular Stroke ◽  
Design And Methods

ObjectivePheochromocytomas are rare chromaffin cell-derived tumors causing paroxysmal episodes of headache, palpitation, sweating and hypertension. Life-threatening complications have been described in case reports and small series. Systematic analyses are not available. We took an opportunity of a large series to make a survey.Design and methodsWe analyzed records of patients diagnosed with pheochromocytomas in three geographically spread German referral centers between 2003 and 2012 (n=135).ResultsEleven percent of the patients (ten women, five men) required in-hospital treatment on intensive care units (ICUs) due to complications caused by unsuspected pheochromocytomas. The main reasons for ICU admission were acute catecholamine induced Tako-Tsubo cardiomyopathy (n=4), myocardial infarction (n=2), acute pulmonary edema (n=2), cerebrovascular stroke (n=2), ischemic ileus (n=1), acute renal failure (n=2), and multi organ failure (n=1). One patient required extracorporeal membrane oxygenation due to a hypertensive crisis with lung edema occurring during delivery (n=1). Two patients died of refractory shock and pheochromocytomas were found postmortem. Two patients were treated by emergency surgery. Compared to pheochromocytoma patients without life-threatening events (n=120), patients with complications had a significant larger maximal tumor diameter (7.0 vs 4.5 cm, P<0.01), higher levels of catecholamines (20- vs ninefold upper limit of normal, P<0.01), and tended to be younger (42 vs 51 years, P=0.05).ConclusionAlthough pheochromocytomas are rare, they are likely to be associated with a life-threatening situation. Clinicians have to be aware of these situations and perform a timely diagnosis.

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