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 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 Silent Spontaneous Uterine Rupture at 36 Weeks of Gestation

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
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.

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.

Uterine rupture secondary to placenta percreta in a near-term pregnant woman with a history of hysterotomy

2010 ◽  
Vol 37 (1) ◽  
pp. 71-74 ◽  
Author(s):  
Ching-Hui Chen ◽  
Peng-Hui Wang ◽  
Jui-Yu Lin ◽  
Yen-Hsieh Chiu ◽  
Hong-Ming Wu ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Uterine Rupture ◽  
Placenta Percreta ◽  
History Of ◽  
Near Term

scholarly journals A CASE OF SILENT SPONTANEOUS UTERINE RUPTURE AT 27-28 WEEKS OF GESTATION, TWO PRIOR C- SECTIONS AND HISTORY OF UTERINE RUPTURE

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Lutfi, M.D. ◽  
Tengku Puspa Dewi
Keyword(s):  
Uterine Rupture ◽  
Spontaneous Rupture ◽  
Hypovolemic Shock ◽  
Postoperative Recovery ◽  
Base Line ◽  
Second Trimester ◽  
Spontaneous Uterine Rupture ◽  
Risk Of Rupture ◽  
History Of ◽  
High Index Of Suspicion

Introduction.Silent spontaneous rupture of the uterus at the second trimester of gestation was very rare. In this case was accompaniedby extrusion of an intact amniotic sac and normal fetal heart rate base line. Silent uterine rupture can be very difficult to diagnose, as the clinical features of uterine rupture, including abdominal pain, vaginal bleeding, maternal hypovolemic shock or hemorrhage, may be absent.Very few cases have been reported in literature.CasePresentation.Wereport a case of silent spontaneous uterine ruptureat 27-28 Weeks of Gestation.Patient had history of two prior cesarean sections with the last C-sections has uterine rupture. The residents were misdiagnosis silent spontaneous rupture with condition of dyspepsia. She underwent cesarean subtotal hysterectomy and deliveredalive infant. She had a good postoperative recovery and was discharged on postoperative day 3. Conclusion.Silent spontaneous rupture of the uterus at second trimester of gestation with extrusion of an intact amniotic sac is rare.For this case even there were no sign of acute abdomen and shock but only sign of dyspepsia. We have to think about the risk of Rupture uterine imminens. A high index of suspicion and good imagingduring pregnancy are important in making this diagnosis. Keywords: uterine rupture, dyspepsia, cesareanhysterectomy

scholarly journals Spontaneous Uterine Rupture in a Preterm Pregnancy following Myomectomy

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Claire Sutton ◽  
Prue Standen ◽  
Jade Acton ◽  
Christopher Griffin
Keyword(s):  
Abdominal Pain ◽  
Caesarean Section ◽  
Uterine Rupture ◽  
Good Condition ◽  
Acute Onset ◽  
Uterine Wall ◽  
Unusual Presentation ◽  
Postoperative Course ◽  
Spontaneous Uterine Rupture ◽  
History Of

A 44-year-old nulliparous woman was transferred to a tertiary obstetric hospital for investigation of acute onset abdominal pain. She was at gestation of 32 weeks and 2 days with a history of previous laparoscopic fundal myomectomy. An initial bedside ultrasound demonstrated oligohydramnios. Following an episode of increased pain early the following morning, a formal ultrasound diagnosed a uterine rupture with the fetal arm extending through a uterine rent. An uncomplicated classical caesarean section was performed and the neonate was delivered in good condition but with a bruised and oedematous right arm. The neonate was transferred to the Special Care Nursery for neonatal care. The patient had an uncomplicated postoperative course and was discharged home three days following delivery. This is an unusual presentation of uterine rupture following myomectomy where the fetal arm had protruded through the uterine wall.

scholarly journals Determinants of anemia among pregnant women: A hospital based cross sectional study

2019 ◽  
Vol 8 (9) ◽  
pp. 3609
Author(s):  
P. Kalpana ◽  
A. Kavitha
Keyword(s):  
Pregnant Women ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Hemoglobin Level ◽  
Sectional Study ◽  
Cross Sectional ◽  
Lower Segment Cesarean Section ◽  
Menstrual History ◽  
History Of ◽  
The Mean

Background: The objective was to study the determinants of anemia among pregnant women. There is a negative effect on the health of the mother and as well as that of the child due to anemia in women with pregnancy. Death rate is more in women who are pregnant and having anemia. The objective of this study was to study the determinants of anemia among pregnant women.Methods: A hospital based cross sectional study was carried out among 40 pregnant women over a period of six months. Demographic data like age, residence, occupation etc was recorded. Obstetric data like gravida, parity, previous LSCS was also recorded. The data was presented as means and student’s t test was applied.Results: The mean age was 23.43±3.4 years. Majority were young between the ages of 19-22 years. Majority belonged to urban residents i.e. 57.5%. 20% of the subjects were found to be illiterate. Majority of the mothers were housewives i.e. 82.5%. Majority were multi-gravida i.e. 60%. Majority had no history of abortions in the past i.e. 75%. Out of total 19 repeat pregnancies, majority i.e. 84.2% had lower segment cesarean section. Majority reported that they had normal menstrual history. The mean hemoglobin level was found out to be 7.94 gm/dl. It was found that the mean hemoglobin level did not differ significantly across age, residence, education, occupation, gravidity, history of abortions, type of delivery but differed significantly by abnormal menstrual cycle.Conclusions: Mean hemoglobin level was more in women with normal menstrual history compared to those women with abnormal menstrual history and this difference was found out to be statistically significant. Hence abnormal menses should be promptly treated, hemoglobin assessed.

scholarly journals A case report: spontaneous postpartum rupture of unscarred uterus

2018 ◽  
Vol 7 (8) ◽  
pp. 3420
Author(s):  
Swati Singh ◽  
Ravinder Ahlawat
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Unusual Case ◽  
Surgical Intervention ◽  
Emergency Laparotomy ◽  
Full Thickness ◽  
Uterine Incision ◽  
History Of ◽  
Rupture Of Uterus ◽  
Specific Symptoms

Rupture of uterus is characterized by a breach in the wall of the uterus involving its full thickness. An unscarred uterus rupture is uncommon. It has non-specific symptoms and presentation differs according to site and time of rupture. Authors report an unusual case of spontaneous rupture of unscarred uterus. A 32-year-old, pregnant woman, developed postpartum bleeding with no history of prior uterine incision. She was diagnosed as a case of rupture of uterus and emergency laparotomy was done. Early diagnosis and immediate surgical intervention may significantly improve the prognosis. Differential diagnosis of uterine rupture should always be kept in mind in all patients with or without risk factors.

scholarly journals Group B Streptococcus Recto-Vaginal Colonization in Near-Term Pregnant Women, Southwest Ethiopia

2020 ◽  
Vol 30 (5) ◽  
Author(s):  
Woubishet Girma ◽  
Nadia Yimer ◽  
Tesfaye Kassa ◽  
Elias Yesuf
Keyword(s):  
Pregnant Women ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Group B Streptococcus ◽  
Susceptibility Pattern ◽  
Southwest Ethiopia ◽  
Vaginal Colonization ◽  
History Of ◽  
Near Term ◽  
Group B

BACKGROUND: Group B Streptococcus (GBS) is recognized as an important cause of maternal and neonatal morbidity and mortality. Maternal vaginal carriage of GBS (Streptococcus agalactiae) can lead to vertical transmission to the neonate at the time of delivery. However, little is known about its prevalence, predictors and antibiotic susceptibility pattern in Jimma, Ethiopia. This study assessed the prevalence, antimicrobial susceptibility pattern and determinants of GBS recto-vaginal colonization among near-term pregnant women.METHODS: A cross-sectional study was conducted from May to August 2015 at Jimma University Medical Centre in Southwest Ethiopia. Data through questionnaire and GBS isolates from vaginal and rectal swabs were collected. Antimicrobial susceptibility testing was performed.RESULTS: The overall prevalence of GBS colonization among near term pregnant women (35-37 weeks) was 16.3% (22/135). The majority of GBS isolates were sensitive to Ampicillin and Penicillin G with 95.5% and 90.1%, respectively. Erythromycin and clindamycin were resisted by 50% and 40.9% of the isolates, respectively, whereas gentamicin was resisted by all isolates. GBS colonization was significantly associated with a history of preterm delivery (PTD) (AOR: 6.3, 95% CI: 1.42, 28.3) and history of urinary tract infection (UTI) during current pregnancy (AOR: 6.4, 95% CI, 1.95, 21.1).CONCLUSION: Our study indicated that one among six near-term pregnant women had recto-vaginal GBS colonization. In places where universal screening is not feasible, selective screening for factors particularly history of PTD and UTI during current pregnancy may be a reasonable option. Antibiotic susceptibility testing should be performed while using Erythromycin, Clindamycin or Gentamicin. 

scholarly journals Uterine Rupture with Massive Late Postpartum Hemorrhage due to Placenta Percreta Left Partially In Situ

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Mehmet Coskun Salman ◽  
Pinar Calis ◽  
Ozgur Deren
Keyword(s):  
Uterine Rupture ◽  
Bladder Wall ◽  
Placental Tissue ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Uterine Wall ◽  
Placenta Percreta ◽  
Emergency Laparotomy ◽  
Life Threatening

Placental adhesive disorders involve the growth of placental tissue into or through the uterine wall. Among these disorders, placenta percreta is the rarest one. However, it may cause significant complications. This report aimed to report a neglected patient with placenta percreta who developed uterine rupture with life-threatening late postpartum intra-abdominal hemorrhage. On admission, the patient had acute abdomen with moderate abdominal distention and was subjected to emergency laparotomy. A full-thickness defect of the anterior uterine wall involving the hysterotomy site was seen. Placental tissues occupied both sides of the incision and posterior bladder wall was also invaded by placenta. Total abdominal hysterectomy with partial resection of the posterior bladder wall was performed.

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