Abstract
IntroductionUterine rupture is a life-threatening condition both to mothers and fetuses. Its early diagnosis and treatment may save their lives. Previous myomectomy is a high risk factor for uterine rupture. Intestinal adhesion due to previous myomectomy may also prevent early diagnosis of uterine rupture.Case presentationA 38-year-old primiparous non-laboring Japanese woman with a history of myomectomy was admitted in her 34th week due to lower abdominal pain. Although the pain was slight and her vital signs were stable, computed tomography revealed massive fluid collection in her abdominal cavity, which led us to perform a laparotomy. Uterine rupture had occurred at the site of the previous myomectomy; however, the small intestine was adhered tightly to the rupture, thus masking it. The baby was delivered through a low uterine segment transverse incision. The ruptured uterine wall was reconstructed.ConclusionIntestinal adhesion due to a prior myomectomy occluded a uterine rupture, possibly masking its symptoms and signs, which may have prevented early diagnosis.
Highlights
Uterine rupture is a life-threatening condition both to mothers and fetuses
Case presentation: A 38-year-old primiparous non-laboring Japanese woman with a history of myomectomy was admitted in her 34th week due to lower abdominal pain
Uterine rupture had occurred at the site of the previous myomectomy; the small intestine was adhered tightly to the rupture, masking it
Summary
Diagnosis of uterine rupture and awareness of its risk factors are clinically important Previous uterine surgery, such as Cesarean section, myomectomy or adenomyomectomy, is a risk factor [2,3,4]. Case presentation A 38-year-old Japanese primiparous woman with a history of myomectomy four years previously complained of lower abdominal pain in her 34th week This was her second pregnancy with spontaneous conception, with her first pregnancy resulting in spontaneous abortion at six weeks one year earlier. A vaginal and abdominal ultrasound revealed no fluid retention in Pouch of Douglas and no apparent uterine rupture; no detailed observation of uterine wall continuity was. CTG subsequently indicated recurrent late deceleration, requiring an emergent Cesarean section Laparotomy revealed that her small intestine tightly covered the anterior uterine wall, with bleeding observed from the edge of the intestinal covering (Figure 1, arrow). The mother and baby had an uneventful course without sequelae
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
