Case Of Spontaneous Uterine Rupture Research Articles

Spontaneous rupture of uterine during pregnancy after laparoscopic myomectomy: A case report

The danger of future uterine rupture is a serious concern for women who become pregnant after uterine leiomyomectomy or adenomyomectomy, despite the fact that these procedures are commonly used to alleviate symptoms like dysmenorrhea or hypermenorrhea and improve fertility. Although it happens very infrequently, uterine rupture is the most dreaded pregnancy complication and is linked to a high rate of maternal and fetal morbidity and mortality. Here, we present a case of spontaneous uterine rupture during the third trimester of pregnancy.

Life-Threatening Obstetrical Emergency: Spontaneous Uterine Rupture Associated with Placenta Percreta in the First Trimester of Pregnancy—Case Report and Literature Review

Background: The greatest risk for the occurrence of the placenta accreta spectrum (PAS) is represented by uterine scars, which most frequently result after cesarean sections. Uterine rupture is a rare condition and appears mainly in the third trimester of pregnancy. The association between these two conditions is extremely rare in the first trimester of pregnancy. Methods: We performed a systematic review of abnormal placental adhesions and spontaneous uterine ruptures in the first trimester of pregnancy. We also reported a case of spontaneous uterine rupture in a 12-week pregnancy that presented with massive hemoperitoneum and hemorrhagic shock. Results: A 33-year-old patient with two previous cesarean sections, at the twelfth week of pregnancy at the time to this visit to the emergency room, presented with syncope and intense pelvic–abdominal pain. A clinical examination and ultrasound scan established the diagnosis of hemoperitoneum and hemorrhagic shock. Surgical exploration was performed, uterine rupture was identified, and hemostasis hysterectomy was necessary. The histopathological results showed placenta percreta. There have been eight reported cases of spontaneous uterine rupture in the first trimester of pregnancy associated with PAS. In these cases, it was found that 62.5% of the patients had undergone at least one cesarean section in the past; in 75% of the cases, hysterectomy was performed; and, in 87.5% of the cases, the presence of placenta percreta was confirmed. Conclusions: A high rate of cesarean sections determines the increase in the incidence of placenta accreta spectrum disorders. The possible life-threatening complications caused by this pathology can be observed in early pregnancies.

A Rare Case of Spontaneous Uterine Rupture in Second Trimester Pregnancy with Bicornuate Uterus: A Case Report

Eighteen weeks gestation of 34 years-old-woman with abdominal pain in the last 12 hours because of uterine rupture. Abdominal pregnancy was found with 2D ultrasound. On laparotomy exploration, bicornuate uterus was found with uterine rupture and an unviable fetus. Supravaginal hysterectomy was performed to control haemorrhage. Uterine anomaly is rare. However, the complications that occur will be an obstetric emergency. Screening uterine anomalies at premarital or early antenatal care is needed for predicting the risk of maternal mortality.

Spontaneous Uterine Rupture Of Healthy Uterus : About A Case And Literature Review

Uterine rupture in a healthy uterus remains a rare complication of labour. However, given its seriousness in putting the life of the mother and the fetus at risk, it is important to think about it in the presence of any metrorrhagia during labour, even in a healthy uterus. It is more frequent in the case of a scarred uterus. We present a rare case of spontaneous uterine rupture in a healthy uterus in a 28 year old patient with no previous history of pathological history, diagnosed after six hours of delivery due to postpartum haemorrhage. Through this case and the review of the literature, we discuss the extreme caution that must be maintained even in the case of a non-scarring uterus, as well as the clinical signs of appeal, the risk factors, the diagnostic methodology and the therapeutic management of this rare but potentially serious entity.

An Unusual Case of Spontaneous Uterine Rupture After a Salpingectomy Following an Interstitial Ectopic Pregnancy

Spontaneous uterine rupture following a history of surgical treatment of an interstitial tubal ectopic pregnancy (EP) is a rare clinical form. This uterine rupture occurring after a wedge resection of the uterine horn, is a serious obstetric complication involving maternal and fetal vital prognosis and obstetric fate of patients in the absence of immediate management. Our observation concerned a 32-year-old gestant, G3P1 (without living children), with a history of interstitial EP dating back to 3 years during which a uterine wedge resection was performed. For this patient, a prophylactic caesarean was recommended between 36 and 37 weeks of amenorrhea. The patient presented during her prenatal follow-up at 37 weeks and 6 days, a complete uterine rupture involving the right uterine horn with the death of a fetus weighing 2900g. The rupture extended throughout the uterine horn, with the right uterine pedicle intact and the right fallopian tube absent. A conservative treatment of the uterus was decided since the patient had no living children. The purpose of our observation is to recall the risk of uterine rupture after cornual uterine excision hence the importance of performing during a EP if possible, a salpingectomy at the level of the uterine horn and if necessary coagulate the intramural portion of the tube. And also in case of uterine wedge resection, to hasten the prophylactic caesarean section as soon as sufficient maturity of the fetus to reduce the incidence of this pregnancy complication.

Placental site trophoblastic tumor during pregnancy complicated by uterine rupture

The placental site trophoblastic tumor is a rare highly malignant form of trophoblastic disease, which occurs in as few as 0.4-2.0 % of all trophoblastic tumors. Available publications describes not more than 200 clinical cases of this pathology often affecting patients of reproductive age, thereby underscoring special importance of its diagnostics and treatment. Here we describe the rare clinical case of spontaneous uterine rupture in pregnant woman at 26 weeks of gestation carrying placental site trophoblastic tumor, previously undescribed in research literature. The complexity of diagnosing such pathology that resulted in antenatal fetal death and hysterectomy is demonstrated.

Clinical analysis of 12 cases of spontaneous uterine rupture caused by placenta percreta

Objective: To investigate the clinical characteristics and early identification of spontaneous rupture of uterus caused by placenta percreta. Methods: The clinical data of 12 patients with spontaneous uterine rupture caused by placenta percreta and admitted to the First Affiliated Hospital of Zhengzhou University from June 2014 to December 2019 were collected. The age, gestational age, gestational history, clinical manifestations, diagnostic methods, uterine operation history, rupture location, surgical method, treatment and outcome were analyzed. Results: (1) General condition: the median age of pregnant women was 37 years (range: 30-43 years), and the median gestational week of uterine rupture was 29+6 weeks (range: 18+3-36+3 weeks). (2) Clinical manifestation: among the 12 pregnant women, 9 showed different degrees of abdominal pain; chest distress accompanied by waist soreness, abdominal distension in 2 cases; one asymptomatic pregnant women was found with uterine rupture during elective cesarean section. Preoperative color Doppler ultrasonography indicated that 9 of the 12 pregnant women had peritoneal effusion, and 6 of them underwent diagnostic peritoneal puncture or posterior vault puncture for non-clotting blood extraction. (3) Uterine operation history and rupture location: among the 12 cases of spontaneous rupture of uterus caused by placenta percreta pregnant women, 10 had placenta previa after cesarean section, including 4 cases of rupture at the incision of the original cesarean section, 3 cases of rupture at the penetrating placental implantation of the lower segment of the anterior wall of the uterus, and 1 case of placenta percreta occurred at the myomectomy site of the right angle of the uterus. Among the 2 pregnant women with spontaneous uterine rupture caused by penetrating placental implantation without a history of cesarean section, 1 case with history of multiple abortions, and uterine rupture occurred at the bottom of the palace, 1 had rupture of placental penetrating implantation after hysteroscopic electroresection of endometrial polyps, and the uterine rupture occurred at the anterior wall of the lower segment of the uterus. (4) Maternal and fetal outcomes: 11 pregnant women were injected with suspension RBC and 1 pregnant woman was not injected with blood products. Nine cases underwent hysteroplasty and 3 cases underwent subtotal hysterectomy. There were 11 maternal survivors and 1 maternal death; 7 neonates survived and 6 stillbirths. Conclusions: Uterine rupture caused by placenta percreta is of great harm to mother and infant, due to its heterogeneity in clinical manifestations, which increases the possibility of misdiagnosis. For pregnant women with risk factors of placenta percreta, early diagnosis should be made during pregnancy. For those who have been diagnosed with placenta percreta, when there is typical or atypical uterine rupture, doctors should be alert to the occurrence of uterine rupture.

A case of spontaneous uterine rupture discovered during a cesarean section after a laparoscopic adenomyomectomy and literature review

A case of spontaneous uterine rupture discovered during a cesarean section after a laparoscopic adenomyomectomy and literature review

Second trimester uterine rupture in a septated unscarred uterus: a case report study

Introduction: Uterine rupture in the second trimester before the onset of labor is a rare condition that can lead to high maternal morbidity and fatal fetal outcome. Case Report: The authors report a case of spontaneous uterine rupture in a 35-year-old woman at the 16th week of a twin gestation, after IVF. She presented with intraperitoneal haemorrhage, maternal collapse, fetal demise, and required immediate surgical management. Conclusions: Uterine rupture in a primigravid uterus is a rare but life-threatening situation. Studies have shown that the unscarred uterus is not immune to such an event. Even though it is not a common complication, it should always be considered in primigravid women presenting with abdominal pain, hemodynamic instability, and indications of fetal demise.

First trimester spontaneous rupture of an unscarred uterus in a multiparous woman: a case report

The rupture of an unscarred uterine is a rare life-threatening event that usually occurs late in pregnancy or during labor. Spontaneous uterine rupture, as in our case, is extremely uncommon and rarely diagnosed before laparotomy. Herein, we present a case of spontaneous uterine rupture in a 32 year old multiparous woman with no previous uterine surgery. The patient presented with acute abdomen at 11 weeks of gestation. Preoperative diagnosis based on clinical and ultra-sonographic findings was ruptured ectopic pregnancy. However, emergency laparotomy showed uterine rupture with extrusion of a dead fetus within intact amniotic sac in the abdomen. The defect was repaired in layers and the patient was discharged in a good condition after five days of hospital stay. Multiparity is a risk factor for spontaneous uterine rupture even in the first trimester. It should be kept in mind in any pregnant multiparous woman presenting with acute abdomen and shock. The absence of vaginal spotting and lack of history of uterine surgery give a false sense of security.

陣痛発来前に子宮破裂を来たした腹腔鏡手術後妊娠の2症例

陣痛発来前に子宮破裂を来たした腹腔鏡手術後妊娠の2症例

A case of uterine rupture in mid-trimester spontaneous abortion: a complication of gemeprost vaginal administration

The only prostaglandin analogue licensed in Italy for induction of labour in spontaneous and therapeutic abortion is gemeprost. The authors report a case of spontaneous uterine rupture of a scarred uterus, for previous caesarean sections, in a woman at 20 weeks of gestation with a diagnosis of spontaneous abortion. She received a pessary of gemeprost every three hours. After the fifth pessary, she complained of severe pain. At the ultrasound examination, uterine cavity appeared empty and the dead fetus was dislocated in the abdomen. Emergency laparotomy was performed and uterine tear was repaired. To induce labour for fetal demise or therapeutic abortion in second trimester in women with scarred uterus, the authors decided to lengthen the time between administrations of pessary from four to five hours depending on patient’s symptoms. However the appropriate drug regimen has still to be found and more data are necessary.

Spontaneous Uterine Rupture From Placenta Percreta

INTRODUCTION: Placenta percreta is a known cause of life-threatening hemorrhage requiring peripartum hysterectomy but only rarely leads to spontaneous uterine rupture before viability. Few case reports exist in the literature, yet this may become a more common occurrence with increasing cesarean delivery rates. We report a series of six cases of placenta percreta during an 18-month period at our institution, of which three resulted in spontaneous uterine rupture before viability. METHODS: This was a retrospective chart review of all placenta percreta cases at a single tertiary care center between December 2011 and May 2013. Patient demographics, pregnancy history, clinical presentation, intraoperative findings, and pathology results were reviewed (Table 1). Statistical analysis was performed using the Student's t test.RESULTS: Three cases of spontaneous uterine rupture from placenta percreta occurred between 17 and 21 weeks of gestation. All three ruptured cases presented with abdominal pain of unclear etiology. One of the ruptured cases did not have suspected placenta accreta preoperatively. The mean number of prior cesarean deliveries was 2.3 for both ruptured (±1.2) and unruptured (±0.6) patients (P=.87). The mean estimated blood loss was higher for ruptured cases (7,500±500 mL), compared with unruptured cases (2,650±786 mL) (P<.001). Pathological examination confirmed the diagnosis of placenta percreta in all six cases. CONCLUSIONS: Given rising cesarean delivery rates, obstetricians should consider the possibility of placenta percreta resulting in spontaneous uterine rupture if a patient presents with abdominal pain with a history of prior cesarean deliveries and suspected abnormal placentation.

Unexplained Spontaneous Complete Uterine Rupture in the Second Trimester: A Rare Event. Case Report and Literature Review

Abstract Background: Rupture of a pregnant uterus occurs most often in a scarred uterus, and spontaneous rupture of an unscarred uterus in the second trimester is very rare. Case: An extremely rare case of spontaneous uterine rupture involving uterine fundus at 16 weeks of gestation in an unscarred uterus, and with no apparent risk factors, is reported. Results: Surgery was performed to remove the fetus and placenta, the patient received a transfusion of red blood cells as well as antibiotics. The postoperative period was uneventful, and the patient was discharged in stable condition. Conclusions: Uterine rupture should be considered as a possibility in a pregnant woman with severe abdominal pain, regardless of gestation, and even in absence of classic risk factors. (J GYNECOL SURG 30:108)

First Trimester Spontaneous Uterine Rupture in a Young Woman with Uterine Anomaly

Spontaneous uterine rupture is a life-threatening obstetrical emergency carrying a high risk for the mother and the fetus. Spontaneous uterine rupture in early pregnancy is very rare complication and it occurs usually in scarred uterus. Uterine anomalies are one of the reasons for spontaneous unscarred uterine rupture in early pregnancy. Obstetricians must consider this diagnosis when a pregnant patient presented with acute abdomen in early pregnancy. We present a case of spontaneous uterine rupture at 12 weeks of gestation in 24-year-old multigravida who had uterine anomaly presenting as an acute abdomen. Our preoperative diagnosis was ectopic pregnancy. Emergency laparotomy confirmed a spontaneous uterine rupture. Uterine anomaly is a risk factor for spontaneous uterine rupture in the early pregnancy. Clinical signs of uterine rupture in early pregnancy are nonspecific and must be distinguished from acute abdominal emergencies.

Spontaneous uterine rupture at 32 weeks of gestation after previous uterine artery embolization

Uterine artery embolization (UAE) is a common treatment for post-partum hemorrhage and uterine fibroids. However, the effects of UAE on subsequent pregnancies have not been established. Here, we present a case of spontaneous uterine rupture after previous UAE. A 31-year-old woman underwent UAE for a cervical ectopic pregnancy. Contrast-enhanced magnetic resonance imaging (MRI) at days 5 and 25 post-UAE suggested a regionally decreased blood supply in the mid-posterior wall of the uterine fundus. During a subsequent pregnancy at age 35 years, she underwent an emergency cesarean delivery due to spontaneous uterine rupture at the mid-posterior wall of the uterus at 32 weeks of gestation. Obstetricians should be attentive to the possibility of spontaneous uterine rupture in pregnant women who have previously undergone UAE. Detection of ischemic uterine muscle on MRI may predict potential for uterine rupture in a subsequent pregnancy.

Complete spontaneous rupture of the uterine fundus on an unscarred malformed uterus (double uterus) in a 15 weeks of pregnancy

Uterine rupture is a major obstetric emergency as a life-threatening situation. Rupture of a pregnant uterus in early pregnancy and an unscarred uterus are extremely rare. We present a rare case of spontaneous uterine rupture on a patient with unscarred, malformed uterus, at 15 weeks of pregnancy. <br/><a href=

The Spontaneous Prelabour Rupture of Anunscarred Uterus at 34 Weeks of Pregnancy

Uterine rupture is an obstetric emergency needs immediate surgery and is associated with poor fetal & maternal outcome. Usually uterine rupture occurs at the lower segment (weakest part) if there is no history of uterine surgery. We hereby are reporting a case of spontaneous uterine rupture at fundus, at 34 weeks of gestation in a patient who has never had uterine surgery. Only uterine curettage was done once for missed abortion. In this case, diagnosis was delayed until the patient went into massive hemorrhagic shock; because, there was no history of previous uterine surgery. However, clinical picture of the ruptured uterus at the fundus suggests there was some weakness at the fundus. Thereafter, D & C operation was taken into account. Subtotal hysterectomy was done as the rupture was irreparable damage to the fundus. Her one month follow up was uneventful.

Spontaneous uterine rupture in a primigravid woman in the early third trimester attributed to adenomyosis: A case report and review of the literature

We report a rare case of spontaneous uterine rupture of an unscarred uterus caused by adenomyosis in the early third trimester. A 33-year-old primigravid woman was referred to our department because of severe acute abdominal pain and signs and symptoms of hemorrhagic shock. Ultrasound exanimation performed at admission revealed a living, intrauterine fetus of 28 weeks gestational age with reduced amniotic fluid and presence of free peritoneal fluid. The fetal heart rate was non-reassuring with variable decelerations and severe fetal bradycardia. Emergency cesarean section revealed massive hemoperitoneum and complete rupture in the uterine fundus. Subtotal peripartum hysterectomy with conservation of adnexae was performed. Histological examination revealed adenomyosis at the site of uterine rupture.

A Rare Case of Vaginal Delivery After Uterine Rupture

Rupture of uterus is a serious obstetric complication. Consequences can be more dangerous if it remains undiagnosed. Spontaneous rupture of a scarred uterus is an uncommon event but it is rare for it to be followed by vaginal delivery and to be diagnosed postpartum period is still rare. We report a case of spontaneous uterine rupture which was followed by a vaginal delivery which was diagnosed postpartum. A tender uterus after delivery was the only consistent sign present.