Objectives: The aim of this study was to investigate the incidence, etiology and obstetric outcomes of rupture in unscarred uterine rupture and in those with a history of uterine rupture Material and methods: The hospital records of women who had delivered between May 2005 and May 2017 at a tertiary center were examined retrospectively. Data on patients with unscarred uterine rupture in pregnancy who had undergone fertility-preserving surgery were evaluated. Results: During the study period, 185,609 deliveries occurred. Of those, unscarred uterine rupture has occurred in 67 women. There were no ruptures reported in nulliparous women. The rupture was observed in the isthmic region in 60 (89.6%) patients and in the fundus in 7 (10.4%) patients. Thirty-eight (56.7%) patients had undergone a total or subtotal hysterectomy, and 29 (43.3%) patients had received primary repair. Ten patients had reconceived after the repair. Of these, eight patients who had a history of isthmic rupture, successfully delivered by elective C-section at 36-37 wk. of gestation, and two experienced recurrent rupture at 33 and 34 wk. of gestation, respectively. Both patients had a history of fundal rupture, and their inter-pregnancy interval was 9 and 11 mo., respectively. Conclusions: The incidence of rupture in unscarred pregnant uteri was found to be one per 2,770 deliveries. Owing to the high morbidity, regarding more than half of the cases with rupture eventuated in hysterectomy, clinicians should be prudent in induction of labour for multiparous women since it was the main cause of rupture in this series. Short inter-pregnancy intervals and history of fundal rupture may confer a risk for rupture recurrence. Those risk factors for recurrence should be validated in another studies.
If definitive care is not available in your facility make early contact with retrieval services Primary survey Includes organising the trauma team, calling the surgeon and notifying the blood bank. Also consider early call to Retrieval Services (AMRS 'formerly MRU' 1800 650 004). REMEMBER -BP and HR will not identify all trauma patients who are in shock. ASSESS -History and perfusion indices -ABG's, base deficit, lactate, Hb and HCT. * Diagnostic Peritoneal Aspiration (DPA). >10mls of frank blood = positive DPA. ** Focused Abdominal Sonography in Trauma (FAST). Free fluid = positive FAST.
The aim of this study was to examine the maternal and fetal outcomes of patients undergoing peripartum hysterectomy (PH) after vaginal delivery (VD) and cesarean section (C/S). Methods: The files of patients undergoing PH following postpartum hemorrhage (PPH) between January 2005 and November 2018 were reviewed retrospectively. Patients undergoing PH were divided into two groups as C/S and VD. Age, parity, gestational weeks, time between delivery and hysterectomy, estimated blood loss, duration of operation, number of blood transfusions, hospitalization time, APGAR scores of the fetus at the 1st and 5th minutes, previous C/S histories, fetal and maternal mortality, indications for PH, additional surgeries performed during PH, and pre-op and postop complications were recorded retrospectively and the groups were compared.
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