Conservative Management of Uterine Rupture Diagnosed Prenatally on the Basis of Sonography

Oyelese, Yinka; Tchabo, Jean-Gilles; Chapin, Brian F.; Nair, Anitha; Hanson, Patricia; McLaren, Rodney

doi:10.7863/jum.2003.22.9.977

Cited by 17 publications

(18 citation statements)

References 8 publications

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“…The prenatal detection of corporeal uterine rupture without hemoperitoneum and maternal compromise is rare and limited to a few case reports [9,10] . Incomplete uterine rupture with preservation of the integrity of the amniotic sac, frequently denoted by the term uterine dehiscence, has also been reported prenatally, both in the lower uterine segment [1,11] and the uterine corpus [2,8,12] .…”

Section: Discussionmentioning

confidence: 99%

Prenatal Detection and Conservative Management of a Partial Fundal Uterine Dehiscence

2009

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Uterine defects in pregnancy are rare and may pose difficulties in definition and clinical management. Defects involving the myometrium encompass entities such as uterine rupture, dehiscence, sacculation or diverticulum. There are only a few reported cases of uterine fundal defects where the pregnancy continues into the third trimester. The following case describes the prenatal imaging diagnosis and subsequent clinical management of a large fundal uterine defect in the third trimester of pregnancy.

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Section: Discussionmentioning

confidence: 99%

Prenatal Detection and Conservative Management of a Partial Fundal Uterine Dehiscence

2009

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“…No hemoperitoneum was noted clinically and radiologically, and she was hemodynamically stable with hematocrit level of 12 g/dl. The general belief is that a herniated amniotic sac into the abdominal cavity is strongly suggestive of imminent uterine rupture [18]. However, uterine rupture does not always occur immediately after sonographic detection of extrusion of the amniotic sac because a thin layer of myometrium and even uterine serosa may be around the herniated sac which may be difficult to detect sonographically [17].…”

Section: Discussionmentioning

confidence: 99%

“…The management of amniocele depends on the gestational age and the clinical state of the mother and fetus [17,18]. Before fetal lung maturity, two management protocols are advocated; these are surgical management and conservative management [17].…”

Section: Discussionmentioning

confidence: 99%

A large amniocele through a fundal uterine defect diagnosed on 2D ultrasound imaging

Aiyekomogbon¹,

Ojah²,

Shinkafi³

et al. 2017

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. ABSTRACTIntroduction: Amniocele is herniation of amniotic sac through a uterine myometrial defect. It commonly results from intrauterine procedures such as suction evacuation, dilatation and curettage, manual removal of placenta and other products of conception, etc. Early diagnosis is imperative as that will go a long way to reduce morbidity and mortality. Case Report: A 35-year-old G4P3+0 women was presented to our health facility at 21st week gestation with a week history of lower abdominal pain. Obstetric ultrasound scan done at presentation revealed a fundal myometrial defect with a large amniocele through it, resulting in apparent oligohydramnios. Her first two deliveries were uneventful, but the third was complicated by post-partum hemorrhage due to retained placenta. This necessitated instrumentation and manual removal in the theatre at a secondary Health institution, four years prior to the index pregnancy. No immediate complication was noticed after the procedure. Two weeks after this diagnosis, precisely at 23rd week gestation, she had laparotomy, aimed at reducing the herniated amniotic sac and repairing the defect. This was not possible due to the narrow neck of the defect. She was then closed back and kept on exclusive bed rest and weekly sonographic evaluation of the pregnancy. A scan done at 31st week gestation revealed ruptured herniated amniotic sac into the peritoneal cavity with fetal distress. Estimated ultrasound fetal weight at this time was 1.76 kg. She had emergency cesarean section with delivery of a live very low birth weight baby whose APGAR score was 7 and 8 at 1 and 5 minutes respectively. The baby was admitted into special care baby unit (SCBU) but died 10 hours thereafter. The myometrial defect and uterine incision were repaired in layers. She did well, hemodynamically stable and was discharged on postoperative day-7. Follow-up visits were satisfactory. Conclusion:This case is presented to emphasize the need for training and retraining of physicians and midwives on active management of third stage of labor to forestall the observed pitfalls. It also brings to the fore the utility of gray scale and color Doppler ultrasound in antenatal diagnosis of uterine defect and placenta accreta.

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“…1 Expectant management has been reported in the absence of acute symptoms, hemorrhage into the peritoneal cavity, constriction of fetal limbs or umbilical cord, or rupture of membranes. [1][2][3] We describe a case in which sonographic and magnetic resonance imaging (MRI) findings were used to confirm stable maternal and fetal conditions, allowing for conservative management.…”

mentioning

confidence: 99%

Successful Pregnancy Outcome After Conservative Management of Second‐Trimester Cornual Uterine Rupture

Demishev

Avila

Figueroa

et al. 2014

J of Ultrasound Medicine

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Conservative Management of Uterine Rupture Diagnosed Prenatally on the Basis of Sonography

Cited by 17 publications

References 8 publications

Prenatal Detection and Conservative Management of a Partial Fundal Uterine Dehiscence

Prenatal Detection and Conservative Management of a Partial Fundal Uterine Dehiscence

A large amniocele through a fundal uterine defect diagnosed on 2D ultrasound imaging

Successful Pregnancy Outcome After Conservative Management of Second‐Trimester Cornual Uterine Rupture

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