Late Presentation of Uterine Rupture: A Case Report

Ali, Meher Binte; Ali, Mashal Binte

doi:10.7759/cureus.5950

Cited by 7 publications

(6 citation statements)

References 6 publications

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“…The surgical mode of the parturient depends on the type of uterine rupture, the position of the rupture, the length of the rupture, the rupture time, the infection degree of the rupture, bleeding, the physical tolerance of the parturient and the willingness of the woman to give birth again. A uterus-saving procedure is performed only in patients whose uterus is viable and only when it is deemed to not threaten the life of the patient[ 17 ]. In addition, a rare method was used to immediately repair the uterine defect, leading to a prolonged pregnancy[ 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Uterine rupture in patients with a history of multiple curettages: Two case reports

Deng

Zhang

et al. 2020

WJCC

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BACKGROUND Uterine rupture is a serious obstetric emergency, a severe event, and a serious threat to maternal and fetal life. It is a rare and not well characterized by the fact that multiple operations of uterine cavities contribute to uterine rupture during pregnancy. Atypical uterine rupture is easily misdiagnosed as other obstetric or surgical diseases. In current guidelines, abdominocentesis is a contraindication for late pregnancy. Therefore, the cases presented in this report provide new ideas for clinical diagnosis and treatment of uterine rupture. CASE SUMMARY Case 1, a 34-year-old woman (gravida 5, para 2), 32 wk and 4 d of gestation, presented with acute upper abdominal pain for 8 h with nausea and vomiting. Computed tomography (CT) revealed pelvic and abdominal effusion. We extracted 3 mL unclotted blood from her abdominal cavity. An emergency caesarean section was performed. A uterine rupture was found, and the fimbrial portion of the left fallopian tube was completely adhered to the rupture. The prognosis of both the mother and the infant was good. Case 2, a 39-year-old woman (gravida 10, para 1) at 34 wk and 3 d of gestation complained of persistent lower abdominal pain for half a day. Her vital signs were normal. CT revealed a high probability of pelvic and abdominal hemoperitoneum. We extracted 4 mL dark red blood without coagulation. An emergency laparotomy was performed. Uterine rupture was identified during the operation. Postoperative course in both the mother and infant was uneventful. CONCLUSION For pregnant women in the second or the third trimester with persistent abdominal pain, abdominal effusion, fetal distress and even fetal death, the possibility of uterine rupture should be highly suspected. CT can identify acute abdominal surgical or gynecological and obstetric diseases. Abdominocentesis is helpful for diagnosing and clarifying the nature of effusion, but its clinical value need to be confirmed by further clinical studies.

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Section: Discussionmentioning

confidence: 99%

Uterine rupture in patients with a history of multiple curettages: Two case reports

Deng

Zhang

et al. 2020

WJCC

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“…Uterine sparing surgery is possible when the entire uterus is alive and procedure does not threaten maternal life. Antibiotics, surgical repair, and debridement of necrotic tissue are the main components of treatment in uterine sparing surgery (9). Performing of TAH in 8 (57.2%) patients included in this study can be explained by the fact that the cases are at an advanced stage, the loss of viability of the uterine tissue, and the presence of morbidity that may threaten the life of the mother.…”

Section: Materials and Methods Introductionmentioning

confidence: 99%

Uterine Rupture Following Vaginal Birth After Caesarean Section (VBAC): CT Findings and Clinical Course in Delayed Cases

Şahin

Tahtabaşı

2020

Jinekoloji-Obstetrik Ve Neonatoloji Tıp Dergisi

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Aim: This research was aimed the show of the effectiveness of computed tomography (CT) in the diagnosis of intraabdominal complications in patients with uterine rupture (UR) due to vaginal birth after caesarean section (VBAC) and admitted to the clinic late. It was aimed to discuss the treatment management and clinical course of patients. Materials and Method: Between July 2015 and February 2020, 21 patients who developed UR among 5820 births in the Mogadishu Recep Tayyip Erdogan Hospital in Somalia were examined. Those without a history of caesarean section, patients with uterine scar dehiscence without symptoms, and gestational age <28 weeks were excluded. Clinical and laboratory data and thoracoabdominal CTs of the patients were evaluated retrospectively from electronic records. Results:The mean maternal age of 15 patients included in the study was 25.06±5.46 (range 18-32) years. There were one caesarean history in 9 (60%) patients and two caesarean section history in 6 (40%) patients. The mean time between two births was 14.57±3.35 (range 11-19) months. None of the patients had antenatal care (ANC) follow-up. In 2 (13.3%) patients who developed fetal and maternal mortality, it was determined that the fetus was born into the peritoneal cavity in these 2 patients. The mean duration of admission to the hospital after vaginal delivery was 16.6±1.99 days. The hospitalization period of 8 (53.3%) patients admitted to the postoperative intensive care unit was 2.26±3.10 (in the range of 2-8) days, and the mean hospitalization time of all patients was 13.13±4.13 days. 8 (53.3%) patients underwent total abdominal hysterectomy. In CTs of 13 (86.6%) patients, uterine wall defect and peritonitis detected in 13 of them (100%), intraabdominal abscess detected in 11 of them (84.6%), acid detected in 10 of them (76.9%), air in the uterine cavity, paralytic ileus and pneumonia detected in 8 of them (61.5%), pleural effusion detected in 5 of them (38.4%), and splenic infarction detected in 1 of them (7.6%). Conclusion:The prevalence of pregnant women without ANC follow-up is high in underdeveloped countries such as Somalia. It is necessary to start antenatal follow-up early, especially in those who are planned VBAC, and this procedure should be done in equipped centers. Furthermore, we believe in the necessity of performing CT, which is fast and reliable for all patients, in terms of evaluating complications, finding correct diagnosis, and treatment management in patients with delayed UR.

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“…Pristatyta į ligoninę dėl negausaus kraujavimo iš makšties ir čiuopiamo sukietėjimo pilvo apačioje. Cezario pjūvio vietoje rasta hematoma, pacientei buvo išsivystęs peritonitas [19]. Šie klinikiniai atvejai panašūs, bet ir savaip unikalūs.…”

Section: Diskusijaunclassified

Gimdos Plyšimo Ir Atonijos Sukeltas Kraujavimas. Klinikinis Atvejis

Gečytė¹,

Navickaitė²,

Baliulienė³

et al. 2023

Health Sciences

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Gimdos plyšimas ir atonija – reta, gyvybei pavojinga būklė, kurią, nepaisant daugelio rizikos veiksnių, sunku numatyti. Šios akušerinės komplikacijos baigtis priklauso nuo greitos reakcijos į kintančias aplinkybes. Intervencijos, po kurių gimdos sienelėje lieka randas, didina mirtinų komplikacijų nėštumo metu riziką. Net keli mililitrai šviežio kraujo gali būti dramatiškos situacijos, kuri reikalauja neatidėliotinų sprendimų, požymis. Straipsnyje pristatomas klinikinis atvejis, kai dirbtinai apvaisintai 49 metų moteriai 31 nėštumo savaitę įtarta placentos atšoka. Operacijos metu paaiškėjo, kad plyšo gimda ir įvyko jos atonija, o vaisius ir placenta pateko į pilvaplėvės ertmę. Pacientės akušerinėje ginekologinėje anamnezėje − ginekologinės ligos ir intervencijos, bei medicininių duomenų stoka apie jas. Gelbstint gyvybę, konsiliumo sprendimu, dėl medikamentais ir chirurginėmis intervencijomis nesuvaldomo akušerinio kraujavimo, sukelto gimdos plyšimo ir atonijos, pašalinta gimda, koreguota volemija, anemija, koaguliopatija. Dėl greitų, nors ir sunkių sprendimų, naujagimė ir gimdyvė sėkmingai išvyko į namus.

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Late Presentation of Uterine Rupture: A Case Report

Cited by 7 publications

References 6 publications

Uterine rupture in patients with a history of multiple curettages: Two case reports

Uterine rupture in patients with a history of multiple curettages: Two case reports

Uterine Rupture Following Vaginal Birth After Caesarean Section (VBAC): CT Findings and Clinical Course in Delayed Cases

Gimdos Plyšimo Ir Atonijos Sukeltas Kraujavimas. Klinikinis Atvejis

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