Postpartum unscarred uterine rupture caused by placenta accreta: A case report and literature review

Okaniwa, Jun; Higeta, Daisuke; Kameda, Takashi; Uchiyama, Yosuke; Inoue, Masashi; Iwase, Akira

doi:10.1002/ccr3.3851

Cited by 6 publications

(8 citation statements)

References 12 publications

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“…The speci c pathological reasons for preeclampsia or eclampsia increasing the risk of uterine rupture are not clear. The placenta accreta spectrum has been reported to increase the risk of uterine rupture [51][52][53][54][55], similar to our ndings. One study suggested that uterine weakness caused by placental hyperplasia may be one of the causes of nonscarred uterine rupture [56].…”

Section: Discussionsupporting

confidence: 90%

The incidence, associated factors and adverse maternal and perinatal outcomes of uterine rupture among vaginal births after caesarean section: An observational study from the National Maternal Near-Miss Surveillance System in China

Zhou

Chen

et al. 2023

Preprint

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Background The most serious problem during vaginal birth after caesarean section (VBAC) is the risk of uterine rupture but there is controversy regarding important related factors. With the relaxation of birth policy in China, the maternal and perinatal outcomes after uterine rupture during VBAC are a societal concern. The lack of any large-scale study of uterine rupture during VBAC in China underscores the need for more research evidence. Methods We studied singleton pregnant women with VBAC from 2012 to 2019 registered in China’s National Maternal Near-Miss Surveillance System (NMNMSS). First, we calculated the incidence of uterine rupture during VBAC. Second, using a logistic regression model with weighting for the sampling distribution of the population and clustering of births within hospitals, we examined the association of sociodemographic and obstetric characteristics and maternal diseases with uterine rupture during VBAC. With multivariable logistic regression, adjusted odds ratio were estimated using two models. Finally, we compared the risk of adverse maternal and perinatal outcomes in women with and without uterine rupture during VBAC. Results This study included 155774 singleton pregnant women with VBAC, and the incidence of uterine rupture was 0.23%. Characteristics associated with the increased risk of uterine rupture during VBAC included two (aOR = 1.70; 95% CI: 1.06–2.73) and three or more (aOR = 2.59; 95% CI: 0.54–12.44) previous caesarean sections, delivery at 42 weeks or later (aOR = 2.62; 95% CI: 1.58–4.35), and foetal birthweight greater than 4000 g (aOR = 1.93; 95% CI: 1.30–2.87). Compared with those without these conditions, the risk of uterine rupture during VBAC among women with amniotic fluid embolism, severe anaemia, placenta accreta spectrum, placental abruption, preeclampsia or eclampsia, and mild anaemia was 25.7-fold, 15.89-fold, 4.17-fold, 3.96-fold, and 2.49-fold higher, respectively. The incidence of adverse maternal outcomes during VBAC was higher in women with uterine rupture than in women without. Conclusion The incidence of uterine rupture during VBAC is comparable between China and some developed countries. In the clinical medical practice of obstetrics, it is necessary to be vigilant to factors associated with uterine rupture during VBAC and identify uterine rupture as soon as possible to improve maternal and perinatal outcomes.

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Section: Discussionsupporting

confidence: 90%

The incidence, associated factors and adverse maternal and perinatal outcomes of uterine rupture among vaginal births after caesarean section: An observational study from the National Maternal Near-Miss Surveillance System in China

Zhou

Chen

et al. 2023

Preprint

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“… Hysterectomy Huang et al, (2005) [15] G3P2, near cornual pregnancy 16 weeks Accreta In fatal condition due to massive hemorrhage. Multiple organ failure Emergency hysterectomy Enebe et al, (2019) [15] multiparous 33 weeks Percreta Spontaneous uterine rupture Hypovolemic shock Intrauterine foetal death Okaniwa et al, (2020) [5] Use of uterotonics and manual removal of placenta 39 weeks, second day of postpartum Accreta Hysterectomy. Blood loss during surgery was 3100 ml; Total of blood transfusion was 14 IU TBC, 960 ml FFP, and 20 IU PC.…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, PASD can cause uterine rupture, leading to intraabdominal hemorrhage. This complication can occur during pregnant period and postpartum [4] , [5] . In some cases of PASD, the diagnosis may be delayed and misdiagnosed with other pathologies.…”

Section: Introduction and Importancementioning

confidence: 99%

Placenta accreta spectrum on an unscarred uterus in the third-trimester pregnancy: two rare cases at Tu Du Hospital in Vietnam

Vuong

Nguyen

2022

International Journal of Surgery Case Reports

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“…Uterine rupture is a rare obstetrical condition that can result in life-threatening situations for both the mother and the fetus 1 .…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, very few cases of unscarred uterine rupture possibly caused by PAS have been reported 1 , 12-13 .…”

Section: Introductionmentioning

confidence: 99%

Antepartum unscarred uterine rupture caused by placenta percreta: a case report and literature review

Nardi,

Seravalli,

Abati

et al. 2023

Pathologica

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Summary The main risk for uterine rupture is the presence of a uterine scar due to prior cesarean delivery or other uterine surgery. However, rupture in an unscarred uterus is extremely rare, and risk factors include multiple gestations, trauma, congenital anomalies, use of uterotonics and placenta accreta spectrum. Placenta accreta spectrum, also known as morbidly adherent placenta, is becoming increasingly common and is associated with significant maternal and neonatal morbidity and mortality. We report a case of unscarred uterine rupture due to placenta percreta in a multiparous woman that required emergency peripartum hysterectomy.

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Postpartum unscarred uterine rupture caused by placenta accreta: A case report and literature review

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 6 publications

References 12 publications

The incidence, associated factors and adverse maternal and perinatal outcomes of uterine rupture among vaginal births after caesarean section: An observational study from the National Maternal Near-Miss Surveillance System in China

The incidence, associated factors and adverse maternal and perinatal outcomes of uterine rupture among vaginal births after caesarean section: An observational study from the National Maternal Near-Miss Surveillance System in China

Placenta accreta spectrum on an unscarred uterus in the third-trimester pregnancy: two rare cases at Tu Du Hospital in Vietnam

Antepartum unscarred uterine rupture caused by placenta percreta: a case report and literature review

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