Spontaneous rupture of an unscarred non-labouring gravid uterus at 32 weeks gestation

Silva, Grc; Gange, Paul; Karunarathne, N; Senevirathne, N

doi:10.4038/sljog.v34i2.4828

Cited by 4 publications

(4 citation statements)

References 4 publications

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“…Eight ruptures (14.8%) in the body of the uterus were anterior ruptures, and 4 (7.4%) were on the lateral wall of the uterus. Of the 81 ruptures for which the time of their occurrence was reported, 60.5% 49 occurred before the onset of labor. All the ruptures after 23 weeks of gestation occurred during labor, whereas all the ruptures before 23 weeks occurred without evidence of prior uterine contraction.…”

Section: Resultsmentioning

confidence: 95%

“…Whereas most of the women with ruptures had at least 1 risk factor, 25% of the women (21/84) did not have any 28,29,37–55 . A single risk factor was found in 47.6% (40/84) of the women 4,9,11,13,21,25,26,32,35,36,56–83 …”

Section: Resultsmentioning

confidence: 99%

“…Whereas most of the women with ruptures had at least 1 risk factor, 25% of the women (21/84) did not have any. 28,29,[37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55] A single risk factor was found in 47.6% (40/84) of the women. 4,9,11,13,21,25,26,32,35,36, The most common risk factors were the use of uterotonic drugs for induction or augmentation of labor (22/84 [26.2%]), 3,4,11,34,36,[56][57][58][59][60][61][62][84][85][86][87][88][89][90] mainly oxytocin a...…”

Section: Etiological and Risk Factorsmentioning

confidence: 99%

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Spontaneous Rupture of the Unscarred Uterus: A Review of the Literature

Sgayer,

Dabbah,

Farah

et al. 2023

Obstetrical &Amp; Gynecological Survey

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Importance Uterine rupture is defined as a nonsurgical disruption of all layers of the uterus. Most ruptures occur in the presence of a scar, usually secondary to a previous cesarean delivery. Rupture of an unscarred uterus is rare and is associated with severe maternal and neonatal outcomes. Objective To outline the literature on potential predisposing factors, clinical findings, and maternal and fetal outcomes of a rupture of an unscarred uterus. Evidence Acquisition PubMed was searched for the phrases “uterine rupture,” “unscarred,” and “spontaneous.” Individual case reports, retrospective case series, and review articles in English between 1983 and 2020 were included. Results We found 84 case reports in 79 articles. The mean maternal age was 29.3 (SD, 5.7) years; 38 women (45.2%) were nulliparous. Uterine rupture occurred in 37% of the women at term; in 9.9%, the gestational age was ≤12 weeks. The most common clinical presentations were abdominal pain (77.4%), signs of hypovolemic shock (36.9%), fetal distress (31%), and vaginal bleeding (22.6%). The most common risk factors were the use of uterotonic drugs for induction or augmentation of labor and a prior curettage procedure. The most frequently ruptured site was the body of the uterus. Hysterectomy managed 36.9% of the ruptures. Four women died (4.8%). Perinatal mortality was 50.6%. Perinatal death was higher in developing than developed countries. Conclusions and relevance Although rare, spontaneous rupture of the unscarred uterus has serious consequences to the mother and the fetus and should be included in the differential diagnosis of acute abdomen in pregnancy. Target Audience Obstetrician-gynecologists, family medicine physicians. Learning Objectives After completing this activity, the learner will be better able to describe the consequences of spontaneous rupture of the unscarred uterus to the mother and fetus; discuss risk factors for spontaneous rupture of the unscarred uterus and its potential occurrence in nulliparous, antepartum, and the first trimester; and discuss how timely assessment of a pregnant woman presenting with abdominal pain impacts survival of the mother and child.

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Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

Section: Etiological and Risk Factorsmentioning

confidence: 99%

See 1 more Smart Citation

Spontaneous Rupture of the Unscarred Uterus: A Review of the Literature

Sgayer,

Dabbah,

Farah

et al. 2023

Obstetrical &Amp; Gynecological Survey

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“… Rana 2009 [11] G3P2L2 32 weeks Not in labour Multipara Right side of fundus 2 cm anterior to cornua 5. Silva 2012 [12] G2P1L1 32 weeks Not in labour Multipara Left side of the anterior aspect of the uterus extending from the lower segment to the fundus. 6.…”

Section: Clinical Discussionmentioning

confidence: 99%

Idiopathic spontaneous rupture of unscarred uterus in a primigravida in active labour

Mishra¹,

Mala²

2022

International Journal of Surgery Case Reports

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Spontaneous Rupture of an Unscarred Gravid Uterus in a Primigravid Woman at 32 Weeks of Gestation

Mizutamari

Honda

Ohba

et al. 2014

Case Reports in Obstetrics and Gynecology

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Uterine rupture usually occurs in a scarred uterus, especially secondary to prior cesarean section. Antepartum uterine rupture in an unscarred uterus is extremely rare. We report a case of spontaneous rupture of an unscarred gravid uterus at 32 weeks of gestation in a primigravid woman. Ultrasonography and magnetic resonance imaging showed a bulging cystic lesion communicating with the intrauterine cavity. Operative findings during emergent cesarean section revealed uterine perforation in the right cornual area and a prolapsed, nonbleeding amniotic sac. The left cornual area was also focally thin. An arcuate uterus was suspected based on follow-up hysterosalpingography. Antepartum uterine rupture tends to occur in the uterine cornual area. In this case, Müllerian duct anomalies may have been associated with focal myometrial defects.

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Spontaneous rupture of an unscarred non-labouring gravid uterus at 32 weeks gestation

Cited by 4 publications

References 4 publications

Spontaneous Rupture of the Unscarred Uterus: A Review of the Literature

Spontaneous Rupture of the Unscarred Uterus: A Review of the Literature

Idiopathic spontaneous rupture of unscarred uterus in a primigravida in active labour

Spontaneous Rupture of an Unscarred Gravid Uterus in a Primigravid Woman at 32 Weeks of Gestation

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