Uterine Rupture at Term in a Patient With Abdominal Cerclage

Dandapani, Monica; Pflugner, Lindsey P.; Fanning, Nicole S

doi:10.1097/aog.0000000000003228

Cited by 7 publications

(6 citation statements)

References 6 publications

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“…For patients with an in situ transabdominal cerclage, cesarean delivery is recommended between 37 0/7 and 39 0/7 gestational weeks. [ 15 ] Dandapani et al [ 16 ] reported the experience of a woman with a transabdominal cerclage who was admitted at 39 2/7 gestational weeks, presenting with contractions, abdominal pain, and fetal bradycardia. Emergency cesarean delivery revealed a ruptured uterus with the fetus and placenta floating in the abdominal cavity.…”

Section: Discussionmentioning

confidence: 99%

Silent uterine rupture in the term pregnancy: Three case reports

Chen,

Li,

Peng

et al. 2024

Medicine

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Rationale: Uterine rupture is extremely hazardous to both mothers and infants. Diagnosing silent uterine rupture in pregnant women without uterine contractions is challenging due to the presence of nonspecific symptoms, signs, and laboratory indicators. Therefore, it is crucial to identify the elevated risks associated with silent uterine rupture. Patient concerns: on admission, case 1 was at 37 gestational weeks, having undergo laparoscopic transabdominal cerclage 8 months prior to the in vitro fertilization embryo transfer procedure, case 2 was at 38 4/7 gestational weeks with a history of 5 previous artificial abortion and 2 previous vaginal deliveries, case 3 was at 37 6/7 gestational weeks with a history of laparoscopic myomectomy. Diagnoses: The diagnosis of silent uterine rupture was based on clinical findings from cesarean delivery or laparoscopic exploration. Interventions: Case 1 underwent emergent cesarean delivery, revealing a 0.25 cm × 0.25 cm narrow concave area above the Ring Ties with active and bright amniotic fluid flowing from the tear. Case 2 underwent vaginal delivery, and on the 12th postpartum day, ultrasound imaging and magnetic resonance imaging revealed a 5.8 cm × 3.3 cm × 2.3 cm lesion on the lower left posterior wall of the uterus, and 15th postpartum day, laparoscopic exploration confirmed the presence of an old rupture of uterus. Case 3 underwent elective cesarean delivery, revealing a 3.0 cm × 2.0 cm uterine rupture without active bleeding at the bottom of the uterus. Outcomes: The volumes of antenatal bleeding for the 3 patients were approximately 500 mL, 320 mL, and 400 mL, respectively. After silent uterine ruptures were detected, the uterine tear was routinely repaired. No maternal or neonatal complications were reported. Lessons: Obstetricians should give particular consideration to the risk factors for silent uterine rupture, including a history of uterine surgery, such as laparoscopic transabdominal cerclage, laparoscopic myomectomy, and induced abortion.

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Section: Discussionmentioning

confidence: 99%

Silent uterine rupture in the term pregnancy: Three case reports

Chen,

Li,

Peng

et al. 2024

Medicine

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“…The primary high-risk factors for uterine rupture at non-cesarean scar sites predominantly involve concealed scar uterus (involving a history of induced abortion and hysteroscopy surgery), fetal malposition, inadequate development of the uterine muscle layer, anomalous uterine development, external version procedures, multiparity, placental abnormalities, labor induction using drugs, fetal head disproportion, uterine adenomyosis, connective tissue disorders, a history of ectopic pregnancy, and laparoscopic cervical cerclage. [1,[4][5][6] Hysteroscopic surgery is increasingly common and serves an indispensable role in diagnosing and managing intrauterine diseases. Uterine rupture during pregnancy subsequent to hysteroscopic surgery constitutes a long-term complication of these procedures.…”

Section: Etiologymentioning

confidence: 99%

Uterine rupture in patients with a history of hysteroscopy procedures: Case series and review of literature

Shao,

Yang,

Yan

et al. 2024

Medicine

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Rationale: Uterine rupture during pregnancy poses significant risks to both the fetus and the mother, resulting in high mortality and morbidity rates. While awareness of uterine rupture prevention after a cesarean section has increased, insufficient attention has been given to cases caused by pregnancy following hysteroscopy surgery. Patient concerns: We report 2 cases here, both of whom had a history of hysteroscopy surgery and presented with severe abdominal pain during pregnancy. Diagnoses: Both patients had small uterine ruptures, with no significant abnormalities detected on ultrasonography. The diagnosis was confirmed by a CT scan, which showed hemoperitoneum. Interventions: We performed emergency surgeries for the 2 cases. Outcomes: We repaired the uterus in 2 patients during the operation. Both patients recovered well. The children survived. No abnormalities were detected during their follow-up visits. Lessons: Attention should be paid to the cases of pregnancy after hysteroscopy.

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“…Other complications, including uterine perforation, pelvic infection, bowel injury, or bladder injury, are overall rare (1.1% of laparoscopic cerclages) (5). Single case reports have documented suture migration through the cervix, erosion into the vagina, or uterine rupture with an abdominal cerclage in place (34,35).…”

Section: Laparoscopic Approachmentioning

confidence: 99%

Laparoscopic abdominal cerclage: a highly effective option for refractory cervical insufficiency

Clark

Einarsson

2020

Fertility and Sterility

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Laparoscopic abdominal cerclage is emerging as the preferred treatment option for patients with refractory cervical insufficiency. Laparoscopic abdominal cerclage reduces second-trimester loss and preterm birth with success rates similar to open abdominal cerclage. Increasing evidence also suggests improved neonatal survival rates with abdominal cerclage compared with repeat vaginal cerclage in patients who delivered prematurely despite a vaginal cerclage. The option to perform a highly effective treatment using minimally invasive techniques suggests laparoscopic abdominal cerclage will become the standard of care for refractory cervical insufficiency. This review examines the literature with regard to the indications and outcomes of abdominal cerclage, highlighting the laparoscopic technique. (Fertil Steril Ò 2020;113:717-22. Ó2020 by American Society for Reproductive Medicine.

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Uterine Rupture at Term in a Patient With Abdominal Cerclage

Cited by 7 publications

References 6 publications

Silent uterine rupture in the term pregnancy: Three case reports

Silent uterine rupture in the term pregnancy: Three case reports

Uterine rupture in patients with a history of hysteroscopy procedures: Case series and review of literature

Laparoscopic abdominal cerclage: a highly effective option for refractory cervical insufficiency

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