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Spontaneous postpartum rupture of an intact uterus: a case report.

Mavromatidis G, Karavas G, Margioula-Siarkou C, Petousis S, Kalogiannidis I, Mamopoulos A, Rousso D - J Clin Med Res (2014)

Bottom Line: Despite tocolysis administration, her pregnancy was delivered vaginally after 2 days, giving birth to a male neonate of 3,020 g with normal Apgar scores at first and fifth minute.Her blood tests revealed a CRP value at 27.6 mg/L, whereas the X-rays revealed an extensive impacted fecal mass in the colon.Postoperative follow-up period was not characterized by any complications and patient was finally discharged 4 days after hysterectomy.

View Article: PubMed Central - PubMed

Affiliation: The 3rd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece.

ABSTRACT
Rupture of uterus is an obstetrical complication characterized by a breach in the uterine wall and the overlying serosa. We report an unusual case of spontaneous rupture of an unscarred uterus in a 33-year-old woman, a day after her third successful vaginal delivery. A 33-year-old pregnant woman, gravid 3, para 3, was referred to our department at 39 gestational week because of rupture of membranes. Despite tocolysis administration, her pregnancy was delivered vaginally after 2 days, giving birth to a male neonate of 3,020 g with normal Apgar scores at first and fifth minute. Her uterus was intact and gynecological examination after delivery was normal without any potential signs or symptoms of pathology. However, the day following her labor, patient complained of left iliac fossa pain. Her blood tests revealed a CRP value at 27.6 mg/L, whereas the X-rays revealed an extensive impacted fecal mass in the colon. MRI revealed that the left lower myometrial part of the uterus was depicted abrupt, with simultaneous presence of hemorrhagic stuff. The decision of laparotomy was therefore made in order to further evaluate rupture of uterus and properly treat patient. And subtotal hysterectomy was performed. Postoperative follow-up period was not characterized by any complications and patient was finally discharged 4 days after hysterectomy.

No MeSH data available.


Related in: MedlinePlus

MRI of left lower myometrial part of the uterus: abruption with simultaneous presence of hemorrhagic stuff.
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Figure 1: MRI of left lower myometrial part of the uterus: abruption with simultaneous presence of hemorrhagic stuff.

Mentions: Gynecological examination after delivery was normal and did not indicate any signs or symptoms of pathology. However, the day following her labor, patient complained of left iliac fossa pain. Her blood tests revealed a CRP value at 27.6 mg/L, whereas the X-rays revealed an extensive impacted fecal mass in the colon. Colon evacuation did not lead to pain amelioration and the abdominal computed tomography (CT) that was performed 2 days after revealed filthiness of the left parametrium with pachynsis of peritoneum. CT was followed by magnetic resonance imaging (MRI), performed the next day. According to MRI, the left lower myometrial part of the uterus was depicted abrupt, with simultaneous presence of hemorrhagic stuff (Fig. 1). In parallel, an increase was observed in CRP values (CRP = 172 mg/L) and in her temperature (37.7 °C).


Spontaneous postpartum rupture of an intact uterus: a case report.

Mavromatidis G, Karavas G, Margioula-Siarkou C, Petousis S, Kalogiannidis I, Mamopoulos A, Rousso D - J Clin Med Res (2014)

MRI of left lower myometrial part of the uterus: abruption with simultaneous presence of hemorrhagic stuff.
© Copyright Policy - open access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4217756&req=5

Figure 1: MRI of left lower myometrial part of the uterus: abruption with simultaneous presence of hemorrhagic stuff.
Mentions: Gynecological examination after delivery was normal and did not indicate any signs or symptoms of pathology. However, the day following her labor, patient complained of left iliac fossa pain. Her blood tests revealed a CRP value at 27.6 mg/L, whereas the X-rays revealed an extensive impacted fecal mass in the colon. Colon evacuation did not lead to pain amelioration and the abdominal computed tomography (CT) that was performed 2 days after revealed filthiness of the left parametrium with pachynsis of peritoneum. CT was followed by magnetic resonance imaging (MRI), performed the next day. According to MRI, the left lower myometrial part of the uterus was depicted abrupt, with simultaneous presence of hemorrhagic stuff (Fig. 1). In parallel, an increase was observed in CRP values (CRP = 172 mg/L) and in her temperature (37.7 °C).

Bottom Line: Despite tocolysis administration, her pregnancy was delivered vaginally after 2 days, giving birth to a male neonate of 3,020 g with normal Apgar scores at first and fifth minute.Her blood tests revealed a CRP value at 27.6 mg/L, whereas the X-rays revealed an extensive impacted fecal mass in the colon.Postoperative follow-up period was not characterized by any complications and patient was finally discharged 4 days after hysterectomy.

View Article: PubMed Central - PubMed

Affiliation: The 3rd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece.

ABSTRACT
Rupture of uterus is an obstetrical complication characterized by a breach in the uterine wall and the overlying serosa. We report an unusual case of spontaneous rupture of an unscarred uterus in a 33-year-old woman, a day after her third successful vaginal delivery. A 33-year-old pregnant woman, gravid 3, para 3, was referred to our department at 39 gestational week because of rupture of membranes. Despite tocolysis administration, her pregnancy was delivered vaginally after 2 days, giving birth to a male neonate of 3,020 g with normal Apgar scores at first and fifth minute. Her uterus was intact and gynecological examination after delivery was normal without any potential signs or symptoms of pathology. However, the day following her labor, patient complained of left iliac fossa pain. Her blood tests revealed a CRP value at 27.6 mg/L, whereas the X-rays revealed an extensive impacted fecal mass in the colon. MRI revealed that the left lower myometrial part of the uterus was depicted abrupt, with simultaneous presence of hemorrhagic stuff. The decision of laparotomy was therefore made in order to further evaluate rupture of uterus and properly treat patient. And subtotal hysterectomy was performed. Postoperative follow-up period was not characterized by any complications and patient was finally discharged 4 days after hysterectomy.

No MeSH data available.


Related in: MedlinePlus