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Silent Spontaneous Uterine Rupture at 36 Weeks of Gestation.

Woo JY, Tate L, Roth S, Eke AC - Case Rep Obstet Gynecol (2015)

Bottom Line: Case Presentation.Conclusion.A high index of suspicion and good imaging during pregnancy are important in making this diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Michigan State University/Sparrow Hospital, Lansing, MI 48912, USA.

ABSTRACT
Introduction. Silent spontaneous rupture of the uterus before term, with extrusion of an intact amniotic sac and delivery of a healthy neonate, with no maternal or neonatal morbidity or mortality is very rare. Very few cases have been reported in literature. Case Presentation. We report a case of silent spontaneous uterine rupture, found during a scheduled repeat cesarean section at 36 weeks of gestation. Patient had history of two prior classical cesarean sections. She underwent cesarean section, with delivery of a healthy male infant. She had a good postoperative recovery and was discharged on postoperative day 3. Conclusion. Silent spontaneous rupture of the uterus before term with extrusion of an intact amniotic sac is rare. A high index of suspicion and good imaging during pregnancy are important in making this diagnosis.

No MeSH data available.


Related in: MedlinePlus

Silent uterine rupture, with extruded amniotic sac.
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fig1: Silent uterine rupture, with extruded amniotic sac.

Mentions: Upon entering the abdominal cavity via a vertical skin incision, a complete uterine rupture was seen at the prior classical incisional scar with the amniotic sac protruding into the abdomen (Figure 1). Fetal parts were palpable through the protruding membrane. No active bleeding was noted, and the uterine scar appeared to be fibrotic at both edges. The fetus was found in oblique presentation and was delivered after amniotomy in normal fashion. Neonate's APGAR at 1 and 5 minutes were 8 and 9, respectively. Birthweight was 3645 g. Inspection of the uterus revealed that the uterine scar rupture occurred left of midline due to a severely rightward rotated uterus. The posterior lower uterine segment was very thin and was ballooning outwards. Dense adhesion was noted between the bladder and anterior lower uterine segment. Uterus was repaired with multilayer closure. Tubal ligation was performed as planned. Remainder of the surgery was completed in the usual fashion.


Silent Spontaneous Uterine Rupture at 36 Weeks of Gestation.

Woo JY, Tate L, Roth S, Eke AC - Case Rep Obstet Gynecol (2015)

Silent uterine rupture, with extruded amniotic sac.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556862&req=5

fig1: Silent uterine rupture, with extruded amniotic sac.
Mentions: Upon entering the abdominal cavity via a vertical skin incision, a complete uterine rupture was seen at the prior classical incisional scar with the amniotic sac protruding into the abdomen (Figure 1). Fetal parts were palpable through the protruding membrane. No active bleeding was noted, and the uterine scar appeared to be fibrotic at both edges. The fetus was found in oblique presentation and was delivered after amniotomy in normal fashion. Neonate's APGAR at 1 and 5 minutes were 8 and 9, respectively. Birthweight was 3645 g. Inspection of the uterus revealed that the uterine scar rupture occurred left of midline due to a severely rightward rotated uterus. The posterior lower uterine segment was very thin and was ballooning outwards. Dense adhesion was noted between the bladder and anterior lower uterine segment. Uterus was repaired with multilayer closure. Tubal ligation was performed as planned. Remainder of the surgery was completed in the usual fashion.

Bottom Line: Case Presentation.Conclusion.A high index of suspicion and good imaging during pregnancy are important in making this diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Michigan State University/Sparrow Hospital, Lansing, MI 48912, USA.

ABSTRACT
Introduction. Silent spontaneous rupture of the uterus before term, with extrusion of an intact amniotic sac and delivery of a healthy neonate, with no maternal or neonatal morbidity or mortality is very rare. Very few cases have been reported in literature. Case Presentation. We report a case of silent spontaneous uterine rupture, found during a scheduled repeat cesarean section at 36 weeks of gestation. Patient had history of two prior classical cesarean sections. She underwent cesarean section, with delivery of a healthy male infant. She had a good postoperative recovery and was discharged on postoperative day 3. Conclusion. Silent spontaneous rupture of the uterus before term with extrusion of an intact amniotic sac is rare. A high index of suspicion and good imaging during pregnancy are important in making this diagnosis.

No MeSH data available.


Related in: MedlinePlus