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Two pregnancy cases of uterine scar dehiscence after laparoscopic myomectomy.

Song SY, Yoo HJ, Kang BH, Ko YB, Lee KH, Lee M - Obstet Gynecol Sci (2015)

Bottom Line: Within a few hours after observing, the patient complained of abdominal pain that was aggravating as fetal leg protruded through the defect.In both cases, babies were born by emergency cesarean section.However, clinicians should always be aware of the possibility of obstetric emergencies.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Chungnam National University Hospital, Daejeon, Korea.

ABSTRACT
Uterine scar dehiscence following laparoscopic myomectomy rarely occurs but can compromise both maternal and fetal well-being in subsequent pregnancy. We here present two cases of pregnancy complicated by preterm birth that resulted from uterine scar dehiscence following laparoscopic myomectomy. First case was a igravida who had scar dehiscence at 26 weeks of gestation after having a laparoscopic myomectomy 3 months prior to conception. Two weeks later, we observed her fetal leg protruding through the defect. The other case was a primigravida with a history of prior cesarean delivery, whose sonography revealed myomectomy scar dehiscence at 31 weeks of gestation. Within a few hours after observing, the patient complained of abdominal pain that was aggravating as fetal leg protruded through the defect. In both cases, babies were born by emergency cesarean section. Conservative management can be one of treatment options for myomectomy scar dehiscence in preterm pregnancy. However, clinicians should always be aware of the possibility of obstetric emergencies.

No MeSH data available.


Related in: MedlinePlus

The newborn's left leg shows bruise and edema.
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Figure 1: The newborn's left leg shows bruise and edema.

Mentions: A 35-year-old igravida was admitted with a complaint of abdominal discomfort at 26 weeks of gestation. She had a 3-month history of laparoscopic myomectomy before conception. On admission, she had normal vital signs and laboratory findings. Non-stress test showed moderate fetal heart rate variability with irregular uterine contractions. On sonographic evaluation, however, we found that there was a 2.9-cm-sized defect on the left uterine wall. The fetal membrane was protruded from the defect but the placenta, umbilical cord and the fetus seemed intact. We decided to prolong the pregnancy and thus started tocolytic treatment. At 28 weeks of gestation, follow up ultrasound showed that the fetus had a leg stretched through the defect. Through emergency cesarean section, a 1,200-g male newborn was delivered and we found a 4-cm-sized uterine defect through which fetal leg protruded. We repaired the defect using a 2-layer sutures. Initially, the baby had a bruise and an edema on the left leg(Fig. 1) but eventually recovered during hospitalization. The patient underwent uneventful postoperative course and was discharged.


Two pregnancy cases of uterine scar dehiscence after laparoscopic myomectomy.

Song SY, Yoo HJ, Kang BH, Ko YB, Lee KH, Lee M - Obstet Gynecol Sci (2015)

The newborn's left leg shows bruise and edema.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663232&req=5

Figure 1: The newborn's left leg shows bruise and edema.
Mentions: A 35-year-old igravida was admitted with a complaint of abdominal discomfort at 26 weeks of gestation. She had a 3-month history of laparoscopic myomectomy before conception. On admission, she had normal vital signs and laboratory findings. Non-stress test showed moderate fetal heart rate variability with irregular uterine contractions. On sonographic evaluation, however, we found that there was a 2.9-cm-sized defect on the left uterine wall. The fetal membrane was protruded from the defect but the placenta, umbilical cord and the fetus seemed intact. We decided to prolong the pregnancy and thus started tocolytic treatment. At 28 weeks of gestation, follow up ultrasound showed that the fetus had a leg stretched through the defect. Through emergency cesarean section, a 1,200-g male newborn was delivered and we found a 4-cm-sized uterine defect through which fetal leg protruded. We repaired the defect using a 2-layer sutures. Initially, the baby had a bruise and an edema on the left leg(Fig. 1) but eventually recovered during hospitalization. The patient underwent uneventful postoperative course and was discharged.

Bottom Line: Within a few hours after observing, the patient complained of abdominal pain that was aggravating as fetal leg protruded through the defect.In both cases, babies were born by emergency cesarean section.However, clinicians should always be aware of the possibility of obstetric emergencies.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Chungnam National University Hospital, Daejeon, Korea.

ABSTRACT
Uterine scar dehiscence following laparoscopic myomectomy rarely occurs but can compromise both maternal and fetal well-being in subsequent pregnancy. We here present two cases of pregnancy complicated by preterm birth that resulted from uterine scar dehiscence following laparoscopic myomectomy. First case was a igravida who had scar dehiscence at 26 weeks of gestation after having a laparoscopic myomectomy 3 months prior to conception. Two weeks later, we observed her fetal leg protruding through the defect. The other case was a primigravida with a history of prior cesarean delivery, whose sonography revealed myomectomy scar dehiscence at 31 weeks of gestation. Within a few hours after observing, the patient complained of abdominal pain that was aggravating as fetal leg protruded through the defect. In both cases, babies were born by emergency cesarean section. Conservative management can be one of treatment options for myomectomy scar dehiscence in preterm pregnancy. However, clinicians should always be aware of the possibility of obstetric emergencies.

No MeSH data available.


Related in: MedlinePlus