Limits...
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

Uterine wall dehiscence. (A) Ultrasonography showed the protrusion of the amniotic sac through the uterine defect. (B) Photograph of the uterine defect.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4663232&req=5

Figure 2: Uterine wall dehiscence. (A) Ultrasonography showed the protrusion of the amniotic sac through the uterine defect. (B) Photograph of the uterine defect.

Mentions: A 40-year-old primigravida visited us, complaining abdominal pain at 31 weeks of gestation. She had a 2-year-history of taking laparoscopic myomectomy. At 10 months thereafter, one year before this pregnancy, she had delivered the first baby by elective cesarean section. Intraoperative findings showed the thinning of the right fundal uterine wall where the myoma had been removed previously. On admission, while other test results were within normal range, ultrasound showed the myomectomy scar dehiscence (Fig. 2A). Since there were no findings suggestive of fetal distress, we decided to carry out the conservative management initially, but the pain aggravated despite a few hours use of tocolytics. On follow-up ultrasound, fetal leg was protruded through the defect as case 1. Through an emergency cesarean section, she delivered a 1,460-g baby with Apgar scores of 8 and 9 at 1 and 5 minutes, respectively. Intraoperatively, there was a 5 cm sized uterine defect (Fig. 2B) with protrusion of fetal leg, which was repaired using a 2-layer suture technique. Previous cesarean section scar was intact. The newborn did not show any leg abnormalities but had respiratory distress due to prematurity and the mother had uneventful postoperative course.


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)

Uterine wall dehiscence. (A) Ultrasonography showed the protrusion of the amniotic sac through the uterine defect. (B) Photograph of the uterine defect.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Uterine wall dehiscence. (A) Ultrasonography showed the protrusion of the amniotic sac through the uterine defect. (B) Photograph of the uterine defect.
Mentions: A 40-year-old primigravida visited us, complaining abdominal pain at 31 weeks of gestation. She had a 2-year-history of taking laparoscopic myomectomy. At 10 months thereafter, one year before this pregnancy, she had delivered the first baby by elective cesarean section. Intraoperative findings showed the thinning of the right fundal uterine wall where the myoma had been removed previously. On admission, while other test results were within normal range, ultrasound showed the myomectomy scar dehiscence (Fig. 2A). Since there were no findings suggestive of fetal distress, we decided to carry out the conservative management initially, but the pain aggravated despite a few hours use of tocolytics. On follow-up ultrasound, fetal leg was protruded through the defect as case 1. Through an emergency cesarean section, she delivered a 1,460-g baby with Apgar scores of 8 and 9 at 1 and 5 minutes, respectively. Intraoperatively, there was a 5 cm sized uterine defect (Fig. 2B) with protrusion of fetal leg, which was repaired using a 2-layer suture technique. Previous cesarean section scar was intact. The newborn did not show any leg abnormalities but had respiratory distress due to prematurity and the mother had uneventful postoperative course.

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