Spontaneous uterine rupture during early pregnancy is an extremely rare occurrence and may vary in presentation and course of events, hence the clinical diagnosis is often challenging. We present our experience with two such cases of spontaneous uterine rupture in the first trimester of pregnancy without any identifiable underlying risk factors. The first case was at 12 weeks of gestation and the second case was at 6 weeks gestational age (GA). Both cases were diagnosed and managed by the laparoscopic approach. We are reporting the earliest documented GA in which spontaneous uterine rupture occurred. So far, the earliest GA reported in the literature according to our knowledge was at 7+3 weeks. Access to a laparoscopic facility is crucial in the early definitive diagnosis and prompt management of these cases, since this may significantly reduce the risk of severe morbidity and mortality.
Our study reinforces the critical role of the PAMG-1 biomarker test to aid in risk assessment of imminent spontaneous preterm delivery in patients with symptoms of PTL. The PAMG-1 test was found to be statistically superior to standard clinical assessment alone, with respect to specificity. Based on our data, the introduction of a PAMG-1 test result into clinical decision making could reduce up to 91% of unnecessary admissions for women presenting with threatened preterm labor.
Original research article studies have stated prevalence from 5-15% (2). Sufferers make up a sizeable proportion of those attending gynecologic practices, whether seeking help for infertility, or because the condition has become chronic with disabling effects. Although it is not easy to determine how prevalent the disease is among the general population (at present, it can only be confirmed by laparoscopy or laparotomy), there are indications that it is increasing. One factor in this could be the considerable delay between the onset of pain and the surgical diagnosis, as well as the change in family planning, with a shift among young females towards professional rather than personal ambition. In addition to the physical effects of the disease, the psychological impact of endometriosis is also a cause for concern. Every practicing primary care provider and gynecologist should be aware of the feelings of frustration and consequent depression experienced by women with endometriosis. The definitions of endometriosis have changed over time, contributing to biases in the literature. In the mid-1980s, the
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