Management of Persistent Postpartum Hemorrhage Caused by Inner Myometrial Lacerations

Inner myometrial laceration: Case report and literature review

“…Since its first description, there has been 16 cases of IML reported including one that was associated with secondary PPH, 7 days after delivery. 5,[7][8][9][10][11][12] In this review, only IML cases causing primary PPH are included and presented in Tables 1 and 2. The incidence of IML is not known and it is thought that some of the cases could have been missed as the diagnosis can only be made by direct examination of hysterectomized uteri or during hysterotomy. There might also be minor lacerations that had been successfully managed with intrauterine tamponade.…”

“…Since its first description, there has been 16 cases of IML reported including one that was associated with secondary PPH, 7 days after delivery 5,7–12 . In this review, only IML cases causing primary PPH are included and presented in Tables 1 and 2.…”

Spontaneous partial uterine laceration in primigravida at 16 weeks of gestation: A case report

“…In contrast with uterine rupture, the partial disruption of the uterine wall, which some reports described as inner myometrial laceration, has not well discussed [ [4] , [5] , [6] , [7] ]. This type of uterine injury sometimes occurs in women without a history of uterine surgery [ 4 , 7 ].…”

“…Hayashi investigated 37 cases of inner myometrial laceration and hypothesized that severe stress on the uterine cervix was caused by an abnormal rise in intrauterine pressure during labor resulting in uterine laceration [ 4 ]. In fact, the inner myometrial laceration in all reported cases occurred during labor [ [4] , [5] , [6] , [7] ]. However, we experienced partial uterine myometrial laceration in 16 weeks of gestation and was not associated with labor.…”

“…While there are many reports and data about uterine rupture, uterine laceration, in which a part of the myometrium is torn, is not well discussed. Uterine laceration is rare and almost unknown; however, it sometimes causes massive intraperitoneal bleeding and has poor prognosis [ [4] , [5] , [6] , [7] ].…”