Re: Transverse uterine fundal incision for placenta praevia with accreta, involving the entire anterior uterine wall: a case series. Spontaneous uterine rupture during the subsequent pregnancy after transverse uterine fundal incision for placenta praevia with accreta

Fujiwara-Arikura, Sayaka; Nishijima, Koji; Tamamura, Chiyo; Nishikawa, Yukiko; Takahashi, Jin; Kawamura, Hiroshi; Nakago, Satoshi; Kotsuji, Fumikazu; Yoshida, Yoshio

doi:10.1111/1471-0528.14899

Cited by 5 publications

(7 citation statements)

References 3 publications

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“…However, it may become difficult to observe the scar in cases where the previous incision was made on the uterine fundus, as the gravid uterus was enlarged. Perinatal management and outcomes in similar cases have rarely been reported 3,4 . In the present case report, we describe a case of uterine rupture in a pregnant woman with a previous cesarean section by a transverse uterine fundal incision who recovered from cardiac arrest by CPR and PMCD and survived by multidisciplinary management.…”

Section: Introductionmentioning

confidence: 78%

“…However, it is uncertain when or how many MRIs should be performed during pregnancy, and when admission or termination should be recommended due to the findings. There are limited reports of uterine rupture caused by prior transverse uterine fundal incision 3,4 . Previous case reports and the current case are summarized in Table 1.…”

Section: Discussionmentioning

confidence: 96%

“…There are limited reports of uterine rupture caused by prior transverse uterine fundal incision. 3 , 4 Previous case reports and the current case are summarized in Table 1 . Two patients, including the current patient, underwent MRI at 12 months postpartum, which revealed cesarean section scar thinning and a defect at the uterine fundus.…”

Section: Discussionmentioning

confidence: 99%

“…Perinatal management and outcomes in similar cases have rarely been reported. 3,4 In the present case report, we describe a case of uterine rupture in a pregnant woman with a previous cesarean section by a transverse uterine fundal incision who recovered from cardiac arrest by CPR and PMCD and survived by multidisciplinary management. We also reviewed cases of uterine rupture in pregnant women who underwent a previous cesarean section via a transverse uterine fundal incision.…”

Section: Introductionmentioning

confidence: 89%

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Uterine rupture in the third trimester of a pregnancy subsequent to a cesarean section by transverse uterine fundal incision: A case report and literature review

Koshimizu

Kakogawa

Murata

et al. 2022

Clinical Case Reports

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Section: Introductionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 89%

See 2 more Smart Citations

Uterine rupture in the third trimester of a pregnancy subsequent to a cesarean section by transverse uterine fundal incision: A case report and literature review

Koshimizu

Kakogawa

Murata

et al. 2022

Clinical Case Reports

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“…Briefly, five interrupted retention sutures (absorbable 1 − 0 threads) were set as wide as possible, and the myometrial wound was closed using two layers of interrupted sutures (absorbable 2 − 0 threads). The retention sutures were then tied [ 6 , 12 ] (Fig. 2 ).…”

Section: Methodsmentioning

confidence: 99%

Evaluation of incision healing status after transverse uterine fundal incision for cesarean delivery and postoperative pregnancy: a ten-year single-center retrospective study

Kotsuji,

Shibata,

Nakago

et al. 2024

BMC Pregnancy Childbirth

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Background Transverse uterine fundal incision (TUFI) is a beneficial procedure for mothers and babies at risk due to placenta previa-accreta, and has been implemented worldwide. However, the risk of uterine rupture during a subsequent pregnancy remains unclear. We therefore evaluated the TUFI wound scar to determine the approval criteria for pregnancy after this surgery. Methods Between April 2012 and August 2022, we performed TUFI on 150 women. Among 132 of the 150 women whose uteruses were preserved after TUFI, 84 women wished to conceive again. The wound healing status, scar thickness, and resumption of blood flow were evaluated in these women by magnetic resonance imaging (MRI) and sonohysterogram at 12 months postoperatively. Furthermore, TUFI scars were directly observed during the Cesarean sections in women who subsequently conceived. Results Twelve women were lost to follow-up and one conceived before the evaluation, therefore 71 cases were analyzed. MRI scans revealed that the “scar thickness”, the thinnest part of the scar compared with the normal surrounding area, was ≥ 50% in all cases. The TUFI scars were enhanced in dynamic contrast-enhanced MRI except for four women. However, the scar thickness in these four patients was greater than 80%. Twenty-three of the 71 women conceived after TUFI and delivered live babies without notable problems until August 2022. Their MRI scans before pregnancy revealed scar thicknesses of 50–69% in two cases and ≥ 70% in the remaining 21 cases. And resumption of blood flow was confirmed in all patients except two cases whose scar thickness ≥ 90%. No evidence of scar healing failure was detected at subsequent Cesarean sections, but partial thinning was found in two patients whose scar thicknesses were 50–69%. In one woman who conceived seven months after TUFI and before the evaluation, uterine rupture occurred at 26 weeks of gestation. Conclusions Certain criteria, including an appropriate suture method, delayed conception for at least 12 months, evaluation of the TUFI scar at 12 months postoperatively, and cautious postoperative management, must all be met in order to approve a post-TUFI pregnancy. Possible scar condition criteria for permitting a subsequent pregnancy could include the scar thickness being ≥ 70% of the surrounding area on MRI scans, at least partially resumed blood flow, and no abnormalities on the sonohysterogram. Trial registration Retrospectively registered.

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Re: Transverse uterine fundal incision for placenta praevia with accreta, involving the entire anterior uterine wall: a case series. Spontaneous uterine rupture during the subsequent pregnancy after transverse uterine fundal incision for placenta praevia with accreta

Cited by 5 publications

References 3 publications

Uterine rupture in the third trimester of a pregnancy subsequent to a cesarean section by transverse uterine fundal incision: A case report and literature review

Uterine rupture in the third trimester of a pregnancy subsequent to a cesarean section by transverse uterine fundal incision: A case report and literature review

Evaluation of incision healing status after transverse uterine fundal incision for cesarean delivery and postoperative pregnancy: a ten-year single-center retrospective study

Importance of understanding the operative procedures of the transverse uterine fundal incision, postoperative management, and patient education

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