Spontaneous Complete Uterine Rupture in a Nonlaboring, Early Third-trimester Uterus: Missed Diagnosis by Ultrasound

Dixon, Luke; Carlan, S. J.; O’Leary, Tony; Pérez, José A.

doi:10.1055/s-0033-1341575

Cited by 7 publications

(5 citation statements)

References 9 publications

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“…Whereas most of the women with ruptures had at least 1 risk factor, 25% of the women (21/84) did not have any 28,29,37–55 . A single risk factor was found in 47.6% (40/84) of the women 4,9,11,13,21,25,26,32,35,36,56–83 …”

Section: Resultsmentioning

confidence: 99%

“…The most common risk factors were the use of uterotonic drugs for induction or augmentation of labor (22/84 [26.2%]), 3,4,11,34,36,56–62,84–90 mainly oxytocin and misoprostol, and a history of a curettage procedure (16/84 [19%]) 4,21,23,34,63–69,91–93 …”

Section: Resultsmentioning

confidence: 99%

“…4,9,11,13,21,25,26,32,35,36, The most common risk factors were the use of uterotonic drugs for induction or augmentation of labor (22/84 [26.2%]), 3,4,11,34,36,[56][57][58][59][60][61][62][84][85][86][87][88][89][90] mainly oxytocin and misoprostol, and a history of a curettage procedure (16/84 [19%]). 4,21,23,34,[63][64][65][66][67][68][69][91][92][93] Fourteen women (19%) were 35 years or older, 15,23,30, 34,78-80,87,89,90,94-96 and 4 (4.8%) were grand multiparous, with 5 or more past deliveries. 3,81,86,87 Three women (3.6%) were pregnant with a macrocosmic baby (≥4000 g), …”

Section: Etiological and Risk Factorsmentioning

confidence: 99%

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Spontaneous Rupture of the Unscarred Uterus: A Review of the Literature

Sgayer,

Dabbah,

Farah

et al. 2023

Obstetrical &Amp; Gynecological Survey

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Importance Uterine rupture is defined as a nonsurgical disruption of all layers of the uterus. Most ruptures occur in the presence of a scar, usually secondary to a previous cesarean delivery. Rupture of an unscarred uterus is rare and is associated with severe maternal and neonatal outcomes. Objective To outline the literature on potential predisposing factors, clinical findings, and maternal and fetal outcomes of a rupture of an unscarred uterus. Evidence Acquisition PubMed was searched for the phrases “uterine rupture,” “unscarred,” and “spontaneous.” Individual case reports, retrospective case series, and review articles in English between 1983 and 2020 were included. Results We found 84 case reports in 79 articles. The mean maternal age was 29.3 (SD, 5.7) years; 38 women (45.2%) were nulliparous. Uterine rupture occurred in 37% of the women at term; in 9.9%, the gestational age was ≤12 weeks. The most common clinical presentations were abdominal pain (77.4%), signs of hypovolemic shock (36.9%), fetal distress (31%), and vaginal bleeding (22.6%). The most common risk factors were the use of uterotonic drugs for induction or augmentation of labor and a prior curettage procedure. The most frequently ruptured site was the body of the uterus. Hysterectomy managed 36.9% of the ruptures. Four women died (4.8%). Perinatal mortality was 50.6%. Perinatal death was higher in developing than developed countries. Conclusions and relevance Although rare, spontaneous rupture of the unscarred uterus has serious consequences to the mother and the fetus and should be included in the differential diagnosis of acute abdomen in pregnancy. Target Audience Obstetrician-gynecologists, family medicine physicians. Learning Objectives After completing this activity, the learner will be better able to describe the consequences of spontaneous rupture of the unscarred uterus to the mother and fetus; discuss risk factors for spontaneous rupture of the unscarred uterus and its potential occurrence in nulliparous, antepartum, and the first trimester; and discuss how timely assessment of a pregnant woman presenting with abdominal pain impacts survival of the mother and child.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Etiological and Risk Factorsmentioning

confidence: 99%

See 1 more Smart Citation

Spontaneous Rupture of the Unscarred Uterus: A Review of the Literature

Sgayer,

Dabbah,

Farah

et al. 2023

Obstetrical &Amp; Gynecological Survey

View full text Add to dashboard Cite

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“…For these reasons, unfortunately, the diagnosis has to be made through a surgical approach. Thus, the indication is to stabilize the patient, starting with an ultrasound examination and then evaluate the necessity of other imaging; however, in case of suspicion or absence of other causes that can explain the clinical condition, a surgical examination is required [20,24].…”

Section: Discussionmentioning

confidence: 99%

A Study to Examine the Relationship Between Mothers’ Psychosocial Status and Pregnancy Outcome

Seca¹,

Selvaggia²,

Paola³

et al. 2023

BIJG

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Objective: The aim of this study was to summarize the main features of spontaneous uterine rupture in primigravid patients before the onset of labor, emphasize the possibilities of therapeutic conduct, and offer points of reflection on the post-rupture management. Methods: We performed a literature review of all the individual case reports, retrospective case series, and reviews concerning uterine rupture in peer-reviewed journals from January 1975 to October 2021. Result: The diagnosis of uterine rupture was commonly made by abdominal pain, with or without concomitant nausea and vomiting. Uterine ruptures occur more frequently at the end of pregnancy or in the third trimester. The most frequently involved site is the uterine cornua followed by the posterior wall of the uterus. Other described cases identify the broad ligament, uterus sacral ligament, lower uterine segment, and anterior wall as possible points of rupture. The most frequently used suturing technique is the repair of the breach in two layers. Conclusion: Uterine rupture is an extremely rare obstetric emergency, correlated to life-threatening consequences for both the newborn and the woman. Considering the maternal and fetal risks, a tempestive diagnosis is mandatory.

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Section: Discussionmentioning

confidence: 99%

Uterine rupture in nulliparous woman without risk factors:a case report and literature review

Seca,

Selvaggia,

Paola

et al. 2023

BJOG

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Objective: The aim of this study was to summarize the main features of spontaneous uterine rupture in primigravid patients before the onset of labor, emphasize the possibilities of therapeutic conduct, and offer points of reflection on the post-rupture management. Methods: We performed a literature review of all the individual case reports, retrospective case series, and reviews concerning uterine rupture in peer-reviewed journals from January 1975 to October 2021. Results: The diagnosis of uterine rupture was commonly made by abdominal pain, with or without concomitant nausea and vomiting. Uterine ruptures occur more frequently at the end of pregnancy or in the third trimester. The most frequently involved site is the uterine cornua followed by the posterior wall of the uterus. Other described cases identify the broad ligament, uterus sacral ligament, lower uterine segment, and anterior wall as possible points of rupture. The most frequently used suturing technique is the repair of the breach in two layers. Conclusion: Uterine rupture is an extremely rare obstetric emergency, correlated to life-threatening consequences for both the newborn and the woman. Considering the maternal and fetal risks, a tempestive diagnosis is mandatory.

show abstract

Spontaneous Complete Uterine Rupture in a Nonlaboring, Early Third-trimester Uterus: Missed Diagnosis by Ultrasound

Cited by 7 publications

References 9 publications

Spontaneous Rupture of the Unscarred Uterus: A Review of the Literature

Spontaneous Rupture of the Unscarred Uterus: A Review of the Literature

A Study to Examine the Relationship Between Mothers’ Psychosocial Status and Pregnancy Outcome

Uterine rupture in nulliparous woman without risk factors:a case report and literature review

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