Spontaneous rupture of an unscarred uterus in early pregnancy: a rare but life-threatening emergency

Amro, Bedayah; Lotfi, Ghassan

doi:10.1136/bcr-2018-228493

Cited by 8 publications

(7 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of this group, most cases had a uterine anomaly (10/23, 43.48%), 3 had a PAS disorder (3/23, 13.04%), 2 had an ART-induced pregnancy (2/23, 8.70%), 2 had a pharmacological termination of pregnancy (2/23, 8.70%), 3 others were multiparous (three or more previous births) (3/23, 13.04%) [9,16,26] (Table 1, Table 2, and Supplementary Tables S3-S5). However, in 4 cases, no clearly recognizable predisposing factor was present (4/19, 21.05%) [8,12,55,77].…”

Section: Variablesmentioning

confidence: 99%

First Trimester Uterine Rupture: A Case Report and Literature Review

Cecchini

Tassi

Londero

et al. 2020

IJERPH

View full text Add to dashboard Cite

The aim is to report a case of spontaneous uterine rupture in the first trimester of pregnancy and to review the literature on the topic. Methods: A literature search was performed using PubMed and Scopus. Relevant English articles were identified without any time or study limitations. The data were aggregated, and a summary statistic was calculated. Results: A 35-year-old gravida 5, para 2 was admitted at our department because of fainting and abdominal pain. The woman had a first-trimester twin pregnancy and a history of two previous cesarean sections (CSs). Suspecting a uterine rupture, an emergency laparotomy was performed. The two sacs were completely removed, and the uterine rupture site was closed with a double-layer suture. The patient was discharged from hospital four days later in good condition. On the basis of this experience, a total of 76 case reports were extracted from PubMed and included in the review. Fifty-three patients out of 76 (69.74%) underwent previous surgery on the uterus. Most women (67.92%) had a CS, and in this group a cesarean scar pregnancy (CSP) or a placenta accreta spectrum (PAS) disorder was found to be the etiology in 77.78% of cases. Furthermore, 35.85% of the women had hysterectomy after uterine rupture. Twenty-three patients out of 76 (30.26%) had an unscarred uterus. Of this group, most women presented a uterine anomaly (43.48%). Moreover, 17.39% of these women had a hysterectomy. Conclusion: According to the literature, the current pandemic use of CS explains most cases of first-trimester uterine rupture.

show abstract

Section: Variablesmentioning

confidence: 99%

First Trimester Uterine Rupture: A Case Report and Literature Review

Cecchini

Tassi

Londero

et al. 2020

IJERPH

View full text Add to dashboard Cite

show abstract

“…We identified 84 ruptures of spontaneous unscarred uteruses, reported in 79 articles. Three articles reported on 2 ruptures each, 4,34,35 and 3 ruptures were reported in 1 article. 36…”

Section: Resultsmentioning

confidence: 99%

“…28,29,[37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][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, 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...…”

Section: Etiological and Risk Factorsmentioning

confidence: 99%

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

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.

show abstract

“…6 Furthermore, Armo and Lotfi reported two cases of spontaneous unscarred uterine ruptures at 6 and 12 weeks of gestation. 7 The pregnancies were terminated by removal of the conceptuses in all cases. Several risk factors such as the use of oxytocin and prostaglandin, dystocia, and macrosomia are involved in unscarred uterine ruptures during labor.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous unscarred uterine rupture and surgical repair at 11 weeks of gestation in a twin pregnancy

Takahashi

Ota

Jimbo

et al. 2020

J of Obstet and Gynaecol

View full text Add to dashboard Cite

A uterine rupture may result in a massive hemoperitoneum, which can be fatal to both the fetus and mother. Most uterine ruptures during pregnancy occur within a scarred uterus, rarely occurring in an unscarred uterus. Here, we report a very rare case of spontaneous rupture in an unscarred uterus at 11 weeks of gestation of a twin pregnancy and its surgical repair. A 37‐year‐old nulliparous infertile woman became pregnant with twins after artificial insemination and gonadotropin therapy. She underwent emergency surgery at 11 weeks of gestation due to an acute abdomen caused by massive hemoperitoneum. Upon laparotomy, one fetus with placenta was extruded into the abdominal cavity through a 3‐cm myometrium rupture on the left posterior wall of the uterus. After surgical repair of the rupture site, the remaining fetus was alive and was successfully delivered by cesarean section at 34 weeks of gestation.

show abstract

Spontaneous rupture of an unscarred uterus in early pregnancy: a rare but life-threatening emergency

Cited by 8 publications

References 3 publications

First Trimester Uterine Rupture: A Case Report and Literature Review

First Trimester Uterine Rupture: A Case Report and Literature Review

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

Spontaneous unscarred uterine rupture and surgical repair at 11 weeks of gestation in a twin pregnancy

Contact Info

Product

Resources

About