Spontaneous uterine rupture during the first trimester of a partial molar pregnancy in a scar uterus: A rare case report

Miski, Fatiha El; Benjelloun, A; Bouab, Maryem; Lamrissi, Amine; Fichtali, Karima; Bouhya, S.

doi:10.1016/j.ijscr.2021.106229

Cited by 3 publications

(3 citation statements)

References 12 publications

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“…Presentations of cesarean scar molar pregnancy are vaginal bleeding, nausea, abdominal pain, and persistent spotting after uterine evacuation (8). Molar pregnancy in the scar of the uterus may have serious complications such as severe hemorrhage and uterine perforation because of the thin myometrium at the site of the scar (9). As the first step in dealing with a suspected case of such complication, special attention should be paid to the ultrasonic diagnostic criteria, including the evidence of "snowflake" and "honeycomb" mixed echoic lesions with high blood supply, presenting "lake" and "dry branch" manifestations in the clinical background with no evidence of International Journal of Reproductive BioMedicine Hosseinimousa et al…”

Section: Discussionmentioning

confidence: 99%

“…Treatments varied in different cases, including dilation and curettage, ultrasoundguided surgical evacuation (with or without uterine arterial embolization before the procedure), laparotomy and resection of the mass and uterine repair, recent total laparoscopic management with resection of the mass and uterine repair, and robotic-assisted laparoscopic hysterectomy. Also, chemotherapy with methotrexate and in one case with Etoposide, Methotrexate, Actinomycin D/ Etoposide, Cisplatin were needed (1,2,5,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

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Molar cesarean scar ectopic pregnancy: Report of 2 cases with review of literature

Hosseinimousa,

Navaei,

Talebian

2024

IJRM

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Background: The occurrence of hydatidiform mole at the cesarean scar site is a rare problem. Few cases have been reported, thus there is not enough information for accurate diagnosis and management of this event. Case Presentation: Herein, we present 2 cases of an invasive hydatidiform mole embedded in cesarean scar tissue, one presented with occasional hypogastric pain and nausea and another with spotting both with a history of cesarean section. Transvaginal ultrasonography and a considerably high titer of beta-human chorionic gonadotropin blood test suggested the existence of molar pregnancy on the cesarean scar, which was confirmed through histological assessment. In the first case, evacuation of molar pregnancy followed by scar resection at the cesarean scar site led to successful fertility preservation management. Conclusion: The presence of abdominal pain and unexplained bleeding in a pregnant woman without gestational sac in ultrasonography, strongly suggests ectopic pregnancy. The process of diagnosis should be followed by definitive diagnostic evaluation, including beta-human chorionic gonadotropin titer measurement, ultrasonographic assessment (2 and 3-dimensional), magnetic resonance imaging, diagnostic laparoscopy, and finally biopsy of the lesion. Key words: Cesarean scar pregnancy, Ectopic pregnancy, Hydatidiform mole, Molar pregnancy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Molar cesarean scar ectopic pregnancy: Report of 2 cases with review of literature

Hosseinimousa,

Navaei,

Talebian

2024

IJRM

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“…Spontaneous UR in early pregnancy is a rare but serious obstetric complication, especially if associated with a wrong or late diagnosis. Several cases have been reported in the literature [2,[7][8][9][10][11]. The presence of a previous scar in the uterus is a very important risk factor for developing UR [12].…”

Section: Discussionmentioning

confidence: 99%

It Is Not Always an Ectopic or Heterotopic Pregnancy

Mohamed¹,

Awadalla²,

Nawaz³

2023

Cureus

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Uterine rupture is a life-threatening peripartum complication. Spontaneous uterine rupture in early pregnancy is very rare. The diagnosis of uterine rupture should be considered when a pregnant patient presents with an acute abdomen because its clinical signs in early pregnancy are non-specific and the differentiation with other acute abdominal emergencies is challenging. Here, we present a case of acute abdominal pain. The patient was a 14-week pregnant 39-year-old female (gravida 4, para 2+1) with a history of two lower-segment cesarean sections. Our preoperative diagnosis was either heterotopic pregnancy or acute abdomen. Emergency laparotomy confirmed the presence of a spontaneous uterine rupture.

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Uterine rupture in the first trimester: a case report and review of the literature

Mutiso,

Oindi,

Mundia

2024

J Med Case Reports

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Background Uterine rupture is a rare complication that can occur in the first trimester of pregnancy. It can lead to serious maternal morbidity or mortality, which is mostly due to catastrophic bleeding. First trimester uterine rupture is rare; hence, diagnosis can be challenging as it may be confused with other causes of early pregnancy bleeding such as an ectopic pregnancy. We present a case of first trimester scar dehiscence and conduct a literature review of this rare condition. Case presentation A 39-year-old African patient with four previous hysterotomy scars presented with severe lower abdominal pain at 11 weeks of gestation. She had two previous histories of third trimester uterine rupture in previous pregnancies with subsequent hysterotomies and repair. She underwent a diagnostic laparoscopy that confirmed the diagnosis of a 10 cm anterior wall uterine rupture. A laparotomy and repair of the rupture was subsequently done. Conclusion In conclusion, the case presented adds to the body of evidence of uterine scar dehiscence in the first trimester. The risk factors, clinical presentation, diagnostic imaging, and management outlined may help in early identification and management of this rare but life threatening condition.

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Spontaneous uterine rupture during the first trimester of a partial molar pregnancy in a scar uterus: A rare case report

Cited by 3 publications

References 12 publications

Molar cesarean scar ectopic pregnancy: Report of 2 cases with review of literature

Molar cesarean scar ectopic pregnancy: Report of 2 cases with review of literature

It Is Not Always an Ectopic or Heterotopic Pregnancy

Uterine rupture in the first trimester: a case report and review of the literature

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