Spontaneous uterine rupture of an unscarred uterus in primigravida: case report

Bansode, Minakshi D.

doi:10.18203/2320-1770.ijrcog20201261

Cited by 2 publications

(3 citation statements)

References 7 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%

“…Nine women (10.7%) had a morbidly adherent placenta, mainly a placenta percreta, 13,15,74–77,93,94,97 and 2 (2.4%) had adenomyosis 96,98 . A uterine anomaly was present in 8 ruptures (9.5%): 3 bicornuate uteri, 9,72,73 2 didelphys, 70,97 1 arcuate with right tubal occlusion, 26 and 2 unicornuate with noncommunicating rudimentary horns 32,71 …”

Section: Resultsmentioning

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%

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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“…Uterine rupture represents a dire emergency in obstetrics, typically associated with a higher frequency in multigravida or previously scarred uteri, and commonly occurring during labor (1). Despite its rarity in the early stages of pregnancy, such instances, particularly in the first and second trimesters, are often related to congenital uterine malformations (0.1-3.0%) (2,3). These anomalies are even more prevalent among women who have experienced recurrent pregnancy loss, with figures reaching up to 10% in those who have undergone three or more consecutive miscarriages (4,5).…”

Section: Introductionmentioning

confidence: 99%

Rupture of Bicornuate Uterus: A Case Report

Dars,

Khan,

Awan

et al. 2024

JHRR

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Background: Uterine anomalies, particularly the bicornuate uterus, pose significant risks to pregnancy outcomes, often leading to complications such as recurrent pregnancy loss, preterm birth, and cervical insufficiency. The bicornuate uterus, characterized by a partial fusion of the Müllerian ducts, represents a unique clinical challenge, particularly when pregnancy occurs in a rudimentary horn. Objective: To report a rare case of early second-trimester rupture in a primigravida with a bicornuate uterus, discussing the diagnostic challenges and management strategies, as well as highlighting the importance of recognizing uterine malformations as a differential diagnosis in early gestation presentations. Methods: A retrospective case review was conducted, detailing the presentation, diagnosis, and management of a 25-year-old primigravida who presented with acute abdominal pain at 14 weeks and 5 days of gestation. Clinical assessment included a thorough physical examination, sonographic imaging, and emergent laparotomy. The diagnostic process examined vital signs, abdominal conditions, and ultrasound findings, leading to surgical intervention. Preoperative and postoperative care procedures were analyzed. Results: The patient's emergency ultrasound indicated hemoperitoneum and an empty uterine cavity, with a nearby gestational sac corresponding to a 10-week fetus. Laparotomy revealed 2.5 liters of hemorrhagic fluid and a ruptured rudimentary horn with a 4 x 2 cm rent. Postoperative recovery was uneventful, and histopathological examination confirmed the bicornuate nature of the uterus. Conclusion: This case elucidates the critical need for vigilance and early diagnostic consideration of congenital uterine anomalies in pregnant patients presenting with non-specific abdominal pain. Effective management and improved outcomes hinge upon rapid identification and treatment of such high-risk pregnancies.

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Spontaneous uterine rupture of an unscarred uterus in primigravida: case report

Cited by 2 publications

References 7 publications

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

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

Rupture of Bicornuate Uterus: A Case Report

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