Successful pregnancy with fundal placenta percreta replacing the myometrial defect from previous uterine rupture

Crespigny, C. Champion de; Shetty, P.; Inglis, Emma; Anpalagan, Anbu; Chatterjee, Ushmi; Alahakoon, Thushari I.

doi:10.1080/01443615.2018.1557125

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…It is important to be mindful that although our patient had an excellent outcome, there are numerous case reports in the literature of uterine rupture following iatrogenic perforation of the uterus. These women have a wide range of presentations, including sudden onset of abdominal pain, hypotension, postpartum haemorrhage and intrapartum fetal death 6–8. There have also been cases of silent uterine rupture that have subsequently presented as a secondary abdominal pregnancy 9 10…”

Section: Discussionmentioning

confidence: 99%

Two uterine scars and a vaginal birth

Christie²,

Nayyar

2021

BMJ Case Rep

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Uterine scarring increases the risk of uterine rupture during labour, which can result in significant maternal and fetal morbidity and mortality. There is insufficient evidence for a clear recommendation on the safety of vaginal delivery in the context of a patient with both a uterine perforation and a previous lower uterine segment caesarean section. We present the case of a woman with a history of one previous caesarean section and uterine perforation with a uterine manipulator, who subsequently had an uncomplicated normal vaginal delivery.

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Section: Discussionmentioning

confidence: 99%

Two uterine scars and a vaginal birth

Christie²,

Nayyar

2021

BMJ Case Rep

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“…Table 1 shows a summary of evaluated studies (n = 4), including our case [8,10,34,35]. Among these studies, three were case reports [10,34,35], and one was an original article that examined the effects of 37 prior uterine ruptures on maternal outcomes in subsequent pregnancies. In the original article, there was one case of prior uterine rupture in gestational week 17 [8].…”

Section: Study Characteristicsmentioning

confidence: 99%

Maternal and Fetal Outcomes after Prior Mid-Trimester Uterine Rupture: A Systematic Review with Our Experience

et al. 2021

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Background and Objectives: Since spontaneous uterine rupture in the mid-trimester is rare, maternal and fetal outcomes in subsequent pregnancies remain unclear. Therefore, this study aimed to examine the maternal and fetal outcomes of subsequent pregnancies after prior mid-trimester uterine rupture. Materials and Methods: A systematic review using PubMed, the Cochrane Central Register of Controlled Trials, and Scopus until 30 September 2021, was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The studies that clarified the maternal and fetal outcomes after prior mid-trimester uterine rupture and our case (n = 1) were included in the analysis. Results: Among the eligible cases, there were five women with eight subsequent pregnancies after prior mid-trimester uterine rupture. The timing of prior mid-trimester uterine rupture ranged from 15 to 26 weeks of gestation. The gestational age at delivery in subsequent pregnancies was 23–38 gestational weeks. Among the included cases (n = 8), those involving prior mid-trimester uterine rupture appeared to be associated with an increased prevalence of placenta accreta spectrum (PAS) (n = 3, 37.5%) compared with those involving term uterine rupture published in the literature; moreover, one case exhibited recurrent uterine rupture at 23 weeks of gestation (12.5%). No maternal deaths have been reported in subsequent pregnancies following prior mid-trimester uterine rupture. Fetal outcomes were feasible, except for one pregnancy with recurrent mid-trimester uterine rupture at 23 weeks of gestation, whose fetus was alive complicated by cerebral palsy. Conclusions: Our findings suggest that clinicians should be aware of the possibility of PAS and possible uterine rupture in pregnancies after prior mid-trimester uterine rupture. Further case studies are warranted to assess maternal and fetal outcomes in pregnancies following prior mid-trimester prior uterine rupture.

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“…One patient experienced three successive pregnancies complicated by spontaneous preterm (23-33 weeks) fundal rupture, with fundal placenta percreta in the fourth pregnancy. 14 Only her first rupture at 26 weeks (twins) as a primigravid nullipara is included in this series, giving 25 discrete patients with complete rupture (Table 1). Thirteen dehiscence cases are reported in Table S1 for reference but not further considered.…”

Section: Uterine Rupture Ratesmentioning

confidence: 99%

Ten years of uterine rupture in an Australian tertiary hospital

Wu¹,

McGee

2021

Aust NZ J Obst Gynaeco

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Complete uterine rupture is a rare and serious complication of pregnancy.Although most commonly associated with attempted vaginal birth after caesarean (VBAC), rupture also occurs in atypical/non-VBAC cases. This retrospective, singletertiary-institution observational study aimed to assess the prevalence and morbidity of complete uterine rupture during 2010-2020.Methods: Hospital discharge codes and local maternity databases identified uterine rupture cases, with medical record reviews confirming the diagnosis, distinguishing complete rupture from dehiscence, and extracting additional data. VBAC attempt was defined as planned labour trial after one prior caesarean.Results: Over the decade, 27 complete ruptures occurred among 58 614 women, a rate of 4.6 per 10 000 births. One woman with three successive fundal ruptures had only the first included in further analysis, leaving 25 discrete women; 19 ruptures occurred in term planned VBAC attempts and six in preterm atypical/non-VBAC cases (two nulliparas and four women with multiple prior caesareans). The VBAC-attempt rupture rate was 0.74%, similar to published reports. All five perinatal deaths occurred in preterm atypical/non-VBAC cases. In the term VBAC-attempt group, rupture-related perinatal morbidity included four cases (21%) of hypoxicischaemic encephalopathy, with two cases (11%) of cerebral palsy at follow-up.Overall, perinatal morbidity was highest with total fetal extrusion. Maternal blood loss ≥1500 mL or transfusion was almost threefold higher, and postnatal length-ofstay was three days longer, after vaginal than caesarean birth, with delay in rupture recognition being a factor. Conclusion:A high suspicion index for uterine rupture is imperative during any labour, particularly in the scarred uterus, with vigilance continuing after successful vaginal birth.

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Successful pregnancy with fundal placenta percreta replacing the myometrial defect from previous uterine rupture

Cited by 3 publications

References 8 publications

Two uterine scars and a vaginal birth

Two uterine scars and a vaginal birth

Maternal and Fetal Outcomes after Prior Mid-Trimester Uterine Rupture: A Systematic Review with Our Experience

Ten years of uterine rupture in an Australian tertiary hospital

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