Uterine rupture in pregnancy subsequent to previous laparoscopic electromyolysis

Abstract

Reports about uterine rupture in pregnancy subsequent to previous laparoscopic surgery are not frequent. This may be due to the lack of long term follow up of patients who had undergone this surgery rather than the rarity of this complication. A case of uterine rupture subsequent to laparoscopic myomectomy is reported. An increasing rate of the occurrence of this complication is reviewed in current literature, thus reiterating the need for more stringent selection criteria for patients who benefit from this surgical technique.

Spontaneous antenatal uterine rupture 3 years after laparoscopic myomectomy

“…The minimum haemoperitoneum in this case and in other reported cases support this hypothesis [3,4,[7][8][9][10][11].…”

“…However, the potential weakness of the hysterotomy scar manifesting as a uterine rupture in the third trimester of pregnancy before labour is being realised [3][4][5]. This risk exists not only after intramural but also subserosal laparoscopic myomectomies, even when the myoma was superficial [4].…”

Pregnancy Outcomes Following Laparoscopic Myomectomy

“…(Dubuisson et al, 2000;. Thermal damage has been especially blamed in cases where subserous myomas were removed (Nkemayim et al, 2000). Correct reapproximation is not dependent on the number of layers of sutures but on the technique of full thickness, evenly spaced suture placement, thus avoiding haematoma formation.…”

Alternatives thérapeutiques des fibromes hors traitement médicamenteux et embolisation

“…Six cas de rupture utérine gravidique après myolyse bipolaire ont été rapportés dans la littérature, entre 26 et 39 SA avec un délai de grossesse de trois mois à quatre ans après la myolyse [10][11][12][13].…”