Uterine rupture in pregnancy subsequent to hysteroscopic surgery: A case series

Abstract

Uterine rupture during pregnancy is associated with high mortality and morbidity rates in both the fetus and the mother. Hysteroscopic surgeries such as myomectomy and septum resection are known risk factors for uterine rupture in pregnancy following the operation. We present four infertile patients who were admitted to Kocaeli Medical Park Hospital between February 2014 and November 2016. Three of the patients underwent hysteroscopic septum resection without complication and one had hysteroscopic myomectomy and a 7-8 mm sized rupture was detected. All of the patients became pregnant in less than a year after the operations. The first three patients had uterine rupture at 22nd, 38th, and 10th week, which is the earliest rupture in the literature. The last patient had an uneventful pregnancy and the rupture was observed during cesarean section. A short interval between hysteroscopy and pregnancy may increase the risk of rupture. It may be possible to become pregnant despite rupture and not have any problems during the entire pregnancy.

Uterine rupture in patients with a history of laparoscopy or hysteroscopy procedures

“…Several factors may be responsible for rupture of the uterus, including advanced maternal age, overdue pregnancy, macrosomia, a shorter interval of deliveries, single-layer uterine closure, multiple previous cesarean deliveries, trial of labor after cesarean section, [4] bicornuate uterus, [5] laparoscopic or abdominal myomectomy or adenomyomectomy, [6–8] and hysteroscopic surgery. [1] As we have previously reported, interstitial pregnancy treated with uncomplicated laparoscopic cornual wedge resection and laparoscopic salpingectomy can also lead to UR. [9,10] There are some other factors for UR due to placenta percreta to which we need to pay close attention, including in vitro fertilization (IVF) pregnancy.…”

“…At the same time, hysteroscopic surgeries, such as myomectomy and septum resection, are also known risk factors for UR in pregnancy. [1]…”

Changing trends in uterine rupture audit, from the Institute of obstetrics and gynecology, modern government maternity hospital, Osmania medical college

“…At the same time, hysteroscopic surgeries, such as myomectomy and septum resection, are also known risk factors for UR in pregnancy. 7,8 Previous surgeries on the uterus also increase the risk of morbidly adherent placenta.…”

Spontaneous fundal uterine rupture in a non-labouring 31-week twin pregnancy and unknown previous hysteroscopic adhesiolysis: A case report

“…Uterine rupture in pregnancy is a serious condition, carrying high materno-fetal morbidity and mortality [ 1 ]. To achieve the best outcome, surgical intervention must occur without delay.…”