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      Repair of Uterine Rupture during Second Trimester Leading to Successful Pregnancy Outcome: Case Study and Literature's Review

      case-report
      Author(s): , MD 1 , , MD, PhD 1 , 2 , , MD, PhD 1
      Publication date (Electronic):
      Journal: AJP Reports
      Publisher: Thieme Medical Publishers
      Keywords: fleece-coated fibrin glue, second trimester, uterine rupture

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          Abstract

          It was thought to be impossible to prolong the pregnancy in a case of uterine rupture in the second trimester. We encountered a case of rupture of the pregnant uterus in early mid-trimester, which we repaired with suture and overlapping of collagen fleece coated with fibrin glue, resulting in pregnancy prolongation until the 34th week. Our case and five previously reported cases were reviewed. Pregnant uterine rupture in mid-trimester could be repaired with suture and overlapping of collagen fleece in the absence of placenta percreta.

          Most cited references13

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          Intrapartum rupture of the unscarred uterus.

          Mark Paul, William Miller, Jessica Goodwin … (1997)
          To examine risk factors and maternal and neonatal outcomes in ten cases of intrapartum rupture of the unscarred uterus. Uterine ruptures in women without previous cesarean deliveries were identified from an ongoing log for a 12-year period beginning January 1, 1983. Detailed information was obtained by review of hospital records. From January 1, 1983, through December 31, 1994, we identified 13 uterine ruptures in women without previous cesarean deliveries. Three resulted from motor vehicle accidents and were excluded from analysis. Ten occurred during labor and are the subjects of our report. The incidence of intrapartum rupture of an unscarred uterus was 1 in 16,849 deliveries. Associated factors included oxytocin use (four cases), prostaglandin use (three cases), use of vacuum or forceps (three cases), grand multiparity (two cases), and malpresentation (two cases). Intervention was prompted by fetal heart rate decelerations in seven cases and by severe hemorrhage in three. Uterine rupture was associated with acute abdominal pain in six cases, maternal tachycardia in five, and severe hypotension in two. Neonatal outcomes were normal in nine cases. There were no maternal or perinatal deaths. Intrapartum rupture of the unscarred uterus is a rare obstetric emergency. Maternal and perinatal outcomes are optimized by awareness of risk factors, recognition of clinical signs and symptoms, and prompt surgical intervention.
          Article 0 comments Cited 35 times – based on 0 reviews     Review now
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            A 10-year population-based study of uterine rupture.

            Thomas F Baskett, Katharina Kieser (2002)
            To review the incidence, associated factors, methods of diagnosis, and maternal and perinatal morbidity and mortality associated with uterine rupture in one Canadian province. Using a perinatal database, all cases of uterine rupture in the province of Nova Scotia for the 10-year period 1988-1997 were identified and the maternal and perinatal mortality and morbidity reviewed in detail. Over the 10 years, there were 114,933 deliveries with 39 cases of uterine rupture: 18 complete and 21 incomplete (dehiscence). Thirty-six women had a previous cesarean delivery: 33 low transverse, two classic, one low vertical. Of the 114,933 deliveries, 11,585 (10%) were in women with a previous cesarean delivery. Uterine rupture in those undergoing a trial for vaginal delivery (4516) was complete rupture in 2.4 per 1000 and dehiscence in 2.4 per 1000. There were no maternal deaths, and maternal morbidity was low in patients with dehiscence. In comparison, 44% of those with complete uterine rupture received blood transfusion (odds ratio 7.60, 95% confidence interval 1.14, 82.14, P =.025). Two perinatal deaths were attributable to complete uterine rupture, one after previous cesarean delivery. Compared with dehiscence, infants born after uterine rupture had significantly lower 5-minute Apgar scores (P <.001) and asphyxia, needing ventilation for more than 1 minute (P <.01). In 92% of cases, uterine rupture was associated with previous cesarean delivery. Uterine dehiscence was associated with minimal maternal and perinatal morbidity. In contrast, complete uterine rupture was associated with significantly more maternal blood transfusion and neonatal asphyxia.
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              Rupture of the pregnant uterus: a 53-year review.

              Donna Parker, R S Gall, Emily Eden (1986)
              A 53-year (1931-1983) review of 48 patients who experienced uterine rupture and were cared for at Duke University Medical Center was conducted. The observed incidence was one uterine rupture per 1424 deliveries. From January 1, 1963, through December 31, 1983, 24 cases of ruptured uterus were identified; a detailed review of these patients is presented.
              Article 0 comments Cited 9 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): AJP Rep
                Journal ID (iso-abbrev): AJP Rep
                Journal ID (doi): 10.1055/s-00000169
                Title: AJP Reports
                Publisher: Thieme Medical Publishers (333 Seventh Avenue, New York, NY 10001, USA. )
                ISSN (Print): 2157-6998
                ISSN (Electronic): 2157-7005
                Publication date (Electronic): 17 December 2013
                Publication date (Print): May 2014
                Volume: 4
                Issue: 1
                Pages: 9-12
                Affiliations
                [1 ]Department of Obstetrics and Gynecology, Akita University School of Medicine, Hondo, Akita, Japan
                [2 ]Perinatal Medical Center, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan
                Author notes
                Address for correspondence Masaki Ogawa, MD, PhD Perinatal Medical Center Tokyo Women's Medical University, Kawadacho 8-1, Shinjuku, Tokyo 1628666Japan masakiogawa3@ 123456gmail.com
                Article
                Publisher ID: 130027
                DOI: 10.1055/s-0033-1361926
                PMC ID: 4078177
                SO-VID: bf473285-6489-4d67-ad35-e2241d816a60
                Copyright © © Thieme Medical Publishers
                History
                Date received : 06 September 2013
                Date accepted : 12 October 2013
                Categories
                Subject: Article

                Keywords: fleece-coated fibrin glue,second trimester,uterine rupture
                Data availability:
                Keywords: fleece-coated fibrin glue, second trimester, uterine rupture

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