Kfier Kuba*, Dara N. Matseoane-Peterssen and Dena Goffman
Department of Obstetrics and Gynecology, Columbia University Medical Center, USAFulltext PDF
Background: Uterine rupture is an obstetric emergency with potential for catastrophic maternal and fetal outcomes. Uterine instrumentation has not been commonly thought to be associated with uterine rupture. Case
Presentation: A 31 year old, gravida 21, para 3, 0, 17, 3 underwent induction of labor at 40 6/7 weeks. She had no prior cesarean deliveries, two prior spontaneous abortions, and fifteen prior surgical terminations of pregnancy in the first trimester. Her active phase of labor was complicated by deterioration of the fetal heart tracing. She underwent vacuum assisted vaginal delivery followed by a postpartum hemorrhage. Bimanual examination revealed a lower uterine segment defect with palpable intra-abdominal contents. She underwent exploratory laparotomy and supracervical hysterectomy.
Conclusion: A high index of suspicion and early diagnosis are paramount to the management of uterine rupture. Uterine rupture should be considered in patients with a history of uterine instrumentations.
Kuba K, Matseoane-Peterssen DN, Goffman D. Rupture of an Unscarred Uterus in a Woman with Recurrent Prior Uterine Instrumentation. J Clin Obstet Gynecol Infertil. 2018; 2(1): 1030.