1/35. Primary repair of cornual rupture occurring at 21 weeks gestation and successful pregnancy outcome.The successful delivery in a 31 year old woman at 33 weeks gestation is reported, after repair to a cornual rupture which occurred at 21 weeks gestation. The patient exhibited acute abdominal pain and pending shock. Emergency laparotomy showed a cornual rupture and an intrauterine vital fetus having intact amnion membrane. On the patient's family's insistence, primary repair for a cornual rupture was performed and preservation of the fetus attempted. Postoperatively, tocolytic agent with ritodrine hydrochloride was administered and close follow-up of the patient was uneventful. The patient had a smooth obstetric course until 33 weeks gestation when premature rupture of the membranes occurred, soon followed by the onset of labour. She underwent an elective Caesarean section and delivered a normal male fetus weighing 2140 g with Apgar scores at 1, 5 and 10 min of 6, 8, and 9 respectively. Because of this successful outcome, we suggest that primary repair for such an unusual patient should be accepted.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
2/35. Spontaneous second trimester uterine rupture after classical cesarean.BACKGROUND: Several cases of spontaneous second trimester uterine rupture have been reported, but none as early as 15 weeks' gestation after classical cesarean and with placenta percreta. CASE: A 23-year-old woman, gravida 5, para 3, at 15 37 weeks' gestation with a history of classical cesarean incision presented to the emergency department with abdominal pain, hypotension, and tachycardia. Ultrasound showed a normal intrauterine pregnancy. She developed worsening pain, abdominal rebound, and abdominal distention. On exploratory laparotomy, a large uterine rupture was found and hysterectomy was done. CONCLUSION: Spontaneous uterine rupture after classical cesarean can occur as early as 15 weeks' gestation. uterine rupture must be considered in differential diagnoses of severe abdominal pain even in the early second trimester.- - - - - - - - - - ranking = 2keywords = abdominal pain (Clic here for more details about this article) |
3/35. Late second stage rupture of the uterus and bladder with vaginal birth after cesarean section: a case report and review of the literature.Rupture of a uterine scar during labor with concomitant severe injury to the maternal bladder has been reported sporadically. Previously reported cases have been diagnosed under a variety of conditions, commonly at the time of repeat Cesarean delivery. A case of maternal bladder rupture diagnosed following forceps-assisted vaginal delivery after Cesarean is presented. Severe bradycardia developed suddenly in the second stage of labor. Rupture of the uterine scar was diagnosed after sudden onset of severe lower abdominal pain with delivery of the placenta. At laparotomy, extensive injury to the bladder was found and successful repair of both injuries was performed. A review of previously reported similar cases with their mechanism of injury and presentation is presented. Serious maternal bladder injury at the time of uterine rupture remains a risk of attempted vaginal delivery after prior cesarean section.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
4/35. placenta percreta: report of two cases and review of the literature.placenta percreta is a serious complication of pregnancy. Two cases of placenta percreta confirmed histologically were treated by supravaginal hysterectomy. Case 1: A case of uterine rupture secondary to placenta percreta was diagnosed in a 29-year-old term primigravida during an elective abdominal delivery of a healthy fetus. Spontaneous rupture of the primigravid uterus due to placenta percreta without a history of trauma or infection is a very rare occurrence. Case 2: A 33-year-old previously healthy G4P2 woman was admitted at 29 weeks of gestation with acute abdominal pain and hemorrhagic shock. There was a history of one induced abortion and two cesarean section deliveries. A review of risk factors, diagnostic tools and treatment possibilities are given.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
5/35. uterine rupture associated with castor oil ingestion.A woman at 39 weeks' gestation with a previous Cesarean delivery had severe abdominal pains and rupture of membranes shortly after ingesting 5 ml of castor oil. Forty-five minutes later, repetitive variable decelerations prompted a Cesarean delivery. At surgery, a portion of the umbilical cord was protruding from a 2-cm rupture of the lower transverse scar.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
6/35. Vernixuria: another sign of uterine rupture.uterine rupture complicates approximately 1% of trials of labor after cesarean. Classic signs and symptoms include loss of station, cessation of labor, vaginal bleeding, fetal distress, and abdominal pain. Other signs are also possible. We report a case of uterine rupture at VBAC trial that includes an unusual clinical sign of uterine rupture: vernix caseosa observed in the urine of the parturient. During labor, a bladder catheter was inserted to evaluate oliguria. vernix caseosa and blood were found in the tubing. Prompt cesarean delivery followed. A tear extending from the original transverse scar into the bladder dome was found. Vernixuria is an additional sign of uterine rupture.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
7/35. Extrusion of fetus into the abdominal cavity following complete rupture of uterus: a case report.A gravida 10 para 9, after one cesarean section (CS) followed by four vaginal deliveries was admitted at term without uterine contractions complaining of abdominal pain. The type of uterine scar was unknown. Severe bradycardia was observed at admission and an emergency cesarean section was performed. A complete uterine rupture was revealed, the fetus in intact membranes and placenta were found in the abdominal cavity.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
8/35. First-trimester uterine rupture from a placenta percreta. A case report.BACKGROUND: Cesarean scar pregnancy complicated by placenta percreta and uterine rupture is an uncommon gynecologic emergency. CASE: A woman presenting with abdominal pain and shock was found to have a cesarean scar pregnancy complicated by placenta percreta and uterine rupture. CONCLUSION: Implantation within a cesarean scar may cause placenta percreta, leading to uterine rupture in the first trimester and mimicking other gynecologic emergencies.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
9/35. Combined cornual pregnancy and intrauterine twin pregnancy after in vitro fertilization and embryo transfer: report of a case.A case of combined cornual pregnancy and intrauterine twin pregnancy after in vitro fertilization (IVF) and transfer of six embryos is presented. The case was diagnosed as intrauterine triplets ultrasonographically at seven weeks of gestation. Unfortunately, the patient suffered from severe lower abdominal pain and hypovolemic shock at 10 weeks of gestation, and an emergent laparotomy was done. During the operation, a ruptured cornual pregnancy with accompanying hemoperitoneum was found. Because fetal heart beats were not detected by intraoperative ultrasonography in the other two intrauterine fetuses, evacuation of the gestational contents through the uterine defect was done, and the rupture site was repaired. The incidence, mechanism and management of heterotopic pregnancies after in vitro fertilization and embryo transfer are discussed.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
10/35. Spontaneous rupture of a first-trimester gravid uterus in a woman exposed to diethylstilbestrol in utero. A case report.BACKGROUND: Poor reproductive outcome was well documented in several studies of women exposed to diethylstilbestrol in utero. Spontaneous rupture of an unscarred uterus is rare and very uncommon in the first trimester of pregnancy. CASE: Spontaneous rupture of the uterus was diagnosed in a 28-year-old nullipara who developed acute abdominal pain at 12 weeks' gestation. She was known to have been exposed to diethylstilbestrol in utero. laparotomy revealed the rupture in the anterior fundal area of the uterus. Both tubes were normal. CONCLUSION: Several spontaneous ruptures have been described, but this is the first case of first-trimester spontaneous rupture of an unscarred uterus in a diethylstilbestrol-exposed woman.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
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