1/126. 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 = pregnancy (Clic here for more details about this article) |
2/126. uterine rupture after hysteroscopic metroplasty and labor induction. A case report.BACKGROUND: Hysteroscopic metroplasty has become the method of choice for the treatment of uterine septa. uterine perforation has been reported in about 1% of surgical hysteroscopic procedures. Ultrasound allows the detection of uterine lesions. CASE: A woman who conceived after complicated hysteroscopic metroplasty underwent emergency cesarean section because of uterine rupture during labor induced with prostaglandins (PGE2). An ultrasound scan performed two years later revealed a uterine lesion that corresponded to the myometrial tear reported at cesarean section. CONCLUSION: Complicated hysteroscopic metroplasty may promote acute uterine rupture during pregnancy and labor. Ultrasound is a useful tool for the detection of uterine lesions. If adequately considered, it might have allowed more rational management of labor in this case. PGE2 should never be used for induction of labor after complicated metroplasty.- - - - - - - - - - ranking = 0.25keywords = pregnancy (Clic here for more details about this article) |
3/126. Spontaneous bilateral cornual uterine dehiscence early in the second trimester after bilateral laparoscopic salpingectomy and in-vitro fertilization: case report.A bilateral cornual uterine dehiscence is reported, which occurred 14 weeks after in-vitro fertilization (IVF) in a patient having a medical history of previous bilateral salpingectomy via laparoscopy. uterine rupture is a rare obstetric complication usually occurring during the third trimester of pregnancy within a uterus which has previously undergone an operation. Ectopic pregnancy is a well known complication of IVF. Post-salpingectomy cornual localization with rupture has also been published. Possible causes are discussed and the attention of the counselling physician is directed to the necessary awareness of such a complication in this high risk population. The reported case is an extreme rarity: a similar case has not been previously published in the literature.- - - - - - - - - - ranking = 0.5keywords = pregnancy (Clic here for more details about this article) |
4/126. Extrauterine pregnancy resulting from early uterine rupture.BACKGROUND: Cesarean scar rupture of a gravid uterus in early gestation is rare. CASE: A 38-year-old woman, gravida 4, para 2-0-1-1, presented at 13 weeks' gestation with cramping and spotting. She had a history of two cesareans. Ultrasound and magnetic resonance imaging indicated probable uterine dehiscence and a viable extrauterine pregnancy. After embolization of the uterine arteries with subsequent fetal death, the subject had a hysterectomy. Intraoperatively, she had complete rupture of the lower uterine segment, but the pregnancy was enclosed within scar tissue between the uterus and bladder. placenta percreta was found by histologic examination. CONCLUSION: women with histories of cesareans might be at risk of early uterine rupture.- - - - - - - - - - ranking = 1.5keywords = pregnancy (Clic here for more details about this article) |
5/126. uterine rupture in a multiparous woman during labor induction with oral misoprostol.A multigravida with gestational diabetes, mild pregnancy-induced hypertension and a previous curettage received four doses of misoprostol (100 microg) at three hourly intervals for induction of labor at term. Vaginal delivery of a live healthy baby occurred 1 h after the fourth dose. Hindwaters were bloodstained. Three hours later, she had excessive bleeding. Examination showed that the left lateral uterine wall had ruptured. She recovered after hysterectomy and blood transfusions.- - - - - - - - - - ranking = 0.25keywords = pregnancy (Clic here for more details about this article) |
6/126. Spontaneous uterine rupture in the early third trimester after laparoscopically assisted myomectomy. A case report.BACKGROUND: The development of new and innovative laparoscopic instruments has allowed a greater number of gynecologic surgeons to laparoscopically remove large, intramural leiomyomata. Cases of both successful pregnancy and uterine rupture following laparoscopic myomectomy have been reported. This is the first report of uterine rupture in pregnancy following a laparoscopically assisted myomectomy. CASE: A 26-year-old, nulligravid woman underwent a laparoscopically assisted myomectomy. While the myomectomy had been performed laparoscopically, the uterine incision had been repaired in layers through a minilaparotomy incision. Two years later she became pregnant and, at 29 weeks' gestation, presented to labor and delivery with contractions and uterine tenderness. Over the next several hours, a nonreassuring fetal heart rate developed, and a cesarean section was performed, revealing hemoperitoneum and uterine rupture at the site of the prior myomectomy. CONCLUSION: The ultimate integrity of a uterine incision may depend not only on how the incision is repaired but also on how it is made. Laparoscopically created uterine incisions may not be as strong as those made at laparotomy, regardless of the method of closure.- - - - - - - - - - ranking = 0.5keywords = pregnancy (Clic here for more details about this article) |
7/126. uterine rupture during pregnancy following myomectomy via coelioscopy.A 33-year-old woman underwent a myomectomy via coelioscopy and then showed 5 years later a uterine rupture at the 32nd week of amenorrhea. The rupture was diagnosed after the echography, while there was no peritoneal maternal patency nor foetal consequence. After a cesarean and an uterine repair, the recovery of the mother was satisfactory but the newborn was to die at the 6th week of life. This obstetrical complication raises the problem of myomectomy via coelioscopy in young women, whose indications are being discussed.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
8/126. 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 = 0.25keywords = pregnancy (Clic here for more details about this article) |
9/126. uterine rupture in pregnancy subsequent to previous laparoscopic electromyolysis. Case report and review of the literature.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.- - - - - - - - - - ranking = 1.25keywords = pregnancy (Clic here for more details about this article) |
10/126. fertility-sparing surgery, with subsequent pregnancy, in persistent gestational trophoblastic neoplasia: case report.Gestational trophoblastic neoplasia (GTN) is primarily a disease of women of reproductive age. In most instances, it is cured by surgical evacuation of the uterus, with persistent disease being very sensitive to chemotherapy. hysterectomy, recommended for persistent chemotherapy-resistant uterine disease, may be unacceptable to the woman who wishes to maintain her fertility. Uterine resection of localized disease, with uterine reconstruction, may be a viable alternative. A case is presented of a woman with persistent uterine GTN, treated with localized uterine resection and reconstruction, followed by two successful pregnancies and deliveries. The literature is reviewed and potential pregnancy complications of this management, particularly uterine rupture, are discussed.- - - - - - - - - - ranking = 1.25keywords = pregnancy (Clic here for more details about this article) |
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