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Uterine rupture after hysteroscopic metroplasty and labor induction. A case report
A Gabriele1, G Zanetta, F Pasta
1Third Department of Obstetrics and Gynecology, University of Milan, Ospedale San Gerardo, Monza, Italy.
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.
