[Conservative management of perforation, dehiscence, and uterine rupture]

Of 237 cases that suffered a perforation, dehiscence or uterine rupture, the conservative treatment was carried out in 71.3% of all cases. 155 which were conservatively handled, were followed. 55 corresponded to perforation, 89 to dehiscence and 11 to rupture. Out of 155 patients 82 (52.9%) became pregnant again, some thereof even on five occasions, thus reaching a total of 117 gestations. 13.6% ended in abortion, 23.8% has a vaginal birth. A cesarean section was applied in 47% of the cases and 5.1% a cesarean hysterectomy. Only in 2 cases (1.7%), the disunion occurred again. A hysterographical control was exerted. 41% of the hysterograms were normal. 26.2% showed the "habitual post surgical isthmic defect" and only in 32.7% of the cases, there were abnormal patterns in isthmic and cavity. The absolute post natal morbility was 6.5% and the noncorrected perinatal mortality was 5.4%. Based on these results, we recommended that, whenever it is possible, one should apply a conservative therapy, in cases of these accidents.