Uterine rupture after laparoscopic removal of a pedunculated myoma

A patient conceived 7 years after undergoing a routine laparoscopic myomectomy of an 11-cm pedunculated myoma. Monopolar modulated current (coagulating) was used for hemostasis, and no suturing was necessary. The pregnancy was uneventful until the 34th week, when pain and contractions signaled uterine rupture. Mother and baby did well after emergency cesarean section. A wide area of adjacent tissue injury after complete hemostasis with monopolar modulated current (coagulating) was felt to be responsible for poor myometrial healing and subsequent rupture.