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Spontaneous uterine rupture in pregnancy after endometrial ablation
Meaghan R Bowling1, Patrick S Ramsey
1From the University of Alabama at Birmingham, Center for Women's Reproductive Health, Department of Obstetrics/Gynecology, Birmingham, Alabama; and Pediatrix/Obstetrix Center for Research and Education, Texas Perinatal Group, San Antonio, Texas.
Background:
Uterine rupture after endometrial ablation is rare and has not been reported previously in the English literature.
Case:
A 33-year-old multigravida at 26 5/7 weeks of gestation had undergone two endometrial ablation procedures. The first attempt 2 years before pregnancy was complicated by uterine perforation. She presented with severe abdominal pain. A cesarean delivery was performed for recurrent late fetal heart rate deceleration, and a complete spontaneous uterine rupture was discovered.
Conclusion:
Pregnancies that occur after endometrial ablation have a risk of morbidity. Physicians must counsel women on the importance of contraception or sterilization as a critical component of the procedure.
