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Mouse Model of Surgical Uterine Injury and Subsequent Pregnancy Outcomes
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Early second trimester uterine scar rupture.
Sunanda Bharatnur1, Shripad Hebbar, G Shyamala
1Department of OBG, Manipal University, Manipal, Karnataka, India.
BMJ Case Reports
|December 12, 2013
Summary
Spontaneous uterine rupture, though rare in early pregnancy, requires urgent diagnosis. This case highlights the need to consider uterine rupture in pregnant women with acute abdomen, even with a viable fetus.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Surgical Case Reports
Background:
- Spontaneous uterine scar rupture is a rare but life-threatening obstetric emergency.
- Early mid-trimester uterine rupture presents diagnostic challenges.
- Previous cesarean section is a significant risk factor for uterine rupture.
Observation:
- A 30-year-old woman, 19 weeks pregnant (G2P1L1) with a prior cesarean section, presented with acute abdomen and shock.
- Laparotomy confirmed a spontaneous uterine scar rupture.
- Despite complete placental separation, the fetus was found to be alive.
Findings:
- Successful surgical repair of the uterine rupture was performed after evacuation of conception products.
- The case demonstrates a rare instance of a viable fetus surviving uterine rupture in the second trimester.
- Prompt diagnosis and surgical intervention are critical for maternal and fetal outcomes.
Implications:
- Uterine rupture must be considered in the differential diagnosis for pregnant women presenting with acute abdominal pain.
- This case underscores the importance of vigilant monitoring and timely management of uterine scar defects during pregnancy.
- Highlights the possibility of fetal survival even in severe obstetric emergencies like uterine rupture.
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