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Ruptura uterina en el segundo trimestre con muerte fetal
Louise Dunphy1, Thomas McCormack2, Shanthi Pinto2
1Obstetrics and Gynaecology, Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust, Middlewich Road, Crewe, CW1 4QJ, UK Louise.Dunphy@doctors.org.uk.
BMJ case reports
|February 15, 2026
Resumen
Una rotura uterina en una mujer con cicatriz uterina, tras una cesárea clásica, provocó complicaciones graves como muerte fetal y coagulopatía intravascular diseminada. Este caso resalta cómo una paciente
Área de la Ciencia:
- Obstetricia y Ginecología
- Medicina Materno-Fetal
Sus antecedentes:
- La rotura uterina es una emergencia obstétrica rara pero potencialmente mortal.
- Los factores de riesgo incluyen cirugías uterinas previas, particularmente cesáreas.
- Los úteros con cicatrices son más susceptibles a la rotura durante el embarazo o el parto.
Objetivo del estudio:
- Presentar un caso de rotura uterina en una mujer multípara con antecedentes de cesárea clásica.
- Destacar los desafíos diagnósticos y el manejo de la rotura uterina grave.
- Enfatizar la importancia de la atención prenatal de alto riesgo en pacientes con cicatrices uterinas.
Principales métodos:
- Informe de caso de una mujer multípara (Gesta 10, para 5+4) que se presenta a las 22+6 semanas de gestación.
- Diagnóstico de muerte fetal intrauterina y rotura uterina completa.
- El manejo implicó laparotomía de emergencia y una transfusión de sangre significativa.
Principales resultados:
- Rotura uterina completa a través de una cicatriz de cesárea clásica previa.
- La paciente experimentó inestabilidad hemodinámica y coagulopatía intravascular diseminada.
- Hemorragia masiva de 5,5 L se manejó durante la laparotomía.
Conclusiones:
- Las mujeres jóvenes y sanas pueden enmascarar patologías intraabdominales graves debido a sus reservas físicas.
- La descompensación puede ser un signo tardío y crítico de rotura uterina.
- La intervención quirúrgica rápida es crucial en el manejo de la rotura uterina y sus complicaciones asociadas.
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