UNSCARRED UTERINE COMPLETE RUPTURE IN A CASE OF FULL-TERM PRIMIPAROUS PREGNANCY
Keywords:
Gravid uterus, Unscarred, Rupture, Labor pain, Trauma, HemoperitoneumAbstract
Rupture of gravid uterus is mainly associated with previous uterine surgeries with presence of scars. Intact unscarred uterus rupture is rare entity during pregnancy. Only few cases have documented correlation with some other risk factors than surgery. History of trauma is important risk factor. Most of these cases are not diagnosed in proper time due to non-specific clinical presentation, leading to high mortality of mother and baby. Abdominal pain due to impending uterine rupture especially in third trimester can be confused with the labor pain and furthers delays the diagnosis. We encountered a rare case of Maternal death with 38 weeks gestation brought dead in the trauma and emergency department of tertiary care center of Dibrugarh, Assam. She had history of accidental fall on the road. We found complete full thickness rupture of anterior wall of uterus with hemoperitoneum and fetal demise. Hence, autopsy findings of the case have been presented here with relevant literature review.
References
G.J. Hofmeyr, L. Say, A.M. Gülmezoglu. WHO systematic review of maternal mortality and morbidity: The prevalence of uterine rupture. BJOG, 112 (9) (2005), pp. 1221-1228
Fogelberg M., Baranov A., Herbst A., Osser O.V. Underreporting of complete uterine rupture and uterine dehiscence in women with previous cesarean section. J. Matern. Neonatal Med. 2016;30:2058–2061. doi: 10.1080/14767058.2016.1236249
Cecchini F, Tassi A, Londero AP, Baccarini G, Driul L, Xodo S. First Trimester Uterine Rupture: A Case Report and Literature Review. Int J Environ Res Public Health. 2020 Apr 24;17(8):2976. doi: 10.3390/ ijerph17082976. PMID: 32344763; PMCID: PMC7215710.
Smith GCS, Pell JP, Pasupathy D, et al. Factors predisposing to perinatal death related to uterine rupture during attempted vaginal birth after caesarean section: Retrospective cohort study. BMJ,2004:329:375.
Zwart JJ, Richters JM, Öry F, De Vries JI, Bloemenkamp KW, Van Roosmalen J. Uterine rupture in the Netherlands: A nationwide population-based cohort study. BJOG 2009;116:1069-78
Guise JM, Eden K, Emeis C, et al. Vaginal birth after caesarean: new insights. Evid Rep Technol Assess (Full Rep). 2010, 191:1-397.
Ripley DL. Uterine emergencies. Obstet Gynecol Clin North Am 1999;26(3):419–34.
Deneux TC. Uterus cicatricial: aspects epidemiologiques. J Gynecol Obst Biol Reprod. 2012;41(8):697-707.
G.J. Hofmeyr, L. Say, A.M. Gülmezoglu. WHO systematic review of maternal mortality and morbidity: the prevalence of uterine rupture. BJOG, 112 (9) (2005), pp. 1221-1228
Zwart JJ, Richters JM, Ory F, de Vries JIP, Bloemenkamp KWM, van Roosmalen J. Uterine rupture in the Netherlands: a nationwide population based cohort study. BJOG 2009;116(8):1069–80.
Guiliano M, Closset E, Therby D, LeGoueff F, Deruelle P, Subtil D. Signs, symptoms and complications of complete and partial uterine ruptures during pregnancy and delivery. Eur J Obstet Gynecol Reprod Biol 2014;179:130–4.
Al-Zirqi I, Stray PB, Forsen L, et al. Uterine rupture: trends over 40 years. BJOG.2016;123(5):780-787
I. Al-Zirqi, A.K. Daltveit, S. Vangen. Maternal outcome after complete uterine rupture. Acta Obstet. Gynecol. Scand., 98 (8) (2019), pp. 1024-1031
Montenegro CAB, Rezende Filho J. Rezende: Obstetriìcia Fundamental. 14. ed. Rio de Janeiro: Guanabara Koogan, 2018.
A. Islam, et al., A two-year analysis of uterine rupture in pregnancy. J. Ayub Med. Coll. Abbottabad, 30 (Suppl. 1 (4)) (2018), pp. S639-S641
Kaczmarczyk M, Sparen P, Terry P, et al. Risk factors for uterine ruptures and neonatal consequences of uterine rupture: a population based study of successive pregnancies in Sweden. BJOG.2017:114 (10):1208-1214