PDF(Pubmed)
Abstract：
UNASSIGNED: Uterine rupture is a rare condition that typically occurs in a scarred uterus and can happen during late pregnancy, labor, or the early postpartum period. Since most cases are seen in patients with a history of cesarean surgery, the anterior lower uterine segment is the most affected area. Most patients present with acute symptoms that compromise the fetus and the mother in a life-threatening manner.
METHODS: We present a case of uterine rupture with subacute symptoms occurring in the second trimester, which is extremely rare. The patient was a stable second-trimester multiparous woman with chronic abdominal pain, but without any signs of peritoneal bleeding or instability. No history of previous cesarean section was present, and she had recently undergone a non-complicated hysteroscopic polypectomy. Transabdominal and transvaginal ultrasounds were performed, revealing a significant full-thickness myometrial defect in the posterior uterine lower segment. This defect allowed the amniotic sac to protrude into the posterior cul-de-sac. No abdominopelvic hematoma was detected. These findings were confirmed in an urgent MRI, and the patient underwent a laparotomy during which a significant full-thickness defect was discovered at the posterior of the uterus. As it was impossible to continue the pregnancy, the fetus was surgically removed and then prepared using multiple layers.
UNASSIGNED: The difference between our case and the previously reported one is in the aspect of gradual stable presentation and lacks of vaginal bleeding.
CONCLUSIONS: Previous hysteroscopy carries a risk for future pregnancy complications, such as uterine rupture.
METHODS: We present a case of uterine rupture with subacute symptoms occurring in the second trimester, which is extremely rare. The patient was a stable second-trimester multiparous woman with chronic abdominal pain, but without any signs of peritoneal bleeding or instability. No history of previous cesarean section was present, and she had recently undergone a non-complicated hysteroscopic polypectomy. Transabdominal and transvaginal ultrasounds were performed, revealing a significant full-thickness myometrial defect in the posterior uterine lower segment. This defect allowed the amniotic sac to protrude into the posterior cul-de-sac. No abdominopelvic hematoma was detected. These findings were confirmed in an urgent MRI, and the patient underwent a laparotomy during which a significant full-thickness defect was discovered at the posterior of the uterus. As it was impossible to continue the pregnancy, the fetus was surgically removed and then prepared using multiple layers.
UNASSIGNED: The difference between our case and the previously reported one is in the aspect of gradual stable presentation and lacks of vaginal bleeding.
CONCLUSIONS: Previous hysteroscopy carries a risk for future pregnancy complications, such as uterine rupture.
摘要：
■子宫破裂是一种罕见的疾病，通常发生在瘢痕子宫中，可能发生在妊娠晚期。劳动,或产后早期。由于大多数病例出现在有剖宫产手术史的患者中，子宫前下段是受影响最大的区域。大多数患者出现急性症状，危及胎儿和母亲的生命。
方法：我们介绍一例妊娠中期出现亚急性子宫破裂症状的病例，这是非常罕见的。该患者是一名稳定的孕中期多胎女性，患有慢性腹痛，但没有任何腹膜出血或不稳定的迹象.既往无剖宫产史，她最近接受了非复杂的宫腔镜息肉切除术。进行了经腹和经阴道的超声检查，显示子宫后下段明显的全层子宫肌层缺损。这种缺陷使羊膜囊伸入后盲囊。未见腹盆腔血肿。这些发现在紧急MRI中得到证实，患者接受了剖腹手术，在此期间在子宫后部发现了明显的全层缺损。因为不可能继续怀孕，胎儿被手术切除，然后使用多层准备。
■我们的病例与先前报道的病例之间的区别在于逐渐稳定的表现和缺乏阴道出血。
结论：以前的宫腔镜检查存在未来妊娠并发症的风险，如子宫破裂。
方法：我们介绍一例妊娠中期出现亚急性子宫破裂症状的病例，这是非常罕见的。该患者是一名稳定的孕中期多胎女性，患有慢性腹痛，但没有任何腹膜出血或不稳定的迹象.既往无剖宫产史，她最近接受了非复杂的宫腔镜息肉切除术。进行了经腹和经阴道的超声检查，显示子宫后下段明显的全层子宫肌层缺损。这种缺陷使羊膜囊伸入后盲囊。未见腹盆腔血肿。这些发现在紧急MRI中得到证实，患者接受了剖腹手术，在此期间在子宫后部发现了明显的全层缺损。因为不可能继续怀孕，胎儿被手术切除，然后使用多层准备。
■我们的病例与先前报道的病例之间的区别在于逐渐稳定的表现和缺乏阴道出血。
结论：以前的宫腔镜检查存在未来妊娠并发症的风险，如子宫破裂。
