A case report of delayed diagnosis of uterine rupture following vaginal delivery
Journal Title: International Journal of Medical Reviews and Case Reports - Year 2017, Vol 1, Issue 2
Abstract
Introduction: A uterine rupture is still a rare event but its incidence appears to be increasing, even in the unscarred uterus. In our case, the uterine rupture presented itself in an unscarred uterus and after a vaginal delivery. Case report: A 36 years old women with three previous normal deliveries, comes to our hospital for assistance at 32 weeks with a poor pregnancy surveillance. After diagnosing Gestational Diabetes, she is admitted for therapeutic adjustment. She is discharged after achieving metabolic control but comes back a few days later with a stillbirth, born by vaginal delivery. Six days later she presents with: fever and pain; anemia leukocytosis and a heterogeneous image on ultrasound. However, was decided to start intravenous antibiotics before choosing for surgery. Her condition worsens and an exploratory laparotomy is done: a posterior uterine wall rupture that required a hysterectomy. Conclusion: Risk factors for uterine rupture were present (maternal age over 35, higher parity, fetal macrosomia) but the absence of any symptom, the normal examination after delivery, and mostly, an unscarred uterus, resulted in a delay in the diagnosis of more than one week, leading to catastrophic consequences: hysterectomy. This case reminds us that uterine rupture happens not only in case of previous uterine surgery, and these cases seem to be increasing because of the increase in other risk factors: advanced maternal age and diabetes with resulting fetal macrosomia.
Authors and Affiliations
Vanessa Falé Rosado, Sara Rocha, Catarina Vasconcelos, Maria Luisa Martins, Maria José Alves
Keywords
Related Articles
- EP ID EP427900
- DOI 10.5455/IJMRCR.uterine-rupture-delayed-diagnosis
- Views 144
- Downloads 0
Case Report: Bilateral Ainhum in a 6-year-old Black African Male child
Background: Ainhum is an uncommon surgical condition and rarer still in children, and is gradually disappearing due to improved socioeconomic condition of the populace. This has consequently led to paucity of literature...
An original reconstruction of a full thickness defect secondary to a parietal invading bladder tumor
Backgrounds: The reconstruction of large full-thickness abdominal wall defects usually requires microsurgical flaps. When microsurgery is not an option, the association of two pedicled flaps can be an alternative. This a...
Kikuchi-Fujimoto disease: case report and review
OBJECTIVE: The development of associated febrile to lymphadenomegaly leads to several diagnostic hypotheses, among them the Kikushi-Fujimoto disease. METHOD: This review was set up by searching PubMed/Medline, Web of Sc...
Tuberculous granulomatous interstitial nephritis of solitary kidney in a renal donor
Background:Unexplained azotaemia in a renal donor needs urgent evaluation. Renal biopsy is required when the urine examination shows proteinuria and when there is an unexplained worsening of renal functions. Granulomatou...
Comparison of Total Antioxidant Capacity (TAC) in the Multibacillary (MB) Type of Leprosy Patients Before and After 3 Months of MDT-MB WHO Therapy
Leprosy is chronic infectious disease caused by the intracellular parasitic pathogen Mycobacterium Leprae involves accumulation of highly reactive oxygen species (ROS) production and decreased levels of antioxidant in af...