“Insidious Spontaneous Complete Uterine Rupture in a 17-Week Primigravida with a Rudimentary Hemi-Uterus: A Case Report and Literature Review”
Journal Title: INTERNATIONAL JOURNAL OF CURRENT RESEARCH IN MEDICAL SCIENCES - Year 2017, Vol 3, Issue 1
Abstract
M.N., a 21-year old female patient presented to the emergency room with a one-day history of lower abdominal pain and signs of hypovolaemic shock. The patient had underwent a dilatation and curettage (D&C) 11 weeks prior for elective pregnancy termination at another facility. Transvaginal ultrasound revealed a well-circumscribed anechoic collection measuring 10/16 centimeters in diameter in the Douglas pouch and a pregnant uterus carrying a 17-week fetus with cardiac activity. Upon emergency laparotomy, 1500 milliliters of blood were found, as well as a black- violet-colored rudimentary hemi-uterus, covered with clots. Upon gentle maneuvers to remove the clots from the left hemi-uterine surface, spontaneous complete uterine rupture ensued with exteriorisation of a 17-centimeter fetus into the peritoneal cavity. Resistance was encountered upon attempt to detach the placenta, and upon a closer look, placenta accreta was diagnosed. Consequently, the left rudimentary hemi-uterus was excised with a hemi- hysterectomy. The patient’s postoperative follow-up was uneventful and her prognosis is favorable from the perspective of fertility-conserving surgery. This is the third case reported in the world and the second case published since the new millennium of spontaneous complete uterine rupture during the second trimester in a primigravida with a rudimentary hemi-uterus.
Authors and Affiliations
Samantha Mc Kenzie Stancu MD 1 , Dragos Stefan Dobritoiu MD, PhD 2 , Manuela Russu MD, PhD1,
Keywords
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- EP ID EP564247
- DOI 10.22192/ijcrms.2017.03.01.002
- Views 126
- Downloads 0
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