Silent rupture of unscarred uterus at 32 weeks: Case reports
Journal Title: Indian Journal of Obstetrics and Gynecology Research - Year 2018, Vol 5, Issue 3
Abstract
Introduction Rupture in an unscarred uterus prior to onset of labor in third trimester is a rare event and very few cases have been reported in literature so farCase Report 1 We describe a case of a primigravida who presented in emergency with pain abdomen with placenta praevia and severe oligominos An ultrasound was conducted which reported bicornuate unicollis uterus with single live foetus 334 weeks having severe oligohydromnios AFI2 with placenta anterior and reaching upto internal os in one cornua the other cornua was empty A MRI was conducted which was also inconclusive She was taken up for laprotomy peroperatively pregnancy was present in left horn of uterus which had ruptured with intact amniotic sac and was covered with omentum the placenta was covering the lower half of the left horn and the right horn looked like normal uterus and was empty The omentum was carefully separated and baby that was delivered weighed 700gms The left horn was excised and then uterus was closed in layers Patient was followed up for 6 months mother was doing well though baby was 5 kg which was less than the weight for that age and had slow developmental milestonesCase Report 2 Our second case was a 30 years old gravida 5 para 2 abortion 2 woman with 8 months amenorrhea She was referred with chief complaint of pain abdomen On examination she looked almost stable Even though she was pale vital signs were within normal parameters An ultrasound was conducted which showed single live intrauterine foetus 292 weeks with absent liquor with placenta praevia with placenta acreta Emergency laprotomy was decided in view of placenta acreta It was found to be an abdominal pregnancy Amnion along with omentum and blood clot matting sac like structure sitting over the fundus with placenta perforating the fundus small incision was given at the fundus and baby weighing 115 kg delivered through it Placenta did not separate and so decision of hysterectomy takenConclusion Rupture in a non laboring unscarred uterus is a very rare condition and needs high index of suspicion for diagnosis it should be kept in differential diagnosis of pregnancy with abdominal pain of any degreeKeywordsAdvanced abdominal pregnancy Ectopic pregnancy Silent rupture
Authors and Affiliations
Divya Dr. , Sarita Singh, Achla Batra, Sunita Malik, Rupali Dewan
Keywords
Related Articles
- EP ID EP475153
- DOI 10.18231/2394-2754.2018.0098
- Views 90
- Downloads 0
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