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01.12.2018 | Case report | Ausgabe 1/2018 Open Access

BMC Pregnancy and Childbirth 1/2018

Spontaneous uterine rupture and surgical repair at 21 weeks gestation with progression to live birth: a case report

Zeitschrift:
BMC Pregnancy and Childbirth > Ausgabe 1/2018
Autoren:
Lesley Hawkins, Deborah Robertson, Helena Frecker, Howard Berger, Abheha Satkunaratnam

Abstract

Background

Uterine rupture in the non-laboring uterus is a rare occurrence, which can lead to significant morbidity and mortality for the mother and fetus. Management of this presentation is complex at pre-viable gestations.

Case presentation

A 35 year old primigravid woman with multiple previous myomectomies presented with spontaneous complete thickness uterine rupture at 21 weeks gestation. A 10 cm myometrial defect and iatrogenic amniotomy were surgically corrected with fetal preservation. This led to pregnancy continuation to 32 weeks gestation when elective cesarean delivery resulted in excellent neonatal outcome.

Conclusions

Early surgical diagnosis, multidisciplinary team approach, iatrogenic amniotomy and continuous two-layer myometrial closure were factors that contributed to pregnancy prolongation in this large myometrial rupture.
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