SECOND TRIMESTER UTERINE RUPTURE WITH PLACENTA PERCRETA IN PREVIOUS LOWER SEGMENT CESAREAN SCAR

AVINASH P DUBBEWAR; AJAI SRIVASTAVA; KATHPALIA  SK; RAVISHEKAR N HIREMATH; SANDHYA GHODKE; NIRAJ CHOUREY; AUDUKOORI SREENIVAS

doi:10.22159/ajpcr.2022.v15i3.43996

Authors

AVINASH P DUBBEWAR Department of Obstetrics and Gynecology, AFMS, New Delhi, India.
AJAI SRIVASTAVA Department of Obstetrics and Gynecology, AFMS, New Delhi, India.
KATHPALIA SK Department of Obstetrics and Gynecology, AFMS, New Delhi, India.
RAVISHEKAR N HIREMATH Department of Community Medicine, Public Health Specialist, Bangalore, Karnataka, India. 3Consultant Anaesthesia, Rainbow Children’s Hospital, Bangalore, Karnataka, India.
SANDHYA GHODKE Consultant Anaesthesia, Rainbow Children’s Hospital, Bangalore, Karnataka, India.
NIRAJ CHOUREY Department of Obstetrics and Gynecology, AFMS, New Delhi, India.
AUDUKOORI SREENIVAS Department of Community Medicine, Public Health Specialist, Bangalore, Karnataka, India.

DOI:

https://doi.org/10.22159/ajpcr.2022.v15i3.43996

Keywords:

UTERINE, RUPTURE, PLACENTA PERCRETA, cesarean scar

Abstract

Rupture of a pregnant uterus is a serious threat to the mother’s life and her unborn child. Most of the reported cases of uterine rupture in scarred uterus are due to dehiscence of previous cesarean scar or a rupture of myomectomy scar and usually occur in the third trimester. Spontaneous uterine rupture in first or second trimester is very rare. Here we report a case of second-trimester spontaneous uterine rupture with a particular emphasis on the etiological factors, discuss the course of events and difficulties in the diagnosis. The lesson learned from this case is that, although uterine rupture is very rare in the second trimester of pregnancy, it should be taken into consideration in the differential diagnosis of acute abdomen, especially if there is a predisposing factor such as previous lower segment caesarean section and fluid in the abdomen.

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References

Abdulwahab DF, Ismail H, Nusee Z. Second-trimester uterine rupture: Lessons learnt. Malays J Med Sci 2014;21:61-5.

Pakniat H, Soofizadeh N, Khezri MB. Spontaneous uterine rupture after abdominal myomectomy at the gestational age of 20 weeks in pregnancy: A case report. Int J Reprod Biomed 2016;14:483-6.

Mundhra R, Bahadur A, Kunwar K, Mishra J, Yadav A, Das D. Silent uterine rupture in second trimester: a differential diagnosis to remember. Int J Reprod Contracept Obstet Gynecol 2020;9:3081-3.

Ho WY, Wang C, Hong SC, Han HC. Spontaneous uterine rupture in the second trimester: A case report. Obstet Gynecol Int J 2017;6:00211.

Pontis A, Prasciolu C, Litta P, Angioni S. Uterine rupture in pregnancy: Two case reports and review of literature. Clin Exp Obstet Gynecol 2016;43:304-9.

Pan HS, Huang LW, Hwang JL, Lee CY, Tsai YL, Cheng WC. Uterine rupture in an unscared uterus after application of fundal pressure. J Reprod Med 2002;47:1044-6.

Green-top Guideline. Number 45. London: Royal College of Obstetricians and Gynaecologists Press, Royal College of Obstetricians and Gynaecologists: Birth after Previous Caesarean Birth; 2007.

Ronen JA, Castaneda K, Sadre SY. Early accreta and uterine rupture in the second trimester. Cureus 2018;10:e2904.

Fahrni AC, Salomon D, Zitiello A, Feki A, Ali NB. Recurrence of a second-trimester uterine rupture in the fundus distant from old scars: A case report and review of the literature. Case Rep Womens Health 2020;28:e00249.