title: Sonographic diagnosis of traumatic and later recurrent uterine rupture.
abstract: We report a case of traumatic transverse fundal uterine rupture with fetal death, followed by recurrent rupture during the subsequent (twin) pregnancy. Rupture was sonographically diagnosed within minutes of arrival at hospital following a motor vehicle accident in the first pregnancy and defined operative intervention, which was lifesaving for the mother. Rupture was again diagnosed sonographically in the second pregnancy based on extrusion of the bag of waters through the uterine incision without fetal distress. Emergency cesarean section was performed with good outcomes for both babies. Causes and clinical/sonographic diagnosis of uterine rupture are reviewed and obstetric management discussed. A high level of suspicion, early diagnosis, and expeditious management are keys to favorable outcome.
authors.affiliation: Mary Birch Hospital for Women, Sharp Memorial Hospital and Trauma Surgery, Sharp Perinatal Center, San Diego, California 92123, USA.
authors.forename: V A
authors.initials: VA
authors.lastname: Catanzarite
authors.forename: K E
authors.initials: KE
authors.lastname: Mehalek
authors.forename: T
authors.initials: T
authors.lastname: Wachtel
authors.forename: C
authors.initials: C
authors.lastname: Westbrook
mesh_terms: D002585:Cesarean Section; D005260:Female; D005313:Fetal Death / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011272:Pregnancy, Multiple; D012008:Recurrence; D012307:Risk Factors; D014427:Twins; D016216:Ultrasonography, Prenatal; D014597:Uterine Rupture / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery