title: Spontaneous uterine rupture of a twin pregnancy after a laparoscopic adenomyomectomy: a case report.
abstract: Adenomyomectomy is a treatment option to preserve fertility and reduce symptoms associated with adenomyosis. Although this procedure is reasonably expected to increase the risk of uterine rupture during pregnancy, reports on this issue are scarce. We recently encountered a 33-year-old nulliparous woman with a twin pregnancy who experienced a spontaneous uterine rupture at 30 weeks' gestation. This patient was the first to conceive after undergoing laparoscopic adenomyomectomy at our institution. Her pregnancy was established with in vitro fertilization-embryo transfer 12 months after laparoscopic adenomyomectomy. The uterine rupture was heralded by a sudden onset of severe abdominal pain while she was receiving intravenous ritodrine. This case reinforces that pregnancy after adenomyomectomy should be closely monitored with respect to uterine rupture.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Hokkaido University, Sapporo, Japan. wa_shin_2002@yahoo.co.jp
authors.forename: Shin-ichiro
authors.initials: S
authors.lastname: Wada
authors.forename: Masataka
authors.initials: M
authors.lastname: Kudo
authors.forename: Hisanori
authors.initials: H
authors.lastname: Minakami
mesh_terms: D000328:Adult; D002585:Cesarean Section; D004630:Emergencies; D004715:Endometriosis / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005307:Fertilization in Vitro; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D011272:Pregnancy, Multiple; D018570:Risk Assessment; D012422:Rupture, Spontaneous / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D014427:Twins; D014591:Uterine Diseases / Q000175:diagnosis / Q000601:surgery*; D014597:Uterine Rupture / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery