Uterine rupture due to traumatic assisted fundal pressure.
OBJECTIVE
Uterine rupture is potentially a life-threatening condition for both mother and infant. In this article, we report a rare occurrence of uterine rupture due to traumatic assisted fundal pressure associated with hydrops fetalis and shoulder dystocia.


METHODS
A 29-year-old woman was admitted for termination of pregnancy at 34 weeks' gestation because of fetal hydrops. Assisted uterine fundal pressure was done during delivery because of coexistent shoulder dystocia. After a series of assisted uterine fundal pressure, a dead hydropic baby weighing 4,000 g was delivered, and persistent postpartum hemorrhage occurred. An emergency laparotomy was performed, which revealed a large left broad ligament hematoma with multiple bleeding points. The bleeders were safely sutured and the tears of the left lateral uterine wall were primarily restored. The patient was discharged 8 days later.


CONCLUSIONS
Assisted fundal pressure during painful delivery can be traumatic and results in uterine rupture. In this article, we suggest that uterine rupture should be considered whenever a pregnant woman experiences a sudden onset of abdominal pain during the course of assisted uterine fundal pressure.
Wei
Shen-Chuan
SC
Department of Obstetrics and Gynecology, Li Shin Hospital, Taoyuan, Taiwan.
Chen
Chih-Ping
CP
D000328:Adult; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000379:methods*; D004420:Dystocia / Q000628:therapy*; D005260:Female; D005313:Fetal Death; D006801:Humans; D015160:Hydrops Fetalis / Q000628:therapy*; D011247:Pregnancy; D011312:Pressure; D012782:Shoulder; D014597:Uterine Rupture / Q000209:etiology*; D014599:Uterus