Uterine rupture at scar of prior laparoscopic cornuostomy after vaginal delivery of a full-term healthy infant.
A 30-year-old, gravida 2, para 0 woman who had a history of a laparoscopic cornuostomy for a left interstitial pregnancy was admitted for a vaginal delivery due to labor pains at 40 weeks gestation. A prolonged placental delivery, persistent abdominal pain, and hemorrhagic shock were noted after the delivery of the infant. An emergency laparotomy was carried out, and the diagnosis of a uterine rupture at the scar of a prior cornuostomy was confirmed. The entire placenta extruded through the rupture wound into the abdominal cavity. A Medline computer search revealed that a similar case of a uterine rupture after full-term vaginal delivery has yet to be reported. In order to prevent a uterine rupture, we suggest that a planned cesarean delivery, before the onset of labor in a subsequent pregnancy, may be safer for a patient with a scarred uterus from a prior cornuostomy for an interstitial pregnancy.
Department of Obstetrics and Gynecology, Kuang Tien General Hospital, Chung Shan Medical University Hospital, Taichung, Taiwan.
Chi Feng
CF
Su
Horng Jyh
HJ
Tsai
Gin Den
GD
Chen
Yang Tse
YT
Shih
Maw Sheng
MS
Lee
D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D013513:Obstetric Surgical Procedures / Q000009:adverse effects*; D049590:Postpartum Period; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000601:surgery; D047929:Term Birth; D014597:Uterine Rupture / Q000209:etiology*