title: Adenomyosis and uterine rupture during labour in a primigravida: an unusual obstetric emergency in Nigeria.
abstract: The primigravid uterus is believed to be immune to rupture during labour. This may not be true for those who have had prior adenomyomectomy, hence this report. The patient was a 28-year-old nullipara who became pregnant 11 months after an adenomyomectomy. Twelve hours after vaginal delivery at term, she developed haemoperitoneum of unclear cause. Emergency laparotomy and subsequent histology showed a fundal complete uterine rupture through the adenomyomectomy site, which was repaired. It is concluded that adenomyomectomy predisposes a pregnant uterus to rupture during labour. Therefore, such women should be offered elective caesarean delivery at term.
authors.affiliation: Department of Obstetrics, University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria. dyme72@yahoo.com
authors.forename: Cyril C
authors.initials: CC
authors.lastname: Dim
authors.forename: Polycarp U
authors.initials: PU
authors.lastname: Agu
authors.forename: Ngozi R
authors.initials: NR
authors.lastname: Dim
authors.forename: Arthur C
authors.initials: AC
authors.lastname: Ikeme
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000150:complications* / Q000601:surgery; D005260:Female; D020073:Gravidity; D006465:Hemoperitoneum / Q000209:etiology; D006801:Humans; D007022:Hypotension / Q000209:etiology; D009549:Nigeria; D011247:Pregnancy; D011644:Puerperal Disorders / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014591:Uterine Diseases / Q000150:complications* / Q000601:surgery; D014597:Uterine Rupture / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery