title: Spontaneous uterine rupture in a primigravid woman in the early third trimester attributed to adenomyosis: a case report and review of the literature.
abstract: We report a rare case of spontaneous uterine rupture of an unscarred uterus caused by adenomyosis in the early third trimester. A 33-year-old primigravid woman was referred to our department because of severe acute abdominal pain and signs and symptoms of hemorrhagic shock. Ultrasound exanimation performed at admission revealed a living, intrauterine fetus of 28 weeks gestational age with reduced amniotic fluid and presence of free peritoneal fluid. The fetal heart rate was non-reassuring with variable decelerations and severe fetal bradycardia. Emergency cesarean section revealed massive hemoperitoneum and complete rupture in the uterine fundus. Subtotal peripartum hysterectomy with conservation of adnexae was performed. Histological examination revealed adenomyosis at the site of uterine rupture.
authors.affiliation: Department of Obstetrics and Gynecology, Medical School, University of Patras, Patras, Greece. nikolaoumarinos@upatras.gr
authors.forename: Marinos
authors.initials: M
authors.lastname: Nikolaou
authors.forename: Helen P
authors.initials: HP
authors.lastname: Kourea
authors.forename: Kostas
authors.initials: K
authors.lastname: Antonopoulos
authors.forename: Katerina
authors.initials: K
authors.lastname: Geronatsiou
authors.forename: George
authors.initials: G
authors.lastname: Adonakis
authors.forename: George
authors.initials: G
authors.lastname: Decavalas
mesh_terms: D062788:Adenomyosis / Q000150:complications*; D000328:Adult; D005260:Female; D020073:Gravidity; D006801:Humans; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D014597:Uterine Rupture / Q000209:etiology* / Q000473:pathology; D014599:Uterus / Q000473:pathology*