Spontaneous uterine rupture at 32 weeks of gestation after previous uterine artery embolization.
Uterine artery embolization (UAE) is a common treatment for post-partum hemorrhage and uterine fibroids. However, the effects of UAE on subsequent pregnancies have not been established. Here, we present a case of spontaneous uterine rupture after previous UAE. A 31-year-old woman underwent UAE for a cervical ectopic pregnancy. Contrast-enhanced magnetic resonance imaging (MRI) at days 5 and 25 post-UAE suggested a regionally decreased blood supply in the mid-posterior wall of the uterine fundus. During a subsequent pregnancy at age 35 years, she underwent an emergency cesarean delivery due to spontaneous uterine rupture at the mid-posterior wall of the uterus at 32 weeks of gestation. Obstetricians should be attentive to the possibility of spontaneous uterine rupture in pregnant women who have previously undergone UAE. Detection of ischemic uterine muscle on MRI may predict potential for uterine rupture in a subsequent pregnancy.
Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan.
Jun
J
Takeda
Shintaro
S
Makino
Atsuyuki
A
Ota
Tetsuo
T
Tawada
Naoki
N
Mitsuhashi
Satoru
S
Takeda
D000328:Adult; D002584:Cervix Uteri; D002585:Cesarean Section; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000503:physiopathology; D050498:Live Birth; D009215:Myometrium / Q000098:blood supply; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011271:Pregnancy, Ectopic / Q000601:surgery; D016896:Treatment Outcome; D055357:Uterine Artery Embolization / Q000009:adverse effects*; D014597:Uterine Rupture / Q000209:etiology* / Q000601:surgery
magnetic resonance imaging; pregnancy; side-effects; uterine artery embolization; uterine rupture