title: Spontaneous Complete Uterine Rupture in a Nonlaboring, Early Third-trimester Uterus: Missed Diagnosis by Ultrasound.
abstract: Objective Describe potential consequences and remedy for not intermittently auscultating fetal heart tones during travel to the imaging department and misdiagnosing a ruptured uterus on ultrasound as a synechiae. Study Design Retrospective chart review of case. Results Spontaneous uterine rupture in pregnancy is a rare and catastrophic event. Fetal monitoring is an important component for diagnosis, but fetal heart auscultation is usually discontinued while the patient is receiving imaging. We present a ruptured uterus at 28 weeks with delayed diagnosis secondary to interrupted fetal heart tone auscultation and a misdiagnosis of a rupture as a synechiae resulting in a seriously compromised newborn at delivery. Conclusion Intermittent fetal heart tone auscultation is a possible method of monitoring when the patient is off continuous fetal monitoring.
authors.affiliation: Department of Obstetrics and Gynecology, Winnie Palmer Hospital, Orlando Regional Healthcare, Orlando, Florida.
authors.forename: Luke
authors.initials: L
authors.lastname: Dixon
authors.forename: S J
authors.initials: SJ
authors.lastname: Carlan
authors.forename: T D
authors.initials: TD
authors.lastname: O'Leary
authors.forename: Jose
authors.initials: J
authors.lastname: Perez
keywords: fetal auscultation; spontaneous; third trimester; uterine rupture