title: Uterine rupture at 26 weeks of pregnancy following laparoscopic salpingectomy with resection of the interstitial portion: a case report.
abstract: Uterine rupture in pregnancy can occur in patients with a history of uterine surgery such as myomectomy and Cesarean section. Here, we report a case of spontaneous uterine rupture that occurred in the early third trimester in a pregnant woman who had previously undergone laparoscopic removal of the right fallopian tube and interstitial portion for treatment of interstitial pregnancy. The patient presented with sudden onset of abdominal pain at 26 weeks of gestation. Detailed ultrasonography and magnetic resonance imaging led to diagnosis of uterine rupture. In emergency laparotomy, the fetus was delivered by Cesarean section, the placenta and membranes were removed, and the uterus was preserved with closure of the rupture and wound. This case highlights the importance of close follow-up of a pregnant patient who has previously had a uterine incision. The case also raises the question of whether the prevalence of uterine rupture may increase as more patients are treated with laparoscopic surgery of the uterus.
authors.affiliation: Department of Obstetrics and Gynecology Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. y-nishi@is.icc.u-tokai.ac.jp.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nishijima
authors.forename: Takahiro
authors.initials: T
authors.lastname: Suzuki
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kashiwagi
authors.forename: Atsuya
authors.initials: A
authors.lastname: Narita
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Kanno
authors.forename: Masaru
authors.initials: M
authors.lastname: Hayashi
authors.forename: Mari
authors.initials: M
authors.lastname: Shinoda
authors.forename: Chisato
authors.initials: C
authors.lastname: Noji
authors.forename: Kanako
authors.initials: K
authors.lastname: Mitsuzuka
authors.forename: Osamu
authors.initials: O
authors.lastname: Nishimura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ishimoto
mesh_terms: D002585:Cesarean Section; D004630:Emergencies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012422:Rupture, Spontaneous; D058994:Salpingectomy; D014463:Ultrasonography; D014597:Uterine Rupture / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D014599:Uterus / Q000601:surgery*