title: Spontaneous uterine rupture in the 35th week of gestation after laparoscopic adenomyomectomy.
abstract: Uterine rupture rarely occurs during pregnancy, but it is a critical situation if so. It is already known that a history of uterine surgeries, such as cesarean section or myomectomy, is a risk factor for uterine rupture. Currently, the laparoscopic adenomyomectomy is a widely performed procedure, but associated risks have not been defined. We observed a case of spontaneous uterine rupture in a patient during the 35th week of gestation, after a laparoscopic adenomyomectomy. A 42-year-old, gravida 2, para 0 woman became pregnant after a laparoscopic adenomyomectomy and her pregnancy was conventional. At a scheduled date in the 35th week of gestation, after combined spinal epidural anesthesia and frequent uterine contractions, a weak pain suddenly ensued. After 13 minutes of uterine contractions, vaginal bleeding was evident. A cesarean section was performed, and the uterine rupture was found in the scar. After a laparoscopic adenomyomectomy, a pregnant uterus can easily rupture by rather weak and short uterine contractions, and is characterized by vaginal bleeding. When uterine bleeding is observed in pregnant women that have a history of adenomyomectomy, one should consider uterine rupture.
authors.affiliation: Department of Obstetrics and Gynecology, Japanese Red Cross Nagoya Daiichi Hospital, Aichi, Japan ; Department of Obstetrics and Gynecology, Japanese Red Cross Ise Hospital, Mie, Japan.
authors.forename: Yukari
authors.initials: Y
authors.lastname: Nagao
authors.affiliation: Department of Obstetrics and Gynecology, Japanese Red Cross Ise Hospital, Mie, Japan ; Department of Obstetrics and Gynecology, School of Medicine, Mie University, Mie, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Osato
authors.affiliation: Department of Obstetrics and Gynecology, Japanese Red Cross Ise Hospital, Mie, Japan.
authors.forename: Michiko
authors.initials: M
authors.lastname: Kubo
authors.affiliation: Department of Obstetrics and Gynecology, Japanese Red Cross Ise Hospital, Mie, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Kawamura
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Mie University, Mie, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ikeda
authors.affiliation: Department of Obstetrics and Gynecology, Japanese Red Cross Ise Hospital, Mie, Japan.
authors.forename: Takaharu
authors.initials: T
authors.lastname: Yamawaki
keywords: laparoscopic adenomyomectomy; pregnancy; uterine contraction; uterine rupture; vaginal bleeding