Past Issue

Volume 9, Supplement 1, Summer 2015 (Presented at 16th Congress on Reproductive Biomedicine and 10th Royan Nursing and Midwifery Seminar) Pages: 83-83

P-96: Extensive Fundal Uterine Rupture in Post-resection Bicornuate Uterus in a Term Pregnancy: A Case Report


Background
Uterine rupture in a term pregnancy is an adverse and rare event with serious maternal and fetal consequences. The history of uterine septum resection is considered as a risk factor for uterine rupture. Women with such circumstances are thus recommended to be considered as having a high-risk pregnancy. Accordingly, their prenatal care should be implemented in shorter intervals during which more attention should be paid to auscultation of fetal heart rate and warning signs (e.g. hemorrhage and severe and sudden pain). We report a case of asymptomatic fundal uterine rupture in a woman with term pregnancy.
Materials and methods
Uterine rupture can be caused by various reasons. However, according to previous studies, the most important reason is the history of a previous cesarean scar in a pregnant uterus. In the case we presented at Akbarabadi Hospital, the history of uterine septum resection was the cause of uterus rupture. Incidence of uterus rupture is possible during the whole stage of pregnancy, especially during the labor and due to induction with oxytocin. In our case, asymptomatic uterine rupture was observed in a female with term pregnancy who was not induced with oxytocin. Such a case has never been reported. It should be noted that despite a previous cesarean scar in our case, the uterine fundus was ruptured due to a scar caused by uterine septum resection. Possible causes of such ruptures in previous reported cases included deep resection of myometrium and weakening of the fundus and/or an undiagnosed rupture.
Results
Maternal health care providers should pay more attention to the outcomes of the septum resection itself. They are required to prevent uterine rupture with more accurate control of patients and faster diagnosis of a uterine susceptible to rupture.
Conclusion
Maternal health care providers should pay more attention to the outcomes of the septum resection itself. They are required to prevent uterine rupture with more accurate control of patients and faster diagnosis of a uterine susceptible to rupture.