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Uterine Rupture

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1. Sonographic lower uterine segment thickness after prior cesarean section to predict uterine rupture: a systematic review and meta-analysis. (PubMed)

Sonographic lower uterine segment thickness after prior cesarean section to predict uterine rupture: a systematic review and meta-analysis. Cesarean section rates are increasing with a decrease in the rate of trial of labor after cesarean section. The objective of this study was to systematically review predictive characteristics of sonographic measurement of lower uterine segment thickness for uterine rupture during labor.The review was carried out in agreement with PRISMA and SEDATE (...) studies.The association between thin lower uterine segment measurement and utertine dehiscence and uterine rupture was shown in 27 and 4 studies, respectively. Nineteen studies were included in a meta-analysis with a subgroup analysis by ultrasound methodology. In the subgroup using the ultrasound methodology associated with uterine rupture, the cut-off value is more precise (2.0-3.65 mm) among these 12 studies. There were 18 cases (1.0%) of uterine rupture, 120 (6.8%) of uterine dehiscence and 1617 (92.4

2019 Acta Obstetricia et Gynecologica Scandinavica

2. Maternal and fetal outcomes of uterine rupture and factors associated with maternal death secondary to uterine rupture. (PubMed)

Maternal and fetal outcomes of uterine rupture and factors associated with maternal death secondary to uterine rupture. Maternal mortality and morbidity are the priority agenda for sub-Saharan Africa including Ethiopia. Uterine rupture is the leading cause of maternal and fetal death in developing countries. Limited evidence is available on the magnitude of uterine rupture; maternal and fetal outcomes of uterine rupture and factors associated with maternal death secondary to uterine rupture (...) in Ethiopia. This study aimed to assess the magnitude of uterine rupture; maternal and fetal outcome of uterine rupture and factors associated with maternal death secondary to uterine rupture in Debremarkos Referral Hospital, Northwest Ethiopia.An institutional-based cross-sectional study was conducted in December 2015 in Debremarkos referral hospital, Northwest Ethiopia. A total of 242 records of mothers with uterine rupture at Debremarkos referral Hospital during the year 2011-2014 were included

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2017 BMC Pregnancy and Childbirth

3. Estimates of Uterine Rupture Bad Outcomes Using Propensity Score and Determinants of Uterine Rupture in Mizan-Tepi University Teaching Hospital: Case Control Study (PubMed)

Estimates of Uterine Rupture Bad Outcomes Using Propensity Score and Determinants of Uterine Rupture in Mizan-Tepi University Teaching Hospital: Case Control Study Uterine rupture is a tear in the wall of uterus which carries grave risks to the mother as well as her baby.To estimate uterine rupture bad outcomes using propensity score and its determinants in Mizan-Tepi University teaching hospital.A case control study on 363 participants, 121 cases and 242 controls, was conducted. Data (...) was analyzed by STATA 14. Propensity score matching analysis was used to see causes. Level of significance of p value is ≤0.05.Females who reside in rural areas (AOR = 3.996; 95% CI: 2.011, 7.940) are at higher risk of acquiring uterine rupture. Females who had ANC follow-up (AOR = 0.315; 95% CI: 0.164, 0.606) and preterm gestational age (AOR = 0.135; 95% CI: 0.025, 0.725) are at lower risk of developing uterine rupture. Propensity score matching analysis shows that, from 100 participants who had uterine

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2017 Journal of pregnancy

4. Diagnosis and management of a heterotopic pregnancy and ruptured rudimentary uterine horn (PubMed)

Diagnosis and management of a heterotopic pregnancy and ruptured rudimentary uterine horn Heterotopic pregnancies implanted in a rudimentary uterine horn account for 1 in 2-3 million gestations, and confer significant risk of morbidity due to uterine rupture and hemorrhage.A 34-year-old nullipara presented with acute pelvic pain at 17 weeks of gestation with dichorionic-diamniotic twins, one in each horn of an anomalous uterus first diagnosed in pregnancy as bicornuate. Three-dimensional (...) and ruptured rudimentary uterine horn. This case demonstrates the importance of pre-pregnancy diagnosis and management of mullerian anomalies.

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2018 Fertility research and practice

5. Concurrent intraoperative uterine rupture and placenta accreta. Do preoperative chronic hypertension, preterm premature rupture of membranes, chorioamnionitis, and placental abruption provide warning to this rare occurrence? (PubMed)

Concurrent intraoperative uterine rupture and placenta accreta. Do preoperative chronic hypertension, preterm premature rupture of membranes, chorioamnionitis, and placental abruption provide warning to this rare occurrence? Uterine and placental pathology can be a major cause of morbidity and mortality in the parturient and infant. When presenting alone, placental abruption, uterine rupture, or placenta accreta can result in significant peripartum hemorrhage, requiring aggressive surgical (...) and anesthetic management; however, the presence of multiple concurrent uterine and placental pathologies can result in significant morbidity and mortality. We present the anesthetic management of a parturient who underwent an urgent cesarean delivery for non-reassuring fetal tracing in the setting of chronic hypertension, preterm premature rupture of membranes, and chorioamnionitis who was subsequently found to have placental abruption, uterine rupture, and placenta accreta.

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2018 Romanian Journal of Anaesthesia and Intensive Care

6. A case of scarred uterine rupture at 11 weeks of gestation having a uterine scar places induced by in vitro fertilization-embryo transfer (PubMed)

A case of scarred uterine rupture at 11 weeks of gestation having a uterine scar places induced by in vitro fertilization-embryo transfer Having a uterine scar places a woman at increased risk of complications, such as Cesarean scar pregnancy (CSP), uterine rupture, placenta previa, and placenta accreta, in subsequent pregnancies. We report a case of uterine rupture at 11 weeks of gestation in a woman with a previous Cesarean section. A 43-year-old woman with a history of abdominal myomectomy (...) and Cesarean section had her pregnancy induced by in vitro fertilization with donor eggs. The exact location of the gestational sac was identified on her first day of hospitalization, and her pregnancy was suspected to be a CSP. The following day, the patient complained of sudden lower abdominal pain. A uterine scar rupture was diagnosed, and an emergency surgery was required. It may be that first-trimester screening could allow the early recognition of patients at risk for these perinatal complications.

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2018 Clinics and practice

7. The International Network of Obstetric Survey Systems study of uterine rupture: a descriptive multi-country population-based study

The International Network of Obstetric Survey Systems study of uterine rupture: a descriptive multi-country population-based study International comparison of complete uterine rupture.Descriptive multi-country population-based study.International.International Network of Obstetric Survey Systems (INOSS).We merged individual data, collected prospectively in nine population-based studies, of women with complete uterine rupture, defined as complete disruption of the uterine muscle and the uterine (...) serosa, regardless of symptoms and rupture of fetal membranes.Prevalence of complete uterine rupture, regional variation and correlation with rates of caesarean section (CS) and trial of labour after CS (TOLAC). Severe maternal and perinatal morbidity and mortality.We identified 864 complete uterine ruptures in 2 625 017 deliveries. Overall prevalence was 3.3 (95% CI 3.1-3.5) per 10 000 deliveries, 22 (95% CI 21-24) in women with and 0.6 (95% CI 0.5-0.7) in women without previous CS. Prevalence

2018 EvidenceUpdates

8. Maternal outcome after complete uterine rupture. (PubMed)

Maternal outcome after complete uterine rupture. Complete uterine rupture, a rare peripartum complication, is often associated with a catastrophic outcome for both mother and child. However, few studies have investigated large datasets to evaluate maternal outcomes after complete ruptures, particularly in unscarred uteri. This paucity of studies is partly due to the rarity of both the event and the serious outcomes, such as peripartum hysterectomy and maternal death. The incidence of uterine (...) rupture is expected to increase, due to increasing cesarean section rates worldwide. Thus, it is important to have more complete knowledge about the immediate maternal outcome following a complete uterine rupture. The objective was to identify maternal outcomes and their risk factors following complete uterine ruptures.This was a population-based study using data from the Medical Birth Registry of Norway, the Patient Administration System and medical records. Maternities with complete uterine rupture

2019 Acta Obstetricia et Gynecologica Scandinavica

9. Silent spontaneous posterior uterine rupture of a prior caesarean delivery at 36 weeks of gestation. (PubMed)

Silent spontaneous posterior uterine rupture of a prior caesarean delivery at 36 weeks of gestation. In caesarean section patients, the spontaneous rupture of the posterior wall of the uterus is extremely rare, with nonspecific signs and symptoms being present. Perinatal and maternal morbidity and mortality are high.A 28-year-old woman at 36 + 6 weeks of gestation presented with mild uterine contractions and developed a sudden abdominal distension. An emergency laparotomy was performed (...) , and the posterior wall of the uterus had ruptured. A baby boy was born.Silent uterine rupture is very rare and easy to ignore due to nonspecific clinical symptoms, unexplained haemoglobin reduction and haemoperitoneum, but these features caution us to more closely consider uterine rupture in patients.

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2019 BMC Pregnancy and Childbirth

10. Uterine scar rupture - Prediction, prevention, diagnosis, and management. (PubMed)

Uterine scar rupture - Prediction, prevention, diagnosis, and management. The increasing rate of elective and indicated caesarean sections worldwide has led to new pathologies and management challenges. The number of patients undergoing trial of labor after caesarean section (TOLAC) is also increasing. Three professional societies provide detailed guidelines based on scientific evidence for the management of patients attempting vaginal birth after caesarean section (VBAC). However, they do (...) not provide any recommendations for the actual surgical steps to be followed to minimize the risks of uterine rupture (UR) during TOLAC. Uterine scar condition, intrapartum management and maternal health status correlate to uterine scar rupture risk and provide guidance for parturient TOLAC eligibility. TOLAC and vaginal delivery success rate as reported by the largest studies is between 60% and 77%. Uterine rupture is more prevalent in VBAC-2 patients (1.59%) in contrast to VBAC-1 (0.72%). Additionally

2019 Best practice & research. Clinical obstetrics & gynaecology

11. Uterine rupture among mothers admitted for obstetrics care and associated factors in referral hospitals of Amhara regional state, institution-based cross-sectional study, Northern Ethiopia, 2013-2017. (PubMed)

Uterine rupture among mothers admitted for obstetrics care and associated factors in referral hospitals of Amhara regional state, institution-based cross-sectional study, Northern Ethiopia, 2013-2017. Maternal morbidity and mortality have been one of the most challenging health problems that concern the globe over the years. Uterine rupture is one of the peripartum complications, which cause nearly about one out of thirteen maternal deaths. This study aimed to assess the prevalence (...) and associated factors of uterine rupture among obstetric case in referral hospitals of Amhara Regional State, Northern Ethiopia.Institution based cross sectional study was conducted from Dec 5-2017-Jan 5-2018 on uterine rupture. During the study randomly selected 750 charts were included by using simple random sampling method. Data were checked, coded and entered into Epi info version 7.2 and then exported to SPSS Version 20 for Analysis. Binary Logistic regression was used to identify the predictors

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2018 PLoS ONE

12. Uterine Rupture at Term in a Patient With Abdominal Cerclage. (PubMed)

Uterine Rupture at Term in a Patient With Abdominal Cerclage. When labor ensues in the setting of transabdominal cerclage, uterine rupture is a potential complication associated with significant morbidity and mortality for both mother and fetus.A woman with a transabdominal cerclage presented at 39 2/7 weeks of gestation with contractions, tachycardia, abdominal pain, and fetal bradycardia. Emergent cesarean delivery revealed a ruptured uterus with fetus and placenta floating in the abdomen (...) . Neonatal Apgar scores were 2, 2, and 5 at 1, 5, and 10 minutes of life respectively, with cord pH less than 6.8. After transfusion for the mother and rehabilitation for the neonate, both made a good recovery.Uterine rupture can be catastrophic, and prevention is paramount. In addition to individualized delivery planning, women with transabdominal cerclage in place should be counseled to present to the hospital immediately in the presence of contractions to prevent poor outcomes.

2019 Obstetrics and Gynecology

13. Infant Outcome after Complete Uterine Rupture. (PubMed)

Infant Outcome after Complete Uterine Rupture. Complete uterine rupture is a rare peripartum complication often associated with a catastrophic outcome for both mother and child. However, little has been written based on large data sets about maternal and infant outcome after complete ruptures. This is partly due to the rarity of the event and the serious maternal and infant outcome; it is also partly due to the use of international diagnostic codes that do not differentiate between the less (...) catastrophic partial rupture and more catastrophic complete uterine rupture. As uterine rupture is expected to increase due to increased cesarean delivery rates worldwide, it is important to know more completely about the outcome following complete uterine rupture.We sought to explore risk factors associated with poor infant outcome in cases of complete uterine rupture.This population-based study used data from the Medical Birth Registry of Norway, the Patient Administration System, and medical records. We

2018 American Journal of Obstetrics and Gynecology

14. Placenta Percreta and Uterine Rupture in the First Trimester of Pregnancy (PubMed)

Placenta Percreta and Uterine Rupture in the First Trimester of Pregnancy Spontaneous uterine rupture in the first trimester of pregnancy is uncommon and difficult to diagnose. Although extremely rare, it is important to consider the occurrence of placenta percreta as differential diagnosis of acute hemorrhagic abdomen at the beginning of pregnancy. We describe below a case of uterine rupture in the first trimester of pregnancy related to placenta percreta.

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2018 Case reports in obstetrics and gynecology

15. Placenta percreta complicated by uterine rupture and thrombotic microangiopathy (PubMed)

Placenta percreta complicated by uterine rupture and thrombotic microangiopathy Uterine rupture at the site of a previous caesarean scar with abnormal placental penetration through the uterus wall with bladder invasion is a rare and serious pregnancy complication. Our aim was to report a case of uterine rupture with placenta percreta complicated by thrombotic microangiopathy.We did a literature review and analysed medical documentation retrospectively.A patient was admitted with complaints (...) of lower abdominal pain at 21 weeks of gestation. Sonography of the caesarean scar increased suspicion of placental penetration. Anaemia, thrombocytopenia, coagulopathy, and acute kidney injury developed and led to the diagnosis of thrombotic microangiopathy. The termination of pregnancy was required due to severe deterioration in organ functions. The complete uterine rupture with placenta percreta invading the urinary bladder was confirmed, and total hysterectomy was performed to control life

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2018 Acta Medica Lituanica

16. Uterine torsion and subsequent rupture in a gravid bicornuate uterus associated with an elevated alpha-fetoprotein (PubMed)

Uterine torsion and subsequent rupture in a gravid bicornuate uterus associated with an elevated alpha-fetoprotein Uterine torsion is a rare obstetric complication with a non-specific presentation. We describe a patient with a bicornuate uterus and a pregnancy complicated by a markedly elevated second-trimester maternal serum alpha-fetoprotein (MSAFP), intermittent pelvic pain and fetal growth restriction. At 24 weeks gestational age, she presented to labour and delivery with an acute abdomen (...) . A subsequent exploratory laparotomy revealed torsion and rupture of her right uterine horn. Uterine torsion can be difficult to diagnose because it is not associated with specific symptoms or characteristic imaging findings. In patients with a bicornuate uterus who present with abdominal pain, an elevated mid-trimester MSAFP may be a harbinger of placental ischaemia as a result of uterine torsion.© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved

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2018 BMJ case reports

17. The Rising Triad of Cesarean Scar Pregnancy, Placenta Percreta, and Uterine Rupture: A Case Report and Comprehensive Review of the Literature (PubMed)

The Rising Triad of Cesarean Scar Pregnancy, Placenta Percreta, and Uterine Rupture: A Case Report and Comprehensive Review of the Literature As the rate of cesarean sections continues to rapidly rise, knowledge of diagnosis and management of cesarean scar pregnancies (CSPs) is becoming increasingly more relevant. CSPs rest on the continuum of placental abnormalities which include morbidly adherent placenta (accreta, increta, and percreta). A CSP poses a clinical challenge which may have

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2018 Case reports in obstetrics and gynecology

18. Characteristics of uterine rupture after laparoscopic surgery of the uterus: clinical analysis of 10 cases and literature review (PubMed)

Characteristics of uterine rupture after laparoscopic surgery of the uterus: clinical analysis of 10 cases and literature review Objective An increasing trend of uterine rupture (UR) after laparoscopic surgery of the uterus (LSU) has been observed. Although the overall incidence is extremely low, UR may have catastrophic outcomes. Therefore, investigation of its potential risk factors is important. Methods We retrospectively reviewed the medical data of 10 women who developed UR after LSU (...) cases. Silent rupture with unremarkable symptoms was not rare. Similar risk factors were identified in the literature review. Conclusions Excessive use of energy equipment and the lack of multilayer suturing were the most common characteristics of UR after LSU. A history of LSU should always be considered a risk factor for UR.

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2018 The Journal of international medical research

19. Early Accreta and Uterine Rupture in the Second Trimester (PubMed)

Early Accreta and Uterine Rupture in the Second Trimester The differential diagnosis of third trimester bleeding can range from placenta abruptia to placenta previa to uterine rupture and the placenta accreta spectrum (PAS). However, patients with risk factors such as multiple cesarean sections (c-sections), advanced maternal age (AMA), grand multiparity, and single-layer uterine closure are at greater risk of developing these complications earlier than we would traditionally expect. This case (...) as the patient was stable, she was discharged home. She presented to a different hospital the next day with the same complaints. Imaging was consistent with accreta and her presentation with abruption. During the hospital stay, the patient went into threatened preterm labor (PTL). At first, we suspected preterm premature rupture of membranes (PPROM) due to apparent pooling of amniotic fluid in the vaginal canal. Upon further work up, the diagnosis was consistent with chronic abruption oligohydramnios

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2018 Cureus

20. Incidence of uterine rupture in second trimester abortion with gemeprost alone compared to mifepristone and gemeprost. (PubMed)

Incidence of uterine rupture in second trimester abortion with gemeprost alone compared to mifepristone and gemeprost. To compare uterine rupture rates in women having a medical abortion receiving gemeprost alone to those receiving mifepristone plus gemeprost.We reviewed the records of women undergoing medical abortion at 13 0/7-23 6/7 weeks from January 2007 to December 2014 at a single center in Italy. Prior to January 2011, we used gemeprost 1 mg vaginally every 3 h up to a maximum of five (...) doses. After January 2011, we added mifepristone 200 mg orally 24 h prior to the same gemeprost protocol. The primary outcome of the study was the incidence of uterine rupture. We compared the outcome between women receiving gemeprost alone with the combination of gemeprost and mifepristone.One thousand and sixty-one (58.5%) and 753 (41.5%) women underwent medical abortion in the gemeprost-alone and the gemeprost/mifepristone groups, respectively. Five (0.47%) uterine ruptures occurred

2018 Contraception

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