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Uterine Rupture

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1. Laparoscopic uterine surgery as a risk factor for uterine rupture during pregnancy. Full Text available with Trip Pro

Laparoscopic uterine surgery as a risk factor for uterine rupture during pregnancy. The incidence of uterine rupture through a previous cesarean scar (CS) is declining as a result of a lower parity and fewer options for vaginal birth after cesarean. However, uterine ruptures attributable to other causes that traumatize the myometrium are on the rise. To determine whether changes in the causes of uterine rupture had occurred in recent years, we retrospective retrieved the clinical records of all (...) singletons with uterine rupture observed in the delivery room of a Taiwanese tertiary obstetric center over a 15-year period. The overall uterine rupture rate was 3.8 per 10,000 deliveries. A total of 22 cases in 20 women (with two of them experiencing two episodes). Seven uterine ruptures occurred through a previous cesarean scar (CS ruptures, 32%), 13 through a non-cesarean scar (non-CS ruptures, 59%), whereas the remaining two (9%) were in women who did not previously undergo any surgery. All

2018 PLoS ONE

2. Diagnosis and management of a heterotopic pregnancy and ruptured rudimentary uterine horn Full Text available with Trip Pro

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.

2018 Fertility research and practice

3. Estimates of Uterine Rupture Bad Outcomes Using Propensity Score and Determinants of Uterine Rupture in Mizan-Tepi University Teaching Hospital: Case Control Study Full Text available with Trip Pro

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

2017 Journal of pregnancy

4. Maternal and fetal outcomes of uterine rupture and factors associated with maternal death secondary to uterine rupture. Full Text available with Trip Pro

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

2017 BMC Pregnancy and Childbirth

5. The International Network of Obstetric Survey Systems study of uterine rupture: a descriptive multi-country population-based study Full Text available with Trip Pro

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

6. 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? Full Text available with Trip Pro

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.

2018 Romanian Journal of Anaesthesia and Intensive Care

7. A case of scarred uterine rupture at 11 weeks of gestation having a uterine scar places induced by in vitro fertilization-embryo transfer Full Text available with Trip Pro

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.

2018 Clinics and practice

8. 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. Full Text available with Trip Pro

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

2018 PLoS ONE

10. Uterine rupture in patients with a history of laparoscopy or hysteroscopy procedures: Three case reports. Full Text available with Trip Pro

Uterine rupture in patients with a history of laparoscopy or hysteroscopy procedures: Three case reports. Uterine rupture is a rare incidence but can lead to catastrophic maternal and fetal consequences. We still need to place a high premium on these cases.The patients all showed hemodynamic shock with complaints of serious pain in the abdomen. They all had a history of laparoscopy or hysteroscopy procedures.Case 1 and 2 were diagnosed during surgery. Case 3 was diagnosed by an urgent abdominal (...) ultrasonogram before surgery.We performed emergency surgeries for the 3 cases.Three patients all recovered well. But only the child in case 2 survived.It must be emphasized that pregnant women with a history of such surgeries should be aware of uterine rupture during pregnancy.

2019 Medicine

11. Grandmultiparity, maternal age, and the risk for uterine rupture-A multicenter cohort study. (Abstract)

Grandmultiparity, maternal age, and the risk for uterine rupture-A multicenter cohort study. Uterine rupture is a critical complication causing fetal and maternal morbidity and mortality. Data are conflicting regarding whether grandmultiparity (parity ≥ 6) is a risk factor. This multicenter cohort study aimed to determine whether grandmultiparity (parity ≥ 6) poses a risk for uterine rupture in women with no previous cesarean delivery.A multicenter retrospective study of deliveries (...) of multiparous women. Grandmultiparous women were significantly older (33.9 ± 5 vs 27.3 ± 5 years; P < 0.0001). Fourteen cases of uterine rupture were recorded in the grandmultiparae group (1 per 3855 labors) vs 41 in the multiparae group (1 per 8166 labors) (odds ratio [OR] 2.07, 95% confidence interval [95% CI] 1.13-3.81; P = 0.030). However, in a multivariable model controlling for maternal age, the association between grandmultiparity and uterine rupture lost its significance (adjusted OR 1.26, 95% CI

2019 Acta Obstetricia et Gynecologica Scandinavica

12. Silent spontaneous posterior uterine rupture of a prior caesarean delivery at 36 weeks of gestation. Full Text available with Trip Pro

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.

2019 BMC Pregnancy and Childbirth

13. Uterine Rupture at Term in a Patient With Abdominal Cerclage. (Abstract)

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

14. Uterine scar rupture - Prediction, prevention, diagnosis, and management. (Abstract)

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

15. Maternal outcome after complete uterine rupture. (Abstract)

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

16. Pregnancy in Women With a History of Uterine Rupture. (Abstract)

Pregnancy in Women With a History of Uterine Rupture. With increased rates of primary and repeat cesarean deliveries, the potential for uterine rupture and management of women with a history of uterine rupture has also increased. Taking care of a pregnant woman with a prior uterine rupture requires understanding of the risks, the need for additional surveillance, and the limitations of our knowledge about how rupture affects subsequent pregnancies.The aims of this study were to review (...) the literature on pregnancy after uterine rupture and to summarize the evidence to help the obstetrician care for a pregnant woman with a history of uterine rupture.Evidence for this review was acquired using PubMed.Pregnancy after uterine rupture carries a risk of spontaneous repeat rupture before the onset of labor and of repeat rupture during early labor. Elective cesarean delivery before the onset of labor is the safest strategy to prevent maternal and neonatal morbidity and mortality. However, more

2018 Obstetrical & Gynecological Survey

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

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

18. Early Accreta and Uterine Rupture in the Second Trimester Full Text available with Trip Pro

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

2018 Cureus

19. Uterine rupture at 28 weeks of gestation after laparoscopic myomectomy – a case report Full Text available with Trip Pro

Uterine rupture at 28 weeks of gestation after laparoscopic myomectomy – a case report There are many reasons for sterility, and uterine malformations are of the greatest concern. Among uterine disorders, myomas play a significant role and are present in 27% of infertile women. The occurrence of myomas is frequent - 20-40% in women of reproductive age. Thus, for those infertile patients surgical treatment may be needed to preserve an opportunity to conceive. This case report refers (...) to an uterine rupture at 28 weeks of gestation after laparoscopic myomectomy (3 months before conceiving). The myomectomy was conducted correctly and two layers of sutures on the myometrium were performed. The purpose of the myomectomy in a young woman should be well considered. In cases of infertility, removal of the lesions is usually necessary to give the patient a chance of pregnancy. At the same time, the risk of uterine rupture is increased. There are some suggestions referring to myomectomy to reduce

2018 PrzeglaÌœd menopauzalny = Menopause review

20. Placenta Percreta and Uterine Rupture in the First Trimester of Pregnancy Full Text available with Trip Pro

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.

2018 Case reports in obstetrics and gynecology

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