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Uterine Rupture

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2501. Nearly fatal uterine rupture during manual removal of the placenta: a case report. (PubMed)

Nearly fatal uterine rupture during manual removal of the placenta: a case report. A uterine scar is a well-known riskfactorfor both abnormal placentation and uterine rupture, both of which may lead to a serious obstetric hemorrhage.A 23-year-old woman, gravida 2, para 0 with a history of first-trimester dilatation and curettage (D&C) experienced a life-threatening obstetric hemorrhage due to uterine rupture during manual removal of a placenta increta. Cessation of the bleeding occurred only (...) following secondary embolization after hysterectomy.Obstetricians should be aware of the risk of uterine scarring and abnormal placentation in women who have undergone D&C, as it could lead to a life-threatening obstetric hemorrhage.

2007 Journal of Reproductive Medicine

2502. Term delivery after repair of a uterine rupture during the second trimester in a previously unscarred uterus: a case report. (PubMed)

Term delivery after repair of a uterine rupture during the second trimester in a previously unscarred uterus: a case report. Rupture of the unscarred gravid uterus is very rare. The event occurs mostly during the intrapartum period and is potentially catastrophic for both mother and fetus. The management in general is prompt termination of pregnancy and hysterectomy.A successful term delivery followed spontaneous rupture of the uterus during the second trimester and surgical repair. The uterus (...) ruptured with no apparent risk factors at 26 weeks of gestation. The rent, at the right side of the fundus, was repaired without damaging the amniotic membrane. After the operation, the patient received tocolysis for irregular uterine contractions until 37 weeks' gestation and delivered a healthy, male infant by cesarean section.Spontaneous rupture of a nonlaboring, unscarred uterus, especially in the second trimester, is extremely rare. This report suggests that conservative treatment for spontaneous

2007 Journal of Reproductive Medicine

2503. Changes in fetal heart rate and uterine patterns associated with uterine rupture. (PubMed)

Changes in fetal heart rate and uterine patterns associated with uterine rupture. To determine changes in fetal heart rate (FHR) and uterine patterns preceding complete uterine rupture.FHR and uterine patterns of 50 women with uterine rupture were compared with 601 tracings of controls without scarred uteri. Tracings were interpreted using the National Institute of Child Health and Human Development Research Planning Workshop guidelines.Interobserver and intraobserver agreements of FHR (...) and uterine tracings in the uterine rupture group were excellent (kappa of .96 for both variables). Comparing tracing patterns during the first stage, higher rates of severe fetal bradycardia (4.0% vs. 1.0%, P = .064), fetal tachycardia (8.0% vs. 2.3%, P = .042), reduced baseline variability (24.0% vs. 12.5%, P = .021), uterine tachysystole (10.0% vs. 0.8%, P < .001) and disappearance of contractions (6.0% vs. 0, P < .001) were noted among patients with uterine rupture as compared to the controls. During

2004 Journal of Reproductive Medicine

2504. Collagen content and growth factor immunoexpression in uterine lower segment of type IA osteogenesis imperfecta: Relationship with recurrent uterine rupture in pregnancy. (PubMed)

Collagen content and growth factor immunoexpression in uterine lower segment of type IA osteogenesis imperfecta: Relationship with recurrent uterine rupture in pregnancy. The purpose of this study was to evaluate collagen content and platelet-derived growth factor, vascular endothelial growth factor, and connective tissue growth factor expression in the myometrium of the uterine lower segment from a patient with type IA osteogenesis imperfecta with recurrent uterine rupture and to evaluate (...) the existence of a relationship between the rare recurrent uterine rupture and the tissue disorders of type IA osteogenesis imperfecta.Collagen content and platelet-derived growth factor, vascular endothelial growth factor, and connective tissue growth factor expression in the uterine lower segment were assessed in the patient with type IA osteogenesis imperfecta and in eight otherwise healthy ("control") patients.Type IA osteogenesis imperfecta contained less total collagen amount, with no difference

2003 American Journal of Obstetrics and Gynecology

2505. Diffuse uterine leiomyomatosis with uterine rupture and benign metastatic lesions of the bone. (PubMed)

Diffuse uterine leiomyomatosis with uterine rupture and benign metastatic lesions of the bone. We report a case of diffuse uterine leiomyomatosis in pregnancy complicated by uterine rupture and dissemination to the bone.A 35-year-old nulliparous woman with a history of uterine leiomyoma presented at term with fetal demise. Failed induction of labor and hemodynamic instability due to uterine rupture resulted in a cesarean hysterectomy. A free-air series performed postoperatively to confirm (...) paralytic ileus revealed multiple lytic bone lesions. The diagnosis of diffuse uterine leiomyomatosis with metastasis was made on histology of the resected uterus and fine-needle aspiration biopsy of the bone. She was managed conservatively, and the lesions are now regressing.Diffuse uterine leiomyomatosis should be considered in pregnant women with a history of uterine fibroids and peripartum hemorrhage.

2007 Obstetrics and Gynecology

2506. Uterine rupture and epidural analgesia during trial of labour. (PubMed)

Uterine rupture and epidural analgesia during trial of labour. A case of complete uterine rupture during a trial of labour in which epidural analgesia was used is described. The pain of uterine rupture was not masked by the addition of fentanyl 25 micrograms to bupivacaine 0.25% 6 ml but was relieved by bupivacaine 0.375% 6 ml.

1997 Anaesthesia

2507. Effect of previous vaginal delivery on the risk of uterine rupture during a subsequent trial of labor. (PubMed)

Effect of previous vaginal delivery on the risk of uterine rupture during a subsequent trial of labor. We examined the effect of prior vaginal delivery on the risk of uterine rupture in pregnant women undergoing a trial of labor after prior cesarean delivery.The medical records of all pregnant women with a history of cesarean delivery who attempted a trial of labor during a 12-year period at a single center were reviewed. For the current analysis, the study population was limited to term (...) pregnancies. The effect of previous vaginal delivery on the risk of uterine rupture during a subsequent trial of labor was evaluated. Separate analyses were performed for women with a single previous cesarean delivery and for those with >1 prior cesarean delivery. For each of these subgroups, the rate of uterine rupture among women who had > or =1 prior vaginal delivery was compared with the rate among women with no prior vaginal delivery. Logistic regression analysis was used to examine the associations

2000 American journal of obstetrics and gynecology

2508. Uterine rupture in an unscarred uterus after application of fundal pressure. A case report. (PubMed)

Uterine rupture in an unscarred uterus after application of fundal pressure. A case report. Rupture of an unscarred uterus is rare, with a reported incidence of 1 in 8,000-15,000 pregnancies. We report a case occurring during labor.A 33-year-old woman, gravida 3, para 0, abortion 2, was admitted at 40 weeks' gestation with ruptured membranes. Fundal pressure was applied during delivery due to maternal exhaustion. Uterine rupture was diagnosed from palpation of the fetal extremities coupled (...) with a decreased fetal heartbeat. A 6-cm transverse laceration was discovered over the lower uterine segment during emergency cesarean section. The uterus was sutured. There were no further complications, and the postoperative course was uneventful.Spontaneous rupture of the unscarred uterus during labor is rare, with only one case recorded at our institution over a 10-year period. Risk factors include weakness of the uterine muscle and the application of fundal pressure. Early detection and immediate surgical

2002 Journal of Reproductive Medicine

2509. Interdelivery interval and uterine rupture. (PubMed)

Interdelivery interval and uterine rupture. The purpose of this study was to measure the impact of the interdelivery interval on uterine rupture during subsequent delivery.An observational cohort study was performed to assess the rate of uterine rupture in women with a previous low transverse cesarean delivery and no previous vaginal delivery who undergo a trial of labor from 1988 to 2000 in a tertiary care center. The rate of uterine rupture was measured for each of the following interdelivery (...) intervals: 36 months of gestation. Multivariate logistic regression analysis was used to adjust for selected confounding variables.Of the 1527 women who met the study criteria, the rate of uterine rupture was 4.8% for patients with an interdelivery interval of

2002 American Journal of Obstetrics and Gynecology

2510. A 10-year population-based study of uterine rupture. (PubMed)

A 10-year population-based study of uterine rupture. To review the incidence, associated factors, methods of diagnosis, and maternal and perinatal morbidity and mortality associated with uterine rupture in one Canadian province.Using a perinatal database, all cases of uterine rupture in the province of Nova Scotia for the 10-year period 1988-1997 were identified and the maternal and perinatal mortality and morbidity reviewed in detail.Over the 10 years, there were 114,933 deliveries with 39 (...) cases of uterine rupture: 18 complete and 21 incomplete (dehiscence). Thirty-six women had a previous cesarean delivery: 33 low transverse, two classic, one low vertical. Of the 114,933 deliveries, 11,585 (10%) were in women with a previous cesarean delivery. Uterine rupture in those undergoing a trial for vaginal delivery (4516) was complete rupture in 2.4 per 1000 and dehiscence in 2.4 per 1000. There were no maternal deaths, and maternal morbidity was low in patients with dehiscence

2002 Obstetrics and Gynecology

2511. Pelvic umbrella pack for refractory obstetric hemorrhage secondary to posterior uterine rupture. (PubMed)

Pelvic umbrella pack for refractory obstetric hemorrhage secondary to posterior uterine rupture. Pelvic hemorrhage continues to be a serious complication of pregnancy and can lead to significant maternal morbidity. The pelvic umbrella pack is a useful alternative to control pelvic bleeding when standard measures fail.A patient with a previous low transverse cesarean delivery presented in active labor at term. After an uneventful vaginal delivery, defects in the posterior vaginal wall and lower (...) uterine segment were identified. A hysterectomy with repair of the vaginal laceration was performed, but diffuse bleeding persisted. After routine surgical techniques failed to achieve adequate hemostasis, a pelvic umbrella pack was successfully used to tamponade pelvic bleeding.In the event of continued hemorrhage after hysterectomy, bleeding that is uncontrolled by surgical intervention may be controlled with a pelvic umbrella pack.

2002 Obstetrics and Gynecology

2512. Uterine rupture at term after uncomplicated hysteroscopic metroplasty. (PubMed)

Uterine rupture at term after uncomplicated hysteroscopic metroplasty. In patients with a prior uterine septum resection, uterine rupture during pregnancy has been reported with the use of energy sources or when complicated by perforation.A woman was found to have a uterine abnormality during her first pregnancy. After delivery, a septum was diagnosed and hysteroscopically incised using cold scissors without complication. Follow-up hysterosalpingogram showed a small residual septum. In her (...) subsequent pregnancy, emergency cesarean after fetal bradycardia in early labor showed the placenta and fetus totally exteriorized through a cornua to cornua rupture of the fundus.Uterine rupture during pregnancy after metroplasty is rare but may occur regardless of the method of metroplasty, absence of complications, or careful follow-up.

2002 Obstetrics and Gynecology

2513. Rupture of noncommunicating rudimentary uterine horn pregnancy. (PubMed)

Rupture of noncommunicating rudimentary uterine horn pregnancy. We present a rare case of pregnancy in a noncommunicating rudimentary horn that ruptured at 20 weeks.A 30-year-old woman presented with a history of two spontaneous abortions. An ultrasound scan showed a bicornuate uterus, with one normal and one hypoplastic horn. Hysterosalpingography revealed a single uterine cavity with only one tube, suggesting a unicornuate uterus. Hysteroscopy and laparoscopy were recommended but declined (...) . She presented again 2 months later at 7 weeks' gestation. A single intrauterine pregnancy in the hypoplastic right horn was diagnosed. A transvaginal scan showed a single cervical canal in continuity with the left uterine horn, which led to the suspicion of a pregnancy in a rudimentary horn. The option of pregnancy termination was offered. A laparoscopy was repeatedly suggested but declined. Excision of a ruptured noncommunicating rudimentary horn and ipsilateral salpingectomy were performed after

2002 Obstetrics and Gynecology

2514. Massive and acute hemoperitoneum due to rupture of the uterine artery by erosion from an endometriotic lesion. (PubMed)

Massive and acute hemoperitoneum due to rupture of the uterine artery by erosion from an endometriotic lesion. To report a case of acute hemoperitoneum due to erosion of the uterine artery by an endometriotic lesion of the left ovary.Case report and review of literature.University medical center.A 39-year-old nulliparous woman with stage 3 endometriosis.Operative laparoscopy followed by laparotomy, oophorectomy, and ligation of the bleeding uterine artery.Patient is fully recovered (...) and is attempting to conceive.An endometriotic lesion eroded the wall of the uterine artery, causing massive, acute hemoperitoneum. Such an event may be overlooked during laparotomy and attributed to the trauma of surgery.

2002 Fertility and Sterility

2515. Uterine rupture after termination of pregnancy with gemeprost. (PubMed)

Uterine rupture after termination of pregnancy with gemeprost. 2025719 1991 06 12 2018 11 13 0959-8138 302 6780 1991 Apr 06 BMJ (Clinical research ed.) BMJ Uterine rupture after termination of pregnancy with gemeprost. 852 Byrne P P Onyekwuluje T T eng Case Reports Letter England BMJ 8900488 0959-8138 0 Abortifacient Agents, Nonsteroidal 45KZB1FOLS gemeprost F5TD010360 Alprostadil AIM IM Abortifacient Agents, Nonsteroidal adverse effects Abortion, Induced adverse effects methods Adult (...) Alprostadil adverse effects analogs & derivatives Female Humans Pregnancy Uterine Rupture chemically induced 1991 4 6 1991 4 6 0 1 1991 4 6 0 0 ppublish 2025719 PMC1669182 Br J Obstet Gynaecol. 1990 Nov;97(11):1061-2 2252872 Singapore Med J. 1988 Aug;29(4):351-2 3249961

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1991 BMJ : British Medical Journal

2516. Management of spontaneous rupture of the membranes and no uterine activity in healthy primigravidae after 34 weeks' gestation. (PubMed)

Management of spontaneous rupture of the membranes and no uterine activity in healthy primigravidae after 34 weeks' gestation. 2564526 1989 05 03 2017 09 20 0140-6736 1 8640 1989 Apr 01 Lancet (London, England) Lancet Management of spontaneous rupture of the membranes and no uterine activity in healthy primigravidae after 34 weeks' gestation. 721 Mahmood T A TA Dick M J MJ Smith N C NC eng Clinical Trial Letter Randomized Controlled Trial England Lancet 2985213R 0140-6736 K7Q1JQR04M (...) Dinoprostone AIM IM Clinical Trials as Topic Dinoprostone therapeutic use Female Fetal Membranes, Premature Rupture drug therapy Fetus physiopathology Humans Parity Pregnancy Pregnancy Trimester, Third Random Allocation 1989 4 1 1989 4 1 0 1 1989 4 1 0 0 ppublish 2564526 S0140-6736(89)92231-9

1989 Lancet (London, England) Controlled trial quality: uncertain

2517. Uterine rupture during preinduction cervical ripening with misoprostol in a patient with a previous Caesarean delivery. (PubMed)

Uterine rupture during preinduction cervical ripening with misoprostol in a patient with a previous Caesarean delivery. We report a case of uterine rupture in a patient with a previous low transverse Caesarean delivery, in which transvaginal misoprostol was used for preinduction cervical ripening.

1998 The Australian & New Zealand journal of obstetrics & gynaecology Controlled trial quality: uncertain

2518. Labour characteristics and uterine activity: misoprostol compared with oxytocin in women at term with prelabour rupture of the membranes. (PubMed)

Labour characteristics and uterine activity: misoprostol compared with oxytocin in women at term with prelabour rupture of the membranes. To compare the labour pattern and uterine activity of oral misoprostol with oxytocin for labour induction in women presenting with prelabour rupture of membranes at term.Prospective randomised study.Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong.Eighty women presenting with prelabour rupture of membranes at term.The women were (...) randomised to receive either 100 microg misoprostol orally every 4 hours to a maximum of three doses, or intravenous oxytocin infusion according to the hospital protocol. Intrauterine pressure transducers were inserted one hour before induction of labour in both groups of women. We compared the pattern of uterine activity, the induction-to-delivery interval, duration of labour, mode of delivery and neonatal outcome between the two groups.Both oxytocin and oral misoprostol caused an increase in uterine

2000 BJOG Controlled trial quality: uncertain

2519. Risk factors for uterine rupture and neonatal consequences of uterine rupture: a population-based study of successive pregnancies in Sweden. (PubMed)

Risk factors for uterine rupture and neonatal consequences of uterine rupture: a population-based study of successive pregnancies in Sweden. Uterine rupture is a rare but a catastrophic event. The aim of the present study was to explore the risk factors for uterine rupture and associated neonatal morbidity and mortality among a cohort of Swedish women attempting vaginal birth in their second delivery.Population-based cohort study.Sweden.A total of 300,200 Swedish women delivering two single (...) consecutive births between 1983 and 2001.Swedish population-based registers were used to obtain information concerning demographics, pregnancy and birth characteristics, and neonatal outcomes. Logistic regression was used to analyse potential risk factors for uterine rupture and risk of neonatal mortality associated with uterine rupture. Odds ratios were used to estimate relative risks using 95% CI.Uterine rupture and neonatal mortality in the second pregnancy.Compared with women who delivered vaginally

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2007 BJOG

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