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Uterine Rupture

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101. Tiny Tips: Approach to Abnormal Uterine Bleeding

Tiny Tips: Approach to Abnormal Uterine Bleeding Tiny Tips: Approach to Abnormal Uterine Bleeding - CanadiEM Tiny Tips: Approach to Abnormal Uterine Bleeding In , by Zoe Polsky July 14, 2017 Whether the patient is an expecting mother, a post-menopausal woman, or a young adolescent, abnormal uterine bleeding is distressing for the patient, and often overwhelming for learners. Consider the ‘ CAUSES OF bLOOD ’ to better tailor your investigations and management. C ancer A bruption U rogenital (...) infections (PID, endometritis, salpingitis) S evere menorrhagia E ctopic pregnancy S pontaneous abortion O varian cyst rupture F ibroid (Leiomyoma) b … L ocation of placenta- placenta previa O varian torsion O nset after delivery – Post-Partum Hemorrhage D rugs – anticoagulants, antipsychotics, corticosteroids, hormone replacement This post was copyedited by Dat Nguyen-Dinh (@dat_nd). Reviewing with the Staff The above mnemonic provides a reasonable, but not comprehensive, differential for abnormal

2017 CandiEM

102. Dilation and evacuation after preterm premature rupture of membranes with abdominal cerclage in situ. (Abstract)

Dilation and evacuation after preterm premature rupture of membranes with abdominal cerclage in situ. For women with a history of cervical insufficiency, treatment with transvaginal (TV) or abdominal (TA) cerclage is often recommended; however management of pregnancy complications necessitating uterine evacuation in the second trimester are challenging. We present a patient at 17 weeks 3 day gestation with preterm premature rupture of membranes, and chorioamnionitis with an abdominal cerclage (...) in situ. She desired uterine evacuation via dilation and evacuation. This case report reviews the clinical considerations for uterine evacuation in the second trimester in patients with an abdominal cerclage in situ and discusses options for cervical preparation prior to dilation and evacuation for this unique patient population.Copyright © 2020 Elsevier Inc. All rights reserved.

2020 Contraception

103. Novel pathways of inflammation in human fetal membranes associated with preterm birth and preterm pre-labor rupture of the membranes. (Abstract)

Novel pathways of inflammation in human fetal membranes associated with preterm birth and preterm pre-labor rupture of the membranes. Spontaneous preterm birth (PTB) and preterm pre-labor rupture of the membranes (pPROM) are major pregnancy complications. Although PTB and pPROM have common etiologies, they arise from distinct pathophysiologic pathways. Inflammation is a common underlying mechanism in both conditions. Balanced inflammation is required for fetoplacental growth; however (...) , overwhelming inflammation (physiologic at term and pathologic at preterm) can lead to term and preterm parturition. A lack of effective strategies to control inflammation and reduce the risk of PTB and pPROM suggests that there are several modes of the generation of inflammation which may be dependent on the type of uterine tissue. The avascular fetal membrane (amniochorion), which provides structure, support, and protection to the intrauterine cavity, is one of the key contributors of inflammation

2020 Seminars in immunopathology

104. Hemoperitoneum caused by spontaneous rupture of hepatocellular carcinoma in noncirrhotic liver. A case report and systematic review Full Text available with Trip Pro

] Ferlay J, Shin H, Bray F, Forman D, Mathers C, Parkin D. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127(12):2893–917. . [2] Cianci P, Tartaglia N, Altamura A, Fersini A, Sanguedolce F, Ambrosi A, et al. Hemoperitoneum due to breaking uterine adenosarcoma located in the omentum. Report of a case. Ann Ital Chir. 2016 Dec 20;5:S2239253X16026311. [3] Buczkowski A, Kim P, Ho S, Schaeffer D, Lee S, Owen D, et al. Multidisciplinary management of ruptured (...) Hemoperitoneum caused by spontaneous rupture of hepatocellular carcinoma in noncirrhotic liver. A case report and systematic review Hemoperitoneum caused by spontaneous rupture of hepatocellular carcinoma in noncirrhotic liver. A case report and systematic review × Your purchase has been completed. Your documents are now available to view. × Changing the currency will empty your shopping cart. Confirm Cancel Nicola Tartaglia , Alessandra Di Lascia , Pasquale Cianci , Alberto Fersini , Mario

2020 Open Medicine

105. Uterine sarcoma in a 14 year-old girl presenting with uterine rupture Full Text available with Trip Pro

Uterine sarcoma in a 14 year-old girl presenting with uterine ruptureUterine sarcomas are rare in adolescents. Adenosarcomas are even more rare. Uterine rupture, as a presentation is a rare entity.•It is hard to diagnose sarcomas preoperatively. It is still hard even postoperatively due to variable morphologic features.•Experience of the gynecopathologists and oncologic surgeons is the hallmark of the treatment option.

2014 Gynecologic Oncology Reports

106. Uterine Rupture After Uterine Artery Embolization for Symptomatic Leiomyomas. (Abstract)

Uterine Rupture After Uterine Artery Embolization for Symptomatic Leiomyomas. There are few data regarding safety of pregnancy after uterine artery embolization. However, numerous women desire future fertility after this procedure. Uterine rupture without a history of cesarean delivery or uterine scarring is an exceedingly rare complication in pregnancy.We report a case of uterine rupture in a primigravid woman after uterine artery embolization. Her pregnancy was also complicated by placenta (...) previa with placenta increta, resulting in a favorable neonatal outcome in an otherwise life-threatening situation for mother and fetus.Uterine artery embolization is a risk factor for abnormal placentation and uterine rupture in subsequent pregnancies.

2014 Obstetrics and Gynecology

107. Pregnancies after vaginal radical trachelectomy (RT) in patients with early invasive uterine cervical cancer: results from a single institute. Full Text available with Trip Pro

technology. Cesarean section was performed for all of them. The median time of pregnancy was 34 weeks, and emergent cesarean section was performed for 7 pregnancies (25%). The median birth weight was 2156 g. Four patients had trouble with cervical cerclage, and they suffered from sudden premature preterm rupture of the membrane (pPROM) during the second trimester of pregnancy. We underwent transabdominal cerclage (TAC) for all of them and careful management for the prevention of uterine infection (...) Pregnancies after vaginal radical trachelectomy (RT) in patients with early invasive uterine cervical cancer: results from a single institute. Radical tracheletomy (RT) with pelvic lymphadenectomy has become an option for young patients with early invasive uterine cervical cancer who desire to maintain their fertility. However, this operative method entails a high risk for the following pregnancy due to its radicality.We have performed vaginal RT for 71 patients and have experienced 28

2020 BMC Pregnancy and Childbirth

108. Cervical length surveillance for predicting spontaneous preterm birth in women with uterine anomalies: A cohort study. (Abstract)

 < 34 weeks.Women with uterine anomalies are at increased risk of spontaneous preterm birth, particularly those with unicornuate uterus or uterus didelphys, but cervical surveillance did not identify these cases. Short cervix may be associated with SPTB in women with septate uterus. Preterm prelabor rupture of membranes occurred in 55% of SPTB. More research is required into etiology to help determine appropriate monitoring and treatment.© 2020 Nordic Federation of Societies of Obstetrics (...) Cervical length surveillance for predicting spontaneous preterm birth in women with uterine anomalies: A cohort study. Uterine anomalies occur in an estimated 5% of women and have been shown to confer a higher risk of spontaneous preterm birth (SPTB). A sonographically short cervix (<25 mm) is a risk indicator for SPTB, although its predictive utility has been little studied in this specific high-risk population. We aimed to assess the pregnancy outcomes and predictive ability of short cervix

2020 Acta Obstetricia et Gynecologica Scandinavica

109. Maternal near-miss and death among women with rupture of the gravid uterus: a secondary analysis of the Nigeria Near-miss and Maternal Death Survey. Full Text available with Trip Pro

for pregnancy, childbirth or puerperal complications.Cases of severe maternal outcome [SMO: maternal near-miss (MNM) or maternal death (MD)] following uterine rupture were prospectively identified over 1 year.Incidence of SMO, indicators of quality of care, and avoidable factors associated with deficiencies in care.There were 91 724 live births and 3285 women with SMO during the study period. SMO due to uterine rupture occurred in 392 women: 305 MNM and 87 MD. Uterine rupture accounted for 11.9, 13.3 (...) , and 8.7% of all SMO, MNM, and MD, respectively. SMO, MNM, and intra-hospital maternal mortality ratios due to uterine rupture were 4.3/1000 live births, 3.3/1000 live births, and 94.8/100 000 live births, respectively. Mortality index (% of MD/SMO) was 22.2%, and MNM:MD ratio was 3.5. Avoidable factors contributing to deaths were related to patient-orientated problems, especially late hospital presentation and lack of insurance to cover life-saving interventions. Medical personnel problems contributed

2019 BJOG

110. Spontaneous rupture of unscarred uterus in the third trimester after in vitro fertilization-embryo transfer because of bilateral salpingectomy: A case report. Full Text available with Trip Pro

Spontaneous rupture of unscarred uterus in the third trimester after in vitro fertilization-embryo transfer because of bilateral salpingectomy: A case report. Rupture of an unscarred uterus after in vitro fertilization-embryo transfer (IVF-ET) in a primiparous woman is rare. Assisted reproductive technology (ART)-induced rupture of an unscarred uterus is usually attributable to increased dizygotic twinning rates. Salpingectomy can result in cornual scarring and increase the risk of uterine (...) rupture as well as the mortality rate in a subsequent ectopic pregnancy. Here, we present the first reported case of a spontaneous, third-trimester, uterine rupture in a primiparous woman after IVF-ET due to a history of bilateral salpingectomy because of bilateral oviduct and ovarian cysts; the patient did not have an ectopic pregnancy or any cornual or other uterine scarring during this pregnancy after IVF-ET.A 24-year-old woman with a history of IVF-ET and bilateral salpingectomy was admitted

2019 Medicine

111. Spontaneous uterine rupture in the 35th week of gestation after laparoscopic adenomyomectomy Full Text available with Trip Pro

Spontaneous uterine rupture in the 35th week of gestation after laparoscopic adenomyomectomy 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

2015 International medical case reports journal

112. Spontaneous Posterior Uterine Rupture in Twin-Twin Transfusion Syndrome Full Text available with Trip Pro

Spontaneous Posterior Uterine Rupture in Twin-Twin Transfusion Syndrome Background The maternal and fetal risks of uterine distension in rapidly progressive twin-twin transfusion syndrome (TTTS) in the setting of prior uterine scar are poorly characterized. Case We present the case of a 42-year-old woman, G4P1201, at 21 weeks gestation with stage-1 TTTS who developed a spontaneous posterior uterine rupture necessitating emergent laparotomy and delivery of previable fetuses, possibly due (...) to prior uterine scar from a displaced intrauterine device. Conclusion TTTS may be a risk factor for uterine rupture, including uterine rupture in atypical anatomic locations. Prior unrecognized uterine scars, including perforations, may magnify the risk for atypical uterine rupture in the setting of excessive uterine distension.

2015 AJP Reports

113. Gestational choriocarcinoma with uterine serosal metastasis mimicking ruptured ectopic pregnancy: A case report Full Text available with Trip Pro

Gestational choriocarcinoma with uterine serosal metastasis mimicking ruptured ectopic pregnancy: A case report Primary gestational choriocarcinoma is commonly present in the uterus in cases of atypical genital bleeding. Symptoms similar to those of an ectopic pregnancy develop when an extra-uterine lesion is present in the abdominal cavity, and lesions have been detected in the ovaries and fallopian tubes in a number of cases. In the present study, we describe a patient with choriocarcinoma (...) that metastasized to the uterine serosa and caused symptoms similar to those of an ectopic pregnancy. The patient was a 30-year-old female who presented to our hospital with atypical genital bleeding and a positive pregnancy test 3 months after missed abortion at 10 weeks of gestation. Transvaginal ultrasonography revealed the absence of a gestational sac in or outside the uterus, and intra-abdominal bleeding was noted. An ectopic pregnancy was suspected based on these findings, and emergency laparotomy

2015 Oncology letters

114. Massive hemoperitoneum following spontaneous rupture of an arterial aneurysm overlying a uterine myoma Full Text available with Trip Pro

Massive hemoperitoneum following spontaneous rupture of an arterial aneurysm overlying a uterine myoma Intraperitoneal hemorrhage caused by a uterine myoma is rare. A 54-year-old woman was admitted to the emergency room; on admission, she was in cardiopulmonary arrest with pulseless electrical activity. Transabdominal ultrasonography revealed hyperechoic fluid filled almost the entire abdominal cavity. On contrast-enhanced computed tomography, extravasation of contrast material was observed (...) inside the fluid, although the bleeding site was not identifiable. An emergency operation was performed to stabilize the patient. There was pulsating bleeding from a subserosal myoma on the posterior wall of the uterus; the myoma measured approximately 6 cm in maximum diameter. After resection of the myoma, the bleeding stopped. Pathological assessment of the resected specimen revealed a ruptured arterial aneurysm, approximately 8 mm in diameter, situated on the surface of a leiomyoma without

2015 International journal of clinical and experimental medicine

115. An unusual presentation of recurrent uterine rupture during pregnancy Full Text available with Trip Pro

An unusual presentation of recurrent uterine rupture during pregnancy We describe a case of recurrent uterine rupture at the site of a previous rupture. Our patient had a history of right interstitial pregnancy with spontaneous uterine fundal rupture at 18 weeks of pregnancy. During her subsequent pregnancy, she was monitored closely by a senior consultant obstetrician. The patient presented at 34 weeks with right hypochondriac pain. She was clinically stable and fetal monitoring showed (...) no signs of fetal distress. Ultrasonography revealed protrusion of the intact amniotic membranes in the abdominal cavity at the uterine fundus. Uterine rupture is a rare but hazardous obstetric complication. High levels of caution should be exercised in patients with a history of prior uterine rupture, as they may present with atypical symptoms. Ultrasonography could provide valuable information in such cases where there is an elevated risk of uterine rupture at the previous rupture site.

2015 Singapore medical journal

116. Maternal and fetal morbidity associated with uterine rupture of the unscarred uterus. (Abstract)

Maternal and fetal morbidity associated with uterine rupture of the unscarred uterus. We sought to report obstetric and neonatal characteristics and outcomes following primary uterine rupture in a large contemporary obstetric cohort and to compare outcomes between those with primary uterine rupture vs those with uterine rupture of a scarred uterus.This was a retrospective case-control study. Cases were defined as women with uterine rupture of an unscarred uterus. Controls were women (...) with uterine rupture of a scarred uterus. Demographics, labor characteristics, and obstetric, maternal, and neonatal outcomes were compared. Primary rupture case outcomes were also compared by mode of delivery.There were 126 controls and 20 primary uterine rupture cases. Primary uterine rupture cases had more previous live births than controls (3.6 vs 1.9; P < .001). Cases were more likely to have received oxytocin augmentation (80% vs 37%; P < .001). Vaginal delivery was more common among cases (45% vs 9

2015 American Journal of Obstetrics and Gynecology

117. The Nordic Obstetric Surveillance Study: a study of complete uterine rupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery. Full Text available with Trip Pro

The Nordic Obstetric Surveillance Study: a study of complete uterine rupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery. To assess the rates and characteristics of women with complete uterine rupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery in the Nordic countries.Prospective, Nordic collaboration.The Nordic Obstetric Surveillance Study (NOSS) collected cases of severe obstetric complications (...) complications were reported in 1019 instances among 605 362 deliveries during the study period. The reported rate of severe blood loss at delivery was 11.6/10 000 deliveries, complete uterine rupture was 5.6/10 000 deliveries, abnormally invasive placenta was 4.6/10 000 deliveries, and peripartum hysterectomy was 3.5/10 000 deliveries. Of the women, 25% had two or more complications. Women with complications were more often >35 years old, overweight, with a higher parity, and a history of cesarean delivery

2015 Acta Obstetricia et Gynecologica Scandinavica

118. Uterine rupture risk after periviable cesarean delivery. Full Text available with Trip Pro

Uterine rupture risk after periviable cesarean delivery. To investigate the risk of uterine rupture in women with prior periviable cesarean delivery and prior term cesarean delivery independent of initial incision type.We conducted a retrospective longitudinal cohort study using Washington state birth certificate data and hospital discharge records, identifying primary cesarean deliveries performed at 20-26 weeks and 37-41 weeks of gestation with subsequent delivery between 1989 and 2008. We (...) compared subsequent uterine rupture risk in the two groups considering both primary incision type and subsequent labor induction and augmentation.We identified 456 women with index periviable cesarean delivery and 10,505 women with index term cesarean delivery. Women with index periviable cesarean delivery were younger, more frequently of nonwhite race, more likely to smoke, and more likely to have hypertension. Women in the periviable group had more index classical incisions (42% compared with 1%, P

2015 Obstetrics and Gynecology

119. Neonatal outcomes after the obstetric near-miss events uterine rupture, abnormally invasive placenta and emergency peripartum hysterectomy - prospective data from the 2009-2011 Finnish NOSS study. (Abstract)

Neonatal outcomes after the obstetric near-miss events uterine rupture, abnormally invasive placenta and emergency peripartum hysterectomy - prospective data from the 2009-2011 Finnish NOSS study. Neonatal outcomes after the maternal obstetric near-miss complications of uterine rupture, abnormally invasive placenta, and emergency peripartum hysterectomy were assessed.This case-control study was conducted as part of the Nordic Obstetric Surveillance Study (NOSS). Data on 211 newborns from 197 (...) (OR) 12.5, 95% confidence interval (CI) 6.32-24.9]. In addition, there were two neonatal deaths. The majority of cases (n = 8, 80%) were connected to uterine rupture. The risk of severe birth asphyxia diagnosis was increased compared with controls (n = 17, 8.1% vs. 0.1%, OR 137, 95% CI 82.7-226). A low umbilical artery pH (<7.05) was also observed among these neonates (28.8% vs. 1.0%, OR 28.7, 95% CI 21.5-38.2). Post-term pregnancies were relatively common among the uterine rupture cases. Adverse

2015 Acta Obstetricia et Gynecologica Scandinavica

120. Uterine rupture disguised by urinary retention following a second trimester induced abortion: a case report. Full Text available with Trip Pro

Uterine rupture disguised by urinary retention following a second trimester induced abortion: a case report. Uterine rupture classically presents with severe abdominal pain, loss of fetal station, vaginal bleeding, and shock.We present a case of uterine rupture presenting as significant urinary retention that occurred following a second trimester abortion induced with mifepristone and misoprostol. Uterine rupture was discovered unexpectedly on diagnostic laparoscopy. The uterine rupture (...) was contained by dense adhesions between the omentum and bladder with the previous uterine cesarean hysterotomy scar.This case highlights the difficulties in diagnosis of abnormal placentation and an unusual presentation of uterine rupture. This case was managed successfully laparoscopically.

2015 BMC Women's Health

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